Brain Health

Hormone Replacement Therapy May Ward Off Alzheimer’s

If you’ve watched a loved one suffer from Alzheimer’s, you know how devastating the progressive disease is. And for the 15% to 25% of men and women carrying APOE4—the strongest risk factor gene for the disease, the fear of developing Alzheimer’s may be compounded by the fact that there are still very limited drug options to treat it.

Knowing that nearly two-thirds of Alzheimer’s patients are women, a team of researchers set out to determine if Hormone Replacement Therapy (HRT) could prevent Alzheimer’s Dementia in women carrying the APOE4 gene.

“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,” explains Professor Anne-Marie Minihane from University of East Anglia’s (UEA) Norwich Medical School and director of the Norwich Institute for Healthy Aging at UEA, who co-lead of the study. “We wanted to find out whether HRT could prevent cognitive decline in at-risk APOE4 carriers.”

Early intervention is key

In order to determine the effects of HRT on women most at risk of developing the disease, the team analyzed data from 1,178 female participants who were over 50 and dementia-free when they enrolled in the European Prevention of Alzheimer’s Dementia initiative.

“We found that HRT use is associated with better memory and larger brain volumes among at-risk APOE4 gene carriers,” says UEA Norwich Medical School Senior Research Associate Dr. Rasha Saleh. “The associations were particularly evident when HRT was introduced early—during the transition to menopause, known as perimenopause. The effects of HRT in this observational study, if confirmed in an intervention trial, would equate to a brain age that is several years younger.”

Although more research is needed, the study appears to indicate that HRT could provide an effective strategy to mitigate the higher lifetime risk of Alzheimer’s Dementia in women with the APOE4 gene.

The results were published in the January 9, 2023 edition of the journal Alzheimer’s Research & Therapy.


Wendy Burt-Thomas writes about the brain, mental health and parenting.

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