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J Steroid Biochem Mol Biol. 2010 Feb 28;118(4-5):304-10. doi: 10.1016/j.jsbmb.2009.11.007. Epub 2009 Nov 22.

Postmenopausal hormone therapy and cognitive outcomes: the Women's Health Initiative Memory Study (WHIMS).

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  • 1Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA. lcoker@wfubmc.edu

Abstract

This review discusses major findings from the Women's Health Initiative Memory Study (WHIMS). WHIMS reported hormone therapy (HT)--conjugated equine estrogen (CEE) with or without medroxyprogesterone acetate (MPA)--increased the risk for dementia (HR 1.76 [95% CI, 1.19-2.60]; P=0.005) and global cognitive decline, with a mean decrement relative to placebo of 0.21 points on the Modified Mini Mental State Examination (3MS) (P=0.006) in women age 65 and older. A subset of WHIMS participants joined the ancillary WHI Study of Cognitive Aging (WHISCA) trials, in which domain-specific cognitive tests and mood were measured annually. Compared with placebo, CEE+MPA had a negative impact on verbal memory over time (P=0.01); and CEE-Alone was associated with lower spatial rotational ability (P < or = 0.01) at the initial assessment, but the difference diminished over time. The ancillary WHIMS-MRI study measured subclinical cerebrovascular disease to possibly explain the negative cognitive findings reported by WHIMS and the increased clinical stroke in older women reported by the WHI. WHIMS-MRI reported that while CEE+MPA and CEE-Alone were not associated with increased ischemic brain lesion volume relative to placebo; both CEE+MPA and CEE-Alone were associated with lower mean brain volumes in the hippocampus (P=0.05); frontal lobe (P=0.004); and total brain (P=0.07). HT-associated reductions in hippocampal volumes were greatest in women with baseline 3MS scores < or = 90.

Copyright 2009 Elsevier Ltd. All rights reserved.

PMID:
19932751
[PubMed - indexed for MEDLINE]
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