# Elucidating the role of endocrine aging as a risk factor for Alzheimer's Disease

> **NIH NIH K00** · UNIVERSITY OF PENNSYLVANIA · 2024 · $75,654

## Abstract

Project Summary
Women constitute two-thirds of the Alzheimer’s disease (AD) population. While the sex-specific biological
mechanisms underlying women’s increased prevalence are unclear, accumulating evidence points to
menopause as a neurological transition state that may influence AD risk. Over the last quarter century, the vast
majority of brain imaging studies have studied the neural basis of age-related cognitive decline in adults aged
65 and older. This convention overlooks one of the most significant neuroendocrine changes in a woman’s life—
the transition to menopause—and leaves a gap in our understanding of the aging brain during the critical midlife
years. The menopausal transition is marked by a sweeping decline in the production of sex hormones—up to
90% in the case of 17b-estradiol and progesterone. Animal studies provide powerful evidence that estradiol and
progesterone play a neuroprotective role in brain regions vulnerable to neurodegeneration, including the
prefrontal cortex and medial temporal lobes. However, the degree to which female reproductive aging leads to
changes in human brain morphology, intrinsic brain network connectivity, and susceptibility to increased AD
prevalence represents a significant knowledge gap that has yet to be adequately examined. This proposal will
establish whether the decline in sex steroid hormones over the menopausal transition relates to vulnerability in
brain circuits implicated in AD. In the F99 phase (Aim 1), I will probe the effects of reproductive aging on the
brain in healthy women (N=90, ages 45–55), investigating the endocrine basis of neural aging in midlife. The
well-characterized sample is enriched to include a balanced distribution of pre, peri, and post-menopausal
women across a limited age range in order to isolate the effects of reproductive aging from chronological aging.
I will first determine how the depletion of sex hormones in midlife alters large-scale functional brain networks
using resting-state fMRI and computational approaches from complex systems analysis. I will then use high-
resolution anatomical imaging of the hippocampus and surrounding medial temporal lobe to determine whether
the depletion of sex hormones impacts specific hippocampal subfields (CA1-3, dentate gyrus, subiculum) and
entorhinal, perirhinal, and parahippocampal cortices, regions enriched with sex hormone receptors. In the K00
phase (Aim 2), I will take the skills and insights gained from the F99 phase, including fundamental training in
neuroendocrinology and brain imaging, and use them to establish the relationship between female reproductive
aging and pathological AD biomarkers (b-amyloid, tau). To do this, I will leverage two large community cohorts
(N~620, 60% female) that provide relevant hormonal, cognitive, and molecular positron emission tomography
(PET) data from midlife subjects (ages 40-65) and build a neuroendocrine model of AD risk. Together, this
proposal will identify the role menopause pl...

## Key facts

- **NIH application ID:** 11010116
- **Project number:** 4K00AG079790-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Laura Pritschet
- **Activity code:** K00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $75,654
- **Award type:** 4N
- **Project period:** 2022-09-21 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11010116

## Citation

> US National Institutes of Health, RePORTER application 11010116, Elucidating the role of endocrine aging as a risk factor for Alzheimer's Disease (4K00AG079790-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11010116. Licensed CC0.

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