Timing of menopause and hormone therapy may influence dementia risk in women

Two new studies suggest that the age at which menopause begins and the timing of hormone replacement therapy could affect women's risk of cognitive decline. An analysis of over 180,000 postmenopausal women in the U.K. found that those using hormone therapy had a 10% lower risk of dementia and 16% lower risk of Alzheimer's, with even greater benefits for surgical menopause and earlier treatment. Researchers caution that the findings are not conclusive and further investigation is required.

The Alzheimer's & Dementia study tracked over 180,000 postmenopausal women in the U.K. for 13 years, finding hormone therapy users showed a 10% lower risk of all dementia types and 16% lower risk of Alzheimer's specifically. Benefits were strongest among women with surgical menopause, who saw a 26% risk reduction, and among those who began treatment between ages 46 and 56. The JAMA Network Open study similarly linked earlier menopause onset to greater cognitive decline risk and faster accumulation of white matter hyperintensity, a brain damage marker. Notably, this tissue damage effect appeared more pronounced in women with spontaneous rather than surgical menopause. Both research teams emphasize these findings are correlational, not causal, and require further investigation before clinical recommendations can change.