Systemic Hormone Therapy Tied to Small Increase in Alzheimer's Risk

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Systemic menopausal hormone therapy (HT) may be associated with a slight increase in risk for Alzheimer disease, according to a case-control study in The BMJ.

Using Finnish health and population registries, researchers matched nearly 85,000 women with Alzheimer's to 85,000 controls. Those with Alzheimer's were more likely than controls to have used systemic HT (18.6% vs. 17.0%). Overall, systemic estrogen-progestogen or estradiol-only HT was associated with a small increase in Alzheimer's risk, but for women who began treatment before age 60, a significant risk increase was limited to 10 or more years of use.

Use of vaginal estradiol alone was not associated with Alzheimer's risk.

Dr. Andrew Kaunitz, editor-in-chief of NEJM Journal Watch Women's Health, offered his take: "Data from the large, randomized Women's Health Initiative clinical trial clarify that for young menopausal women (those <age 60, or within 10 years of menopause onset) with bothersome symptoms and without contraindications, menopausal HT is safe. The findings of this case-control study, with the modest effect sizes and substantial potential for bias, will not change how I counsel patients regarding benefits and risks of HT."