chapter  10
10 Pages

Hormone replacement therapy and Alzheimer’s disease

ByTherese van Amelsvoort, Declan Murphy

AD than men, and this cannot be explained

solely by their longer life expectancy, since

women also have greater disease severity and a

higher age-adjusted prevalence of AD than


The prevalence of AD increases dramatically

with age-from less than 1% at age 65 to

about 15% of people in their eighties.4 AD is

accompanied by progressive cognitive

impairment, and this has an enormous impact

on the quality of life of patients and their

caregivers. Risk factors for AD include a

positive family history, presence of Down’s

syndrome, head injury, female sex,

hypothyroidism, depression, and the

possession of the apolipoprotein E4 gene. In

contrast, education, smoking, and non-

steroidal anti-inflammatory agents may be

protective factors.5 On a cellular level, the

disease is characterized by neuronal loss,

accumulation of intracellular neurofibrillary

tangles, and extracellular senile plaques in the

hippocampus and association neocortex.