For men and women undergoing hormone replacement therapy from our San Diego practice , there may be new evidence suggesting that HRT may contribute to a delayed onset of Alzheimer’s disease.
Alzheimer’s primarily affects men and women over the age of 65, and is a degenerative disease that affects the brain tissue, causing dementia. In fact, Alzheimer's is the most common cause for dementia, and may rapidly lead to severe mental decline. Comprehension, memory and speech functions all deteriorate combined with growing difficulty accomplishing simple daily tasks. These symptoms are often accompanied by dramatic mood swings and angry outbursts.
The course of Alzheimer’s may last a few years or up to two decades. Although the disease develops as people grow older, Alzheimer’s is not a natural byproduct of aging. While risk factors ranging from aluminum exposure to head trauma have been blamed for Alzheimer’s, the only conclusive contributors are genetic predisposition (family history) and increasing age.
This small, randomized study, funded in part by the U.S. National Institute on Aging, studied 63 post-menopausal women, 24 of whom carried the APOE-e4 genetic variant, a recognized risk factor for developing Alzheimer’s disease. One copy of APOE-e4 quadruples the risk of contracting Alzheimer’s, while having two copies increases the risk by ten times.
This group of women was then divided into two smaller sections. One section of women was taken off their hormone therapy for the duration of the two-year study, while the others continued their hormone replacement treatment.
Blood samples were drawn at the onset of the study and again after its completion. The blood results were used to examine white blood cell telomere length. The telomere is the protective end section that buffers chromosomes from deterioration. Over time, telomere become shorter, leaving chromosomes more vulnerable. In this study, the carriers of the APOE-e4 variant showed telomere shortening at six times the rates of women who were not carriers. However, in women who maintained their hormone replacement therapy throughout the two years, the telomere length was not significantly shorter after that time, even among APOE-e4 carriers.
It should be noted that this study does not indicate that HRT itself prevents Alzheimer’s, but that women who are taking HRT may be at a reduced risk, due to the enhanced cellular protection granted by HRT. Also, this was not a study specifically to determine Alzheimer’s risks, but rather to more closely examine cellular aging. While the study was very small, the indications are intriguing, and warrant further research.
Benefits of HRT
The idea of using bioidentical hormone replacement therapy is a fairly recent shift in medical treatment for postmenopausal women and women suffering from hormone imbalance. Over time, more clinical studies will be called for and carried out to determine what other kinds of positive impacts may be gained from hormone replacement therapy.
The impact of hormone imbalance is often unpleasant enough to warrant treatment for its own sake, regardless of any secondary benefits. Physical symptoms like hot flashes, reduced libido and vaginal dryness are often relieved under the guidance of a physician experienced with HRT. Emotional symptoms such as mood swings, fatigue and concentration problems also show improvement with hormone replacement treatment.