Sex Hormones and Cerebrovascular Health: Implications for Dementia Risk Across the Lifespan

Sex hormones demonstrate life stage- and sex-specific associations with cerebrovascular health including CBF, CVR, and ATT, all crucial factors in dementia pathogenesis. Both sexes had opposite directions of relationship for estradiol and testosterone. Estradiol was associated with better cerebrovascular health (shorter ATT in perimenopausal females), while testosterone showed negatives effects in females (longer ATT, lower CBF and CVR). Conversely, testosterone was associated with higher CBF in younger males and estradiol lower CBF in older males. These findings underscore the potential for hormone-targeted strategies to support cerebrovascular health and reduce dementia risk through age and stage-specific interventions.