Hormone replacement therapy (HRT) can help prevent Alzheimer’s disease in women at risk of developing Alzheimer’s disease, a study suggests.
HRT, which helps control menopausal symptoms, is linked to better memory, cognitive function and larger brain volume later in life in women who carry the APOE4 gene, say researchers from the Universities of East Anglia and Edinburgh.
Around a quarter of women in the UK are thought to carry the gene, and Alzheimer’s diseaseIt is more common in women than men. APOE4 is the strongest risk factor gene for the disease, although inheriting it does not necessarily mean you will have the disease.
In this study, researchers found that HRT is most effective when given during perimenopause, when symptoms accumulate months or years before menstruation stops.
Professor Anne-Marie Minihane, from University of East Anglia’s (UEA) Norwich Medical School, who led the study together with Professor Craig Ritchie from the University of Edinburgh, said: “We know that 25% of women in the UK are carriers of the virus. The APOE4 gene and almost two-thirds of Alzheimer’s patients are women.
“In addition to living longer, the reason for the higher prevalence among women is thought to be related to the effects of menopause and the greater impact of the APOE4 genetic risk factor on women.
“We wanted to know whether HRT could prevent cognitive decline in high-risk APOE4 carriers.”
The experts looked at data from 1,178 women who participated in the European Prevent Alzheimer’s Dementia Initiative, which studies participants’ brain health over time.
The project involved 10 countries and tracked the brains of 1,906 people over the age of 50 who did not have dementia when the study began.
In the latest study, the experts looked at the results of cognitive tests and brain volumes recorded from MRI scans.
Their results showed that APOE4 carriers who also used HRT had better cognitive performance and higher brain volume than those who did not receive HRT and non-APOE4 carriers.
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Professor Minihane said that while the team did not study dementia cases, cognitive ability and lower brain volume could predict future dementia risk.
Dr Rasha Saleh, also from UEA Norwich Medical School, said: “We found that in high-risk APOE4 gene carriers, use of HRT was associated with better memory and larger brain volume.
“The association was especially pronounced when HRT was introduced early on — during the transition to menopause, so-called perimenopause.
“This is important because drug options for Alzheimer’s disease have been very limited for 20 years and new treatments are desperately needed.
“The effect of HRT in this observational study, if confirmed in an intervention trial, would be equivalent to a few years younger brain age.”
The study was published in the journal Alzheimer’s Research and Therapy.