Women on Estrogen Had Less Alzheimer's in Their Brains.
Every week a woman in my office asks me some version of the same question. Her mother has dementia. She is fifty-two, she is miserable, and she wants to know whether hormone therapy will protect her brain or ruin it. For twenty years the answer has been that dementia is a risk of hormone therapy.
This month we got the most interesting piece of evidence in a long time.
What They Found
A Stanford group published an autopsy study in Neurology on August 12. They pulled 258 women who had used estrogen therapy and 2,701 who had never used hormone therapy, all of whom had donated their brains, and they counted amyloid plaques and neurofibrillary tangles under the microscope.
The estrogen users had 35 percent lower odds of meeting the pathological definition of Alzheimer's disease. Adjusted for age, APOE4 status, blood pressure history, education and race. Estrogen users were also 39 percent less likely to have been diagnosed with dementia while they were alive, and a third less likely to have reported memory decline.
Until now, we only knew about hormones and the aging brain from questionnaires, memory tests and chart review — a woman's account of how she is doing, and her doctor's impression of it. That is subjective. Plaques and tangles are not subjective. They are either in the tissue or they are not, and you can count them. This is the first time anyone has counted them in enough brains to answer the question objectively.
The Warning That Came Off
In February of this year the FDA approved removal of the boxed warning about probable dementia from menopausal hormone therapy labels. That warning rested on the Women's Health Initiative Memory Study done almost 30 years ago. Our standard of practice has been based on a flawed study for nearly 30 years.
What I Recommend
If you are already on estrogen and you have been quietly worried you were trading your memory for your sleep, this study is reason to worry less. If you are not on hormone therapy but considering it, let’s talk about the risks and benefits.
The Bottom Line
For the first time we have looked at the brain tissue itself, and women who took estrogen had less Alzheimer's pathology in it.
Have you been told hormone therapy would raise your dementia risk? Leave a comment and tell me what you were told, and when.
To your good health,
The Longevity Doctor®
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