Preventing Dementia After Menopause
It's premature to think about widespread clinical application by determining a woman's ApoE4 status, says Yaffe. "At this point, we don't have great preventions [for AD], so it probably doesn't make sense to look at testing everyone. But if we do develop good medicines that prevent AD, we may want to know the E4 status, because those are the people who might preferentially go on therapy."
Both Yaffe and Picot note that the study did not look at women using the more common regimen of an estrogen and progesterone combination for hormone replacement. Picot advises nurses counseling patients about the value of hormone replacement therapy to mention the potential prevention of mental decline as one possible benefit -- along with protection against osteoporosis and some types of heart disease -- of the therapy. However, Picot cautions that the contraindications for estrogen use must also be considered. "We don't want to jump on the bandwagon and think that this is for everybody," she says.
Picot thinks the beauty of this study is its effort to factor in environmental variables while investigating genetic differences. "When we consider that the Human Genome Project is suggesting that we're all about 99.5% alike genetically, this particular set of findings is very impressive and believable."