Compassionate Cognitive Care
Caring for Cognitive Decline
A Compassionate Approach with a New Perspective
Throughout my time working in end-of-life care, I had the privilege of supporting countless patients and families through some of the most challenging moments of their lives. A large majority of my patients were living with cognitive decline, dementia, or Alzheimer’s disease—diseases that not only steal memories but profoundly impact quality of life for both the individual and their loved ones.
I witnessed families grapple with helplessness as they watched their loved ones slowly change. Despite their best efforts and the guidance of dedicated healthcare providers, many families felt stuck in the harsh reality that there are few therapeutic options that show meaningful clinical benefit.
- My experience in end-of-life care has shaped my commitment to finding ways to support not just the physical health, but the emotional well-being of both patients and families navigating cognitive decline. Bio-identical hormone therapy represents a promising, innovative tool in this fight—a step toward reclaiming what Alzheimer’s and dementia threaten to take away.
- If you’re looking for new options and a different perspective, I’m here to walk you through your choices and help you create a personalized care plan.
- Together, we can pursue better outcomes and meaningful moments of connection and hope.
Alzheimer’s Disease and Hormone Therapy
Alzheimer’s disease (AD) is the most common cause of dementia, accounting for 60-80% of dementia cases. It is a progressive neurodegenerative disease that primarily affects memory, thinking, and behavior.
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Over 55 million people live with dementia, and Alzheimer’s accounts for the majority of cases
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Nearly 6.7 million Americans over the age of 65 are living with Alzheimer’s.
Gender Breakdown:
Women
Almost two-thirds of those diagnosed with Alzheimer’s are women. After age 60, a woman’s risk of developing Alzheimer’s is greater than her risk for breast cancer.
What is Alzheimer's Disease?
Alzheimer’s disease is a specific form of dementia that progresses in stages, beginning with mild memory loss and leading to significant impairments in daily life. Under the dementia umbrella,
Alzheimer's is characterized by:
- Beta-amyloid plaque buildup in the brain.
- Tau tangles that interfere with neuron communication.
- Neurodegeneration, or the loss of neurons and connections.
- Subtle memory loss, especially difficulty recalling recent events.
- Trouble finding words during conversations.
- Difficulty with planning, organization, or following directions.
- Increased confusion in familiar settings.
- Changes in mood or personality, such as withdrawal or irritability.
Takeaway
Alzheimer’s disease disproportionately affects women and remains a significant health challenge for both genders as they age. However, promising research into hormone therapy—especially testosterone, estrogen, and progesterone—is providing new hope for cognitive resilience. By incorporating regular screenings and early interventions into your health strategy, you can take proactive steps to support brain health and reduce your risk of neurodegeneration.
If you’d like to learn more about how hormone optimization can fit into your long-term health plan, I’m here to guide you. Let’s take care of your brain—together.
Hormone Therapy and Alzheimer’s Disease Prevention
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Testosterone is emerging as an important hormone in the fight against neurodegeneration:
- Protects Against Amyloid Plaque Formation: Research suggests testosterone can help prevent the buildup of beta-amyloid plaques in the brain—one of the hallmarks of Alzheimer’s disease.
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- Testosterone therapy has been shown to support brain health by lowering brain inflammation and protecting neurons from damage.
- Supports Memory and Processing Speed: In both men and women, testosterone optimization has been linked to improved focus, recall, and executive functioning.
The Role of Progesterone in Brain Health for Women
Progesterone plays a vital role in modulating the brain’s stress response and improving sleep quality, which are often disrupted in people with dementia.
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Progesterone helps balance neurotransmitters that regulate mood, reducing symptoms of anxiety and depression.
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Progesterone has calming effects and can enhance REM sleep, improving overall sleep quality—critical for cognitive health.
Estrogen’s Protective Effect: The Timing Hypothesis
Estrogen has long been recognized for its neuroprotective effects:
Increases Blood Flow to the Brain: Estrogen improves vascular function, enhancing nutrient and oxygen delivery.
