Menopause and Alzheimer’s disease

Mark Beaumont MD

January 12, 2022



Can menopause increase the risk for dementia later in life?

We are aware that an estimated 5.8 million Americans age 65 and older are living with Alzheimer’s dementia in 2020. One in 10 people age 65 and older has Alzheimer’s dementia and almost two-thirds of Americans with Alzheimer’s are women. This suggests that there is a factor specific to one’s sex that affects their risk of developing Alzheimer’s disease and dementia.

The results are in for a recent brain imaging study studying the risk of Alzheimer’s disease as women age. The study was supported by Cure Alzheimer’s Fund.

The study involved fifty-nine participants between the ages of forty and sixty with normal cognitive abilities. The researchers were interested in identifying how menopause influences changes in someone’s brain that can increase their risk for Alzheimer’s disease. 

Menopause, also known as the cessation of menses, is one of the many changes that occurs as women reach an age when they can no longer get pregnant. This happens because the ovaries no longer make the hormones estrogen and progesterone. The lack of these hormones can affect the entire body including the bones making them weaker, the skin making it thinner is and even affecting the brain causing metabolic changes that may increase the risk of Alzheimer’s disease. 

The study participants were asked to undergo tests to assess cognitive performance as well as brain imaging using to assess the presence and amount of beta-amyloid, a protein found in the brain of individuals with Alzheimer’s. The female participants included women who were either premenopausal, perimenopausal, or postmenopausal. The study found that in the menopausal and perimenopausal group there was a decline in performance on the memory test as compared to men. The menopausal group exhibited the highest rate of loss in an area of the brain critical for memory known as the hippocampus as well as the greatest increase in amyloid protein deposition.

This study sheds crucial light on the changes in the brain that are specific to women as they age and how these changes influence one’s risk for developing dementia. More importantly the study highlights the optimal window of opportunity for therapeutic intervention to prevent or delay progression of brain changes associated with the aging process. As women age, they should be discussing mid life changes with their primary care physician so they can incorporate preventative and therapeutic measures to limit many of the effects during this time. Hormone replacement therapy is no longer an option for women because it poses too many health risks. Other options include emphasizing eating brain healthy diet, having positive social interactions, exercising and simulating the brain with puzzles and games.