17 November 2025

The Women’s Brain Foundation Academy is proud to announce a new review published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, identifying estrogen as a potential missing link connecting several modifiable risk factors for dementia—such as cholesterol, smoking, and depression—with women’s increased vulnerability to the disease.

The paper, titled “Associations of estrogen with modifiable and non-modifiable risk factors for dementia: A narrative review, (https://alz-journals.onlinelibrary.wiley.com/journal/15525279)” brings together decades of research to examine how, across life stages, estrogen—both endogenous and exogenous–interacts with known dementia risk factors.

Led by Dr. Sarah Gregory (University of Edinburgh) in collaboration with an international team spanning Europe and North America, including researchers from the Women’s Brain Foundation (Switzerland), Barcelonaβeta Brain Research Center (Spain), Trinity College Dublin (Ireland), University of Chicago (USA), and the Global Brain Health Institute, among others, the study underscores how hormonal transitions—from menarche to menopause—may affect lifelong brain health trajectories.

“Estrogen plays a critical role in shaping women’s brain health, influencing key biological pathways that connect cardiovascular, metabolic, and cognitive risk factors to dementia,” said Dr. Antonella Santuccione Chadha, CEO and Founder of the Women’s Brain Foundation. “A deeper understanding of when and how these hormonal shifts occur—especially around menopause—may open crucial windows for prevention. One of the most important questions we must address is why some women transition through peri- and menopause without major implications, while others experience cognitive decline or even develop neurodegenerative diseases.”

The review highlights that:

• Estrogen interacts strongly with several modifiable dementia risk factors, particularly LDL cholesterol, smoking, and depression, suggesting possible intervention opportunities.
• Loss of estrogen after menopause may contribute to increased vascular and metabolic risk, emphasizing the importance of timely hormone and lifestyle interventions.
• Research gaps remain, especially regarding underexplored areas such as air pollution, education, social isolation, and alcohol use.
• Future studies must include more diverse populations and longitudinal data to fully understand estrogen’s neuroprotective effects across the life course.

“This was a great team effort to review the current evidence base to understand whether there are known associations between estrogen and the known modifiable risk factors for dementia,” says Dr. Sarah Gregory, lead author of this publication. “Understanding associations and interactions between sex hormones and modifiable risk factors may give us new insights into why women have increased vulnerability to dementia compared to men. Our review suggests we need significantly more research to understand interactions with risk from both a sex and gender perspective.”

The review also discusses ethical, social, and policy implications surrounding access to hormonal treatments worldwide, highlighting how socioeconomic and cultural factors may influence both exposure to and outcomes from estrogen-based interventions.