Hormone replacement therapy can prevent Alzheimer's disease in high-risk women

According to research from the University of East Anglia, hormone replacement therapy (HRT) can help prevent Alzheimer's in women at risk
.

Studies have shown that for women carrying the APOE4 gene, the use of hormone replacement therapy is associated with better memory, cognitive ability, and greater brain volume, the strongest risk factor gene
for Alzheimer's disease.

The team found that hormone replacement therapy was most effective
when used early in perimenopause.

Professor Anne-Marie Minihane from the University of East Anglia's Norwich Medical School, director of the Norwich Institute for Healthy Ageing at the University of East Anglia, led the study
in collaboration with Professor Craig Ritchie from the University of Edinburgh.

Professor Minihahn said: "We know that 25% of women in the UK carry the APOE4 gene and that almost two-thirds of people with dementia are women
.

"In addition to living longer, the reasons for the higher prevalence in women are thought to be related
to the effects of menopause and the greater impact of APOE4 genetic risk factors on women.
"

"We wanted to know if hormone replacement therapy could prevent cognitive decline
in high-risk APOE4 carriers.
"

The team studied data from 1,178 women who participated in the European Alzheimer's Prevention Initiative, which studies participants' brain health
over time.

The project spanned 10 countries and tracked participants' brains, from "healthy" to some people diagnosed with dementia
.
Participants were over 50 years of age and without dementia
.

The team studied their results, analyzing the effects of
hormone replacement therapy on women carrying the APOE4 genotype.

Dr Rasa Saleh, also from the University of East Anglia's Norwich Medical School, said: "We found that in high-risk APOE4 gene carriers, the use of hormone replacement therapy was associated with
better memory and greater brain volume.
This association is especially pronounced when hormone replacement therapy is introduced early – during the menopausal transition, i.
e.
perimenopause
.

"This is very important because 20 years of very limited drug options to treat Alzheimer's disease and there is an urgent need for new treatments
.
"

"In this observational study, the effect of HRT, if demonstrated in the intervention trial, would be equivalent to a few years
younger in the brain.
"

Professor Anne-Marie Minihahn said: "Our study used MRI scans to look at the relationship between
cognitive performance and brain volume.
We did not study cases of dementia, but reduced cognitive ability and brain volume can predict the risk of
future dementia.

Professor Michael Hornberg, from the University of East Anglia's Norwich Medical School, said: "It is too early to determine whether hormone replacement therapy reduces a woman's risk of dementia, but our findings highlight the potential importance
of hormone replacement therapy and personalised medicines in reducing Alzheimer's risk.
"

"The next phase of this study will be intervention trials to confirm the effects
of early initiation of hormone replacement therapy on cognition and brain health.
" It is also important to analyze which hormone replacement therapy is
most beneficial.
He added
.

Professor Craig Ritchie, from the University of Edinburgh, said: "This important finding from the EPAD cohort highlights the need to challenge many of the assumptions about early Alzheimer's disease and its treatment, particularly given women's brain health
.
" The effects of MRI on cognitive and brain changes support the idea that
hormone replacement therapy has tangible benefits.
However, these initial findings need to be replicated
in other populations.
”

"Hormone replacement therapy is associated with cognitive improvement and brain volume increase in women at high risk of APOE4: results from the European Alzheimer's Disease Prevention (EPAD) cohort," published in the journal Alzheimer's Disease Research and Treatment
.