In an article titled “Perimenopausal use of hormone therapy is associated with enhanced memory and hippocampal function later in life”, Pauline Maki and her colleagues utilized hormone therapy (HT) methods during key menopausal periods to see if it affected certain areas of the brain. They found that women in the perimenopausal period undergoing HT had enhanced verbal memory and hippocampal functionality compared to women who never underwent HT. How have other forms of hormone therapy been used to affect women’s cognition?
Did you know that 2/3 of dementia diagnoses are women? When estrogen is lost in menopause, it can greatly accelerate neuropathology in women. In studies previously, uses of hormone replacement therapy have had mixed results, so in their paper “Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women: results from the European Prevention of Alzheimer’s Disease (EPAD) cohort”, Saleh et al. explore the role of the APOE4 genotype and HRT inflation at specific ages, looking at the heterogeneity of the cognitive response when undergoing HRT. They used various tests of cognition and measured brain volumes using MRI. Their results indicated that when undergoing HRT, APOE4 carriers (women more likely to have cognitive decline/higher Alzheimer’s risk) have improved delayed memory and larger entorhinal and amygdala volumes. These results can suggest possible treatment plans that may target women based on their APOE4 genotype for the possibility of an improvement in their cognition.
In another study titled “Lifetime estrogen exposure and Cognition in late life: the Cache County Study” Joshua Matyi et al. examined the relationship between estrogen and cognitive decline in a 12-year population-based study involving over 2,000 women. Their methodology revolved around a women’s health questionnaire which asked about reproductive history, and HT usage. It was analyzed on the metric of endogenous estrogen exposure (EEE), and calculated depending on the reproductive age at puberty and at the age of menopause with additional adjustments based on whether the women had become pregnant or breastfed. The results indicated a strong positive correlation between EEE and cognitive status, as well as another positive correlation between longer HT use and cognition. There are a few things to note including that HT had a greater benefit on women who were older and the soonest after menopause had happened (within the first 5 years of menopause).
These studies show the importance of the use of different hormone therapies during certain menopausal periods and how they can affect cognition, mainly improving it. We all know women in our lives, and we all want the best for them and their lives as they get older. Knowing these studies we can make a positive impact on the cognition of many women when HT is used at optimal times for optimal impact.
References:
Maki, P. M., Dennerstein, L., Clark, M., Guthrie, J., LaMontagne, P., Fornelli, D., Little, D., Henderson, V. W., & Resnick, S. M. (2011). Perimenopausal use of hormone therapy is associated with enhanced memory and hippocampal function later in life. Brain Research, 1379, 232–243. https://doi.org/10.1016/j.brainres.2010.11.030
Matyi, J. M., Rattinger, G. B., Schwartz, S., Buhusi, M., & Tschanz, J. T. (2019). Lifetime estrogen exposure and cognition in late life: the Cache County Study. Menopause (New York, N.Y.), 26(12), 1366–1374. https://doi.org/10.1097/GME.0000000000001405
Saleh, R.N.M., Hornberger, M., Ritchie, C.W. et al. Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women: results from the European Prevention of Alzheimer’s Disease (EPAD) cohort. Alz Res Therapy 15, 10 (2023). https://doi.org/10.1186/s13195-022-01121-5
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