This is one of the many enduring mysteries of Alzheimer’s: why women seem to be more prone to the disease than men.
“Two-thirds of Americans with Alzheimer’s are women,” said Nicole McGurin of the Alzheimer’s Association of Massachusetts and New Hampshire. “At age 45, the lifetime risk of developing Alzheimer’s is one in five for women and only 1 in 10 for men.”
One possible contributor to the numbers: Women live longer than men.
“Research is mixed on whether differences in life expectancy explain gender differences,” McGurin said. “There is a lot of research that points to why men and women develop Alzheimer’s disease differently.”
On this score, new research suggests that the life transitions that women go through alone may be contributors to dementia.
“What we found was that if women had earlier-onset, premature menopause, they were more likely to accumulate neurotoxic tau protein in the brain,” says Jillian Coughlan, MS, PhD, a research fellow at Massachusetts General Hospital.
Tau proteins are found in normal brain cells, but when they become abnormal or neurotoxic, they can lead to a variety of diseases, including Alzheimer’s.
“Premature menopause or even early menopause can put women at risk of developing dementia in the future,” Coughlan said.
Premature menopause occurs before the age of 40. Early menopause begins between the ages of 40 and 45.
The study also looked at the role of hormone replacement therapy in the development of dementia. HRT, as it’s known, is prescribed to ease menopausal symptoms for women — but it has fallen out of favor because previous studies have shown it can increase the risk of breast cancer and cardiovascular disease in the long term.
Its role in dementia appears to be primarily linked to dosing.
“Women are looking for ways to manage their menopausal symptoms and doctors are recommending hormone replacement therapy,” says Coughlan. “Which seems fine as long as it’s done within five to 10 years of a woman’s onset of menopause.”
But the study did not determine how beneficial HRT is in preventing dementia when given early – although it does not appear to be harmful. Other studies have shown that HRT given long after menopause may contribute to the development of dementia.
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