Breakthrough study linking menopause to increased risk of Alzheimer’s explains why far more women than men get the disease; what the findings suggest women do.

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The News:

Going through menopause may increase women’s risk of developing Alzheimer’s disease, a new study has found. The report from the University of Arizona found that women who have transitioned to menopause have lower levels of glucose in their brains, which makes them more susceptible to the illness, according to Medscape.

Researchers who worked on the report said that their study could prove beneficial to the 850 million women worldwide who live with Alzheimer’s. They are hopeful that their work can lead to the development of interventions that can be applied to pre-menopausal women to lessen their chances of dying from the disease.

Menopause causes symptoms that affect the brain, including anxiety, depression, cognitive deficits and insomnia, which scientists have credited to declining estrogen levels. Previous research has revealed that reduced estrogen levels can make the brain more vulnerable to dysfunction and disease.

For the latest study, researchers observed 43 healthy women who were between ages 40 and 60, 15 of which were pre-menopausal. Fourteen women were peri-menopausal and the remaining women had already undergone the transition.

The researchers used an imaging tool called positron emission tomography (PET) for the study, in which they looked at the amount of glucose, which is a main source of fuel for cells, in participants’ brains. The group found that women who were transitioning to menopause, or had already done so, had significantly lower levels of glucose in their brains than those who had yet to experience the change.

Study researcher Lisa Mosconi, PhD, said: “Our findings show that the loss of estrogen in menopause doesn’t just diminish fertility.” She continued, “It also means the loss of a key neuroprotective element in the female brain and a higher vulnerability to brain aging and Alzheimer’s disease.”

“This study suggests there may be a critical window of opportunity, when women are in their 40s and 50s, to detect metabolic signs of higher Alzheimer’s risk and apply strategies to reduce that risk,” Dr. Mosconi, associate director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine in New York City, said.

The report’s conclusions add to a growing body of evidence that suggests a physiological connection between Alzheimer’s patients and menopause. University of Arizona researchers believe that their study could result in the creation of screening tests and interventions that could work to slow the progress of or reverse the metabolic changes in the brain that lead to Alzheimer’s.

The study was published online October 10, 2017 in PLOS One.

Steve’s Take:

Well, here’s another unsettling piece of news that prompted me to throw my hands up in the air and start screaming. (Well, maybe not the screaming.)

But how about some good news on the Alzheimer’s front for a change? To date, unfortunately, there hasn’t been any. Zilch. Nada. Zip.

So, what do the experts say we do with this worrisome news?

First, some statistical facts I, for one, was surprised by.

In the US, an estimated 5.5 million people of all ages have Alzheimer’s disease. Of these, around 5.3 million are 65 and older and 200,000 are younger and have early-onset Alzheimer’s disease.

About two-thirds of Americans with Alzheimer’s disease are women. This equals to 3.3 million women, age 65 and older having Alzheimer’s disease in the US and two million men. (Source: Alzheimer’s News Today)

Female sex is the second most important risk factor for AD, after advanced age, a fact that suggests a role for estrogen in the development of the disease. Preclinical studies implicate the perimenopause-to-menopause transition as a sex-specific risk factor for AD.

Study results were independent of age, education, and APOE genotype. In addition, perimenopausal and postmenopausal women had lower scores on standard memory tests than premenopausal women.

Hormone Replacement Therapy (HRT), antioxidants to the rescue?

“These findings validate earlier preclinical findings and indicate emergence of bioenergetic deficits in perimenopausal and postmenopausal women, suggesting that the optimal window of opportunity for therapeutic intervention in women is early in the endocrine aging process,” the study’s investigators note.

The results “provide critical evidence for early changes in the aging female brain that are relevant to the twofold greater lifetime risk in Alzheimer’s disease,” senior investigator Roberta Diaz Brinton, PhD, from the University of Arizona Health Sciences in Tucson, added in the news release. “Importantly, these results indicate that we know when to intervene in the aging process to divert the potential for developing this devastating disease.”

Antioxidants may also have a role, Dr. Mosconi told Medscape. “We have very clearly shown that there is an energy issue in women going through perimenopause and menopause, and if the mitochondria are affected, it means there is oxidative stress in the brain, so it would be interesting to see if antioxidants could help. Maybe it’s not just about giving estrogen but also maybe protecting the mitochondria when you are younger,” she said.

In recent years the search for a possible link between estrogen and Alzheimer’s has received renewed attention. Earlier this year, Walter A. Rocca, professor of neurology and epidemiology at the Mayo Clinic in Rochester, MN, reported on several studies that suggest that the timing of hormone therapy is critically important to brain health.

A 2012 study, for example, by Peter P. Zandi, a researcher at Johns Hopkins University’s Bloomberg School of Public Health, also found that the timing of estrogen therapy appeared to play a significant role in reducing the risk of Alzheimer’s, according to the Washington Post.

Bottom Line:

Previously, the following were the only common, clinical indications for prescribing HT such as estrogen, taken daily:

  • To relieve vasomotor symptoms
  • To improve urogenital symptoms (long-term therapy is required)
  • To prevent osteoporosis

Now, we are hearing about adding HT to possibly prevent, delay and/or perhaps mitigate the devastating effects of Alzheimer’s. More, larger studies are underway to confirm this recommendation.

It seems to me, from reading comments to the various news reports of this latest study, there are essentially two camps among women:

  • those who will rush to their doctors and get on hormone therapy and/or other medicines, and
  • those who say all of that is crap served up by the pharma industry to boost sales and profits, and everybody’s going to age and die anyway, etc.
Steve's Take: New study suggests #HormoneTherapy may delay/mitigate #Alzheimers #Dementia Click To Tweet

Outside the realm of the scientific data and possible pharma and non-pharmacological treatments/interventions, there’s another view I saw expressed by a nurse practitioner in a comment about the University of Arizona study. She basically posed the question:

“What about all the women who don’t develop AD or other dementias? Why not study them and stop the pill-pushing pharma industry, hell-bent on making aging a ‘problem,’ fixed with drugs. Maybe what we all really need are improved ways of handling stress, being more active and eating healthier.”

She’s got a point.

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