I never thought about brain health in my 20s. It felt like a problem for a distant future. That changed when I began to notice the slow, subtle decline in my mother.
It was a profound shock to see the woman who taught me so much suddenly struggle to articulate a simple thought. The same person who expertly arranged all our family trips, teaching me how to navigate trains and planes, now needs help walking to the gate and getting through immigration. The person who gave me life, can no longer remember my birthday.
Who else can relate to this heart-wrenching shift?
This personal crisis sent me on a quest for answers, and what I discovered was both alarming and empowering. I learned that dementia or Alzheimer's doesn't just appear overnight. The seeds are often sown decades before a diagnosis is ever made.
A Growing Global Challenge
The numbers are staggering. Experts estimate that the number of people living with dementia will more than double globally, from around 57 million in 2019 to over 152 million by 2050. This isn't just a personal issue; it's a looming public health challenge.
Why Women Are More Vulnerable
As I dug deeper, a troubling pattern emerged: women are disproportionately affected. Approximately two-thirds of all Alzheimer's patients are women. This is due to a combination of factors, with women's longer lifespans being a key one (age is the biggest risk factor). But research is increasingly pointing to another major culprit: the dramatic hormonal changes during perimenopause and menopause.
The connection hit home. I remember my mother suffering for at least a decade through perimenopause. There was one day every month she simply couldn't function, an event we'd all come to accept as "normal."
Now, with more knowledge, I know it doesn't have to be that way. In fact, it's not "normal" to have severe menstrual or menopausal symptoms that disrupt your life—these are signs that need to be addressed, not just suppressed with a painkiller.
If you are in your 30s and 40s, now is the time to protect your brain for the coming decades.
HRT: A Timely Intervention for Brain Health?
One of the most promising areas of research involves Hormone Replacement Therapy (HRT). While not a one-size-fits-all solution, evidence suggests that for some women, HRT could be a powerful tool for prevention.
How HRT May Help Protect the Brain:
- Neuroprotective Effects: Estrogen has a significant impact on the brain. Maintaining hormonal levels during midlife may help protect brain regions vulnerable to Alzheimer's.
- Preserving Brain Volume: Studies link early HRT use to better cognitive function and larger brain volumes in areas like the medial temporal lobe, which is critical for memory.
- Targeted Benefit: It may be particularly effective for women with the APOE4 gene, a known genetic risk factor for Alzheimer's.
Crucial Considerations:
- Timing is Everything: This is the most critical point. Starting HRT early, within 5-10 years of menopause, may lower Alzheimer's risk by 20-32%. Conversely, starting after age 65 is associated with a 38% increase in risk.
- Not a Cure: HRT is not a treatment for existing dementia.
- A Personal Decision: It is essential to consult a doctor to weigh the risks and benefits based on your personal and family health history.
Your Brain Health is a Worthy Investment
Here in Hong Kong, there are doctors who understand the critical importance of HRT and proactive brain health. Personally, I see it not as an expense, but as an investment in my future self—in my memories, my independence, and my quality of life.
So, to all the women reading this: Don't be shy, and don't suffer in silence. It is more than okay to seek help. Talk to your doctor, ask questions, and advocate for your long-term health. The best time to protect your brain was years ago; the second-best time is now.
Disclaimer: This blog post is based on personal experience and research and is for informational purposes only. It is not a substitute for professional medical advice. Please consult with a qualified healthcare provider for any health concerns or before making any decisions related to your treatment.
