At the Kahn Center for Cardiac Longevity, we spend considerable time discussing memory and longevity with all patients, including the female patients, and often recommend hormone replacement therapy or HRT.
Many do not know that females represent approximately 70% of the Alzheimer's disease (AD) cases and the literature has proposed a connection between the decreased estrogen levels during menopause and an increased AD risk.
Previous investigations have predominantly focused on assessing how hormone therapy (HRT) affects the likelihood of AD development and cognitive deterioration.
However, as the research framework has shifted toward using lab tests called biomarker-defined AD and alterations in specific biomarkers could take place years before cognitive decline becomes discernible, it is crucial to examine how HT influences AD biomarkers. We offer testing for these biomarkers at the Kahn Center.
The goal of a new study was to evaluate the impact of HRT on AD biomarker-informed pathophysiology in both cognitively unimpaired (CU) and cognitively impaired (CI) post-menopausal females across the aging and AD spectrum.
STUDY
The cross-sectional study included post-menopausal females without HRT history (HT-) and with HT (HT+) at the time of PET imaging assessment from two cohorts: the Translational Biomarkers in Aging and Dementia (TRIAD) cohort, and the Alzheimer's Disease Neuroimaging Initiative (ADNI). Participants underwent magnetic resonance imaging (MRI), positron emission tomography (PET) and biofluid collection for amyloid and tau markers of brain health.
RESULTS
HRT + females demonstrated significantly lower tau-PET standardized uptake value ratio (SUVR) compared to HRT- females, a marker of lower risk of AD.
HRT + females also showed significantly lower CSF p-tau181 (P < 0.001) and plasma p-tau181 (P < 0.0001) concentrations, again, markers of lower risk for AD.
CONCLUSIONS
Overall, findings from this study suggest that HRT is associated with lower tau neuroimaging and fluid biomarkers in postmenopausal females, suggesting lower risk for AD. Larger studies will clearly be needed. For now, the pros and cons of HRT should be discussed as women near menopause.
The biomarkers (amyloid ratio and tau protein) are available along with ApoE testing at the Kahn Center.
Adopting brain friendly lifestyles like the MIND diet, weight control, exercise, brain activites, and avoidance of excess alcohol are all advised. A whole food plant diet is very supportive of brain health when accompanied by proper vitamin support like B12.
