Women who have nighttime hot flashes may be at greater risk for Alzheimer’s, study finds

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Hot flashes during the night may be more than a midlife annoyance for women. They could also be an early indicator of Alzheimer’s disease, according to new research released Wednesday.

Two-thirds of the about 6.7 million people in the U.S. who have Alzheimer’s disease are women. 

Hot flashes experienced during sleep may be a marker of women at risk of Alzheimer’s disease, according to research presented at the annual meeting of the Menopause Society in Philadelphia. A greater number of nighttime hot flashes was associated with an increased likelihood of the disease, the research found.

About one-third of women experience moderate to severe or frequent vasomotor symptoms — the hot flashes or night sweats due to menopause, researchers said.

“We do not want women to be alarmed. However, if a woman is having nighttime hot flashes several times nightly, they may want to take steps to both treat the hot flashes — because those can be quite interfering with daily functioning — and engage in risk-reduction efforts,” said Rebecca Thurston, the director of women’s biobehavioral health at the University of Pittsburgh and the lead author of the study.

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In the new study, which has not yet been published in a peer-reviewed journal, researchers from the University of Pittsburgh and the University of Illinois monitored 250 women between the ages of 45 and 67 who were experiencing menopausal symptoms. The women wore a monitor to measure the quality of their sleep, as well as a sweat monitor to record their hot flashes.

“Given the adverse effect on quality of life and financial burden of [Alzheimer’s disease], it’s important that we learn as much as possible about potential causes and warning signs so we can be proactive before the onset of [the disease],” said Stephanie Faubion, medical director of the Menopause Society. 

The researchers also analyzed blood samples from the study participants to examine them for certain markers of Alzheimer’s disease, including a specific protein biomarker called beta-amyloid 42/40. Women who had more hot flashes during sleep were more likely to be in the low to abnormal range for beta-amyloid 42/40, the study showed. Such blood-based biomarkers have been useful for assessing risk decades before the emergence of the disease.

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“Right now, some of the best ways to preserve brain health are to engage in all of those healthy behaviors we know are important — such as engaging in regular exercise, eating a healthy diet, sleeping adequately, treating any mental-health conditions and treating any risk factors such as high blood pressure and diabetes,” Thurston said. “There is some evidence that treating hot flashes with a nonhormonal intervention may help improve cognition, but much more needs to be done in that space.” 

Thurston also said it’s important that women in midlife check in periodically with their healthcare provider to make sure that their blood pressure, lipids and glucose levels are within normal ranges. “Midlife is a time of rapid change in many of these standard cardiovascular-disease risk factors. These changes may also have implications for the brain,” she said.

Prior research has linked hot flashes with poor memory performance and with alterations in brain structure, function and connectivity. The objective of this new study was to determine whether objectively assessed hot flashes were associated with Alzheimer’s disease biomarker profiles. The study didn’t determine who had Alzheimer’s disease, but rather looked at who was at increased risk of getting the disease.

“This study underscores the need for ongoing open dialogues between patients and their healthcare professionals so that any treatment options can be carefully considered,” Faubion said.

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