Hormone therapy within five years of menopause lowers Alzheimer’s risk

FDA Highlights by Bruce Sylvester – Women who start hormone therapy within 5 years of menopause onset could reduce their risk of developing Alzheimer’s disease, researchers reported in a study published online on Oct. 24, 2012 in Neurology.

“This has been an area of debate because observational studies have shown a reduced risk of Alzheimer’s disease with hormone therapy use, while a randomized controlled trial showed an increased risk,” said Peter P. Zandi, PhD, Johns Hopkins University, Baltimore, Maryland. “Our results suggest that there may be a critical window near menopause where hormone therapy may possibly be beneficial.”

“On the other hand, if started later in life, hormone therapy could be associated with an increased risk of developing Alzheimer’s disease,” he added.

The researchers enrolled 1,768 women aged 65 years and older and tracked them for 11 years. Subjects provided data on hormone therapy use and the commencement of  menopause.

A total of 1,105 women used hormone therapy, estrogen monotherapy or  combination with a progestin.

The investigators found that 176 women developed Alzheimer’s disease, 87 of the 1,105 women who had taken hormone therapy and 89 of the other 663. The women who began hormone therapy within 5 years of menopause had a 30% lower risk of Alzheimer’s dementia compared to those who had not used hormone therapy.

There was no risk benefit for hormone users who started treatment more than 5 years after menopause. There was, notably, a higher risk of Alzheimer’s disease among women who had started a combined therapy of estrogen and progestin after age 65.

In an accompanying editorial, Victor Henderson, MD, Stanford University, Stanford, California, said, “While this well-designed study supports the possibility that short-term hormone use may reduce the risk of Alzheimer’s disease, more research is needed before we can make new clinical recommendations for women and their use of hormone therapy.”