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Hormone Replacement Therapy May Delay Cognitive Decline In Older Women

ST. PAUL, MN -- December 27, 2001 -- Lifetime exposure to hormone replacement therapy (HRT) may be associated with better maintenance of cognitive function in older women free of dementia, according to a study published in the current issue of Neurology, the scientific journal of the American Academy of Neurology.

More than 2,000 women, age 65 and older, participated in the collaborative study, conducted by investigators at Johns Hopkins University, Utah State University, Duke University Medical Center, and the University of California, San Francisco.

Study participants were assessed using a cognitive measure, the Modified Mini-Mental State Exam (3MS), and a simplified version of the depression section of the Diagnostic Interview Schedule. They also provided demographic and occupational information, psychiatric and medical history, and lifestyle information. These women, all from Cache County, Utah, were followed for three years to assess changes in cognition and depression status and additionally provided detailed information regarding use of HRT.

"This study shows an apparent benefit of lifetime HRT use on cognitive function in nondemented older women," according to study co-author Michelle C. Carlson, PhD, of Johns Hopkins University. Study findings of the effects apparent with HRT use are clinically as well as statistically significant. "And those who also stand to lose the most cognitively -- women over age 85 -- appear to gain the most from HRT exposure."

Yet the Cache County study group presents some limitations in interpreting the study results. Participants reside in a geographically isolated, close-knit community and 90 percent of them are members of the Church of Jesus Christ of Latter-Day Saints, a religion which prohibits alcohol and tobacco use. This presumably healthier-than-average lifestyle may limit the ability to generalize the findings to less healthy populations.

"Though our promising analyses controlled for several confounding factors, our results cannot be regarded as conclusive," cautions Dr. Carlson. Further study is required, she notes, to reach definitive conclusions about the effects of HRT in preventing Alzheimer's disease and mitigating age-related cognitive decline. At least two such trials are currently underway.

SOURCE: American Academy of Neurology

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