Postmenopausal HT reduces vascular dementia, Alzheimer’s disease mortality risks
Postmenopausal women have a reduced risk for death from vascular dementia or Alzheimer’s disease with any use of estradiol-based hormone treatment, study data show.
Tomi S. Mikkola, MD, PhD, of the department of obstetrics and gynecology at Helsinki University Hospital in Finland, and colleagues identified 489,105 Finnish women using systemic HT from 1994 to 2009 from the nationwide drug reimbursement register to determine the risk for mortality attributable to vascular dementia or Alzheimer’s disease.
Through the follow-up from 1995 to 2009, 581 participants died from vascular dementia and 1,057 died from Alzheimer’s disease.
Initiation of HT before age 60 years was more likely among participants with subsequent vascular dementia compared with participants with subsequent Alzheimer’s disease (P < .001). Compared with deaths from Alzheimer’s disease, deaths from vascular dementia were more likely among HT users older than 90 years (P < .001).
Any use of HT for less than 5 years or at least 5 years reduced the risk for vascular dementia death by 37% to 39%. The risk for Alzheimer’s disease death was reduced by 15% to 19% with HT use exceeding 5 years.
There were no significant differences in risk reduction for death due to vascular dementia or Alzheimer’s disease with HT initiation at age younger than 60 years or at least 60 years. However, irrespective of initiation age, any use of HT was associated with a reduced risk for death due to Alzheimer’s disease.
“Estradiol-based systemic HT use was associated with a reduced risk of death both from [vascular dementia] and [Alzheimer’s disease], but the risk reduction was larger and appears sooner in [vascular dementia] than [Alzheimer’s disease],” the researchers wrote. “Our data imply that, in absolute numbers, of 10,000 women using any type of HT for over 5 years and with follow-up for 10 years, 10 fewer would die due to [vascular dementia] and five fewer due to [Alzheimer’s disease]. The vaginal estradiol use also appears protective against [vascular dementia] and [Alzheimer’s disease] death risk. These decreases in numbers of death are probably associated with much higher decreases of clinical presentation of these diseases.” – by Amber Cox
Disclosure: Mikkola reports receiving speaking and/or consultant fees from Mylan and Novo Nordisk.