Rachel Zsido PhD student Department of Neurology  International Max Planck 

Brain Aging in Women Linked to Obesity and Lower Estradiol Levels

MedicalResearch.com Interview with:

Rachel Zsido PhD student Department of Neurology  International Max Planck 

Rachel Zsido

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? 

MedicalResearch.com: What are the main findings? 

Response: Data showed that higher visceral adipose tissue was associated with increased risk for compromised brain network structure in both men and women, but that estradiol was associated with reducing this negative association in women only.

We observed the fastest rate of visceral adipose tissue accumulation in women to be during midlife. After matching these women for VAT and age (35-55 years old), we observed that women with lower estradiol levels had less favorable brain structure patterns as well as weaker cognitive performance. 

MedicalResearch.com: What should readers take away from your report?

Response: This study provides evidence for a deleterious association of visceral adipose tissue with structural brain networks involved in cognitive performance and healthy aging. Estradiol may play a protective role in women, especially during midlife, through maintaining structural gray matter integrity. As midlife is the age range when women typically experience fastest visceral adipose tissue accumulation as well as significant estradiol depletion during perimenopause, these findings highlight the perimenopausal transition as a potential window of opportunity to prevent accelerated brain aging and disease development in women.

MedicalResearch.com: What recommendations do you have for future clinical applications as a result of this work?

Response: These findings encourage future investigation of perimenopause as a potential neurological transition state of interest when studying brain and cognitive aging. These data also emphasize the need for better screening of risk factors during midlife, such as assessment of adipose tissue and hormone profiles during primary care visits, to promote a healthy brain aging trajectory.

No conflicts to disclose.

Citation:

Zsido RG, Heinrich M, Slavich GM, et al. Association of Estradiol and Visceral Fat With Structural Brain Networks and Memory Performance in Adults. JAMA Netw Open. Published online June 21, 20192(6):e196126. doi:10.1001/jamanetworkopen.2019.6126

 

 

Jul 5, 2019 @ 10:45 pm 

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1 Comment
  • JeyWhel
    Posted at 16:37h, 10 July Reply

    Fat tissue, particular central adiposity, does not lower estrogen levels in women, it increases them. High estradiol in older women (and men) is linked to higher stroke risk, vascular dementia, and Alzheimer’s according to the Rotterdam Study. The recent Finnish study on HRT showed higher AD risk in menopausal women on long term oral estradiol, alone or with progestin, for durations of >10 years. As for clinical trials, estrogen therapy was either neutral or harmful for cognitive function – Premarin (conjugated estrogens) increased dementia risk in WHI; Premarin and transdermal estradiol (per KEEPS) decreased brain tissue volume, increased white matter hyperintensities, and caused impaired verbal learning and poorer event recall, respectively per regimen; and oral estradiol did not preserve cognitive function in older or younger menopausal women, per ELITE.

    When considering obesity and HRT, it’s noteworthy that both increase the risk of the very same diseases – heart disease, stroke, dementia, and various cancers. Recommending even MORE estrogen (as a therapy) to obese women only compounds their baseline higher risks of EVERYTHING.

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