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Long-Term Hormone Therapy May Provide Dementia Protection

Long-Term Hormone Therapy May Provide Dementia Protection

New research suggests postmenopausal estrogen-based hormone therapy lasting longer than ten years may reduce the risk of Alzheimer’s disease.

Investigators from the University of Eastern Finland performed the large study that explored the association between postmenopausal hormone replacement therapy, Alzheimer’s disease, dementia, and cognition.

Researchers performed two nation-wide case-control studies and two longitudinal cohort studies. The largest study comprised approximately 230,000 Finnish women and the follow-up time in different studies was up to 20 years.

“The protective effect of hormone therapy may depend on its timing: it may have cognitive benefits if initiated at the time of menopause when neurons are still healthy and responsive,” says Bushra Imtiaz, M.D., MPH, who presented the results in her doctoral thesis.

While hormone therapy may mitigate the risk of dementia, menopause may explain women’s higher dementia risk.

Alzheimer’s disease is the most common cause of dementia, and two out of three Alzheimer’s cases are women. One possible explanation for women’s higher dementia risk is the postmenopausal depletion of sex steroid hormones estrogen and progesterone.

Estrogen receptors are present throughout the body including brain areas primarily affected in Alzheimer’s disease. In in vitro and animal studies, estrogen has showed neuroprotective effects.

However, studies on humans have yielded inconsistent results on the association between postmenopausal estrogen-based hormone replacement therapy and dementia risk.

In the present study, long-term use of hormonal replacement therapy was associated with a better performance in certain cognitive domains — global cognition and episodic memory — and a lower risk of Alzheimer’s disease.

Short-term use was not significantly linked to dementia risk, but in one cohort, dementia risk was higher among short-term users who had started hormone therapy in the late postmenopausal period.

The results were adjusted for various lifestyle, socioeconomic, and demographic variables.

“In the light of these findings, hormonal replacement therapy may have a beneficial effect on cognition if started early, around the time of menopause.

The protective effect of hormonal therapy may depend on the health status of neurons at baseline and may be lost if therapy starts years after menopause,” Dr. Imtiaz concludes.

The study also showed that the postmenopausal removal of ovaries, uterus, or both was not significantly linked to the risk of Alzheimer’s disease, irrespective of the indication of surgery or hormone therapy use.

The research data was from the MEDALZ (Medication use and Alzheimer’s disease), OSTPRE (Kuopio Osteoporosis Risk Factor and Prevention Study), and CAIDE (Cardiovascular Risk Factors, Aging and Dementia) studies.

The new research findings appear in the journal Neurology¬†with the earlier results found in the Journal of Alzheimer’s Disease.

Source: University of Eastern Finland/EurekAlert

Long-Term Hormone Therapy May Provide Dementia Protection

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Long-Term Hormone Therapy May Provide Dementia Protection. Psych Central. Retrieved on September 26, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 17 Feb 2017)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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