Female Sex and Alzheimer's Risk: The Menopause Connection.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic preclinical data and translational imaging studies without systematic review methodology.
PubMed 30298180 · doi:10.14283/jpad.2018.34
What was done
This narrative review synthesizes preclinical and translational neuroimaging literature examining how the menopause transition affects brain bioenergetics, estrogen-regulated neurological systems, and the early accumulation of Alzheimer's disease pathology in women aged 40 to 60 years.
What was found
The abstract reports qualitative observations rather than specific quantitative values. Preclinical models indicate that the menopause transition leads to uncoupling of the estrogen network from brain bioenergetic systems, inducing a hypometabolic state. Neuroimaging studies show that 40- to 60-year-old perimenopausal and postmenopausal women exhibit an Alzheimer's endophenotype of decreased brain metabolic activity and elevated amyloid-beta deposition compared to premenopausal women and age-matched men. No numerical data, sample sizes, or effect estimates are provided in the abstract.
Why it matters
It highlights the menopause transition as a critical biological window driving sex-specific Alzheimer's risk rather than attributing disparities purely to longevity, pointing to midlife as a key timeframe for preventive interventions.
Limits
The review relies on intermediate neuroimaging endophenotypes and animal models rather than prospective clinical endpoints. As an unsystematic narrative review, study selection criteria and risk-of-bias assessments are absent. The abstract omits all numerical findings, sample sizes, and effect sizes.
Cited by
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