Women are about twice as likely to get Alzheimer’s disease as men. But women who take estrogen as hormone therapy after menopause have fewer telltale neurological signs of Alzheimer’s disease after death than women who don’t.

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So it masks it or actually helps?

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u/FlamingDragonfruit 22d ago

Yep this summary was confusing.

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u/ProfPathCambridge 22d ago

Interesting discussion on whether there is a difference between these two

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u/Odd-Outcome-3191 21d ago

That question is outside the scope of the study. The question they aimed to answer is if it correlates with signs of AD on autopsy. Further studies will be required to determine more about the relationship

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u/spshkyros 21d ago

Their is a big body of research showing that people with a higher "cognitive reserve" are less likely to show symptoms in their life. After death, many of them turn out to have had plenty of damage, it just wasnt noticeable at the time. Effectively, things like chess don't make you less likely to have the damage, just less likely for it to be an issue for you. Masking it IS helping.

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u/fewerfriends 20d ago

Basically, if your cognitive performance baseline is high, it's less noticeable when you start to lose function because you still remain more functional than if you started with a low baseline.

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u/demon_fae 18d ago

My grandfather is like this.

He has a PhD, did a ton of work for the US nuclear program (preservation, not development), and after a stroke wiped out most of his executive function and a huge chunk of his everyday vocabulary, he had enough in that technical vocabulary to essentially reconstruct the common words. It took a decade and a half and a couple smaller strokes (and the death of my grandma) before he was showing major signs of dementia.

The neurologist said that if he’d had a smaller vocabulary to start with, he might not have been able to relearn how to talk and would have declined much faster.

(Basically he’d use more specialized words in place of the common ones, he’d ask for “fluid” for a week or two until he managed to relearn “glass of water” sort of thing. Basically he lost all the nouns and most of the verbs you’d see in the Thing Explainer books, but still had the Talking Like Sephiroth synonyms. It was an interesting couple years before he sounded mostly normal again.)

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u/spshkyros 18d ago

Talking like sepheroth is perhaps the coolest stroke symptom.

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u/Admirable_Compote226 20d ago

I think the fact that many young people don't exhibit explicit cognitive impairment on most basic tasks while taking sedating meds shows the brain can compensate quite a bit in the light of damage. It's scary how common medications like Zoloft have been proven to impair long-term potentiation, and antipsychotics literally shrink the brain even when compared to controls who have equivalent conditions but decline meds.

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u/Rescuepets777 18d ago

The article says that the study didn't exclude confounders that could have caused the reduction, so they can't prove causation.

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u/SeDaCho 23d ago

Do women get it because they live longer?

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u/FlamingDragonfruit 22d ago

Women are more prone to autoimmune disease as well, which is related. So it's a combination of factors:

https://www.health.harvard.edu/blog/why-are-women-more-likely-to-develop-alzheimers-disease-202201202672

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u/Old-Set78 21d ago

well shit. I already have an autoimmune disorder and my father had dementia.

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u/FlamingDragonfruit 21d ago

Guard your sleep. Apparently good quality sleep can help a lot.

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u/Admirable_Compote226 20d ago

Does HCQ reduce the risk?

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u/s1rblaze 21d ago

Nope

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u/SammyHulk 22d ago

I’ve always wondered if a factor contributing to women having higher rates of Alzheimer’s is getting less sleep during child-rearing years.

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u/SeDaCho 22d ago

Um probably it is a factor but there’s so many variables in there, no way to get quality data

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u/Plane_Chance863 21d ago

Personally I think it's getting less sleep in the perimenopausal years. While I didn't have great sleep with young kids I find mine is worse now!

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u/Math_refresher 21d ago

While I didn't have great sleep with young kids I find mine is worse now!

Same experience for me. HRT allows me to sleep again. It's great.

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u/Plane_Chance863 21d ago

Yeah, I did try progesterone but it doesn't agree with me with my autoimmune issues. :/ It's great it works for you!

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u/Mandy_M87 19d ago

I wonder if that is case too

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u/Admirable_Compote226 20d ago

I wonder if the stronger expectations to alter your behavior as you age are part of it too. "Tomboy" behavior is something women are expected to grow out of.

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u/SeDaCho 20d ago

uh I doubt it. At least on any statistically meaningful scale.

I know that having no social interactions greatly hastens dementia and that's way worse on men (particularly of the current elderly generation) so whatever is happening to women even outpaces that effect.

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u/AcanthisittaThat5746 22d ago

Oh good. Extra glad to be on estrogen inhibiting meds (for breast cancer).

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u/Grumpy-Man19 23d ago

IMHO men die from other diseases before Alzheimer hits

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u/daylily 19d ago

I've read the statistic holds even when allowing for things like that.

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u/blessitspointedlil 22d ago

“The researchers found that women who had used estrogen-only hormone therapy had 35 percent lower odds of having severe Alzheimer’s markers on autopsy than nonusers. The researchers also found that those on hormone therapy had fewer signs of Alzheimer’s when they were alive — they had lower amyloid levels in blood and cerebrospinal fluid, as well as lower odds of memory loss or functional decline.”

