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Saturday, February 18, 2017HRT Won't Lower Women's Alzheimer's Risk
Image Source: WOMEN-INFO
There
was some hint that long-term hormone therapy might have a benefit,
but results weren't definitive
Women who use hormone therapy after
menopause may not have a lower risk of developing Alzheimer's, a new
study suggests.
However,
there was some evidence that long-term use -- over a decade -- might
be tied to a lower risk of the memory-robbing brain disease. But the
results were far from definitive, the researchers added.
The
study is the latest to delve into the question of whether menopausal
hormone therapy can benefit women's brains.
Research
so far has yielded conflicting findings. On one hand, a number of
trials have found no brain benefits for women using hormone therapy,
said Dr. JoAnn Pinkerton, executive director of the North American
Menopause Society.
On
the other hand, small trials have found that when hormone therapy is
given after surgical menopause, women can see "cognitive
benefits," said Pinkerton, who was not involved in the new
study.
On
top of that, some studies of women in the "real world" have
found lower Alzheimer's rates among those who started hormone
replacement therapy early -- soon after menopause began.
Altogether,
the research hints that there's a "critical window" where
hormones might benefit women's thinking and memory, according to
Julie Dumas, an associate professor of psychiatry at the University
of Vermont.
It's
not clear how the new study fits in, said Dumas, who was not involved
in the research.
That's
partly because the number of Alzheimer's cases studied was actually
fairly small, she pointed out. It may take more time for the
connection between hormone use and Alzheimer's risk to become clearer
in this study group, Dumas explained.
"I'd
like to see what the data look like in five or 10 years," she
said.
For
now, the message for women remains unchanged, both Dumas and
Pinkerton said: Hormone therapy may be an option for relatively
younger women with severe menopause symptoms, like bothersome hot
flashes and vaginal dryness.
But
it's not intended to prevent any diseases.
"No
one is prescribing estrogen for women's brains," Dumas said.
The
new findings are based on over 8,000 Finnish women who were between
the ages of 47 and 56 when the study began in 1989. At that point,
and then every few years, they reported on their hormone use.
Then
in 1995, that information became available in a national prescription
registry. So, the researchers used it to verify the women's reports.
Over
20 years of follow-up, 227 women were diagnosed with Alzheimer's.
In
general, the study found, there was no correlation between women's
hormone use and their risk of Alzheimer's disease.
There
was an exception, though: Women who said they'd used hormones for
more than 10 years were half as likely to develop Alzheimer's as
nonusers were.
That
could be viewed as support for the "critical window"
theory, according to the researchers, led by Dr. Bushra Imtiaz, of
the University of Eastern Finland, in Kuopio.
That
is, women who started hormones earlier may have benefited.
There
was a problem, though. When the researchers looked at the data from
the prescription registry -- not women's reports -- there was no
evidence that long-term hormone use was tied to a lower Alzheimer's
risk.
So
what's going on?
Imtiaz
and her colleagues pointed to a possible explanation: The registry
goes back only to 1995. So women who stopped using hormones before
then would be mistakenly classified as nonusers -- which could muddy
any connection between hormone therapy and Alzheimer's risk.
That's
possible, Dumas agreed.
But,
she added, the findings could also reflect a case of "reverse
causation." Women who were developing memory problems may not
have reported their past hormone use accurately. Or they may have
been less likely to stay on hormones for a long time.
If
women are confused by all the different findings, they are not alone,
according to Dumas. She said researchers are still trying to sort out
whether there are some women who might benefit from hormone therapy
early in menopause.
Still,
practically speaking, there is a clear "bottom line" for
women who are considering hormone therapy, according to Pinkerton.
"In
the absence of more definitive findings," Pinkerton said,
"hormone therapy cannot be recommended at any age to prevent or
treat a decline in cognitive function, or dementia."
Story
Source: The above
story is based on materials provided by WEBMD
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Materials may be edited for content and length
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