Brain autopsies reveal fewer Alzheimer's signs in woman who took menopause drug

A Stanford University study analyzing brain autopsies of over 21,000 deceased women reveals that those who took estrogen-only menopausal hormone therapy (MHT) had a 35% lower risk of developing Alzheimer's disease. While the findings show a significant association, researchers note they do not prove direct causation. The study offers new insights into the gender gap in Alzheimer's, which currently affects over 7 million Americans, nearly two-thirds of whom are women.

Estrogen-only MHT benefits

• ▪Dr. Jennifer Bruno, co-author of the Stanford University study, stated that menopausal hormone therapy exerts a modest, meaningful, and statistically significant protective effect on the risk of developing Alzheimer's pathology.
• ▪A Stanford University study suggests that women taking estrogen-only menopausal hormone therapy have a 35% lower risk of developing Alzheimer's disease during their lifetime compared to women who have never used the treatment.
• ▪Dr. Hadi Hosseini, senior author of the Stanford University study, stated that the study's findings may underestimate the protective benefit of menopausal hormone therapy because the participants tended to initiate therapy late.

Brain autopsy study findings

• ▪The Stanford University study compared brain autopsies from 258 women who reported taking estrogen-only menopausal hormone therapy with roughly 2,701 women who had never used the treatment.
• ▪The Stanford University study findings show an association between estrogen-only menopausal hormone therapy and lower Alzheimer's risk, but do not prove that the treatment prevents the disease.
• ▪Stanford University researchers analyzed brain autopsies from two databases containing information on more than 21,000 deceased women to look for amyloid plaques and neurofibrillary tangles.

Hysterectomy prescription requirements

• ▪Estrogen-only menopausal hormone therapy is generally prescribed to women who have had hysterectomies because taking estrogen alone can cause the uterine lining to thicken, raising the risk of uterine cancer.
• ▪By age 60, more than 30% of women in the United States have had hysterectomies, making them potential candidates for estrogen-only menopausal hormone therapy.

Women's disproportionate Alzheimer's risk

• ▪Nearly two-thirds of the more than 7 million Americans age 65 and older living with Alzheimer's disease are women.
• ▪By 2060, the number of Americans living with Alzheimer's disease is projected to reach 14 million, with women accounting for approximately 8.5 million of those cases.
• ▪The APOE4 genetic variant, which is the strongest known genetic risk factor for late-onset Alzheimer's, may affect women differently than men and contribute to the sex disparity in Alzheimer's cases.

Menopause estrogen decline effects

• ▪The average life expectancy for women in the United States is 81.4 years compared to 76.5 years for men, which contributes to but does not fully explain why women face a higher risk of Alzheimer's.
• ▪The dramatic drop in estrogen during menopause may remove a protective barrier in the brain, potentially leaving women more vulnerable to developing dementia.

2 sources