Assessing the Roles of Aging, Estrogen, Nutrition, and Neuroinflammation in Women and Their Involvement in Alzheimer’s Disease—A Narrative Overview

The purpose of this narrative review is to examine women's cognitive health and to highlight its association with four major pillars: (1) aging, (2) estrogen decline and loss, (3) diet, and (4) neuroinflammation, and their contribution to cognitive decline, with a focus on this combination to increase awareness and address the progression and potential amelioration of Alzheimer's disease (AD). Often overlooked, estrogen decline during perimenopause and loss of estrogen production from the ovaries after menopause negatively influences almost every tissue and organ in the body, including the brain. This estrogen loss leads to inflammation, as can poor nutritional choices, both of which have a profound impact on short- and long-term health and can increase the risk of dementia, including AD. Thus, this overview covers the following four pillars (1) a brief background on cognitive decline and AD with aging, (2) the importance of and changes in estrogen with aging, (3) influence of dietary choices on overall well-being and brain health, and (4) the biochemical and molecular mechanisms by which this combination of factors may lead to neuroinflammation, resulting in cognitive decline and AD. Finally, this review briefly presents a hypothesis on whether women during perimenopause should be administered estrogen to span the transition into menopause to protect against cognitive decline and possibly ameliorate the risk of AD. This article is based on previously conducted studies and does not contain new data/results (studies) of human participants or animals performed by the authors.