Women who have early menopause may have a higher risk of developing Alzheimer’s disease, but women who were prescribed hormone therapy around the age of menopause did not see an increase in risk, a study found. Premature menopause, defined as menopause that occurs spontaneously before age 40 or due to surgical intervention before age 45, is associated with an increased risk of Alzheimer’s disease.
Hormone therapy improves many of the severe symptoms associated with menopause and has been hypothesized to prevent cognitive impairment. The study, published in JAMA Neurology, showed that the highest levels of tau — a protein involved in Alzheimer’s — were seen only in hormone therapy users who reported a longer delay between the onset of menopause and the start of therapy.
Administration of hormone therapy closer to the onset of menopause provides better cognition. “When it comes to hormone therapy, timing is everything,” said Joan Manson, MD, chief of the department of preventive medicine at Brigham and Women’s Hospital.
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“Our previous findings have suggested that starting hormone therapy at the onset of menopause, rather than late initiation, provides better outcomes for cardiovascular disease, cognitive function and all-cause mortality – and this study suggests that tau deposition The same is true for,” Manson said.
In the study, the team used positron emission tomography (PET) neuroimaging scans from 292 people to study how the presence of two proteins involved in Alzheimer’s, beta-amyloid and tau, related to menopause and hormone therapy use . Tau is found in higher amounts in women than in men.
The PET scan results also showed that women had higher levels of tau than men of the same age, especially in cases where they also had increased beta-amyloid.
But the researchers also found that the association between abnormal levels of beta-amyloid and tau was stronger in women with known causes of premature menopause, such as smoking and oophorectomy, and even genetic risk. Earlier onset of menopause even after adjusting for factors. Alzheimer’s.
Specifically, tau levels were higher in the entorhinal and inferior temporal regions, which are located close to the brain’s memory center and are known to be involved in Alzheimer’s progression.
“Hormone therapy is the most reliable way to treat the severe symptoms of menopause, but over the past few decades there has been a lack of clarity on how hormone therapy affects the brain,” said Rachel Buckley, from Massachusetts General Hospital’s department of neurology. ” (MGH).
“The idea that tau deposition might underlie the association between late hormone therapy intervention and Alzheimer’s was a huge finding that hadn’t been seen before,” Buckley said.