The Relationship Between Menopause and Dementia Risk

Monica Bell
4 days ago
5 min read

Optimal health is a goal we champion at Optimal Hormone Health, recognizing that it is a journey, not a destination. To simplify what this means, consider your mental health (cognition and emotions) and physical health. They are intertwined and one affects the other.

One area of great concern and a topic of discussion and research is dementia. You may have noticed the billions spent on research that yields little in the way of drugs that provide the relief that family caregivers and others desperately need. Here are just a few notable failures:

Amyloid-Targeting Antibodies (Monoclonal Antibodies):

Bapineuzumab (Pfizer/J&J): Failed Phase 3 trials for not showing significant cognitive improvement over placebo.
Solanezumab (Eli Lilly): Multiple large trials showed it didn't slow cognitive decline, even in earlier stages of the disease.
Gantenerumab (Roche): Missed goals in Phase 3 trials for early Alzheimer's, failing to slow decline and clear amyloid as hoped, despite earlier attempts.

Amyloid Production Inhibitors (BACE Inhibitors):

Verubecestat (Merck): Scrapped after trials showed virtually no chance of working, despite targeting amyloid production.
Atabecestat (J&J): Shelved due to liver enzyme spikes in participants.

Why is Treating Alzheimer’s So Challenging?

An investigative science journalist for the New York Times has spent decades following this story and has uncovered some disturbing information.

Decades of research have yielded no treatment that halts the progression of Alzheimer’s disease.
Over the past 25 years, Alzheimer’s research has suffered from misconduct and fraud by world-famous researchers.
For years, Alzheimer’s research has been dominated by one single theory: the Amyloid hypothesis, which postulates that amyloid proteins cause biochemical changes in the brain that cause dementia.
Contrary to this hypothesis, there are numerous cases of the presence of massive amyloid deposits found in the brains of deceased individuals who had no symptoms of Alzheimer’s.
Nearly every drug approved for Alzheimer’s dementia is based on this theory.

Alternative Theories on Causes of Alzheimer’s

There are lots of alternative theories on the causes of Alzheimer’s, but we are a long way from developing treatment based on any of these theories. Here is a brief review of some of the alternative theories in play:

Amyloid: A complicated and changing theory based on the buildup of sticky beta-amyloid protein fragments into plaques in the brain.
Cerebrovascular: vascular abnormalities affecting blood flow.
Genetics: Inherited genetic mutations
Gut/Brain: an imbalance in the different types of microscopic organisms living in your body.
Inflammation: Autoimmune response and inflammation
Metabolism: Reduced glucose metabolism precedes amyloid/tau changes.
Oxidative stress: Accumulation of oxidative damage in the brain from free radicals

Could Menopause Play a Part?

Illustration representing the relationship between menopause, estrogen changes, and brain health related to dementia risk.

Of all the adults in the US over 65 who have Alzheimer’s disease, almost two-thirds are women. This discrepancy has been attributed to genetics and women’s longer life spans. Still, there is growing agreement that menopause may be a risk factor for developing Alzheimer’s (or other dementias) later in life. Let’s look at the possible relationship between estrogen and its impact on the brain.

The female brain is rich in estrogen receptors in brain regions that control memory, mood, sleep, and body temperature.

Estrogen has neuroprotective effects in the Central Nervous System, including autoimmune inflammation, stroke, and neurodegenerative diseases.

Estrogen declines during menopause, which not only alters some areas of the brain but is believed to change the brain’s structure. Scans have shown reduced volume in menopausal brains compared to male brains of the same age.

Symptoms of menopause, such as hot flashes and lack of sleep, have also been linked to dementia. Specifically, hot flashes are associated with an increase in tiny lesions in the brain. A recent study also showed that hot flashes during sleep were associated with an increase in blood-based Alzheimer’s markers.

What Can You Do to Protect Your Brain?

Given the competing and complex theories, rather than worrying about what causes Alzheimer’s, taking prudent, rational action now may help mitigate the disease. At the very least, you will be healthier!

Hormone Therapy

It is now indisputable that hormone replacement has significant benefits. Some studies show that hormone therapy started around the time of when menopausal symptoms appear is associated with a reduced risk of dementia.

Regardless of the influence of hormone therapy on dementia risk, hormone therapy provides benefits linked to improved memory and mood.

Exercise

Physical inactivity is a greater risk for neurodegenerative diseases in women than in men. Women are, on average, twice as likely to be inactive as men are. Brain scans of physically active middle-aged women had fewer Alzheimer’s biomarkers compared to inactive women.

Diet

It is generally accepted that the MIND diet is the best approach to healthy eating and may reduce the decline in brain function. MIND stands for a combination of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet. Here is a list of the 9 foods recommended for the MIND diet. (Taken from Healthline)

Green, leafy vegetables: Aim for six or more servings per week. This includes kale, spinach, cooked greens, and salads.
All other vegetables: Try to eat another vegetable in addition to the green leafy vegetables at least once per day. It’s best to choose non-starchy vegetables because they provide a lot of nutrients for a low number of calories.
Berries: Eat berries at least twice per week. Berries such as strawberries, blueberries, raspberries, and blackberries all have antioxidant benefits.
Nuts: Try to get at least 5 servings each week. The creators of the MIND diet don’t specify what kind of nuts to consume, but it is probably best to vary the type of nuts you eat to obtain a variety of nutrients.
Olive oil: Use olive oil as your main cooking oil.
Whole grains: Aim for at least three servings daily. Choose whole grains like oatmeal, quinoa, brown rice, whole wheat pasta, and 100% whole wheat bread.
Fish: Eat fish at least once per week. It is best to choose fatty fish such as salmon, sardines, trout, tuna, and mackerel for their high omega-3 fatty acid content.
Beans: Include beans in at least four meals per week. This category includes all beans, lentils, and soybeans.
Poultry: Try to eat chicken or turkey at least twice per week. Note that fried chicken is not encouraged on the MIND diet.

For more specifics on the MIND diet, check out this article from the Alzheimer’s Association.

How Optimal Hormone Health Can Help with Menopause & Dementia Risk

As someone who is thinking about hormone replacement, or as a current patient, you may have concerns about how to improve your chances of avoiding dementia. There are no guarantees, but committing to boosting your health will yield progressively beneficial results. Talk with us about your goals, and we can create a personalized plan for your optimal health.