[Dementia: risk and protective factors with special consideration of gender and hormone replacement therapy]

This article focuses on the special role of women and their problems regarding the epidemiology and pathogenesis of dementia, especially Alzheimer's disease (AD). Recent epidemiological studies reveal higher rates of women affected by the two major dementing conditions, AD and vascular dementia (VaD). However, it is under debate whether a pure gender effect accounts for this, because gender differences e.g. in education, life expectancy, psychosocial development and health behaviour must be included in the analysis. Therefore it seems to be reasonable to have a look on gender related variances in other risk and protective factors of dementia. Recently, the menopause attracted the interest of dementia researchers, because retrospective studies revealed a favourable effect of hormone replacement therapy (HRT) on the incidence of AD by about 50%. However, in spite of well known "positive effects" of estrogens on the central nervous system, there is still not enough evidence for a recommendation of HRT for the prevention of AD and other dementias.