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HRT could ward off Alzheimer among at-risk women: Research

by Pragati Singh

According to University of East Anglia research, hormone replacement therapy (HRT) might help prevent Alzheimer’s disease in women at risk of getting the condition. According to the findings, HRT usage is connected with improved memory, cognition, and bigger brain volumes in later life in women who possess the APOE4 gene, which is the greatest risk factor gene for Alzheimer’s disease.

HRT was most beneficial when administered early in the menopausal journey, during perimenopause, according to the research team. Prof Anne-Marie Minihane of the University of East Anglia’s Norwich Medical School and head of the Norwich Institute for Healthy Aging at UEA conducted the study with Prof Craig Ritchie of the University of Edinburgh.

Prof Minihane said, “We know that 25 per cent 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,” she added.

The study looked at data from 1,178 women who took part in the European Prevention of Alzheimer’s Dementia programme, which was designed to track participants’ brain health over time. The experiment covered ten nations and monitored individuals’ brains from ‘healthy’ to dementia in certain cases. Participants were eligible if they were over the age of 50 and did not have dementia. The researchers examined their findings to determine the effect of HRT on women with the APOE4 genotype.

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 among at-risk APOE4 gene carriers. 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,” she added.

Prof Anne Marie Minihane said, “Our research looked at associations with cognition and brain volumes using MRI scans. We did not look at dementia cases, but cognitive performance and lower brain volumes are predictive of future dementia risk.”
Prof Michael Hornberger, from UEA’s Norwich Medical School, said, “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,” he added.
Prof Craig Ritchie, from the University of Edinburgh, said, “This important finding from the EPAD Cohort highlights the need to challenge many assumptions about early Alzheimer’s disease and its treatment, especially when considering women’s brain health. An effect on both cognition and brain changes on MRI supports the notion that HRT has tangible benefit. These initial findings need replication however in other populations.”

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