Blood Changes In Menopause Could Predict Dementia Risk Decades Later

For reasons we still don’t fully understand, women get dementia at a higher rate than men. 

Yes, women do live longer, on average – and old age is the number one risk factor for the condition. But experts think this alone isn’t enough to explain the gap. 

Some studies have previously suggested that hormonal changes, especially during menopause and perimenopause, might contribute to this increased risk – though this remains a theory. 

However, a study published in Nature found that brain ageing-related molecules seemed to rise in menopausal women’s blood during this life stage. These have also been noted in older women with a 15% higher risk of developing dementia. 

The study’s co-senior author, Associate Professor Kaitlin Casaletto from the University of California San Francisco (UCSF), clarified that they “don’t think that menopause is directly causing dementia”. 

But she added, “we may be able to predict a woman’s risk for dementia decades later by the levels of these molecules around menopause”.

16 molecules changed throughout menopause

The research involved 80 women, aged between 53 and 58, all of whom were in different stages of menopause. 

The scientists used blood tests which measured more than a hundred molecules linked to brain health to see which, if any, changed during the process. 

One group of molecules linked to the biological development of Alzheimer’s disease seemed to rise as follicle-stimulating hormones (FSH) went up.

FSH levels rise during menopause, and can sometimes stay elevated for years afterwards.

Meanwhile, inflammation markers seemed to shoot up when oestradiol went down. And low oestradiol can also indicate menopause – in fact, oestradiol is often used in hormone replacement therapy (HRT). 

Chronic levels of inflammation have been associated with an accelerated onset of ageing-related diseases. Interestingly, these inflammatory markers were higher among women who reported night sweats, even long after the menopause ended.

Overall, levels of 16 molecules seemed to rise throughout the process.  

After looking at data from more than 12,000 women across four previous studies, the paper’s authors then realised that these 16 markers were all elevated among those in their 60s and 70s who were  15% likelier to go on to develop dementia, and who performed worse on cognitive tests.

This knowledge might lead to better dementia testing 

Right now, we don’t have a single test that can diagnose dementia, though researchers are optimistic about rapidly developing blood tests.

UCSF’s Dr Rowan Saloner, the study’s co-senior author, said: “We’re identifying molecular shifts in blood, in midlife post-menopausal women, that are also predicting cognition later in life... we think these molecules are really important markers of both menopause and cognitive ageing.”

And first author Madeline Wood Alexander, a graduate student from the University of Toronto, added: “Menopause is a normal physiological process that every person who has ovaries [and] lives long enough will go through. We don’t want it to be viewed as a bad thing, but as an opportunity to better understand and maybe modify the biology of brain ageing in women.”

Eventually, they hope to turn these findings into tests which might help spot dementia or its associated red flags earlier. 

Dr Casaletto ended: “Midlife is a critical window for both men and women where we can really set up the brain to be more resilient or more vulnerable to dementia in later life.

“For women, menopause may be this especially powerful time to intervene.”