British Medical Journal (The BMJ)Menopausal Hormone Therapy and Dementia: Nationwide, Nested Case-control Study

A study in Denmark focused on 5,589 incident cases of dementia and 55,890 age-matched controls during 2000-2018.

As physicians are aware, hormone replacement therapy is frequently used to help manage symptoms of menopause, but recent data is shedding light on potential links to dementia. A newly conducted study in Denmark provides significant findings related to menopausal hormone therapy use and the risk of dementia.

Key Points:

• Women aged 50-60 years in 2000 with no history of dementia or contraindications for use of menopausal hormone therapy were included.
• Oestrogen-progestin therapy was found to increase the rate of all-cause dementia (hazard ratio 1.24 (95% CI 1.17 to 1.33)).
• Dementia risk was higher with increased duration of hormone therapy use, with hazard ratios ranging from 1.21 (1.09 to 1.35) for one year or less of use to 1.74 (1.45 to 2.10) for more than 12 years of use.
• Findings were consistent for both continuous and cyclic oestrogen-progestin therapy regimens.
• The association persisted in women who received treatment at age 55 or younger.

Additional Points:

• This association also held true when the analysis was restricted to late-onset dementia and Alzheimer’s disease.
• The study didn’t differentiate between women who were predisposed to dementia and those who weren’t.

Conclusion:

• There is a positive association between menopausal hormone therapy, particularly oestrogen-progestin therapy, and the development of all-cause dementia and Alzheimer’s disease, even in women who received treatment at age 55 or younger. Further studies are needed to elucidate whether this effect is direct or reflects an underlying predisposition in women requiring these treatments.

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Did You Know?
Worldwide, nearly 10 million new cases of dementia are reported each year.