The Relationships Between Reproductive History, Ethnicity and Alzheimer’s Disease Incidence in Women: A Research Protocol

Introduction: In recent years, it has been shown that postmenopausal women have a greater risk of developing Alzheimer’s Disease (AD) than their male counterparts. Additionally, greater parity in postmenopausal women is associated with increased AD prevalence. Menopause and childbirth, two factors that affect estrogen levels, are believed to contribute to this health disparity, as estrogen plays an important role in neuroprotection. In addition, few studies have considered the effect of ethnicity on AD incidence in postmenopausal women. It is important to consider the role of ethnicity in the development of effective AD prevention methods for diverse ethnicities. This study seeks to a) investigate the link between increased parity and the development of AD in postmenopausal women of different ethnicities, and b) investigate the effectiveness of estrogen replacement therapy (ERT) in reducing the risk of AD. Methods: This protocol comprises two studies. Study 1 will include neurological assessment of 200 postmenopausal women to determine AD incidence. These women will be from African, Caucasian, Asian, and Latin ethnicities. The second study will be a randomized, placebo-controlled clinical trial providing ERT to a cohort of 200 menopausal women of the same ethnicities as part A. The treatment will be monitored for AD incidence once every 3 years for 15 years post-intervention. Results: Based on prior literature, we hypothesize that women of African and Latin ethnicities in Study 1 will have higher AD incidence than Caucasian and Asian women. In Study 2, we expect overall AD incidence to be lower in the ERT group than the control group. We also expect AD incidence to be higher in African and Latino participants than Caucasian and Asian participants post-ERT. Discussion: The relationship between ethnicity and AD incidence can be confounded by factors such as migratory status and the indirect relationship between racial and genetic groupings. Future studies are required to investigate these factors. Conclusion: This study will pave the path for further estrogen therapies that can reduce the risk of AD through exogenous estrogen exposure. As AD is prevalent amongst the aging population, findings will also help to reduce health disparities among postmenopausal women of multiple ethnicities.