According to the World Health Organization1, 139 million people worldwide will have dementia by 2050. The CDC estimates that Alzheimer’s disease (AD), the most prevalent form of dementia, accounts for up to 80% of dementia cases, meaning that by 2050, there will probably be more than 100 million AD cases worldwide.
Since Alzheimer’s is typically a condition of old age, these increases are primarily related to the aging population. Living longer is one reason women are nearly twice as likely as men to develop this disease.
However, age alone cannot account for the higher disease occurrence in women. Therefore, researchers are looking into other probable factors. One theory is that the decline in hormones, particularly estrogen, during menopause increases the risk of dementia.
Some previous studies2 have shown that hormone-replacement therapy (HRT), specifically when used long-term, lowers the risk of all neurodegenerative illnesses, including Alzheimer’s. Now, scientists from the Universities of East Anglia and Edinburgh in the UK have shown that HRT may be advantageous, especially for women with a genetic risk factor for AD.
HRT and APOE4 gene
In the new study3, the researchers reviewed data from 1,178 women over the age of 50 who were participating in the European Prevention of Alzheimer’s Dementia (EPAD) program. At the baseline, none of the women had any form of dementia.
The researchers were particularly interested in whether HRT had a higher effect on women who possessed the APOE4 gene. One copy of APOE4 nearly triples an individual’s risk of getting AD, and two copies can elevate that risk by 8–12 times.
Approximately 25% of people carry the gene, and 2–3% of them have two copies of it. The researchers split the participants between those who had APOE4 and those who did not to compare the impact of HRT on AD risk in those with and without the gene.
Anyone who was or had been receiving oral, transdermal, or estrogen plus progestogen therapy was classified as having HRT.
All the individuals undertook a series of cognitive assessments to gauge their abilities in areas like language, attention, delayed memory, and visuospatial construction. Additionally, they had MRI scans to measure their brain volume, which diminishes with Alzheimer’s.
The Research Findings
The results demonstrated that HRT did not affect brain volume or cognitive function in women lacking the APOE4 gene. On the other hand, HRT was linked with better memory and brain volume in women with the APOE4 genotype, with the highest effect shown in those who began HRT earlier.
The hippocampus, a brain region that plays a crucial role in learning and memory, decreases by up to 25% in individuals with Alzheimer’s. Early HRT demonstrated larger hippocampus volume in APOE4 carriers, suggesting that it had a protective impact.
Therefore, starting HRT as soon as menopausal or even perimenopausal symptoms are recognized may be advantageous for women with a hereditary propensity to develop AD.
According to Prof. Michael Hornberger, one of the authors, although it is still too soon to tell if HRT lowers the incidence of dementia in women, the findings underscore the potential value of HRT and customized therapy in reducing the risk of Alzheimer’s.
Alzheimer’s Research Association is a non-profit organization dedicated to helping caregivers of Alzheimer’s disease and dementia. We provide the latest information and news about the illness and helpful tips to help caregivers cope with their daily caregiving challenges. We realize the most important thing that a caregiver needs is financial assistance. Therefore, we provide grants to caregivers to ease their financial burden. Caregivers can apply for grants here: Alzheimer’s Grant Application.
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