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ADVANCE Discourse: Lab

Alzheimer's and Menopause

Published February 15, 2013 4:27 PM by Michael Jones

A story from Medical News Today noted that a variant of the gene ApoE, ApoE4, is carried in 15 to 20 percent of Americans, putting them at increased risk of developing Alzheimer’s disease. In a study from PLOS ONE, lead author Natalie Rasgon, MD, PhD, professor of psychiatry and behavioral sciences at Stanford University’s School of Medicine and director of the Stanford Center for Neuroscience in Women’s Health along with fellow authors, recognized a connection between the gene variant and hormone therapy in menopausal women. As it turns out, hormone therapy allowed menopausal women at an elevated risk of Alzheimer’s disease to deter the effects of biological aging.   

“We know from numerous studies that ApoE4 is a major genetic risk factor for cognitive decline, Alzheimer’s disease and early mortality,” said Emily Jacobs, PhD, first author of the study and postdoctoral fellow at Harvard Medical School in the Medical News today story. “We wanted to see whether an accelerated rate of biological aging explained this risk.”

According to the story, the study examined roughly 70 “relatively well-educated, high-functioning women” between the ages of 45 and 65 as they were divided into two groups, half of which continued hormone therapy while the other half stopped. Fellow co-author, Elizabeth Blackburn, PHD, professor of biochemistry and biophysics at UCSF, won the Nobel Prize in 2009 for work on telomeres -- “intracellular features” that “act as biological clocks.” The telomeres were observed in each of the women as the two-year study continued. By examining the length of the telomeres  -- in this case: the longer, the better  -- the research team was able to discover that “hormone therapy effectively zeroed out ApoE4’s negative influence over time,” while the carriers who had stopped hormone therapy experienced “accelerated biological aging.”

“Our take-home findings from this study were, first, that ApoE4 carriers are at greater risk of biological aging, which is associated with negative health outcomes,” explained Rasgon. “And, second, that if you were a postmenopausal ApoE4 carrier, being on estrogen therapy was a good thing for telomere length, and established measure of biological aging at the cellular level. This brings us a step closer to being able to identify which women will benefit the most from estrogen replacement therapy.”

As research continues, more and more is discovered and understood about our genetic code. The knowledge of potential risk for diseases could be beneficial not only for menopausal woman who could be provided with a more effective form of preventative treatment for Alzheimer’s disease, but also for people at risk for any number of diseases  -- essentially allowing time for the necessary life style changes that could aid in prevention. 

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