The risk of Alzheimer’s is higher in cases of early menopause, suggest Mass General Brigham scientists, whose findings are published in the journal JAMA Neurology. When hormone replacement therapy was started in early menopause, the risk did not change, the researchers added. Until now, it is known that Alzheimer’s disease is more common in women than in men. The ratio is, respectively, two to one third. Hormone replacement therapy is the most reliable way to relieve severe menopausal symptoms, but how it affects the brain is still unclear, said one of the study’s authors, Dr. Rachel Buckley of the Department of Neurology at Massachusetts General Hospital and a founding member of Mass General Brigham Health System. According to her, the highest levels of tau protein that accumulate in the brain in Alzheimer’s disease are found when hormone replacement therapy is started very late after the onset of menopause. According to her, the connection between the accumulation of tau proteins in the brain and the late onset of hormone replacement therapy is a discovery that has not been made before. Premature menopause is associated with an increased likelihood of developing dementia in old age. Premature menopause is when it occurs before age 40 or due to surgery before 45. Hormone replacement therapy is usually prescribed at the discretion of a doctor and aims to improve quality of life, including preventing cognitive impairment. Two decades ago, however, a Women’s Health Initiative (WHI) study found that hormone replacement therapy was associated with twice the incidence of dementia in women over 65 compared to the placebo group. The assumptions at the time were that in these cases hormone replacement therapy was started much later, years after the onset of menopause. To investigate these findings, Dr. Buckley and her colleagues tracked using position-emission tomography how the presence of the two proteins seen in Alzheimer’s disease, beta-amyloid and tau, was related to age at menopause and timing of hormone replacement therapy. therapy. Previous research has looked at symptoms of cognitive decline in menopausal women, but few have analyzed the biological factors underlying these changes, which may be relevant to determining Alzheimer’s risk. “When it comes to hormone replacement therapy, timing is everything,” says Dr. JoAnn Manson, one of the WHI’s lead investigators and chief of preventive medicine at Brigham and Women’s Hospital. She said, and previous research suggests that starting HRT early in menopause provides better outcomes in terms of heart health, cognitive function and life expectancy.The same is evident from the current study of tau proteins, she adds. The researchers used data from the Wisconsin Registry for Alzheimer’s Prevention (WRAP), one of the few Alzheimer’s dementia studies that includes detailed information, including time of menopause, whether hormone replacement therapy was used and images from brain imaging studies. PET scan images of 292 cognitively healthy adults were analyzed to determine levels of beta-amyloid and tau in seven brain regions. Mainly, the scientists focused on the tau proteins, which are normally found in greater amounts in these areas in women compared to men. The study confirmed that women had higher levels of tau than men of the same age, especially when there was also increased beta-amyloid. But this association was stronger in cases of premature menopause, even after adjusting for factors such as smoking and heredity. Tau proteins were high in the entorhinal and inferior temporal regions, which are located near the center of memory and are known to be involved in the progression of Alzheimer’s dementia. Considering that in case of premature menopause, hormone replacement therapy is prescribed, scientists check whether its inclusion is related to the accumulation of beta-amyloid and tau proteins in the brain. Thus, they found that late initiation of hormone replacement therapy—five or more years after menopause—led to this association. Up to 10% of women suffer from premature or early menopause, and study findings so far suggest that early menopause may be a risk factor for Alzheimer’s disease. In these cases, hormone replacement therapy should be administered close to the onset of menopause, as starting it years later has negative effects on cognitive abilities, concluded lead study author Dr. Gillian Coughlan of the Department of Neurology at Massachusetts General Hospital. References: https://jamanetwork.com/journals/jamaneurology/article-abstract/2802791 https://www.massgeneralbrigham.org/But this association was stronger in cases of premature menopause, even after adjusting for factors such as smoking and heredity. Tau proteins were high in the entorhinal and inferior temporal regions, which are located near the center of memory and are known to be involved in the progression of Alzheimer’s dementia. Considering that in case of premature menopause, hormone replacement therapy is prescribed, scientists check whether its inclusion is related to the accumulation of beta-amyloid and tau proteins in the brain. Thus, they found that late initiation of hormone replacement therapy—five or more years after menopause—led to this association. Up to 10% of women suffer from premature or early menopause, and study findings so far suggest that early menopause may be a risk factor for Alzheimer’s disease. In these cases, hormone replacement therapy should be administered close to the onset of menopause, as starting it years later has negative effects on cognitive abilities, concluded lead study author Dr. Gillian Coughlan of the Department of Neurology at Massachusetts General Hospital. References: https://jamanetwork.com/journals/jamaneurology/article-abstract/2802791 https://www.massgeneralbrigham.org/But this association was stronger in cases of premature menopause, even after adjusting for factors such as smoking and heredity. Tau proteins were high in the entorhinal and inferior temporal regions, which are located near the center of memory and are known to be involved in the progression of Alzheimer’s dementia. Considering that in case of premature menopause, hormone replacement therapy is prescribed, scientists check whether its inclusion is related to the accumulation of beta-amyloid and tau proteins in the brain. Thus, they found that late initiation of hormone replacement therapy—five or more years after menopause—led to this association. Up to 10% of women suffer from premature or early menopause, and study findings so far suggest that early menopause may be a risk factor for Alzheimer’s disease. In these cases, hormone replacement therapy should be administered close to the onset of menopause, as starting it years later has negative effects on cognitive abilities, concluded lead study author Dr. Gillian Coughlan of the Department of Neurology at Massachusetts General Hospital. References: https://jamanetwork.com/journals/jamaneurology/article-abstract/2802791 https://www.massgeneralbrigham.org/