Menopause linked to changes in brain ageing and dementia risk

Menopause is associated with a distinct pattern of molecular changes linked to brain ageing and later dementia risk, according to research highlighted by Science.

Researchers identified 16 blood proteins whose levels were higher in postmenopausal women than in premenopausal women.

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The study, published in Nature Medicine, found that the proteins were associated with processes including inflammation, communication between nerve cells, metabolism and biological pathways involved in Alzheimer’s disease.

The researchers initially studied 80 women aged between 43 and 58, who were classified as premenopausal, perimenopausal or postmenopausal. They also included 36 similarly aged men for comparison.

The molecular changes appeared to track hormonal changes more strongly than chronological age, suggesting the differences were associated with the menopause transition rather than simply ageing.

The researchers then tested the findings in a much larger group of 2,814 women and found similar menopause-associated changes.

Further analysis of four independent groups containing nearly 12,000 older women found that stronger menopause-associated protein patterns were linked to poorer cognitive outcomes and higher dementia risk later in life.

The findings add to growing evidence that menopause should not be understood solely as a change involving the reproductive organs.

Oestrogen and other reproductive hormones interact extensively with the brain. Hormonal changes during menopause can affect systems involved in temperature regulation, sleep, memory and mood, helping to explain symptoms including hot flushes, disrupted sleep and brain fog.

However, the results do not show that menopause directly causes dementia.
Dementia risk is influenced by numerous factors, including age, genetics, cardiovascular health, metabolic disease and lifestyle. The protein pattern identified by researchers is instead a potential marker that could help scientists understand why some women may be more vulnerable to cognitive decline later in life.