Breast and brain health have more in common when it comes to aging and menopause than you might think. Both are complex and affected by a mix of factors like aging, hormones, genetics and lifestyle. There is no guaranteed way to prevent breast cancer, dementia or cognitive decline that impacts daily life, but understanding your risk can help you ask questions and take steps to support your health.
Cognitive decline and dementia are not the same thing
It is important to first address what is meant by cognitive decline and identify the diseases that are associated with it. When people talk about “cognitive decline,” they’re referring to changes in how the brain works, such as memory, attention, decision-making or learning. Some of these changes can happen with normal aging, and it varies widely when they may start and how much they may affect someone.
Not every memory lapse or forgotten appointment is a sign of dementia, though. Dementia is an umbrella term for a group of symptoms that cause a noticeable decline from a person’s previous baseline (usual level) of memory and thinking, and that change is big enough to interfere with daily life – for example with managing medications, getting around safely or managing finances. Between normal aging and dementia, there’s also a recognized middle stage called mild cognitive impairment (MCI) where changes may be noticeable but don’t disrupt daily life.
People often think Alzheimer’s disease is the same as dementia, but it is not. Dementia describes a syndrome and the impact of changes in thinking. Alzheimer’s disease is one specific disease that is the most common cause of dementia. Other causes include vascular dementia, Lewy body dementia, among others.
Of note, both breast cancer and cognitive decline do not have a single root cause.
How aging and risk of disease are related
As we grow older, the cells in our bodies have had more time to collect changes in DNA (genetic material), and our bodies can become less efficient at repairing damage, controlling inflammation, clearing waste and keeping blood vessels healthy. Over time, these changes add up and increase the chance of diseases like some cancers and conditions that affect the brain.
In the breast, these gradual changes can make it more likely that some cells begin to grow and divide in uncontrolled ways, which can lead to breast cancer. Most breast cancers occur in women ages 50 and older. Getting older doesn’t cause breast cancer, but it does give cells more time to develop changes that can cause cancer to develop in some people.
In the brain, long-term changes in blood vessels and how the brain clears waste can affect how brain cells function and communicate with one another. Waste clearance, for example, is a critical process that occurs during sleep. As people age and hormones change, sleep patterns often change, which can affect mood, memory and attention. The World Health Organization, also known as the WHO, notes that age is also the strongest known risk factor for conditions that cause dementia, including Alzheimer’s disease. Especially after age 65, the risk of dementia increases, but it is not guaranteed. Many people live their whole lives without developing dementia.
An important takeaway is that getting older can increase risk, but it does not mean that disease is guaranteed and understanding how aging affects the body and brain can help explain why some health problems become more common as a result.
Risk factors often work (or add) together
A risk factor is something that is linked to a person’s chance of developing a disease – some of which can’t be changed, such as age, family history or inherited gene mutations. Other risk factors often accompany certain lifestyle behaviors, medical conditions and access to care, some of which can be managed or changed over time.
Several of the same risk factors show up when it comes to breast health and brain health. They include: physical inactivity, smoking, drinking alcohol, and being overweight or obese (especially after menopause).
For brain health and dementia risk, the WHO has also pointed to factors like high blood pressure, diabetes and high LDL cholesterol being linked to increased risk of cognitive decline and dementia. Also, emerging research finds that hearing loss, untreated vision loss, depression, social isolation and long-term exposure to air pollution can influence brain health over long periods of time.
Risk factors can add up to increase risk. The good news is that small steps in more than one area also can reduce risk. Things like making exercise a part of your routine and managing your body weight or finding a supportive community may affect your health over the long term.
The role of estrogen and menopause
Estrogen is a hormone that plays important roles throughout the body and brain. It influences how breast cells grow and develop, and it also affects brain functions related to memory, sleep, mood and blood flow.
A person’s exposure to estrogen over their lifetime can affect breast cancer risk. For example, younger age at first menstrual period, older age at menopause or older age at first childbirth, high blood estrogen levels following menopause and estrogen plus progestin menopausal hormone therapies (MHT) are some of those linked to increased breast cancer risk. MHT is usually not recommended for women who have had breast cancer because some studies have shown it may increase the risk of the cancer returning.
Changes in estrogen around menopause can also affect the brain like how people feel and think. Some people notice hot flashes, mood changes or brain fog during this time. Researchers are actively studying how different patterns of estrogen exposure may affect brain health and the risk for conditions like dementia. It’s a complex system and considerations should be personalized. If you are considering MHT for menopause symptoms, or if you have a personal history of breast cancer and are concerned about memory or mood changes, it is important to talk with your health care team about your specific situation.
Brain fog and breast cancer treatment
When treated for breast cancer, some people report brain fog or changes in memory during and after treatment. This is sometimes referred to as “chemo brain,” although chemotherapy, hormone therapies, stress and sleep problems can all play a role in an individual’s overall brain health. These changes are generally different and milder than dementia and often improve over time. However, they can be frustrating, so it’s worth raising any concerns with your health care team.
As you can now see, aging, menopause, breast health and brain health are all connected in some ways, but your risk is personal. Much like breast cancer, where healthy lifestyle choices can help reduce disease risk, research continues to show that lifestyle factors such as physical activity, nutrition, cognitive engagement and improving cardiovascular health may also help protect cognitive function as we age. This approach has been strongly supported by findings from the Alzheimer’s Association’s U.S. POINTER (Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk) study, a large randomized clinical trial conducted across the United States.
Start by learning what factors may matter most for you and then bring your questions to your health care team. Download our Breast and Brain Health Risk Guide, which includes key risk factors, healthy steps to consider and questions to ask your doctor.
Content covered in the Know More Educational Series may be an emerging area in research or technology. Talk with your doctor about what is right for you.
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Downloadable Resource:
Downloadable PDF: Breast and Brain Health: A Risk Guide
Read More:
Alzheimer’s Association: Brain Health
Healthy Living and Breast Cancer Risk
Alzheimer’s Association: Brain Health Habit Builder
Know Your Risk: How to Use Risk Assessment Tools to Take Charge of Your Breast Health
Know Your Risk: Educate, Empower, Act
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