Menopause Hot Flashes May Indicate Higher Risk of Alzheimer’s Disease

A woman drinking water.
New research suggests that menopause hot flashes may also be a sign of increased Alzheimer’s risk. Muratdeniz/Getty Images
  • Hot flashes are a common symptom of menopausal people.
  • New research suggests the uncomfortable symptoms may also be an early indicator of Alzheimer’s disease. 
  • However, the research doesn’t show that hot flashes are causing this form of dementia

Hot flashes are an uncomfortable but potential sign that a person may be in perimenopause, which is the menopausal transition, or has reached menopause, which occurs after they haven’t had a period for one year.

New research suggests hot flashes may also be an early indicator of something else: Alzheimer’s disease.

The authors presented the results this week at the 2023 Annual Meeting of The Menopause Society in Philadelphia.

The new study builds on previous research on hot flashes and brain health, including one published online in 2022 that indicated that people who experience them have more of a brain biomarker known as white matter hyperintensities that have been linked to an increased risk of Alzheimer’s Disease and cognitive decline.   

“Hot flashes, particularly those occurring during sleep, have been linked to poorer cognition and, in our prior work, indicators of poorer brain health,” said Rebecca Thurston, PhD, the director of Women’s Biobehavioral Health at the University of Pittsburgh Department of Psychiatry, who also co-authored the 2022 research.

“In this study, we took the next step and looked at the relationships between hot flashes and Alzheimer’s disease biomarkers,” she added.

Thurston believes building on research is important, especially given that more than two-thirds of people living with Alzheimer’s disease are women, according to the Alzheimer’s Association

But should people who experienced hot flashes during menopause be concerned?

Experts discussed the new study and what people can do to lower their risks of Alzheimer’s disease, including what to do if they’re worried about the research.

How the study examined the possible link between hot flashes and Alzheimer’s disease

There isn’t a definitive answer as to why women comprise the majority of Alzheimer’s disease cases. However, some theories center around a decrease in estrogen. Lower estrogen levels are also linked to an increased risk of experiencing hot flashes in menopause, one fertility expert explains.

“More than 80% of women going through menopause may experience hot flashes, and that number can be even higher in those with abrupt onset of menopause like those with surgically-induced menopause who had their ovaries removed),” Asima Ahmad, MD, MPH, FACOG, Carrot Fertility’s chief medical officer and co-founder and a practicing reproductive endocrinologist.

“In that setting, it is thought that the hypothalamus, a part of the brain that helps regulate our body temperature, can cause a more extreme response, causing feelings of extreme heat, dilating the blood vessels, and sweating to cool off the body,” she added.

A 2019 review also cites research that more than 80% of people experience menopausal hot flashes.

So, hot flashes are a common sign of perimenopause or menopause, but what about Alzheimer’s?

To investigate a potential link between Alzheimer’s and hot flashes, researchers examined vasomotor symptoms — or hot flashes and night sweats — in 248 people with a uterus and at least one ovary ages 45-67. The participants were either late-perimenopausal or postmenopausal. 

“In the study, VMS during sleep was associated with a lower amyloid β 42/40 ratio value — a lower value of this biomarker is suggestive of a higher risk of Alzheimer’s,” Ahmad says.

In lay terms?

“The study indicates that women who have hot flashes, or vasomotor symptoms, particularly those that occur during sleep, may have a higher risk for Alzheimer’s,” Ahmad says.

Bear in mind that correlation does not equal causation.

“The study cannot tell us if having vasomotor symptoms during sleep in menopausal women can cause Alzheimer’s,” cautions Nikhil Palekar, MD, the director of the Stony Brook Center of Excellence for Alzheimer’s Disease and director of the Stony Brook Alzheimer’s Disease Clinical Trials Program.

Palekar further adds that the new research is not cause for panic. 

“Hot flashes and night sweats are both hallmark symptoms which are experienced frequently by menopausal women, related to decreased estrogen levels that occur during menopause,” Palekar says. “More longitudinal studies are needed to closely examine the relationship between decreased estrogen levels and risk for Alzheimer’s.”

However, that doesn’t mean patients shouldn’t bring up concerns with their providers, perhaps using this new study as a springboard to discuss Alzheimer’s risk and prevention.

“With any symptoms you may be experiencing, it’s important to have an open and honest dialogue with your physician,” Ahmad says. “Over time, we learn more and more about medical conditions, diseases, their risk factors, and ways to prevent and treat them. As we continue to learn more about menopause, VMS, and other medical conditions, including Alzheimer’s, your physician may be able to update you on new learnings and recommendations on management of VMS and prevention of other conditions.”

Alzheimer’s risk factors and reduction

Palekar says risk factors for Alzheimer’s disease include:

  • Age (The CDC indicates the risk for the disease doubles every five years after 65)
  • Untreated or poorly treated conditions like diabetes and high cholesterol
  • Sedentary lifestyle
  • Diet
  • Poor sleep
  • Genetic risk factors 

Not all risk factors, like age and genetics, can be controlled. But others can, to an extent.

Experts offered the following tips for reducing the risk of Alzheimer’s.

Manage chronic conditions 

A 2020 CDC study indicated a strong link between physical and brain health. People with worsening health conditions, including diabetes, high blood pressure, and chronic obstructive pulmonary disease (COPD), were more likely to experience memory problems. 

Palekar stresses the importance of managing these conditions by taking medications as prescribed and keeping regular appointments with your healthcare team.

Eat nutritious foods 

Palekar suggests a Mediterranean diet with low salt, which increases blood pressure risk. He explains that a Mediterranean diet includes:

  • Leafy green vegetables
  • Beans
  • Whole grains
  • Nuts
  • Antioxidant-rich fruits, like berries
  • Olive oil
  • Fish with Omenga-3 fatty acids, like salmon
  • Lean forms of poultry in moderation

A 2023 cohort study analyzing more than 60,000 people ages 40-69 indicated that a Mediterranean diet could cut dementia risk even if they were genetically predisposed to the disease.

The research conflicted with a 20-year follow-up study published in 2023 that did not find a link between the Mediterranean diet and reduced dementia risk.  

Exercise 

Palekar recommends aerobic exercising that increases the heart rate, such as jogging, biking, or brisk walking, for 150 minutes per week. You can break that time into smaller intervals, such as about 50 minutes three times weekly or 30 minutes five times weekly.

Even patients diagnosed with cognitive decline can benefit from physical activity, a 2020 narrative review suggests. 

Talk with your healthcare provider 

If you’re concerned about this research, menopause, or your risk for Alzheimer’s, speak with a primary care provider. Palekar says this physician can direct you to the appropriate specialist if necessary.

“Your primary care doctor might then refer you to a neurologist or Alzheimer’s expert for a comprehensive evaluation,” Palekar says. “Early screening, detection, and treatment of Alzheimer’s are critical to slow the progression of this illness and help individuals to maintain independent functioning.”

Takeaway

A new study indicates that people who experience hot flashes, especially at night, during menopause are at a higher risk for developing Alzheimer’s disease.

Notably, correlation doesn’t equal causation, so the research doesn’t show that hot flashes are causing this form of dementia.

However, doctors share it’s important to discuss risk factors for Alzheimer’s with your physician.

Age and chronic health conditions like diabetes increase a person’s risk for Alzheimer’s. Lifestyle changes like diet, exercise, and disease management may help decrease a person’s risk.

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