The age you reach menopause may be linked to your future brain health, 18-year study finds: ScienceAlert

Menopause causes major changes in women’s biology, and experts have long wondered whether this could partly explain why Alzheimer’s disease is significantly more common in women than in men.

Previous studies have suggested that the significant drop in estrogen that menopause brings might be involved somewhere: a hormone involved in everything from how brain cells wire to how they produce energy.

To take a closer look, American researchers used health data from 2,603 ​​women, crossing the age of menopause with a number of markers of memory and brain functions, as well as cases of Alzheimer’s disease, up to 18 years old. The results of the study have now been published in Open JAMA Network.

Although the results do not show a direct cause-and-effect link between early menopause and Alzheimer’s disease, several associations are noteworthy and warrant further study.

“Earlier age at menopause was associated with more rapid cognitive decline (global and episodic), earlier onset of Alzheimer’s disease, and greater accumulation of white matter hyperintensity, with the largest effect sizes for structural outcomes observed in spontaneous menopause,” the researchers write in their published paper.

“Associations with total brain volume loss were present but modest.”

The researchers highlight the link between early natural menopause (without surgery) and the accumulation of white matter hyperintensities as “the most striking finding.”

Essentially, these white matter hyperintensities (WMH) are bright spots on brain scans that indicate damage to small blood vessels.

Among naturally menopausal women, menopause five years earlier was associated with about 15% higher WMH volume over the following 10 years, the researchers estimate – assuming the maximum observed difference remains stable.

It’s a link that has been spotted before, but this latest research adds an element of time, suggesting that the link between the timing of menopause and these brain changes plays out over decades.

“Our results extend this literature longitudinally, demonstrating that earlier age of menopause is associated with more rapid accumulation of WMHV decades later, and particularly among women whose hormonal decline was gradual (spontaneous) rather than abrupt (surgical),” the researchers write.

For early-onset Alzheimer’s disease, the statistical association was 1.8 fewer Alzheimer’s-free years for menopause 10 years earlier – this is a relatively small effect, but worth mentioning. The average age of Alzheimer’s diagnosis among participants who developed the disease was 88.4 years.

Add to that Memory Associations, which showed a relationship between earlier menopause and a slightly faster decline in overall cognition and episodic memory (memories of personal experiences and events) – and the results fit the idea that longer exposure to the body’s own hormones may help protect the brain.

“The convergence of cognitive, clinical, and imaging findings is consistent with a model in which prolonged exposure to endogenous hormones contributes to sustained neurobiological resilience in late life,” the researchers write.

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Further research will be needed to determine the exact relationship between menopause, estrogen and Alzheimer’s disease. For example, the data presented here could be interpreted as showing that early menopause is a sign of faster aging that also affects the brain, rather than the cause of these brain changes.

However, given that multiple markers pointed in the same direction and other research we have seen on this topic, it is reasonable to think that there is a significant connection here that is worth investigating further.

Potentially, this link could eventually lead to better treatments and prevention methods, but it also suggests that brain aging is not a phenomenon that only manifests itself later in life. It is possible that age at menopause is a useful early indicator to help health professionals assess risk later in life.

“These findings suggest that age at menopause has lasting associations with structural and functional brain aging decades after the menopausal transition, positioning it as an identifiable midlife marker for dementia risk stratification and early intervention,” the researchers write.

Menopause causes major changes in women’s biology, and experts have long wondered whether this could partly explain why Alzheimer’s disease is significantly more common in women than in men.

Previous studies have suggested that the significant drop in estrogen that menopause brings might be involved somewhere: a hormone involved in everything from how brain cells wire to how they produce energy.

To take a closer look, American researchers used health data from 2,603 ​​women, crossing the age of menopause with a number of markers of memory and brain functions, as well as cases of Alzheimer’s disease, up to 18 years old.

The results of the study have now been published in Open JAMA Network.

Although the results do not show a direct cause-and-effect link between early menopause and Alzheimer’s disease, several associations are noteworthy and warrant further study.

“Earlier age at menopause was associated with more rapid cognitive decline (overall and episodic), earlier onset of Alzheimer’s disease, and greater accumulation of white matter hyperintensity, with the largest effect sizes for structural outcomes observed in spontaneous menopause,” the researchers write in their published paper.

“Associations with total brain volume loss were present but modest.”

The researchers highlight the link between early natural menopause (without surgery) and the accumulation of white matter hyperintensities as “the most striking finding.”

Essentially, these white matter hyperintensities (WMH) are bright spots on brain scans that indicate damage to small blood vessels.

Among naturally menopausal women, menopause five years earlier was associated with about 15% higher WMH volume over the following 10 years, the researchers estimate – assuming the maximum observed difference remains stable.

It’s a link that has been spotted before, but this latest research adds an element of time, suggesting that the link between the timing of menopause and these brain changes plays out over decades.

“Our results extend this literature longitudinally, demonstrating that earlier age of menopause is associated with more rapid accumulation of WMHV decades later, and particularly among women whose hormonal decline was gradual (spontaneous) rather than abrupt (surgical),” the researchers write.

For early-onset Alzheimer’s disease, the statistical association was 1.8 fewer Alzheimer’s-free years for menopause 10 years earlier – this is a relatively small effect, but worth mentioning. The average age of Alzheimer’s diagnosis among participants who developed the disease was 88.4 years.

Add to that Memory Associations, which showed a relationship between earlier menopause and a slightly faster decline in overall cognition and episodic memory (memories of personal experiences and events) – and the results fit the idea that longer exposure to the body’s own hormones may help protect the brain.

“The convergence of cognitive, clinical, and imaging findings is consistent with a model in which prolonged exposure to endogenous hormones contributes to sustained neurobiological resilience in late life,” the researchers write.

))>

Further research will be needed to determine the exact relationship between menopause, estrogen and Alzheimer’s disease. For example, the data presented here could be interpreted as showing that early menopause is a sign of faster aging that also affects the brain, rather than the cause of these brain changes.

However, given that multiple markers pointed in the same direction and other research we have seen on this topic, it is reasonable to think that there is a significant connection here that is worth investigating further.

Potentially, this link could eventually lead to better treatments and prevention methods, but it also suggests that brain aging is not a phenomenon that only manifests itself later in life.

It is possible that age at menopause is a useful early indicator to help health professionals assess risk later in life.

“These findings suggest that age at menopause has lasting associations with structural and functional brain aging decades after the menopausal transition, positioning it as an identifiable midlife marker for dementia risk stratification and early intervention,” the researchers write.

The research was published in Open JAMA Network.