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HRT soon after menopause may cut dementia risk

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The risk of dementia in women may be reduced if they are given hormone replacement therapy (HRT) soon after the menopause.

Treatment with HRT prevented degeneration in key regions of the brain in women at heightened risk of dementia, according to a small study published in the journal PLOS One.

Women were defined as being at a heightened risk of dementia if they had a history of major depression, had a first-degree relative with the condition or carried the Apo4 allele gene.

Apo4 is a gene variant known to significantly increase a person’s risk of developing Alzheimer’s disease.

“This particular study indicates that the use of HRT, especially estradiol, may protect area of the brain associated with dementia in women”

Doug Brown

The research was led by Natalie Rasgon from Stanford University School of Medicine. There were 45 post-menopausal women who remained in the study, 28 of whom continued with HRT while 17 stopped using it.

Brain images were taken at the beginning of the study and two years later. The scans indicated that metabolic activity in the medial prefrontal cortex − essential to decision making − was better preserved among the women who remained on HRT.

There were two HRT drugs taken by women in the study and the researchers discovered that pure estradiol and Premarin − a brand name part made up of estradiol − were associated with the biggest effect in preserving metabolic activity.

Dr Doug Brown, director of research and development at the Alzheimer’s Society, said several previous studies have generated “mixed” results but this latest research “indicates that the use of HRT, especially estradiol, may protect area of the brain associated with dementia in women”.

He continued: “It’s important to note, however, that the study size was very small and no one in the study experienced cognitive decline despite being at risk, making it hard to draw any solid conclusions about how it would affect their risk of developing dementia.”

On the basis of this study the charity said it would not recommend women take HRT with the aim of reducing their dementia risk but “it would be interesting to see more research in this area”.

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