What To Know About Early Menopause and the Risk of Dementia

People who enter menopause early—before the age of 45—may be at a higher risk for having dementia later in life. This link was based on a study published in March 2022.

"Being aware of this increased risk can help women practice strategies to prevent dementia and to work with their physicians to closely monitor their cognitive status as they age," Wenting Hao, MD, study author and PhD candidate, said in the American Heart Association press release.

Here's what to know about the link between early menopause and dementia, along with other risk factors linked to cognitive decline.

The Impact of Early Menopause on Dementia Risk

Alzheimer's disease affects women a lot: They are two times more likely than men to develop the condition.

The research gave a few clues why the disease affects some groups differently—specifically linked to early menopause and the hormonal changes that go along with it. For the study, researchers at Shandong University in Jinan, China, analyzed health data from UK Biobank, a large biomedical database.

The data came from more than 150,000 women, aged 60 years old on average, between 2006 and 2010. Researchers looked at dementia diagnoses among women who entered menopause early or between 50 and 51 years old.

Women in the study who experienced very early or premature menopause (menopause before the age of 40) had a 35% higher risk of any type of late-life dementia than women who entered menopause around their early 50s. The dementia types included Alzheimer's disease, vascular dementia, or dementia of other causes.

Women who entered menopause at age 45 or earlier were 1.3 times more likely to have dementia before age 65, or early-onset dementia. The results held true even after they were adjusted for other factors, including:

• Race
• Cigarette and alcohol use
• Body mass index
• Underlying diseases
  

The researchers did not confirm a cause for the potential link between early menopause and increased risk of dementia, but they noted that estrogen levels may be the culprit. "We know that the lack of estrogen over the long term enhances oxidative stress, which may increase brain aging and lead to cognitive impairment," shared Dr. Hao in the press release.

The link may also be because of where hormone receptors are found in the body. "Hormone receptors, specifically for estrogen, are present in the brain," Alyssa Dweck, MD, a practicing gynecologist in Westchester County, N.Y., and chief medical officer of Bonafide, told Health.

With that in mind, the connection between hormones and cognition makes sense. "It seems reasonable that sudden or gradual decline in estrogen levels, due to menopause and regardless of age, might influence cognition," added Dr. Dweck, who was not involved in the research.

The research had its limitations—primarily that it was self-reported and limited to mainly White women in the UK. Therefore, it couldn't necessarily be generalized to a more diverse population, study authors said.

"It also did not analyze women who underwent early menopause due to surgical intervention for a variety of reasons and whether this was also associated with [early] onset dementia," Gabriel Zada, MD, professor of neurological surgery and director of the USC Brain Tumor Center, who was not involved in the study, told Health.

Regardless, the research still aligned with previous findings. "This study adds to our knowledge about the potential link between reproduction history and brain health," Heather Snyder, PhD, vice president of medical and scientific relations at the Alzheimer's Association, told Health.

Snyder cited another study presented at the 2018 Alzheimer's Association International Conference. The study also found that people who experienced early menopause at 45 or earlier had a heightened risk of dementia.

"The physical and hormonal changes that occur during menopause—as well as other hormonal changes throughout life—are considerable," said Snyder. "And it's important to understand what impact, if any, these changes may have on the brain."

Other Known Risk Factors for Dementia

There are currently no known effective ways to treat or prevent Alzheimer's disease or related types of dementia—but there are ways to help reduce your overall risk of developing the disease.

Knowing the risk factors you can't change is a good start. Age—the greatest known risk factor for Alzheimer's disease and related dementias—and genes are two things that can greatly affect a person's likelihood of developing cognitive issues.

Race and gender also influence a person's risk of dementia. Rates of dementia are higher in African American, American Indian, and Alaska Native populations and in women.

Past those uncontrollable risk factors, certain lifestyle practices can increase your general health overall—and possibly offer some protection against disease. "Recommended practices to help prevent dementia include focusing on overall well-being," said Dr. Zada. Some suggestions include actions such as:

• Controlling high blood pressure
• Managing blood sugar
• Staying mentally and physically active
• Preventing head injuries
• Lessening (or stopping) alcohol and tobacco use

Though it's not currently considered a risk factor or predictor for future dementia diagnoses, study authors said the research showed healthcare professionals should at least be aware of the effect early menopause may have on dementia risk. Additionally, people who experience early menopause should potentially be monitored for cognitive decline.

Still, the study is not the end-all-be-all for research on the link. "Further research is needed to assess the added value of including the timing of menopause as a predictor in existing dementia models," said Dr. Hao in the press release. "This may provide clinicians with a more accurate way to assess a woman's risk for dementia."

A Quick Review

Research has shown that going through early menopause can raise the risk of dementia for an individual. This link is potentially due to a decline in estrogen levels and how that decline affects brain functioning. Other factors that may increase the risk of developing dementia include factors that you can change (e.g., how active you are) and cannot change (e.g., age).