**Menopausal Women on Hormone Replacement Therapy at Elevated Risk of Dementia and Alzheimer’s Disease**
A major new study published in The British Medical Journal reveals that menopausal women on hormone replacement therapy (HRT) may have an elevated risk of developing dementia and Alzheimer’s disease. The increased risk is observed in both short-term users around the age of menopause as well as long-term users. However, further research is needed to determine if HRT is the direct cause of the increased risk. The study suggests that women who require HRT may have an inherent predisposition to dementia, although the reasons for this are still unknown.
**Research Study on HRT and Dementia Risk**
The study involved an analysis of the medical records of thousands of Danish women between the ages of 50 and 60 who did not have a history of dementia and had no medical reason to avoid HRT. The researchers discovered that women who had received estrogen-progestin therapy had a 24% increased risk of developing dementia and Alzheimer’s disease, even among those who started the treatment at age 55 or younger. The risk of dementia was even higher for long-term users, with an increased risk ranging from 21% for those on the therapy for a year or less, to nearly 75% for those on it for more than 12 years.
**Types of HRT and Their Impact on Dementia**
The study found no association between progestin-only therapy or vaginal estrogen therapy and the development of dementia. However, both daily treatment and treatment for just 10 to 14 days a month showed similar increased rates of dementia. This indicates that the frequency of HRT use does not significantly affect the risk of dementia.
**Should Menopausal Women Discontinue HRT?**
While the study’s findings are alarming, experts from the Mayo Clinic and Harvard Medical School caution that they should not influence decisions made by patients and doctors. Prior studies have shown conflicting results regarding the risks and benefits of hormone therapy, particularly in relation to cognitive function and dementia. For example, a 1998 study showed no increased risk of dementia in women who initiated hormone therapy between ages 50 and 55. Additionally, two other studies found no increased risk of dementia among women who started HRT shortly after menopause.
Dr. Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health, suggests that two-thirds of women experience subjective cognitive changes during the menopause transition, which could contribute to the rate of dementia diagnoses in this study. She adds that it is biologically implausible for hormone therapy used for less than a year to cause dementia. Therefore, no changes should be made to a woman’s hormone therapy based solely on these findings. Future studies should focus on brain imaging to better understand the effects of hormone therapy, if any, at an early stage.
The latest study published in The British Medical Journal suggests an increased risk of dementia and Alzheimer’s disease among menopausal women on hormone replacement therapy. However, further research is needed to definitively establish the causal relationship between HRT and dementia. Experts caution against making changes in hormone therapy based solely on these findings and emphasize the need for more comprehensive studies, including brain imaging, to better understand the effects of HRT on cognitive function.