{"id":9825,"date":"2023-01-09T07:49:00","date_gmt":"2023-01-09T06:49:00","guid":{"rendered":"https:\/\/alzheimer.noemiconcept.com\/?p=9825"},"modified":"2024-06-04T10:32:59","modified_gmt":"2024-06-04T09:32:59","slug":"hormone-replacement-therapy-is-associated-with-improvedcognition-and-larger-brain-volumes-in-at-risk-apoe4-womenresults-from-the-european-prevention-of-alzheimers-diseaseepad-cohort","status":"publish","type":"post","link":"https:\/\/ep-ad.org\/index.php\/2023\/01\/09\/hormone-replacement-therapy-is-associated-with-improvedcognition-and-larger-brain-volumes-in-at-risk-apoe4-womenresults-from-the-european-prevention-of-alzheimers-diseaseepad-cohort\/","title":{"rendered":"Alzheimer&#8217;s Research Therapy"},"content":{"rendered":"\n<p><strong>&#8220;Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women: results from the European Prevention of Alzheimer\u2019s Disease (EPAD) cohort&#8221;<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"450\" height=\"200\" src=\"https:\/\/ep-ad.org\/wp-content\/uploads\/2015\/05\/Logo-EPAD-e1442819956731-1.png\" alt=\"\" class=\"wp-image-9683\" srcset=\"https:\/\/ep-ad.org\/wp-content\/uploads\/2015\/05\/Logo-EPAD-e1442819956731-1.png 450w, https:\/\/ep-ad.org\/wp-content\/uploads\/2015\/05\/Logo-EPAD-e1442819956731-1-300x133.png 300w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/figure>\n\n\n\n<p><strong>Authors:<\/strong> Rasha N. M. Saleh, Michael Hornberger, Craig W. Ritchie and Anne Marie Minihan<\/p>\n\n\n\n<p><strong>Abstract:<\/strong><\/p>\n\n\n\n<p>Background: The risk of dementia is higher in women than men. The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women. The use of hormone replacement therapy (HRT) in the prevention of cognitive decline has shown conflicting results. Here we investigate the modulating role of <em>APOE<\/em> genotype and age at HRT initiation on the heterogeneity in cognitive response to HRT.<\/p>\n\n\n\n<p>Methods: The analysis used baseline data from participants in the European Prevention of Alzheimer\u2019s Dementia (EPAD) cohort (total <em>n<\/em>= 1906, women= 1178, 61.8%). Analysis of covariate (ANCOVA) models were employed to test the independent and interactive impact of <em>APOE<\/em> genotype and HRT on select cognitive tests, such as MMSE, RBANS, dot counting, Four Mountain Test (FMT), and the supermarket trolley test (SMT), together with volumes of the medial temporal lobe (MTL) regions by MRI. Multiple linear regression models were used to examine the impact of age of HRT initiation according to <em>APOE4<\/em> carrier status on these cognitive and MRI outcomes.<\/p>\n\n\n\n<p>Results: <em>APOE4<\/em> HRT users had the highest RBANS delayed memory index score (P-<em>APOE<\/em>*HRT interaction = 0.009) compared to <em>APOE4<\/em> non-users and to non-<em>APOE4<\/em> carriers, with 6\u201310% larger entorhinal (left) and amygdala (right and left) volumes (<em>P<\/em>-interaction= 0.002, 0.003, and 0.005 respectively). Earlier introduction of HRT was associated with larger right (standardized <em>\u03b2<\/em>= \u22120.555, <em>p<\/em>=0.035) and left hippocampal volumes (standardized <em>\u03b2<\/em>= \u22120.577, <em>p<\/em>=0.028) only in <em>APOE4<\/em> carriers.<\/p>\n\n\n\n<p>Conclusion: HRT introduction is associated with improved delayed memory and larger entorhinal and amygdala volumes in <em>APOE4<\/em> carriers only. This may represent an effective targeted strategy to mitigate the higher life-time risk of AD in this large at-risk population subgroup. Confirmation of findings in a fit for purpose RCT with prospective recruitment based on <em>APOE<\/em> genotype is needed to establish causality.<\/p>\n\n\n\n<p><strong>DOI:<\/strong> <a href=\"https:\/\/doi.org\/10.1186\/s13195-022-01121-5\" target=\"_blank\" rel=\"noreferrer noopener\">10.1186\/s13195-022-01121-5<\/a><\/p>\n\n\n\n<p>Published online:\u00a09 January 2023 in the Journal Alzheimer&#8217;s Research Therapy<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women: results from the European Prevention of Alzheimer\u2019s Disease (EPAD) cohort&#8221; Authors: Rasha N. M. Saleh, Michael Hornberger, Craig W. Ritchie and Anne Marie Minihan Abstract: Background: The risk of dementia is higher in women than men. The metabolic consequences [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-9825","post","type-post","status-publish","format-standard","hentry","category-publications"],"_links":{"self":[{"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/posts\/9825","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/comments?post=9825"}],"version-history":[{"count":3,"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/posts\/9825\/revisions"}],"predecessor-version":[{"id":10284,"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/posts\/9825\/revisions\/10284"}],"wp:attachment":[{"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/media?parent=9825"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/categories?post=9825"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ep-ad.org\/index.php\/wp-json\/wp\/v2\/tags?post=9825"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}