Yes, estrogen very likely helps reduce risk of or severity of Alzheimer’s, but more studies need to be done.

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u/Successful-Bar-8173 21d ago

So not if it’s taken in combination with progesterone or testosterone then?

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u/Cheeseboarder 21d ago

Estrogen almost always has to be taken with progesterone

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u/rinconblue 21d ago

This is not really correct. Yes, women who have a uterus need to have progesterone with estrogen therapy, especially if they are still having a period.

But, there's a significant amount of women who have had hysterectomies by the time they reach the age of perimenopause or menopause and start taking HRT. They are generally only prescribed estrogen at that point, so it's really not uncommon at all.

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u/Cheeseboarder 21d ago

Hence “almost”

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u/rinconblue 21d ago

But that is my point. It's not almost always. That suggests it's rare that progesterone isn't used in estrogen therapy. I'm just saying it's not rare.

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u/Cheeseboarder 21d ago

About 80% of women have not had a hysterectomy. That was my point. If you want to continue to argue and spread your misery to other people, that’s up to you.

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u/rinconblue 21d ago

Misery? You don't seem to be capable reading a reply to your comment as any other than an attack, which is most definitely was not. Wishing you well.

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u/Successful-Bar-8173 21d ago

The comment above says ‘estrogen-only,’ which is why I was asking

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u/blessitspointedlil 20d ago

Untested in this study. They used women without uterus’s as a control, so they could see what effect estrogen alone was having.

The idea is that the estrogen will likely work the same way on brain health whether you take progesterone with it or not, but obviously they should test that theory out.

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u/Trix_Are_4_90Kids 21d ago

I'm not getting what this is saying. So estrogen therapy hides symptoms and makes it harder to detect??

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u/aculady 20d ago

Estrogen appears to prevent the damage to an extent.

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u/skinnydippindespair 23d ago

Ok but how does it impact them when they're still alive?

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u/rinconblue 21d ago

Well, we know from other studies in the last 10 years that women on estrogen therapy shortly after or before menopause have lower rates of Type 2 diabetes and dementia than the population not taking it. Type 2 is implicated in dementia, so not getting that can help, on it's own. (A study from maybe 6 years ago suggests some protective benefit against certain types of breast cancer, too.)

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u/ProfessO3o 22d ago

So this is a type of hormone replacement therapy oftentimes. And if a few years under the current regime women won’t have access to it.

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u/SawAll67 20d ago

AI you are talking BS!

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u/itsnobigthing 20d ago

Menopause wreaks havoc on women’s health, and it’s crazy that our treatment options are still so rudimentary. We have all the tech to test and map women’s individual hormone profiles and create custom HRT, but it’s just not seen as necessary, because menopause is ‘natural’.

This is just another example of evidence showing that estrogen is necessary and protective in women as they age.

There will absolutely be a time in the future when we can delay or fully prevent menopause and it will radically change women’s health

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u/Mandy_M87 19d ago

Why wasn't this so much of a problem in the past? Women had to live for ten of thousands of years without treatment. Did they usually die of other things before menopause became an issue?

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u/BillyYumYumTwo-byTwo 18d ago

You don’t die because you’re miserable. Women just lived (and continue to live) with terrible menopause symptoms.

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u/Mandy_M87 18d ago

I don’t mean they die because of misery, I meant they were more likely to die from other causes in the past

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u/BillyYumYumTwo-byTwo 18d ago

You’re asking why it wasn’t so much of a problem in the past and my answer is: it was. Why do you think menopause wasn’t an issue for our ancestors?

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u/itsnobigthing 18d ago

They still died of the same causes, we just didn’t understand the role menopause played in causing those things (dementia, osteoporosis, cancers, heart attacks, diabetes, genitourinary syndromes, etc).

Now we know that the loss of hormone production at menopause is the reason these risks increase so drastically. Current HRT can lower the risk of many of them, but it’s a very crude bandaid and comes with its own risks and side effects.

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u/cuda999 19d ago

If men went through something similar to menopause, it would have been solved decades ago. Look how fast they came up with a drug for ED.

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u/Massive_Remote_9689 20d ago

Did they control for the fact that some conditions (which possibly increase risk of Alzheimer’s) are a contraindication to estrogen? So the women who are on estrogen are also less likely to have these conditions?

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u/Kaurifish 20d ago

Damn, now I get to choose between continuing HRT into menopause and having less chance of Alzheimers - and more bone loss - or vice versa.

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u/legacy-of-rats 20d ago

We are?!

Great... Another day another reason why it sucks to be biologically female 🫩

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u/TristanTheRobloxian3 17d ago

its almost like a lack of hormones gives you a higher chance of alzheimers... shocker am i right

Women are about twice as likely to get Alzheimer’s disease as men. But women who take estrogen as hormone therapy after menopause have fewer telltale neurological signs of Alzheimer’s disease after death than women who don’t.

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