Earlier age at menopause, later HT initiation linked to susceptibility to Alzheimer’s disease

Key take away food :

• Female sex, early age at menopause, and HT use were associated with higher regional tau positron emission tomography.
• These results warrant trials evaluating the potential implications of HT momentum on tau deposition.

According to a cross-sectional study published in JAMA Neurology.

“Early trials and observational studies suggest that the use of exogenous hormones, via HT, may improve cognitive impairment in menopausal or postmenopausal people“, Gillian T. Coughlan, MS, PhD, research fellow at department of neurology at Massachusetts General Hospital of Harvard Medical School, and colleagues wrote. “Contrary to these results, however, a seminal randomized clinical trial, the Women’s Health Initiative, found that the use of HT, particularly estrogen plus progestin, was associated with an approximately two-fold higher incidence of dementia. likely compared to placebo.”

Researchers analyzed data from 292 cognitively impaired women and men (mean age, 67) enrolled in the Wisconsin Registry for Alzheimer’s Prevention between November 2006 and May 2021. Early menopause at age 40, early menopause at ages 40 to 45 and regular menopause over age 45, as well as current or past HT use and nonuse, were assessed for associations.

The primary outcomes were seven tau positron emission tomography (PET) regions that show gender differences in the temporal, parietal, and occipital lobes and the interaction of gender, age at menopause, or HT and high beta-amyloid PET on the tau region. Secondary outcomes included the influence of timing of HT in association with age at onset of menopause on regional tau.

In the cohort, 66.1% were female, 52.2% of HT users were female, and 19% of participants had abnormal beta-amyloid. Female sex (P < 0.001), earlier age at onset of menopause (P < .001) and HT use (P = 0.008) were all associated with higher regional tau PET in people with elevated amyloid beta compared to males, later age at onset of menopause, and non-use of HT, respectively, wrote the researchers.

Regions affected by HT use included the medial and lateral regions of the temporal and occipital lobes. Late initiation of HT more than 5 years after onset of menopause was associated with higher PET tau compared to early initiation of HT (P = .001), according to the researchers.

“Women who experience a younger age at menopause may represent a subgroup to be prioritized for inclusion in Alzheimer’s disease prevention trials,” the researchers wrote. “Clinical trials to assess the potential implications of HT synchronization on the tau deposit are also justified.