Women who enter menopause before age 40 are 35% more likely to develop dementia, according to a new report. This finding is of special interest to women with diabetes because diabetes is linked to an increased risk of both premature menopause and dementia. The study, which was conducted by researchers based at Shandong University in Jinan, China, was presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022 in Chicago.
The researchers used statistics from the UK Biobank study, an extensive biomedical database containing genetic and health information on half a million people in the United Kingdom. They retrieved data for 153,291 women who were at an average age of 60 when they began taking part in the Biobank project between 2006 and 2010. The researchers identified women who had been diagnosed with all types of dementia, whether Alzheimer’s disease, vascular dementia (dementia that results from a stroke), and dementia caused by other factors. They adjusted for possible complicating factors, including age, educational level, income, physical activity, race, body-mass index (BMI), smoking, alcohol use, cardiovascular disease, and diabetes. Finally, they determined the age at which the women had entered menopause, whether it was at the average age of 50-51, premature menopause (before age 40), and early menopause (before age 45).
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Premature menopause linked to increased dementia risk
The researchers concluded that, compared to women who experience menopause after age 50, women who begin menopause before the age of 40 (premature menopause) are 35 % more likely to develop some form of dementia in their later years. Women who experience early menopause (before age 45) were 1.3 times more likely to suffer dementia. As for women who experience menopause at the average age of 50-51, they were no more likely to develop menopause than women whose menopause began after age 52. Interestingly, although women are at a greater risk of stroke after menopause then before it, the researchers did not find any relationship between age at menopause and the risk of vascular dementia.
What might lie behind this relationship between early menopause and dementia risk? Because a woman’s estrogen levels decline after she enters menopause, lead author Wenting Hao, MD, speculated that it might have something to do with estrogen levels and oxidative stress (oxidative stress is the result of an imbalance between free radicals and antioxidants in the body and has been implicated in conditions such as chronic inflammation, Alzheimer’s disease, cardiovascular problems, and even diabetes). “We know,” she said, “that the lack of estrogen over the long term enhances oxidative stress, which may increase brain aging and lead to cognitive impairment.”
A great deal of research will have to be done before medical experts advise estrogen therapy for women to prevent dementia. Once it was thought that hormone replacement therapy (HRT) might be kind of a magic bullet for conditions that accompany aging, especially in women, but subsequent research showed that estrogen raised the risk of blood clots and strokes while not lowering the risk of heart attack, and now clinicians are much more hesitant to recommend it. There are, however, other ways to lower the odds of developing dementia. According to Dr. Hao, “Dementia can be prevented, and there are a number of ways women who experience early menopause may be able to reduce their risk of dementia. This includes routine exercise, participation in leisure and educational activities, not smoking and not drinking alcohol, maintaining a healthy weight, getting enough vitamin D, and, if recommended by their physician, possibly taking calcium supplements.”
Want to learn more about maintaining cognitive health with diabetes? Read “Nine Tips to Keep Your Memory With Diabetes,” “Keeping Your Brain Strong With Diabetes” and “Memory Fitness: How to Get It, How to Keep It.”