london according to university of east anglia research hormone replacement therapy hrt may help women who are at risk of acquiring alzheimers dementia to avoid the conditionthe study demonstrates that among women harbouring the apoe4 gene the highest risk factor gene for alzheimers disease hrt use is related to superior memory cognition and greater brain volumes in later lifehormone replacement therapy is associated with improved cognition and larger brain volumes in at risk apoe4 women results from the european prevention of alzheimers disease epad cohort is published in the journal alzheimers research and therapythe research team found that hrt was most effective when introduced early in the menopause journey during perimenopauseimage courtesy dalleprof annemarie minihane from ueas norwich medical school and director of the norwich institute for healthy aging at uea led the study in collaboration with prof craig ritchie at the university of edinburghprof minihane said we know that 25 per cent of women in the uk are carriers of the apoe4 gene and that almost twothirds of alzheimers patients are womenin addition to living longer the reason behind the higher female prevalence is thought to be related to the effects of menopause and the impact of the apoe4 genetic risk factor being greater in womenwe wanted to find out whether hrt could prevent cognitive decline in atrisk apoe4 carriersthe research team studied data from 1178 women participating in the european prevention of alzheimers dementia initiative which was set up to study participants brain health over timeimage courtesy dallethe project spanned 10 countries and tracked participants brains from healthy to a diagnosis of dementia in some participants were included if they were over 50 and dementiafreethe research team studied their results to analyse the impact of hrt on women carrying the apoe4 genotypedr rasha saleh also from ueas norwich medical school said we found that hrt use is associated with better memory and larger brain volumes among atrisk apoe4 gene carriers the associations were particularly evident when hrt was introduced early during the transition to menopause known as perimenopausethis is really important because there have been very limited drug options for alzheimers disease for 20 years and there is an urgent need for new treatmentsthe effects of hrt in this observation study if confirmed in an intervention trial would equate to a brain age that is several years youngerprof anne marie minihane said our research looked at associations with cognition and brain volumes using mri scans we did not look at dementia cases but cognitive performance and lower brain volumes are predictive of future dementia riskprof michael hornberger from ueas norwich medical school said its too early to say for sure that hrt reduces dementia risk in women but our results highlight the potential importance of hrt and personalised medicine in reducing alzheimers riskthe next stage of this research will be to carry out an intervention trial to confirm the impact of starting hrt early on cognition and brain health it will also be important to analyse