Dementia Risk in Middle-aged Women Who Have Surgically Had Their Ovaries and Fallopian Tubes Removed Prior to Menopause
by Dr. Nicole J. Gervais, Dr. Gillian Einstein et el:
More evidence that one of the reasons why more women than men might have Alzheimer's disease is because of early life endocrine changes. Oophorectomy prior to menopause is associated with elevated dementia risk and accelerated cognitive decline. This cognitive decline may start within six months after oophorectomy in middle-aged women, suggested by lower verbal and working memory performance.
Unknown is whether such changes persist beyond 6 months, and whether they are reversed by estradiol-based hormone therapy (E2). Short-term benefits of E2 on verbal memory following oophorectomy were observed in one study, but longer-term effects remain unknown.
In the present study, middle-aged BRCA1/2 mutation carriers with early oophorectomy at least one year prior to study onset were tested on verbal and working memory with results stratified by 1) current E2 use (n=22) or 2) no history of E2 use (n=24), and compared to age-matched premenopausal controls (n=25). Both forms of memory were adversely affected by oophorectomy, but only working memory was maintained by E2 use.
Estrogen metabolite levels correlated with working memory, suggesting a role for E2 in preserving this ability. Memory decline appears to persist after early oophorectomy, particularly for women who do not take E2