New Study Finds Estrogen-Only HRT Cut Alzheimer’s Risk by Nearly 40%
We’re all ears when it comes to preventing cognitive decline. Should we give estrogen-only hormone replacement therapy (HRT) a rethink?
A new study published in Neurology found that women who take estrogen-only hormone HRT had about 39% lower odds of being diagnosed with dementia during their lives. They also had about 35% lower odds of showing signs of advanced Alzheimer’s. This is vital new information because women account for most of the people living with Alzheimer’s.
Earlier research indicated that estrogen-only HRT might actually increase dementia risk, especially if started after age 65. We’re still learning more about the best time to start, but the emerging data is that it’s safest and most useful during or soon after menopause.
“Menopausal hormone therapy appears to exert a modest but meaningful and statistically significant protective effect on the risk of developing Alzheimer’s pathology,” Jennifer Bruno, PhD, an instructor of psychiatry and behavorial science at Stanford Medicine who is the study’s co-author, says in a news release about the findings. “For a long time the going recommendation was ‘Don’t use MHT for memory decline.’ This study flies in the face of that recommendation.”
Stanford researchers looked at data from more than 21,000 deceased women with an average age of 70 whose brains had been autopsied to look for two major signs of Alzheimer’s: neurofibrillary tangles and amyloid plaques. About 260 of the women had used estrogen-only HRT, while the other 2,700 didn’t take any HRT.
When researchers compared the brains, they found that the women who took estrogen-only HRT had fewer of these features. Blood and spinal fluid samples from living women backed up the autopsy findings.
Most women are recommended to take a combination of estrogen and progesterone. Taking estrogen alone has been linked to higher risk of uterine cancers because it thickens the lining of the uterus — the progesterone helps thin it. This is why estrogen-only therapy is nearly always given to women who’ve had a hysterectomy.
There are some limitations to consider about this study: we can’t really say if this is better than taking HRT with both estrogen and progesterone because the researchers couldn’t find enough autopsy findings to draw conclusions. The study also didn’t include women who took topical estrogen-only HRT instead of pills.
All medications have pros and cons, so talk to your doc about the best type of HRT for you. In terms of lowering dementia risk, here’s what we know works:
- Regular exercise — aim for a combo of strength and cardio.
- Getting 7-9 hours of quality, consistent sleep — aim to go to bed and wake up at the same time.
- Eating a nutrient-dense diet filled with proteins, whole grains, fruits, vegetables and healthy fats — try the MIND or Mediterranean diets.
- Managing stress
- Being social
- Challenging your brain by giving it chances to learn, read and solve problems
