05 Jul Brain Aging in Women Linked to Obesity and Lower Estradiol Levels
Posted at 22:44h
in Aging, Author Interviews, Cognitive Issues, Gender Differences, Hormone Therapy, JAMA, Menopause, Weight Research
MedicalResearch.com Interview with:
[caption id="attachment_50128" align="alignleft" width="144"]
Rachel Zsido[/caption]
Rachel Zsido
PhD student
Department of Neurology
International Max Planck
MedicalResearch.com: What is the background for this study?
Response: We integrated measures of brain network structure, visceral adipose tissue (VAT), serum estradiol levels, and cognitive performance from 974 participants in order to shed light on potential mechanisms underlying cognitive health. We believe it is imperative to assess sex-specific risk trajectories in brain aging and cognitive decline, especially given the known sex differences in both VAT accumulation patterns and estradiol fluctuations across the lifespan.
Thus, we aimed to answer three questions in men and in women:
1) Does visceral adipose tissue exacerbate the association between age and brain network structure,
2) Does estradiol mitigate the negative association between VAT and brain network structure, and
3) What does this imply for healthy cognitive aging in men and women?

Dr. Mikkola[/caption]
Tomi Mikkola MD
Associate Professor
Helsinki University Hospital
Department of Obstetrics and Gynecology
Helsinki, Finland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In Finland we have perhaps the most comprehensive and reliable medical registers in the world. Thus, with my research group I have conducted various large studies evaluating association of postmenopausal hormone therapy use and various major diseases (see e.g. the references in the B;MJ paper). There has been various smaller studies indicating that hormone therapy might be protective for all kinds of dementias, also Alzheimer’s disease.
However, we have quite recently shown that hormone therapy seems to lower the mortality risk of vascular dementia but not Alzheimer’s disease (Mikkola TS et al. J Clin Endocrinol Metab 2017;102:870-7). Now in this upcoming BMJ-paper we report in a very large case-control study (83 688 women with Alzheimer’s disease and same number of control women without the disease) that systemic hormone therapy was associated with a 9-17% increased risk of Alzheimer’s disease.
Furthermore, this risk increase is particularly in women using hormone therapy long, for more than 10 years. This was somewhat surprising finding, but it underlines the fact that mechanisms behind Alzheimer’s disease are likely quite different than in vascular dementia, where the risk factors are similar as in cardiovascular disease. We have also shown how hormone therapy protects against cardiovascular disease, particularly in women who initiate hormone therapy soon after menopause.



