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One of the factors associated with the risk of dementia in women is hormones. Now, a study published in PloS Medicine shows that certain reproductive times, such as early or late onset of menstruation, early menopause and hysterectomy, are associated with an increased risk of dementia.
However, or having children was not one of them, since the relationship was similar between the number of children and the risk of dementia in men and women. Now, if you’ve ever been pregnant or had a miscarriage and late menopause, your risk of dementia is higher.
The lead author, Jessica Gongfrom the George Institute for Global Health, notes that although it appeared that reproductive events related to changes in hormone levels in women might be involved in dementia risk, the exact relationship was still unknown.
“While the risk of developing dementia increases with age, we still don’t know if the higher rates seen in women are simply due to living longer,” explains Gong. “But it’s possible that female-specific reproductive factors may explain some of the sex differences.”
Dementia is rapidly becoming a global epidemic, currently affecting about 50 million people worldwide. This is projected to triple by 2050, mainly driven by an aging population. Rates of dementia and associated deaths are known to be higher in women than in men.
Estradiol is the most predominant form of estrogen during reproductive life (from the beginning of menstruation to menopause), and estriol is the main estrogen during pregnancy.
The use of hormones that originate outside the body, such as oral contraceptives during the reproductive years, and hormone replacement therapy (HRT) in old age, can also influence estrogen levels.
To examine these relationships in more detail, George Institute researchers analyzed data from a total of 273,240 women without dementia who were registered with the UK Biobank, a large-scale biomedical database. After adjusting for other factors that might have influenced the results, they found that some of them were associated with an increased risk of dementia.
First of all, the first early or late menstruationfirst birth at a younger age, and hysterectomy, specifically hysterectomy without surgical removal of one or both ovaries, or if the hysterectomy was performed after removal of the ovaries.
In contrast, factors associated with a decreased risk were ever having been pregnant, ever having an abortion, longer reproductive life, and late menopause.
“With regard to external hormones, the use of oral contraceptive pills was associated with a lower risk of dementia, but the findings of our study did not support an association between HRT and the risk of dementia,” says Gong.
The authors proposed that the variation in risk in women may not be associated with childbearing because a similar pattern was observed between the number of children fathered and the risk of dementia among a similar number of men in the same study.
“We found that the increased risk of dementia related to early menopause (natural and artificial) was more pronounced in women of lower socioeconomic status,” he added.
Lack of social interaction is likely to be an important determinant of dementia risk, as well as other aspects of women’s health.”
With dementia on the rise and in the absence of significant advances in treatment, attention has focused on reducing the risk of developing the disease.
“Our findings may be useful in identifying high-risk women for future clinical trials to evaluate possible preventive measures and new treatments.”
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