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J Gerontol A Biol Sci Med Sci. 2017 Jun 1;72(6):838-845. doi: 10.1093/gerona/glw156.

Long-term Effects on Cognitive Trajectories of Postmenopausal Hormone Therapy in Two Age Groups.

Author information

1
Department of Biostatistical Sciences.
2
Department of Social Sciences and Health Policy, and.
3
Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
4
Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
5
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee.
6
Department of Veterans Affairs, Palo Alto Health Care System and.
7
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California.
8
Department of Preventive Medicine, Northwestern University Fienberg School of Medicine, Chicago, Illinois.
9
Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland.

Abstract

Background:

Postmenopausal hormone therapy may have long-term effects on cognitive function depending on women's age.

Methods:

Postintervention follow-up was conducted with annual cognitive assessments of two randomized controlled clinical trial cohorts, beginning an average of 6-7 years after study medications were terminated: 1,376 women who had enrolled in the Women's Health Initiative when aged 50-54 years and 2,880 who had enrolled when aged 65-79 years. Women had been randomly assigned to 0.625mg/d conjugated equine estrogens (CEE) for those with prior hysterectomy (mean 7.1 years), CEE with 2.5mg/d medroxyprogesterone acetate for those without prior hysterectomy (mean 5.4 years), or matching placebos.

Results:

Hormone therapy, when prescribed to women aged 50-54 years, had no significant long-term posttreatment effects on cognitive function and on changes in cognitive function. When prescribed to older women, it was associated with long-term mean (SE) relative decrements (standard deviation units) in global cognitive function of 0.081 (0.029), working memory of 0.070 (0.025), and executive function of 0.054 (0.023), all p < .05. These decrements were relatively stable over time. Findings did not vary depending on the hormone therapy regimen, prior use, or years from last menstrual period. Mean intervention effects were small; however, the largest were comparable in magnitude to those seen during the trial's active intervention phase.

Conclusions:

CEE-based hormone therapy delivered near the time of menopause provides neither cognitive benefit nor detriment. If administered in older women, it results in small decrements in several cognitive domains that remain for many years.

KEYWORDS:

Cognitive aging; Hormone therapy; Women’s health

PMID:
27506836
PMCID:
PMC6075542
DOI:
10.1093/gerona/glw156
[Indexed for MEDLINE]
Free PMC Article

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