Hormone Therapy Associated With Improved Cognition

Women comprise around two thirds of the 5.5 million cases of Alzheimer’s disease in America; as such sex specific factors including estrogen have long been suspected to contribute to the increased risk in women, and many studies suggest that estrogen plays a role in promoting memory and learning. 

In this study 2,114 postmenipausal women with a mean age of 74.94 years who were dementia free at baseline were followed for 12 years to examine the associations between estrogen and cognitive decline, focussing on the duration of exposure to estrogen taking into account factors such as time of menarche to menopause, number of pregnancies, duration of breastfeeding, and use of hormone therapy.

Based on their findings the researchers concluded that a longer duration of estrogen exposure was associated with better cognitive status in older adult women; these beneficial effects were extended with the use of hormone therapy, especially among those who were the oldest; and those who initiated hormone therapy earlier showed higher cognitive test scores, providing support for the critical window of hypothesis of hormone therapy. 

“Although the assessment of the risk-to-benefit balance of hormone therapy use is complicated and must be individualized, this study provides additional evidence for beneficial cognitive effects of hormone therapy, particularly when initiated early after menopause. This study also underscores the potential adverse effects of early estrogen deprivation on cognitive health in the setting of premature or early menopause without adequate estrogen replacement,” says Dr. Stephanie Faubion, NAMS medical director.

Abstract:

“Results: EEE was positively associated with cognitive status (β = 0.03, P = 0.054). In addition, longer duration of HT use was positively associated with cognitive status (β = 0.02, P = 0.046) and interacted with age; older women had greater benefit compared with younger women. The timing of HT initiation was significantly associated with 3MS (β = 0.55, P = 0.048), with higher scores for women who initiated HT within 5 years of menopause compared with those initiating HT 6-or-more years later.

Conclusions: Our results suggest that longer EEE and HT use, especially in older women, are associated with higher cognitive status in late life.”