Know the facts about menopause and memory.

By 2050, 13.8 million people in the United States will likely have Alzheimer's disease, with women accounting for two-thirds of those affected. Economic costs are enormous since they are expected to exceed $2 trillion. Women are at the core of this because the economic threat is particularly grave for women, who are an increasingly significant component of our global economy and account for the great majority of unpaid caretakers. Thus, keeping intact memory beginning in early middle age and continuing through menopause is crucial not only for women, but also for their families, society, and economic health.

Preventing memory loss begins in early middle age.

Cognitive decline is not restricted to neurodegenerative disorders such as Alzheimer's disease (AD) but also occurs naturally as we age, affecting our quality of life. The majority of research on aging and cognitive decline, particularly on Alzheimer's disease, begins in adults in their 70s. However, knowing the events that occur early in life and their effect on age-related brain alterations is crucial for designing prevention strategies for one of the most serious public health problems of our generation.

How does menopause affect women's brains?

Along with chronological aging, women experience reproductive aging in early middle age: menopause, during which ovarian hormones such as estradiol, the predominant form of estrogen that functions in the brain, are depleted over time. Our study team and others have established a direct link between estradiol and alterations in-memory performance and rearrangement of the circuitry in our brain that regulates memory function. Thus, women and men age differently, particularly during early midlife, when reproductive aging is more essential than chronological aging for women. However, cognitive aging is rarely regarded as a problem specific to women's health. This is critical because recognizing that brain aging begins in early middle age and comprehending the influence of menopause on the brain enables the creation of methods to protect women from losing their memory.

Can hormone replacement therapy be beneficial?

Timing is critical, as research demonstrates. Hormone replacement therapy (HR) initiated during perimenopause (approximately four to eight years before menopause) or early menopause may have beneficial benefits on brain activity and memory function, although no systematic HR trials have been undertaken during perimenopause. HR initiation in late menopause may have detrimental effects on the brain and raise the likelihood of developing diseases such as Alzheimer's disease. There is an urgent need for research to determine the most effective timing of administration, hormonal formula, dose, route of administration (oral or by skin patch), and duration.

Additionally, much of the study on human resources have been focused on healthy women, and less is known about its effect on women who have chronic conditions such as diabetes or hypertension. Finally, there may be changes in reactions among women who are genetically predisposed to develop brain illnesses such as AD, indicating an enhanced advantage from HR use. One size does not fit all, and precision medicine is required to determine which women will benefit the most. One example is women who have had their ovaries bilaterally removed, particularly at a young age, and for whom HR has been shown to be quite advantageous for brain function. In certain women, HR may be ineffective, and alternate methods, such as targeting glucose levels and other effects linked with estradiol regulation of the brain, may need to be explored.

What can women do to ensure the health of their brains?

Maintaining intact memory requires three fundamental pillars: strenuous physical exercise, strenuous cognitive activity, and social engagement. The first two of them have been shown to have a direct beneficial effect on the brain, even at the cellular level. Social contact is another way for external stimuli, unique experiences, and perspectives from outside of ourselves to keep our brains busy. Additionally, dietary habits (such as the Mediterranean diet or the use of omega-3 fatty acids found in fish oil) have been shown to improve memory performance. The good news is that these are adjustable lifestyle choices, which may be especially critical for women with hypertension or diabetes who are predisposed to cognitive impairment.

Finally, enough sleep (seven hours per night is generally recommended) is crucial for brain function. Sleep has been found to consolidate learning during specific periods of sleep; that is, sleep is critical for storing and keeping what we learn throughout the day, and even for ridding the brain of amyloid, one of the hallmarks of possible AD pathology. Additional research is necessary to completely comprehend the favorable effects of these modifiable lifestyle variables. However, the moment has come to begin implementing them into your daily life.