New Study Hints At An Alzheimer's–Menopause Connection

mbg Editorial Assistant By Eliza Sullivan
mbg Editorial Assistant
Eliza Sullivan is an editorial assistant at mindbodygreen. She received a B.S. journalism and a B.A. in english literature from Boston University.
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According to Lisa Mosconi, Ph.D., "about two-thirds of people living with Alzheimer's are women," and while that discrepancy is often credited to women living longer than men, her latest research has found another potential cause for this drastic difference.

"Our results show changes in brain-imaging features, or biomarkers, in the brain," explains Mosconi, a neuroscientist at Weill Cornell Medicine, "suggesting menopausal status may be the best predictor of Alzheimer's-related brain changes in women."

Assessing the influence of sex on Alzheimer's risk.

The study, published yesterday in Neurology, considered a group of men and women who had similar scores on cognitive tests and similar health indicators, including blood pressure readings and family histories of Alzheimer's.

The researchers found that women tended to fare worse on all four measures of brain health that they tested: the amount of gray and white matter, amyloid-beta plaque levels (which are a marker for Alzheimer's), and how quickly the brain metabolizes glucose.

They found that women had an average of 30% more amyloid-beta plaques and that their brains metabolized glucose at 22% lower rates. Volumes of gray and white matter in the brain were both approximately 11% lower in women. Losses in gray and white matter volumes has been linked to Alzheimer's disease in previous research.

Participants in the study had an average age of 52 and had no cognitive impairments. Though the study was on the smaller size (85 women and 36 men participated), these consistently worse scores for the female participants contextualizes women's higher risk for developing Alzheimer's.

"Our findings suggest that middle-aged women may be more at risk for the disease, perhaps because of lower levels of the hormone estrogen during and after menopause," Mosconi says. "While all sex hormones are likely involved, our findings suggest that declines in estrogen are involved in the Alzheimer's biomarker abnormalities in women we observed."

She noted that of all the markers for brain health, "The pattern of gray matter loss, in particular, shows anatomical overlap with the brain estrogen network."

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The gap in brain health.

"Somehow, in the landscape of things that we're told a woman should be concerned with," wrote Mosconi in a previous story for mindbodygreen, "her brain has seldom been one of them."

As indicated by the results of this most reasoned study, there's a definite link between healthy brain aging and sex, and women should be as concerned with tracing the health of their brain as they are with getting regular mammograms and other "women's health"-specific procedures.

The higher rates of complications regarding brain health in women aren't limited to Alzheimer's disease: "Women are twice as likely as men to have anxiety and depression, not to mention headaches and migraines," shares Mosconi on the mindbodygreen podcast. "But also, three times more likely to have an autoimmune disorder, including those that attack the brain like multiple sclerosis."

"Hormones are really important to give your brain energy," Mosconi explains. "If your hormones are high, your brain energy is high. But then what happens to testosterone is that it doesn't quite decline that much over time. Whereas for women, estrogens pretty much plummet when women go through menopause [...] and the brain is left a little more vulnerable."

What can be done?

While this may be a frightening thought, women aren't without things they can do to help.

She recommends first finding out what stage of menopause you're in and considering your family history. According to Mosconi, rates of developing Alzheimer's with a family history "about 30% for a maternal family history, and about 9% for a paternal family history."

She recommends starting to assess individual risk early, around 40 or 50, to best track Alzheimer's risk over time and to effectively plan for prevention.

But even with this data, it's important to note that "there is more to Alzheimer's than genetics." In speaking with us, Mosconi shared some actionable items for decreasing risks of cognitive decline, including embracing the Mediterranean diet, limiting exposure to endocrine-disrupting chemicals, drinking a moderate amount of coffee, and implementing regular exercise over a lifetime.

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