The baffling thing about this new, yet inconclusive, Alzheimer's study
to some scientists is how this observed benefit could possibly be real,
since this is a drug that blocks the "brain protective" hormones
estrogen and testosterone. However, if researchers are truly following
all of the current, available evidence surrounding hormones' effects on
cognition, this study should NOT be a surprise! In fact, a lot of valid
scientific evidence points to the contrary, that excessively high levels
of reproductive hormones throughout life may be bad for the brain.
The most conclusive data to date, at least in women, comes from (yet
again) the WHI (Women's Health Initiative) which surprised everyone when
the trials found stroke and memory risks (including dementia) for women
on estrogen or estrogen/progestin. While this study may have been a
shock, there were other observational data out years before this study
that spelled trouble. The Rotterdam study, for example, evaluated the
natural estradiol levels of older women to see if there was any
association with cognition. Surprisingly, the women with the highest
levels had a doubled incidence of vascular dementia and a slightly
greater risk of Alzheimer's.
In April 2000, another study conducted by Terry Manolio of the National
Heart Lung and Blood Institute, looked at the MRIs of the brains of 2000
women, half of whom were taking estrogen. Again, the estrogen users'
brain scans showed slightly more decay than the non-users. Dr. Manolio
herself didn't know what to make of this and worried that this would
scare women off of their hormone replacement since it was basically a
given that the therapy was beneficial! Also, a laboratory study out of
Emory that went virtually unnoticed involved sophisticated cognitive
tests of older female cynamalgous monkeys who either retained their
ovaries or had them removed at a young age.
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This study, according to the scientists, actually found a PROTECTIVE
effect of ovary removal on spatial-visual memory in the older monkeys.
And lastly, a small study out from Urbana-Illinois, reported this
Janurary, showed that high levels of fitness counteracted the cognitive
decline associated with longterm HRT use. Again using brain MRIs of 54
women, this study found that those who used HRT for 10+ years had
decreases in the 4 different areas of gray matter in the brain, but that
exercise lessened these decreases. While only the WHI is truly
definitive out of all these studies, it seems clear that hormones do not
have any preservative effects on thinking and cognitive abilities.
Based on this data, hormonal decline with age should no longer be viewed
as a bad thing, but rather a natural protective mechanism. Secondly,
attempting to replace hormones is fraught with multiple hazards. Third,
the healthiest lifestyles are those which actually lessen the effects of
reproductive hormones on the body's organ systems. Obesity, which is a
risk factor for heart disease, colon and reproductive cancers, and
probably dementia, is a condition involving excessive estrogens and
androgens.
Exercise and a diet than keeps weight down have long been known to be
beneficial, although the precise mechanisms haven't been clearly
pinpointed. Hypothetically, it may be a hormone lowering effect. Taking
all of this into account, it seems that scientists should have enough
basis to be pooling their efforts into exploring the effects of hormonal
manipulation as a way to prevent/treat Alzheimer's, stroke, and other
serious brain degenerating diseases.
A word of caution in all this - to espouse the widespread, longterm use
of drugs that BLOCK hormones (be it Lupron or whatever else comes along)
is just as bad an idea as HRT was!! Both are clearly disrespectful
toward the natural intricacies of human biology. Instead, a more
accurate interpretation (at least in terms of this latest Alzheimer's
research) is that both menopause in women and the natural age related
androgen decline in men do not trigger the aging process but are instead
inherent natural processes that PROTECT us from diseases. And
Alzheimer's, perhaps the scariest of all, might just be one of them. We
now know that hormones don't need replacing. And we also have good
reason, at least from a hormonal standpoint, to be espousing widespread
modalities aimed to lessen the overweight epidemic in this country,
considering all of the various other diseases associated with it.
Conclusive answers are not yet in, but the puzzle is certainly coming
together.
Jonathan Raymond
Correspondent
Books on the Mind
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