Often, patients send articles to get my viewpoint. I recently received an article written for NPR, Hormone Levels Likely Influence a Woman’s Risk of Alzheimer’s, But How?
This is a typical case of researchers conducting statistical studies without looking at the already known science behind the numbers. The article was also trying to reduce a complex issue into a simple one.
Some of the main points from the article:
Women that started menstruation at an early age were less likely to develop dementia. This actually surprised me. The age at the first period is influenced by body fat — heavier girls tend to begin their periods earlier. If a woman continues to stay overweight throughout her life (which is associated with higher insulin levels), she is more likely to get dementia.
Women that experienced late menopause were less likely to develop dementia. It is my experience that healthier, trimmer women who regularly exercise, tend to go through menopause later (some as late as their mid-50’s). These women, not surprisingly, should have less arteriosclerosis in the arteries inside their brains, and less dementia.
Women who gave birth to more than one child were less likely to develop dementia. Having more children requires fertility. Higher carbohydrate consumption raises insulin levels, which actually increases arteriosclerosis and also interferes with ovulation, as in Poly Cystic Ovary Syndrome. Less healthy women tend to have fewer children.
The article lumped together different influences. Different situations can result in a woman having higher estrogen levels. Some situations can make Alzheimer's less likely while others make it more likely.
They also discuss that hormone replacement fell out of favor about a decade ago. Although they don’t refer to it specifically, they are talking about the Women’s Health Initiative Study, (see my article about the WHI study). In the WHI, most of the women were over 60 years old at the start of therapy and they were given a high dose of estrogen, by mouth. Lower doses of estrogen, given through the skin using creams, gels and patches do not cause blood clotting and do not raise the rates of heart attack or stroke.
In the WHI study, only Provera was used (which is not real progesterone; it's medroxyprogesterone acetate). Only the Provera users experienced higher rates of breast cancer, not the estrogen only group.
Menopause at age 45 or younger seemed to increase the risk of dementia by 28%. My question: Did these women receive any hormone replacement, and if so, what kind? Often, early menopause is triggered by surgical removal of the ovaries. The problem that caused the removal of the ovaries might also be a problem that causes dementia. For women under 45 whose periods ended spontaneously, it is usually attributed to an autoimmune disease. This may influence the onset of Alzheimer’s as well.
In summary: Simply looking at statistical relationships is interesting but does not provide much value for the individual. These are complex problems. One really has to unravel what is the cause and what is effect. Number crunching large groups of people does not explain which individual unique conditions lead to which specific problems.
This is a typical case of researchers conducting statistical studies without looking at the already known science behind the numbers. The article was also trying to reduce a complex issue into a simple one.
Some of the main points from the article:
Women that started menstruation at an early age were less likely to develop dementia. This actually surprised me. The age at the first period is influenced by body fat — heavier girls tend to begin their periods earlier. If a woman continues to stay overweight throughout her life (which is associated with higher insulin levels), she is more likely to get dementia.
Women that experienced late menopause were less likely to develop dementia. It is my experience that healthier, trimmer women who regularly exercise, tend to go through menopause later (some as late as their mid-50’s). These women, not surprisingly, should have less arteriosclerosis in the arteries inside their brains, and less dementia.
Women who gave birth to more than one child were less likely to develop dementia. Having more children requires fertility. Higher carbohydrate consumption raises insulin levels, which actually increases arteriosclerosis and also interferes with ovulation, as in Poly Cystic Ovary Syndrome. Less healthy women tend to have fewer children.
The article lumped together different influences. Different situations can result in a woman having higher estrogen levels. Some situations can make Alzheimer's less likely while others make it more likely.
They also discuss that hormone replacement fell out of favor about a decade ago. Although they don’t refer to it specifically, they are talking about the Women’s Health Initiative Study, (see my article about the WHI study). In the WHI, most of the women were over 60 years old at the start of therapy and they were given a high dose of estrogen, by mouth. Lower doses of estrogen, given through the skin using creams, gels and patches do not cause blood clotting and do not raise the rates of heart attack or stroke.
In the WHI study, only Provera was used (which is not real progesterone; it's medroxyprogesterone acetate). Only the Provera users experienced higher rates of breast cancer, not the estrogen only group.
Menopause at age 45 or younger seemed to increase the risk of dementia by 28%. My question: Did these women receive any hormone replacement, and if so, what kind? Often, early menopause is triggered by surgical removal of the ovaries. The problem that caused the removal of the ovaries might also be a problem that causes dementia. For women under 45 whose periods ended spontaneously, it is usually attributed to an autoimmune disease. This may influence the onset of Alzheimer’s as well.
In summary: Simply looking at statistical relationships is interesting but does not provide much value for the individual. These are complex problems. One really has to unravel what is the cause and what is effect. Number crunching large groups of people does not explain which individual unique conditions lead to which specific problems.
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