A study conducted in Denmark suggests that taking hormone replacement therapy (HRT) for as little as a year may increase the risk of dementia and Alzheimer’s disease. The research involved over 60,000 Danish women, and those who used HRT were found to be almost a quarter more likely to develop dementia later in life. The study also revealed that the risk increased the longer women took the medication. However, it is important to note that these findings are observational and other factors could be contributing to the higher risks seen in these women.
The scientific community has conflicting views on whether HRT can increase the risk of dementia or actually improve brain health. The contradictory findings may be due to factors such as the age at which HRT is given, differences in how it is used, and the specific types of HRT used.
To better understand these knowledge gaps, researchers in Denmark examined the use of combined estrogen and progestin therapy and its relationship to the development of dementia. They looked at factors such as the type of hormone treatment, duration of use, and age of the user. The study identified 5,589 cases of dementia among women who had received estrogen-progestin therapy, compared to 16,154 cases in the control group. After accounting for other factors, it was found that women who took HRT had a 24% increased rate of developing dementia and Alzheimer’s disease, even when treatment was started at 55 years of age or younger.
The risk of dementia increased with longer duration of HRT use, ranging from 21% after 12 months to 74% after 12 years or more. Both daily HRT and intermittent use (10-14 days a month) showed similar results. However, the study did not differentiate between different forms of hormone therapy such as tablets or patches. Notably, progestin-only therapy and vaginal estrogen were not associated with a higher risk of dementia.
The researchers were unable to distinguish between vascular dementia and other types of dementia, which could provide further insight into the relationship between HRT and dementia risk. They acknowledged that women using HRT may already have a predisposition to both menopausal symptoms and dementia, and more research is needed to determine if these findings represent a true effect of HRT on dementia risk.
Experts from Harvard and the Mayo Clinic in the US caution that observational research like this cannot replace clinical trials. They note that confounding factors could be influencing the higher dementia risk seen in younger women using hormone therapy, and these findings should not be used to guide decision making about the use of HRT for menopausal symptoms.
Despite the conflicting evidence, the study raises concerns about the potential association between HRT and dementia risk. Dr. Susan Kohlhaas of Alzheimer’s Research UK emphasizes the need for further research to provide clearer answers on this topic. In the meantime, women should consult with healthcare professionals to understand the benefits and risks of HRT in managing menopause symptoms.
It is important to note that HRT is still considered an effective and safe treatment for most women with menopause symptoms, with any associated risk being small. Dr. Anita McGrogan of the University of Bath points out that the prescribing and availability of HRT may vary between countries, and the findings of this study may not apply universally. She also highlights the need to consider other risk factors for dementia that were not addressed in this study.
Overall, while the study provides valuable insights into the potential link between HRT and dementia, more research is needed before any conclusive conclusions can be drawn.
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