Hormone replacement therapy (HRT) may help prevent Alzheimer’s disease in women at risk of developing the disease, a study has found.
Researchers from the Universities of East Anglia and Edinburgh have said HRT, which helps control menopausal symptoms, is associated with better memory, cognitive function and larger brain size later in life. life in women who carry a gene called APOE4.
Around a quarter of women in the UK are believed to carry the gene, and Alzheimer’sis more common in women than in men. APOE4 is the strongest risk factor gene for the disease, although inheriting it does not mean that someone will permanently develop the disease.
In the study, the researchers found that HRT was most effective when given during perimenopause, where symptoms accumulate months or years before periods stop.
Professor Anne-Marie Minihane, from Norwich Medical School at the University of East Anglia (UEA), who led the study with Professor Craig Ritchie from the University of Edinburgh, said: “We know that 25% of women in the UK carry the APOE4 gene and nearly 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.
“We wanted to know if HRT could prevent cognitive decline in at-risk APOE4 carriers.”
Experts studied data from 1,178 women taking part in the European Alzheimer’s Dementia Prevention Initiative, which studied participants’ brain health over time.
The project, which involved 10 countries, tracked the brains of 1,906 people over the age of 50 who did not have dementia at the start of the study.
In the latest research, experts looked at the results of cognitive tests and the brain volumes recorded by MRI scans.
Their results showed that APOE4 carriers who also used HRT had better cognition and higher brain volumes than those who were not on HRT and were not APOE4 carriers.
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Professor Minihane said that although the team did not look at dementia cases, lower cognitive performance and brain volumes are predictive of future dementia risk.
Dr Rasha Saleh, also from UEA’s Norwich Medical School, said: “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.
“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 effects of HRT in this observational study, if confirmed in an intervention trial, would equate to years of younger brain age.”
The study was published in the journal Alzheimer’s Research & Therapy.