Alzheimer’s disease can be a devastating diagnosis for the patient as well as their loved ones. It is the most common form of dementia in the UK and is the progressive deterioration of the brain. Over time it impacts memory, cognitive skills and other mental abilities.
Currently around 900,000 people in the UK are living with dementia, with around six in 10 of those thought to have Alzheimer’s disease.
While there is no cure at the moment, there are treatments available to help relieve some of the symptoms.
But now a new study has found that hormone replacement therapy (HRT) is associated with better memory, cognition and larger brain volumes in later life among women carrying the APOE4 gene, which is the strongest risk factor gene for Alzheimer’s disease.
HRT is currently used to relieve symptoms of the menopause by replacing hormones that are at a lower level.
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The team at the University of East Anglia (UEA) found that HRT was most effective in terms of memory and cognition when introduced early in the menopause journey during perimenopause.
Study lead and director of the Norwich Institute for Healthy Aging at UEA, Professor Anne-Marie Minihane, said: “We know that 25 percent of women in the UK are carriers of the APOE4 gene and that almost two thirds of Alzheimer’s patients are women.
“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.
“We wanted to find out whether HRT could prevent cognitive decline in at-risk APOE4 carriers.”
As part of the research the team analysed data from 1,178 dementia-free women over the age of 50 who were taking part in the European Prevention of Alzheimer’s Dementia initiative.
This initiative included participants from 10 countries and tracked women’s brains from “healthy” to a diagnosis of dementia in some.
These results were studied to determine the impact of HRT on women carrying the APOE4 genotype.
Doctor Rasha Saleh, also from UEA’s Norwich Medical School, said: “We found that HRT use is associated with better memory and larger brain volumes among at-risk APOE4 gene carriers.
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“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 limited drug options for Alzheimer’s disease for 20 years and there is an urgent need for new treatments.
“The effects of HRT in this observation study, if confirmed in an intervention trial, would equate to a brain age that is several years younger.”
It is hoped future research will be able to determine how successful HRT is for Alzheimer’s prevention.
Professor Michael Hornberger, from UEA’s Norwich Medical School, added: “It’s too early to say for sure that HRT reduces dementia risk in women, but our results highlight the potential importance of HRT and personalised medicine in reducing Alzheimer’s risk.
“The next stage of this research will be to carry out an intervention trial to confirm the impact of starting HRT early on cognition and brain health.
“It will also be important to analyse which types of HRT are most beneficial.”
Symptoms of Alzheimer’s disease include:
- Forgetting about recent conversations or events,
- Forgetting the names of places and objects.
- Confusion, disorientation and getting lost in familiar places
- Difficulty planning or making decisions
- Problems with speech and language
- Problems moving around without assistance or performing self-care tasks
- Personality changes, such as becoming aggressive, demanding and suspicious of others
- Hallucinations and delusions
- Low mood or anxiety.
If you experience any of these symptoms and suspect Alzheimer’s, speak to your GP.