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Estrogen helps combat free radicals in the brain, reducing neuroinflammation.
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Estrogen plays a role in maintaining healthy synaptic connections for memory and learning.
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Studies suggest that estrogen therapy is most effective when initiated early in the menopausal transition or soon after menopause. Delaying estrogen therapy may limit its protective benefits, highlighting the importance of timely intervention.
Current Pharmacologic Treatments for Dementia and Alzheimer’s Disease
Here is a list of commonly prescribed medications for Alzheimer’s and related cognitive disorders, along with their typical costs and limitations:
$200–$400/month
- Use: Approved for all stages of Alzheimer’s disease to improve memory, awareness, and function.
- Limitations: Provides only modest improvements in symptoms and does not stop disease progression.
$250–$600/month
- Use: Used in moderate to severe stages to help with daily function and slow symptom progression.
- Limitations: May slow the decline temporarily but rarely results in meaningful cognitive recovery.
$200–$500/month
- Use: Can be taken orally or as a patch to help improve cognitive symptoms.
- Limitations: Effectiveness varies and can cause gastrointestinal side effects that limit tolerance.
$28,000/year (~$2,300/month)
- Use: Used in moderate to severe stages to help with daily function and slow symptom progression.
- Limitations: May slow the decline temporarily but rarely results in meaningful cognitive recovery.
use of these medications
Despite the use of these medications, many patients experience only mild improvements, if any. The high cost of these treatments often adds to the emotional and financial burden without providing substantial cognitive recovery.
Bio-Identical Hormone Therapy:
A Cost-Effective, Innovative Approach
One of the most compelling aspects of bio-identical hormone therapy (BHRT) is its affordability compared to traditional pharmaceutical treatments for cognitive decline—and the promising clinical outcomes many patients experience.
- Monthly Cost of Bio-Identical Hormones
- Estrogen (Creams or Patches): $30/month
- Testosterone (Topical): $40/month
- Progesterone (Oral): $20–$30/month
Compared to pharmaceutical therapies like Aducanumab (Aduhelm) at $2,300/month or Donepezil (Aricept) at $200–$400/month, bio-identical hormones are significantly more affordable and accessible for long-term use.
A Proactive and Affordable Solution
When considering the cost-to-benefit ratio, BHRT offers a more cost-effective and potentially impactful approach to supporting cognitive function compared to standard pharmaceutical treatments. For individuals and families seeking options beyond conventional therapies, bio-identical hormone therapy represents hope with a plan—one that is proactive, affordable, and built around personalized care.
If you’re interested in learning more about whether bio-identical hormone therapy is right for you or your loved one, I’m here to guide you every step of the way. Together, we can explore innovative solutions to support brain health and improve quality of life.
Bio-Identical Hormone Therapy
A New Perspective on a Complex Disease:
In the face of these challenges, I’ve embraced bio-identical hormone therapy as an outside-the-box approach for addressing cognitive decline. Rather than treating symptoms alone, bio-identical hormones aim to address some of the underlying changes in the brain caused by hormonal shifts—especially during aging and menopause.
Supports brain function by improving blood flow, reducing inflammation, and enhancing synaptic connectivity.
Plays a protective role in memory and prevents the accumulation of harmful plaques associated with Alzheimer’s.
Helps regulate mood, reduce anxiety, and improve sleep—key factors that can slow cognitive deterioration and improve quality of life.
Why This Matters:
Research is increasingly showing that hormone therapy may offer neuroprotective benefits, especially when started early. While it may not be a cure, it provides a proactive, personalized approach for individuals at risk or in the early stages of cognitive decline. Unlike traditional medications, bio-identical hormones are designed to work in harmony with your body, offering hope for improved brain health and resilience.
Hormone Therapy and Cognitive Health:
Key Studies by Hormone
1. Estrogen Studies
Study 1
Key Findings:
Women who began estradiol therapy early in menopause experienced better cognitive outcomes and a reduction in brain atrophy compared to those who started later.
Reference: Henderson VW, St John JA, Hodis HN, et al. Cognitive effects of estradiol after menopause: A randomized trial of early initiation. Neurology, 2016.
