Initiating HRT During Early Menopause Could Lower Alzheimer’s Risk in Women

A decrease in estrogen during menopause may affect cognitive function

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Commencing hormone replacement therapy (HRT) within five years of the onset of postmenopause appears to decrease the likelihood of developing Alzheimer’s disease. In contrast, starting HRT later in life may have adverse effects, indicating that the timing of the therapy is crucial for its impact on the brain.

Women face a greater risk of developing Alzheimer’s, particularly after menopause, compared to men. This heightened risk may be linked to reduced estrogen levels, which play vital roles in brain energy regulation and inflammation. Consequently, HRT has surfaced as a potential method to reduce Alzheimer’s risk following menopause. However, research on its effectiveness has produced mixed outcomes.

To investigate this, Fnu Vaibhav Pandit Bagwat Deira Sharma from Health Science University in India and his team analyzed 53 studies encompassing over 8.4 million postmenopausal participants regarding Alzheimer’s disease prevalence.

In a randomized controlled trial, participants receiving HRT exhibited, on average, a 38% greater risk of developing Alzheimer’s compared to those not on HRT. Conversely, observational studies suggested a 22% reduction in Alzheimer’s risk among HRT users.

Vaibhav presented these findings at a meeting with the American Nerve Association in Maryland on September 15th, noting that the disparity is likely age-related. Most subjects in the randomized trial were over 65, while those in observational studies tended to be younger. Further analysis revealed that individuals who initiated HRT within five years post-menopause had a decreased risk of Alzheimer’s by 32% over a follow-up period ranging from five years to others that consumed their lifetime.

“This transition during menopause represents a neurological shift,” stated Roberta Brinton from the University of Arizona, who was not part of the research. As estrogen levels decline, the brain seeks alternative energy sources. There is some evidence suggesting that this reallocation may utilize compounds meant for brain function while sacrificing others, leading to potential neurodegeneration. She posits that HRT may either initiate or halt this transition during menopause. However, if the brain has already undergone this shift, HRT may be ineffective.

“More research is essential to clarify this perplexity,” remarked Vaibhav. Without a clearer comprehension of HRT’s impact, he warns that “women may miss out on advantages, and some may inadvertently face harm.”

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Source: www.newscientist.com

The Role of Brain Mitochondria in Initiating Sleep

Mitochondria may have more functions than just energy production

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The energy-producing organelles in cells, known as mitochondria, may also influence sleep patterns. Research on fruit flies indicates that these organelles in the brain can promote sleep after prolonged wakefulness.

Scientists have begun to unravel the brain’s response to sleep deprivation. Findings include alterations in neuronal firing, changes in cell structure, and gene expression patterns. They have also pinpointed specific neurons triggered during sleep onset, yet the complexities of how these neurons act remain unclear.

“Sleep presents one of biology’s significant mysteries,” notes Gero Miesenböck of Oxford University. To delve deeper, he and his research team employed gene sequencing and fluorescent markers to observe gene activity in sleep-related neurons from around 1,000 female fruit flies (Drosophila melanogaster), which typically sleep for 13-16 hours, mainly during daylight hours.

The group allowed half the flies to rest overnight while keeping the others awake by gently agitating their containers or through genetic modifications that activated wake-promoting neurons with temperature increases.

Among the sleep-deprived flies, the researchers noted a surge in activity from sleep-inducing neurons that regulate genes tied to mitochondrial function and upkeep. The mitochondria displayed signs of stress as well, like fragmentation, damage repair efforts, and increased connections to nearby cellular structures.

This stress is likely due to the mitochondria continuing to generate energy even when neurons are inactive. The research indicates this can cause electron accumulation, leading to the formation of free radicals (unstable molecules capable of damaging DNA), thereby contributing to sleep pressure, according to Miesenböck. Once the flies were permitted to sleep, they repaired the mitochondrial damage.

Further findings showed that fragmented mitochondria in sleep-inducing neurons resulted in flies feeling less sleepy than usual and unable to recover after prolonged wakefulness. Conversely, flies engineered to facilitate mitochondrial fusion demonstrated superior repair capabilities, sleeping more than normal and bouncing back more effectively from sleep deprivation. This reinforces the hypothesis that mitochondria play a role in sleep regulation.

In another phase of the study, flies were genetically altered to enhance mitochondrial activity in response to light. This led to a 20-25% increase in sleep duration after just one hour of artificial light compared to the control group.

While this research focused on fruit fly neurons rather than human cells, mitochondria among different species share notable similarities. According to Ryan Mailloux at McGill University in Quebec, Canada, this adds credence to the idea that the energy production processes in mitochondria across various animals can underscore sleep pressure in humans.

This newfound insight could pave the way for novel treatments for sleep disorders. “This presents exciting possibilities for targeting these pathways to develop effective therapies for individuals struggling with sleep issues,” states Mailloux.

Michele Bereshi of Camerino University in Italy remarked, “This paper is certainly impactful and thought-provoking,” though he expresses concerns regarding the experimental design. “Sleep deprivation does not merely prolong wakefulness; it may introduce additional stressors that elicit cellular responses unrelated to the accumulation of sleep pressure.”

In response, Miesenböck explained that his team utilized diverse methods to keep the flies awake, including non-stressing temperature adjustments through gene editing, all achieving similar effects on mitochondrial activity. “What this study illustrates is that sleep homeostasis actively employs its own mitochondria to assess the need for sleep,” he asserts.

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Source: www.newscientist.com