A groundbreaking study has confirmed what neuroscientists have long suspected: Menopause is not just a reproductive transition; it is a neurological event that may trigger the onset of Alzheimer’s disease.

Research from the University of Cambridge, led by Professor Barbara Sahakian, reveals that the drop in oestrogen during menopause causes a direct loss of grey matter in brain regions critical for memory and emotion. This finding sheds light on a grim statistic: women account for nearly two-thirds of all dementia cases globally. In East Africa, where dementia prevalence among those over 60 is estimated at 4.2%, this link signals a looming public health crisis as life expectancy rises.

"The Brain on Fire"

The study utilized advanced brain scans to observe the "energy crisis" that occurs in the female brain during midlife. As oestrogen levels crash, the brain is deprived of a key neuroprotective element, leading to inflammation and the accumulation of amyloid plaques—the hallmarks of Alzheimer's.

• The HRT Dilemma: Crucially, the study found that while Hormone Replacement Therapy (HRT) can alleviate hot flushes and sleep disturbance, it does *not* necessarily reverse the structural brain changes associated with dementia risk. This nuances the debate on HRT, suggesting it is a symptom manager rather than a cure-all preventative.
• Local Context: In Kenya, dementia is often misunderstood and stigmatized, frequently dismissed as "senility" or even witchcraft. With a prevalence rate of roughly 4.19% in the elderly population, thousands of Kenyan women may be silently suffering from neurodegeneration triggered decades earlier by menopause.
• The Sleep Connection: The research also highlighted severe sleep disturbance during menopause as a compounding factor. Poor sleep prevents the brain from "cleaning" itself of toxins, accelerating cognitive decline.

A Call to Action

"Menopause could make these women vulnerable further down the line," Professor Sahakian warned. "It helps explain why we see almost twice as many cases of dementia in women than in men."

For the Kenyan medical fraternity, this research is a wake-up call to look beyond the reproductive symptoms of menopause. It necessitates a holistic approach that includes cognitive screening for women in their 50s. As the population ages, understanding the "silent thief" of memory is no longer an academic exercise—it is a necessity for dignity in old age.