When hormone therapy is initiated close to the start of menopause in healthy women without diabetes, it does not appear to be associated with any cognitive harm, according to data presented at the 2018 Alzheimer’s Association International Conference.
The seminal Women’s Health Initiative (WHI) Memory Study and WHI Study of Cognitive Aging suggest that hormone therapy was associated with worsening of cognition; however, these results differ from previous studies that found that hormone therapy was associated with cognitive benefits, according to Carey Gleason, PhD, from the Wisconsin Alzheimer’s Disease Research Center at the University of Wisconsin School of Medicine and Public Health.
To determine the cognitive effects of hormone therapy, Gleason reviewed data from more recent studies, including the Kronos Early Estrogen Prevention Study-Cognitive (KEEPS-Cog) and Affective Study, the Early vs. Late Intervention Trial with Estradiol-Cognitive Endpoints (ELITE-Cog) and the WHI Memory Study-Young (WHIMS-Y).
In the KEEPS-Cog study, 662 women within 3 years of their last menstrual period received hormone therapy or placebo for 4 years. The study revealed that there was no difference in multiple cognitive domains among women treated with hormone therapy compared with placebo. However, women receiving oral conjugated equine estrogens had improvements in mood and reductions in anxiety and depressive symptoms.
The ELITE-Cog study demonstrated no cognitive benefit or harm associated with 5 years of oral estradiol treatment among women within 6 years of, or 10 or more years past, menopause.
Additionally, no cognitive effects were observed among women enrolled in WHIMS-Y who were aged between 50 and 54 years when initiating hormone therapy. However, women with type 2 diabetes receiving hormone therapy showed a greater risk for cognitive impairment, compared with women with type 2 diabetes receiving placebo and those without diabetes receiving hormone therapy.
“These findings add to our understanding of the complex effects of hormones on the brain,” Gleason said in a press release. “These data are sorely needed to guide women’s healthcare during and after the menopausal transition and to help women make personalized and informed decisions regarding management of their menopausal symptoms and the prevention of future adverse health outcomes.” – by Alaina Tedesco
Gleason C. An update on menopausal hormone therapy trials. Presented at: Alzheimer’s Association International Conference; July 22-26, 2018; Chicago.
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