Why a Brain Doctor Asks About Hormone Replacement Therapy

This transcript has been edited for clarity.

I'm Dr Richard Isaacson, director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian.

Hormone replacement therapy (HRT) for Alzheimer's prevention is a loaded topic, around which there are a lot of differing opinions out there. Over the past 5 years, I can tell you that my own comfort level with discussing this topic has definitely evolved exponentially.

Five years ago, I wouldn't have even wanted to talk about a topic like this because the data were all over the place. At that time, I may have been able to state one thing: HRT during the perimenopause transition may have some protective effect on the brain. I couldn't say whether it's protective against dementia, Alzheimer's, or cognitive decline—just that taking HRT for 5-7 years during the menopause transition was okay. But I'd add, "I don't know. I'm just a brain doctor. You should probably go see an ob/gyn."

Guiding Patients Means Knowing What to Ask

Today, things are a little bit different. Now when I see a woman with a family history of Alzheimer's diseaseat our program who wants to try to do anything to reduce her risk for dementia, I spend at least 10-15 minutes in the first hour-and-a-half visit just talking about HRT.