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Early Menopause and Late Hormone Therapy Linked to Increased Alzheimer’s Risk in Women

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A new study reveals that early menopause and late initiation of hormone therapy (HT) use may significantly contribute to increased tau protein deposition, a key biomarker of Alzheimer’s disease, in women. The cross-sectional study focused on determining the association between female sex, age at menopause, and hormone therapy use with tau and β-amyloid positron emission tomography (PET) scans. The findings were published in the JAMA Network

Alzheimer’s disease, the most common form of dementia, disproportionately affects women, with postmenopausal women accounting for around 70% of all individuals diagnosed with the condition. Elevated levels of tau protein, which is commonly observed in Alzheimer’s patients, have been previously reported in cognitively unimpaired postmenopausal women compared to age-matched men.

This cross-sectional study included participants enrolled in the Wisconsin Registry for Alzheimer Prevention. The study examined 292 cognitively unimpaired individuals, consisting of 193 women and 99 men, with an average age of 67 years at the time of the tau scan. Researchers found that female sex, earlier age at menopause, and HT use were significantly associated with higher regional tau in individuals with elevated β-amyloid levels. Affected regions included medial and lateral regions of the temporal and occipital lobes.

Late initiation of HT, defined as more than five years after the onset of menopause, was linked to higher tau PET signals compared to early initiation. This finding suggests that the timing of hormone therapy use may play a crucial role in tau deposition and, consequently, Alzheimer’s risk in women.

The results of this study offer valuable insights into potential sex-specific risk factors for Alzheimer’s disease. By identifying a possible connection between early menopause, late initiation of hormone therapy, and increased tau deposition, researchers hope to pave the way for improved prevention and treatment strategies for this debilitating condition.

However, it is essential to note that this study is observational in nature, and further research is needed to confirm the findings and establish a causal relationship between early menopause, hormone therapy use, and Alzheimer’s risk in women. Future studies may also explore the potential benefits of early initiation of hormone therapy in reducing tau deposition and Alzheimer’s risk among women who experience early menopause.

The study highlights the importance of understanding sex-specific risk factors for Alzheimer’s disease, particularly the role of early menopause and hormone therapy use in women. These findings may help healthcare professionals develop personalised prevention and treatment strategies for Alzheimer’s, ultimately improving the lives of millions of people affected by the disease worldwide.

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