Menopause and Dementia | Is there a link?
Is there a connection between menopause and dementia?
Since 2011, dementia has been the number one killer of women in the UK. Women are twice as likely as men, to develop Alzheimer’s disease, the most common form of dementia. Figures for 2020 show 46,000 women and 24,000 men died from dementia.
Menopause and dementia may appear unrelated but there’s increasing evidence suggesting a link with rates of dementia in women continuing to rise. Is there a connection between hormones and the female brain?
What is the link between menopause and Alzheimer’s Disease?
Although women are far more likely than men to suffer from anxiety, depression, migraines, brain injuries, strokes and Alzheimer's disease, research has concentrated on the study of male physiology and biology – with historic male bias, women’s bodies have been seen as the same as men’s but with different reproductive organs. There has been little focus on the links between women’s brains and dementia.
Dr Michael Craig, author of the research paper ‘Estrogen therapy and Alzheimer's dementia’ says that that there is roughly double the risk of women developing Alzheimer’s later in life. Women’s brains age differently to men’s, with evidence to show that brain activity reduces at the frontal part as oestrogen reduces.
What are the effects of oestrogen on the menopause brain?
Oestrogen has been found to play a crucial role in healthy brains and cognitive function, including memory, attention, and learning. It is believed to play a part in helping the body to make antioxidants, protecting brain cells from damage, including preventing the build-up of harmful plaques and amyloid beta proteins; substances that clog up brain function and are involved in the development of dementia.
As oestrogen levels decline during menopause brains my become more vulnerable to damage with increased risks of cognitive decline and dementia.
Research suggests that longer exposure to oestrogen – early periods, pregnancy & late menopause - may make someone less likely to develop dementia. Early surgical menopause may increase the risk of dementia in later years. Unfortunately, all factors that are, in the main, outside our control.
The Alzheimer’s Society recognise that whilst it’s ‘tempting’ to connect oestrogen loss with dementia, more research is needed into the link between dementia and menopause before coming to a firm conclusion.
Other factors may contribute to the development of dementia - genetics, family history of dementia, lifestyle factors, and other medical conditions.
Does HRT help reduce risk of dementia?
Research published in the US JAMA Neurology (April 2023) found that starting HRT around the time of diagnosis, or onset of menopause , may reduce the risk of developing dementia. However starting HRT, five or more, years after going into menopause was linked to the build-up of those abnormal proteins in the brain. This was an early study, much more research is needed. It is essential women talk to their doctor, if they have any concerns about HRT and dementia.
The latest HRT study published in the British Medical Journal reported on an observational study linking HRT with increased risk of dementia. The BMJ conclude a causal link has not been proven. Read why on the BMJ site.
What can women do to reduce the risk of dementia post-menopause
It’s never too late! The risk of developing Alzheimer’s disease may be reduced by preventive medicine strategies and lifestyle changes which happily can help across the board with other symptoms of menopause, by:
Staying physically active: Exercise has been shown to have a positive impact on brain health and can help reduce the risk of cognitive decline. Aim for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, cycling, or swimming.
Eating a healthy diet: One high in fruits, vegetables, whole grains, lean proteins, and healthy fats can help reduce the risk of dementia. Reduce the intake of processed foods, sugary drinks, and alcohol.
Staying socially engaged: Social interaction and engagement can help keep the brain healthy and reduce the risk of cognitive decline. Make an effort to stay connected with friends and family and take part in social activities and hobbies.
Keeping the mind active: Stimulate the brain, stay active and engaged through reading, puzzles and learning new skills. Add mentally stimulating activities into daily routine.
Managing other health conditions: Essential to get medical support to manage conditions such as high blood pressure, diabetes, and depression - to both help reduce the risk of dementia and stay as healthy as possible.
Prioritising sleep: Research into the link between sleep and dementia found poor sleep in mid-life can increase the risk of developing dementia 25 years or more, later. Sleep removes harmful amyloids and helps with memory. Aim for 6-8 hours per night.
And finally…..
It seems that whilst there is some evidence to suggest a link between menopause and dementia, more research is needed to fully understand the relationship between the two conditions. Women in perimenopause or who have gone through menopause should be alert to the potential increased risk of cognitive decline and dementia in menopause and talk to their healthcare provider about ways to maintain healthy brain function and reduce their individual risk.
Want to know more?
Author of the The XX Brain: The Groundbreaking Science Empowering Women to Prevent Dementia, Dr Lisa Mosconi sees the brain in menopause as a restoration project, going through restructuring and rewiring. You’ll find out why hormones are key to understanding the female brain.
Another excellent source of information and safe advice on healthy ageing with a focus on reducing dementia is the Age Well Project, well-researched and crammed with practical tips. Watch our recorded webinar with Age Well author, Susan Saunders: Ageing Well: How to Live Longer, Healthier & Happier in Midlife & Menopause.
One thing is certain, more research is urgently needed to enable women so they can make informed choices about the current types of HRT. All women should talk to their doctor if they are worried about their personal risk.
May 2023
This article is for awareness-raising only. It is essential to consult a doctor or other medical professional for medical advice, diagnoses, or treatment.
