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According to a recent study, the use of hormone replacement therapy, used to better live through menopause, is associated with better cognition and greater brain volume in women carrying a genetic variant associated with Alzheimer’s disease. .
In some cases, hormone replacement therapy (THM) can alleviate the bothersome symptoms of menopause (hot flushes, vaginal dryness, etc.). This treatment could also help prevent Alzheimer’s dementia in women at risk, according to a study from the British University of East Anglia
Menopause linked to Alzheimer’s disease?
According to Professor Anne-Marie Minihane, who led the study, the idea started from a simple observation: “We know that 25% of women in the UK carry the APOE4 gene and that almost two thirds of Alzheimer’s patients are women. In addition to living longer, the reason for the higher female prevalence is thought to be related to the effects of menopause and the impact of the genetic risk factor APOE4 being greater in women.”
What to imagine links between APOE4, THM and Alzheimer’s “We wanted to know if HRT could prevent cognitive decline in at-risk APOE4 carriers,” she explains.
Years younger brain age thanks to treatment
The research team thus studied the data of 1,178 women participating in the European initiative for the prevention of Alzheimer’s dementia. The project spanned 10 countries and tracked participants’ brains from good cognitive health to being diagnosed with dementia in some. The research team studied their results to analyze the impact of hormone replacement therapy on women carrying the APOE4 genotype.
Dr. Rasha Saleh, author of the study, concluded that:
“We found that HRT use is associated with better memory and larger brain volumes in carriers of the at-risk APOE4 gene. The associations were particularly evident when HRT was introduced early, during the transition to menopause, known as perimenopause.”
Professor Anne Marie Minihane said: “Our research examined associations with cognition and brain volumes using MRI scans. We did not examine dementia cases, but lower cognitive performance and brain volumes are predictive of future dementia risk.” Early results suggest that the effects of HRT in this observational study, if confirmed in an intervention trial, would equate to brain age.”several years younger.”
Concrete hope for further research
If they remain cautious about the results on the treatment of Alzheimer’s itself, the researchers are nevertheless enthusiastic: “This is really important because there have been very few drug options for Alzheimer’s disease for 20 years and there is an urgent need for new treatments.”
“The next step in this research will be to conduct an intervention trial to confirm the impact of early initiation of HRT on cognition and brain health. It will also be important to analyze which types of HRT are most beneficial”they continue.
However, these initial findings must be replicated in other populations to gain precision.
THM: the benefit-risk balance remains to be assessed on a case-by-case basis
The study therefore shows that the use of THM in general, is associated with better memory, better cognition and larger brain volumes later in life in women who carry the gene called “APOE4”, a gene known as the strongest risk factor for Alzheimer’s disease.
HRT is effective in treating the symptoms of menopause. It may also be prescribed to prevent osteoporosis, if you are at high risk for fractures and cannot tolerate other treatments indicated for the prevention of osteoporosis. But the THM also involves risks (cardiovascular, cancer…), it must be as short as possible, taking into account the evolution of the benefits and risks of the treatment. The decision to start a HRT must therefore be the subject of a dialogue between you and your doctor.