New research from the University of Texas Health Science Center at San Antonio (UT Health San Antonio) suggests that high levels of the stress hormone cortisol in midlife may increase the risk of developing Alzheimer’s disease for women who are postmenopausal.
The study, published in Alzheimer’s & Dementia, analyzed data from the Framingham Heart Study, a long-term research project that has followed thousands of participants since 1948.
The findings offer fresh insight into how stress may contribute to Alzheimer’s, particularly for women after menopause.
Alzheimer’s disease is a progressive brain disorder that affects memory, thinking, and behavior. It is the most common cause of dementia in older adults, and its main hallmarks are the buildup of two proteins in the brain: amyloid beta and tau.
Amyloid beta forms plaques, while tau creates tangles inside brain cells, both of which disrupt normal brain function.
The research team, led by Dr. Arash Salardini, an associate professor of cognitive and behavioral neurology, focused on a specific risk factor: cortisol. Cortisol is often called the “stress hormone” because its levels rise in response to stress.
It is essential for regulating metabolism, immune response, and the body’s stress reactions. But long-term elevated cortisol levels have been linked to brain changes and cognitive decline.
To explore the connection between cortisol and Alzheimer’s, the researchers examined data from 305 cognitively healthy participants in the Framingham Heart Study. This group included both men and women, with an average age of about 40 at the beginning of the study. Importantly, nearly half of the participants were women.
The team compared their cortisol levels measured during midlife with brain scans taken 15 years later. These scans looked for signs of amyloid buildup, a key indicator of Alzheimer’s.
The results were striking. The researchers found that women who had high cortisol levels during midlife showed more amyloid plaques in their brains when they were scanned 15 years later. This was particularly true for women who were postmenopausal.
In contrast, no similar link was found in men, and there was no significant connection between cortisol and tau, the other protein involved in Alzheimer’s.
Dr. Salardini emphasized the importance of early detection, stating that “the results highlight the importance of identifying early risk factors when biomarkers are detectable but cognitive impairment is absent.” He believes that measuring cortisol levels in midlife could help identify women who are at a higher risk for Alzheimer’s long before symptoms appear.
The research team also explored why postmenopausal women are more affected. According to the study, hormones like estrogen and testosterone help protect the brain against damage from cortisol.
Estrogen, in particular, has neuroprotective effects, which may explain why women seem more vulnerable to the harmful effects of cortisol once their hormone levels drop after menopause.
Dr. Sudha Seshadri, founding director of the Biggs Institute and senior author of the study, suggested that these findings could lead to new ways of preventing Alzheimer’s.
“Our work shows that considering sex and hormonal status in understanding Alzheimer’s disease pathogenesis is important, and suggests that stress reduction and hormonal interventions may hold promise for Alzheimer’s prevention, especially in at-risk women,” she explained.
The study also addresses the concept of “sporadic” Alzheimer’s, which is the most common form of the disease and occurs without a clear genetic link. For many people, the biological changes leading to Alzheimer’s begin years before symptoms are noticeable.
The buildup of amyloid beta in the brain can start silently, setting the stage for cognitive decline much later. By the time symptoms emerge, the disease is already well underway, making early prevention crucial.
One promising area of research is finding ways to manage cortisol levels to reduce the risk of amyloid buildup in the brain. This could include lifestyle changes to reduce stress, such as mindfulness, exercise, and better sleep, as well as medical treatments that specifically target cortisol regulation.
The idea is that by lowering stress and its impact on the brain, it may be possible to slow or prevent the development of Alzheimer’s, particularly for women going through menopause.
Moving forward, the research team plans to continue studying their participants to see if the early amyloid changes they observed will lead to clinical symptoms of Alzheimer’s. This long-term follow-up will be essential to understanding whether reducing cortisol levels in midlife could actually prevent or delay Alzheimer’s.
The findings are important because they add to the growing understanding that Alzheimer’s disease risk is not just influenced by genetics or age, but also by how the brain responds to stress over a lifetime. Women, particularly after menopause, appear to be more vulnerable, suggesting that hormonal changes may play a significant role in brain health.
By identifying cortisol as a potential biomarker for Alzheimer’s in women, researchers hope to pave the way for new treatments that target stress reduction and hormone regulation as part of Alzheimer’s prevention. This could be a major step forward in detecting and managing the disease before it takes hold, offering hope for millions of women at risk.
If you care about Alzheimer’s disease, please read studies about vitamin D deficiency linked to Alzheimer’s and dementia, and strawberries can be good defence against Alzheimer’s.
For more health information, please see recent studies about foods that reduce Alzheimer’s risk, and oral cannabis extract may help reduce Alzheimer’s symptoms.
The research findings can be found in Alzheimer’s & Dementia.
Copyright © 2025 Knowridge Science Report. All rights reserved.
