The Surprising Link Between Hot Flashes and Alzheimer’s

The first in a series on heart health and brain health

Hello, everyone. I write to you from my mother’s house in San Diego where I am helping her caregivers by taking the night shift this week. It’s not yet dawn and I am trying to work as quietly as possible so I don’t wake her up. She is in the stage of Alzheimer’s where she requires round-the-clock care. While it has been good to spend time with my mom, it is exhausting on many levels. Caregivers, I know you can relate! I have so much appreciation for the team of women who care for her day after day, night after night, just like she was their own mother.

Today I’m kicking off a mini-series on the topic of how heart health impacts brain health. Based on many of your comments and questions, I’ll be writing about the following topics in the coming months:

• Menopausal hot flashes and increased risk of Alzheimer’s (today’s topic)

• Cholesterol 101: LDL, HDL, dietary strategies to reduce LDL, and the role of medications (statins and others)

• Vascular dementia: what it is, how it differs from Alzheimer’s, and how to prevent it

Recent report links menopausal hot flashes to an increased risk of Alzheimer's

To be honest, I am hesitant to bring up one more thing that women need to worry about regarding brain health. And yet, each paper that comes out is another piece of the puzzle, and with it comes an opportunity to prevent the disease. 

We already know that women are twice as likely as men to be diagnosed with Alzheimer’s. We know the ApoE4 risk gene for Alzheimer’s seems to have a greater impact on women. And now, a new paper presented at the The Menopause Society meeting on September 27 links vasomotor symptoms—hot flashes and night sweats—to structural changes in the brain that could be the seeds of Alzheimer’s later. 

It’s been known for a long time that vasomotor symptoms are more than a nuisance symptom of menopause—they are also linked to chronic disease. Back in the 2010s there was even research hinting that the severity of hot flashes at menopause were a red flag for increased Alzheimer’s risk later. Before we get into the latest study, let’s talk about vasomotor symptoms. (Or, if you just want the takeaways, scroll to the bottom of the post.)

More than “just” a hot flash

Vasomotor symptoms is what often happens when fluctuating female hormones cause temperature instability. The common vernacular describes these as hot flashes and night sweats. In reality, hot flashes are nothing like a flash. These episodes begin with a drop in core body temperature and a rise in skin temperature and can last several minutes or smolder for up to an hour. Night sweats may sound innocuous, but most women experience these as sleep-disrupting episodes of drenching sweating that soaks pajamas, bedding, pillows, and mattress as the body attempts to rebalance the core temperature drop.

Eighty percent of women experience vasomotor symptoms. They happen during the postpartum period as hormones attempt to normalize. They happen when women breastfeed. They sometimes occur during the phase of a menstrual cycle when hormones take a downward slope. They very commonly occur during the perimenopause—the transition phase that lasts on average 7 years and ends with the last menstrual period. And they often persist into the postmenopausal years. 

Severe vasomotor symptoms may be more concerning