Menopausal hormone therapy is associated with an increased rate of dementia and Alzheimer’s disease, even in women aged 55 years or younger who are short-term users, found a large observational study.
This result confirms findings from the largest randomised, double blind, placebo controlled trial on long-term use of menopausal hormone therapy, the authors state.
Their study set out to also explore the risk for short-term usage (of combined oestrogen and progestogen) and both continuous and cyclic treatment.
Using registry data, the researchers identified 5589 cases of dementia and 55,890 age-matched dementia-free controls between 2000 and 2018 from a population of all Danish women aged 50 to 60 in 2000. The women had no history of dementia and no underlying reason preventing them from using the treatment.
Compared with people who had never used treatment, women who received oestrogen-progestogen therapy had a 24% increased rate of developing all cause dementia and Alzheimer’s disease. Rates were higher with longer use: from 21% for one year or less to 74% for more than 12 years. The increased rate of dementia was similar between continuous and cyclic treatments.
The authors concluded: ‘Further studies are warranted to determine whether these findings represent an actual effect of menopausal hormone therapy on dementia risk, or whether they reflect an underlying predisposition in women in need of these treatments.’
In a linked editorial, researchers highlighted that the results should not be used to infer a causal relationship between hormone therapy and dementia risk.
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