These findings line up with the largest clinical trial performed on this topic, and the researchers call for additional studies “to explore if the observed association in this research study in between menopausal hormonal agent treatment use and increased threat of dementia highlights a causal impact.”
In a connected editorial, researchers argue that while this study has several strengths, the observed associations need to not be used to presume a causal relationship in between hormonal agent therapy and dementia risk.
Menopausal hormone treatment (commonly known as HRT) is used to relieve typical menopausal symptoms such as hot flashes and night sweats. Treatments consist of tablets including estrogen only, or a mix of estrogen and progestogen, along with skin creams, spots, and gels.
Large observational studies have revealed that long-term usage of menopausal hormonal agent therapy is associated with the development of dementia, confirming findings from the Womens Health Initiative Memory Study, the biggest clinical trial on this topic.
The effect of short-term use of menopausal hormone therapy around the age of menopause, as is currently recommended, stays to be completely explored. The result of various treatment programs on the danger of dementia is also unsure.
To attempt and fill these understanding spaces, scientists in Denmark examined the association between making use of combined estrogen and progestin (artificial progestogen) therapy and the development of dementia according to kind of hormone treatment, duration of use, and age at usage.
Making use of national computer system registry information, they identified 5,589 cases of dementia and 55,890 age-matched dementia-free controls in between 2000 and 2018 from a population of all Danish ladies aged 50-60 years in 2000 without any history of dementia and no underlying reason avoiding them from utilizing menopausal hormone treatment.
Other relevant factors consisting of education, earnings, thyroid, diabetes, and high blood pressure disease were likewise taken into account.
The typical age at medical diagnosis was 70 years. Before a diagnosis, 1,782 (32%) cases and 16,154 (29%) controls had received estrogen-progestin therapy from a typical age of 53 years. The average period of usage was 3.8 years for cases and 3.6 years for controls.
The results show that, compared with people who had actually never ever used treatment, individuals who had gotten estrogen-progestin therapy had a 24% increased rate of developing all-cause dementia and Alzheimers disease, even in women who got treatment at the age of 55 years or younger.
Rates were greater with longer usage, varying from 21% for one year or less to 74% for more than 12 years of usage.
The increased rate of dementia was comparable between constant (estrogen and progestin taken daily) and cyclic (day-to-day estrogen with progestin taken 10-14 days a month) treatment routines.
The use of progestin-only treatment and vaginal estrogen just was not associated with the advancement of dementia.
This is an observational research study, so cant establish the cause, and the researchers were unable to isolate vascular dementia from other types of dementia or compare tablets and other ways to take hormonal agent treatment, such as spots.
Whats more, they cant rule out the possibility that ladies utilizing hormonal agent treatment have a predisposition to both menopausal vasomotor signs (eg. hot flushes, night sweats) and dementia.
However, this was a large study based upon premium treatment data with a long follow-up time. The authors were also able to investigate cyclic and continuous hormone formulas separately, as well as age of starting menopausal hormonal agent treatment and length of treatment, enabling them to analyze an essential neglected element of this topic– for example, dementia danger in short-term users of menopausal hormonal agent treatment around the age of menopause start, as advised in treatment standards.
They conclude: “Further studies are necessitated to identify whether these findings represent an actual effect of menopausal hormone treatment on dementia risk, or whether they reflect an underlying predisposition in ladies in requirement of these treatments.”
This view is supported by US scientists in a linked editorial, who say “confounding aspects might be producing a spurious signal for greater dementia threat in younger women utilizing hormonal agent treatment for either a short or long duration.”
” These findings can not inform shared decision-making about the use of hormonal agent therapy for menopausal symptoms,” they compose. “Randomised clinical trials supply the strongest evidence on the impact of hormone treatment on dementia danger.”
They say brain imaging biomarkers “might help to determine the results of hormonal agent treatment on dementia pathophysiology at an earlier stage, making assessment of its impact on dementia risk in trials of recently postmenopausal females feasible.”
Reference: “Menopausal hormone treatment and dementia: across the country, nested case-control study” by Nelsan Pourhadi, Lina S Mørch, Ellen A Holm, Christian Torp-Pedersen and Amani Meaidi, 28 June 2023, BMJ.DOI: 10.1136/ bmj-2022-072770.
New research study suggests that the use of menopausal hormone treatment is linked to an increased risk of dementia and Alzheimers disease. Although the studys findings shouldnt be taken as a direct causal relationship, it calls for additional research study on the subject.
An increase was observed even in people who utilized it for a short-term around the age of menopause; in spite of the uncertain causal connection, it is essential to check out these findings more thoroughly in future research studies.
Menopausal hormonal agent treatment might be connected to a greater risk of dementia and Alzheimers disease, according to a thorough Danish research study just recently published in The BMJ.
The study indicated that not only long-lasting users however also short-term users around the age of menopause (55 years or more youthful) as is presently advised are at an increased risk.