Study 2
Key Findings:
Early estrogen therapy preserved verbal memory and executive function in postmenopausal women. The study emphasized the importance of timing to maximize protective effects.
Reference: Harman SM, Brinton EA, Cedars MI, et al. Timing and duration of menopausal hormone treatment may affect cardiovascular outcomes: Findings from the KEEPS Trial. JAMA Internal Medicine, 2014.
Study 3
Key Findings:
This large study found that combined estrogen-progestin therapy was associated with an increased risk of cognitive decline when started late but highlighted the importance of early intervention.
Reference: Shumaker SA, Legault C, Kuller L, et al. Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women. JAMA, 2004.
2. Testosterone Studies
Study 1
Key Findings:
Low testosterone levels were linked to an increase in beta-amyloid plaques, a hallmark of Alzheimer’s disease. Testosterone supplementation reduced plaque accumulation and may slow cognitive decline.
Reference: Rosario ER, Chang L, Stanczyk FZ, Pike CJ. Age-related testosterone depletion and amyloid-beta accumulation: Link to Alzheimer’s disease pathology. Journal of Neuroinflammation, 2011.
Study 2
Key Findings:
Testosterone therapy improved spatial memory and executive function in aging men with early cognitive decline.
Reference: Cherrier MM, Matsumoto AM, Amory JK, et al. Testosterone improves spatial memory in men with mild cognitive impairment. Neurology, 2005.
Study 3
Key Findings:
- Cognitive Improvements in Specific Domains:
- Memory: Participants receiving testosterone supplementation showed improvements in verbal memory recall tasks.
- Verbal Fluency: There was a noticeable enhancement in participants’ ability to generate words, suggesting benefits in language-related cognitive processing.
Reference: Wahjoepramono EJ, Asih PR, Aniwiyanti V, Taddei K, Dhaliwal SS, Fuller SJ, Foster J, Carruthers M, Verdile G, Sohrabi HR, Martins RN. CNS Neurol Disord Drug Targets. 2016;15(3):337-43.
Study 4
Key Findings:
Testosterone supplementation in postmenopausal women improved verbal memory and overall cognitive performance, demonstrating that balanced testosterone levels benefit cognitive health in both sexes.
Reference: Davis SR, Wahlin-Jacobsen S. Testosterone in women—the clinical significance.
The Lancet Diabetes & Endocrinology, 2015.
Dratva MA, Banks SJ, Panizzon MS, Galasko D, Sundermann EE; Alzheimer’s Disease Neuroimaging Initiative. Low testosterone levels relate to poorer cognitive function in women in an APOE-ε4-dependant manner. Biol Sex Differ. 2024 Jun 5;15(1):45. doi: 10.1186/s13293-024-00620-4. PMID: 38835072; PMCID: PMC11151480.
3. Progesterone Studies
Study 1
Key Findings:
Progesterone improved mood regulation, reduced anxiety, and enhanced sleep quality in women experiencing cognitive disturbances, particularly during menopause.
Reference: Frye CA. Neurosteroids’ effects on cognitive functions and psychiatric symptoms. Frontiers in Endocrinology, 2011.
Study 2
Key Findings:
Progesterone was shown to improve REM sleep and reduce insomnia, which plays a critical role in cognitive resilience and memory retention.
Reference: Kuhl H. Pharmacology of estrogens and progestogens: Influence of different routes of administration.Climacteric, 2005.
Study 3
Key Findings:
Progesterone has been shown to exhibit anti-inflammatory properties and support brain recovery by modulating neural repair mechanisms, potentially benefiting those at risk for Alzheimer’s disease.
Reference: Nilsen J, Brinton RD. Mechanisms of progesterone-mediated neuroprotection. Endocrinology, 2003.
summary highlights
This summary highlights key research findings supporting the use of estrogen, testosterone, and progesterone in improving cognitive health and addressing symptoms of dementia. These studies emphasize the potential of hormone therapy when used at the right time and in the right context for both men and women.
