Hormone replacement therapy may help reduce risk of Alzheimer’s disease in women: Study

A team of researchers from the University of East Anglia (UEA) and the University of Edinburgh in the United Kingdom have found that hormone replacement therapy (HRT), used to relieve symptoms of menopause in women, may help prevent Alzheimer’s disease. The study published in the Alzheimer’s Research & Therapy journal, earlier this week, shows evidence of HRT reducing the risk of the aforementioned disease in women carrying the APOE4 gene. While APOE4 is the strongest risk factor gene for the disease, inheriting it does not necessarily mean that a person will definitely develop the condition.

The recent study found that HRT was most effective when taken before periods stop and the onset of symptoms which then build up for months or years, also known as perimenopause. However, researchers have also said that they cannot say with absolute certainty that HRT will reduce the risk of Alzheimer’s disease in women, but the findings were important given the limited treatment and prevention options for dementia.

“In addition to living longer, the reason behind the higher female prevalence is thought to be related to the effects of menopause and the impact of the APOE4 genetic risk factor being greater in women,” said professor Anne-Marie Minihane from UEA’s Norwich Medical School who co-led the study with the University of Edinburgh, professor Craig Ritchie. She added, “We wanted to find out whether HRT could prevent cognitive decline in at-risk APOE4 carriers”.

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The findings were based on the data analysed from 1,178 women who are a part of the European Prevention of Alzheimer’s Dementia initiative, which was set up to study the participants’ brain health over time. The initiative has reportedly tracked over 1,900 people across 10 countries who were aged over 50 and did not have dementia at the beginning of the study.

Notably, while the study does not look at dementia cases, Minihane said that cognitive performance and lower brain volumes are predictive of future dementia risk. The team of researchers from the UK looked at MRI scans which recorded the results of the cognitive tests and brain volumes and found that APOE4 carriers who used HRT had better cognition and higher brain volumes. This data was then compared to those who did not take the HRT and also were non-APOE4 carriers.

“An effect on both cognition and brain changes on MRI supports the notion that HRT has tangible benefit. These initial findings need replication, however, in other populations,” said Ritchie. Additionally, he also highlighted the need to challenge many assumptions about Alzheimer’s disease and its treatment, particularly in women.

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