Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study
- PMID: 12413371
- DOI: 10.1001/jama.288.17.2123
Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study
Abstract
Context: Previous studies have shown a sex-specific increased risk of Alzheimer disease (AD) in women older than 80 years. Basic neuroscience findings suggest that hormone replacement therapy (HRT) could reduce a woman's risk of AD. Epidemiologic findings on AD and HRT are mixed.
Objective: To examine the relationship between use of HRT and risk of AD among elderly women.
Design, setting, and participants: Prospective study of incident dementia among 1357 men (mean age, 73.2 years) and 1889 women (mean age, 74.5 years) residing in a single county in Utah. Participants were first assessed in 1995-1997, with follow-up conducted in 1998-2000. History of women's current and former use of HRT, as well as of calcium and multivitamin supplements, was ascertained at the initial contact.
Main outcome measure: Diagnosis of incident AD.
Results: Thirty-five men (2.6%) and 88 women (4.7%) developed AD between the initial interview and time of the follow-up (3 years). Incidence among women increased after age 80 years and exceeded the risk among men of similar age (adjusted hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.22-3.86). Women who used HRT had a reduced risk of AD (26 cases among 1066 women) compared with non-HRT users (58 cases among 800 women) (adjusted HR, 0.59; 95% CI, 0.36-0.96). Risk varied with duration of HRT use, so that a woman's sex-specific increase in risk disappeared entirely with more than 10 years of treatment (7 cases among 427 women). Adjusted HRs were 0.41 (95% CI, 0.17-0.86) for HRT users compared with nonusers and 0.77 (95% CI, 0.31-1.67) compared with men. No similar effect was seen with calcium or multivitamin use. Almost all of the HRT-related reduction in incidence reflected former use of HRT (9 cases among 490 women; adjusted HR, 0.33 [95% CI, 0.15-0.65]). There was no effect with current HRT use (17 cases among 576 women; adjusted HR, 1.08 [95% CI, 0.59-1.91]) unless duration of treatment exceeded 10 years (6 cases among 344 women; adjusted HR, 0.55 [95% CI, 0.21-1.23]).
Conclusions: Prior HRT use is associated with reduced risk of AD, but there is no apparent benefit with current HRT use unless such use has exceeded 10 years.
Comment in
-
Hormone therapy and risk of Alzheimer disease: a critical time.JAMA. 2002 Nov 6;288(17):2170-2. doi: 10.1001/jama.288.17.2170. JAMA. 2002. PMID: 12413378 No abstract available.
-
Estrogen replacement and risk of Alzheimer disease.JAMA. 2003 Mar 5;289(9):1101; author reply 1101-2. JAMA. 2003. PMID: 12622567 No abstract available.
-
Estrogen replacement and risk of Alzheimer disease.JAMA. 2003 Mar 5;289(9):1100-1; author reply 1101-2. JAMA. 2003. PMID: 12622568 No abstract available.
-
Estrogen replacement and risk of Alzheimer disease.JAMA. 2003 Mar 5;289(9):1101; author reply 1101-2. JAMA. 2003. PMID: 12622569 No abstract available.
-
Estrogen replacement and risk of Alzheimer disease.JAMA. 2003 Mar 5;289(9):1100; author reply 1101-2. doi: 10.1001/jama.289.9.1100-a. JAMA. 2003. PMID: 12622570 No abstract available.
Similar articles
-
Do statins reduce risk of incident dementia and Alzheimer disease? The Cache County Study.Arch Gen Psychiatry. 2005 Feb;62(2):217-24. doi: 10.1001/archpsyc.62.2.217. Arch Gen Psychiatry. 2005. PMID: 15699299
-
Incidence of AD may decline in the early 90s for men, later for women: The Cache County study.Neurology. 2002 Jan 22;58(2):209-18. doi: 10.1212/wnl.58.2.209. Neurology. 2002. PMID: 11805246
-
Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study.Arch Neurol. 2004 Jan;61(1):82-8. doi: 10.1001/archneur.61.1.82. Arch Neurol. 2004. PMID: 14732624
-
Postmenopausal hormone replacement therapy: scientific review.JAMA. 2002 Aug 21;288(7):872-81. doi: 10.1001/jama.288.7.872. JAMA. 2002. PMID: 12186605 Review.
-
Sex steroid hormones and breast cancer: is there a link with oral contraceptives and hormone replacement therapy?Med J Aust. 1992 Jan 20;156(2):124-32. Med J Aust. 1992. PMID: 1736053 Review.
Cited by
-
Transcriptomic analysis reveals sex-specific patterns in the hippocampus in Alzheimer's disease.Front Endocrinol (Lausanne). 2024 Apr 16;15:1345498. doi: 10.3389/fendo.2024.1345498. eCollection 2024. Front Endocrinol (Lausanne). 2024. PMID: 38689734 Free PMC article.
-
Towards a Deeper Understanding: Utilizing Machine Learning to Investigate the Association between Obesity and Cognitive Decline-A Systematic Review.J Clin Med. 2024 Apr 16;13(8):2307. doi: 10.3390/jcm13082307. J Clin Med. 2024. PMID: 38673581 Free PMC article. Review.
-
Systematic review and meta-analysis of the effects of menopause hormone therapy on cognition.Front Endocrinol (Lausanne). 2024 Mar 4;15:1350318. doi: 10.3389/fendo.2024.1350318. eCollection 2024. Front Endocrinol (Lausanne). 2024. PMID: 38501109 Free PMC article.
-
Association between CNS-active drugs and risk of Alzheimer's and age-related neurodegenerative diseases.Front Psychiatry. 2024 Feb 29;15:1358568. doi: 10.3389/fpsyt.2024.1358568. eCollection 2024. Front Psychiatry. 2024. PMID: 38487578 Free PMC article.
-
Gene-Dose-Dependent Reduction Fshr Expression Improves Spatial Memory Deficits in Alzheimer's Mice.Res Sq [Preprint]. 2024 Feb 29:rs.3.rs-3964789. doi: 10.21203/rs.3.rs-3964789/v1. Res Sq. 2024. PMID: 38463956 Free PMC article. Preprint.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical