Getting a Late Start

Women who start menstruating later, who experience menopause sooner or who have a hysterectomy could have a more significant risk of developing dementia, according to research recently published in Neurology, the medical journal of the American Academy of Neurology.

The study, performed by the Kaiser Permanente Division of Research in Oakland, Calif., found a link between reduced reproductive years and a greater chance of dementia.

The researchers believe that the connection is caused by reduced exposure to high levels of estrogen.

Does this connection really matter in the long run?

Yes, says Dr. Mona Alqulali, a Bettendorf, Iowa, OB-GYN.

"Women have a 50 percent more likely chance of developing dementia and Alzheimer's disease than men, so understanding why that risk exists can help develop preventatives and treatments," Alqulali said.

During the KP study, researchers surveyed 6,137 women who were members of Kaiser Permanente Northern California health care network. These participants completed health surveys and underwent medical exams.

The surveys included questions about when the women had their first menstrual cycle, when they began menopause and whether or not they had a hysterectomy.

After collecting the responses, the researchers calculated the number of reproductive years for each woman.

On average, the age of the first period among the participants was 13, and the average age of menopause among the group was 45.

This gave the researchers an average of 32 reproductive years.

Of the participants, 34 percent reported having a hysterectomy, the surgical removal of the uterus.

Among the participants who did not have a hysterectomy, the average age of menopause was 47. These women had 34 reproductive years.

In addition to calculating reproductive years, the researchers also looked at the medical records of each participant to see who had been diagnosed with dementia later in life and found that 42 percent of the women had been diagnosed with dementia.

The researchers found that those women who started menstruation at age 16 or older had a nearly 25 percent greater risk of developing dementia than women who began menstruating before age 13.

Of the women who started their period at age 13 or younger, 511 out of 1,188 women developed dementia.

Women who experience natural menopause before the age of 47 had an almost 20 percent higher risk of developing dementia than women who began menopause at age 47 or older.

The researchers found that those women who had fewer than 34 reproductive years had a 20 percent greater chance of developing dementia than participants who had more than 34 years.

The researchers also noted that women who had hysterectomies also faced a higher risk of developing dementia than women who did not have the surgery.

Beyond menstruation age, menopause age and factoring for hysterectomies, the researchers took into consideration other risk factors that could increase the risk of developing dementia. These risk factors include things like smoking, diabetes and high blood pressure.

The study did not examine the impact of other things that can impact estrogen levels. These things include pregnancy, hormonal birth control and hormone replacement therapy.

Why Does Estrogen Matter?

How does estrogen factor into dementia? Some researchers believe that estrogen can help to prevent the buildup of amyloid beta and tau protein plaques in the brain. These two proteins have been linked to the development of dementia and Alzheimer's disease.

Source: American Academy of Neurology. "Fewer reproductive years in women linked to an increased risk of dementia." ScienceDaily. ScienceDaily, 27 March 2019.

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