Hormone therapy and Alzheimer disease dementia: new findings from the Cache County Study.

Published

Journal Article

OBJECTIVES: Observational studies suggest reduced risk of Alzheimer disease (AD) in users of hormone therapy (HT), but trials show higher risk. We examined whether the association of HT with AD varies with timing or type of HT use. METHODS: Between 1995 and 2006, the population-based Cache County Study followed 1,768 women who had provided a detailed history on age at menopause and use of HT. During this interval, 176 women developed incident AD. Cox proportional hazard models evaluated the association of HT use with AD, overall and in relation to timing, duration of use, and type (opposed vs unopposed) of HT. RESULTS: Women who used any type of HT within 5 years of menopause had 30% less risk of AD (95% confidence interval 0.49-0.99), especially if use was for 10 or more years. By contrast, AD risk was not reduced among those who had initiated HT 5 or more years after menopause. Instead, rates were increased among those who began "opposed" estrogen-progestin compounds within the 3 years preceding the Cache County Study baseline (adjusted hazard ratio 1.93; 95% confidence interval 0.94-3.96). This last hazard ratio was similar to the ratio of 2.05 reported in randomized trial participants assigned to opposed HT. CONCLUSIONS: Association of HT use and risk of AD may depend on timing of use. Although possibly beneficial if taken during a critical window near menopause, HT (especially opposed compounds) initiated in later life may be associated with increased risk. The relation of AD risk to timing and type of HT deserves further study.

Full Text

Duke Authors

Cited Authors

  • Shao, H; Breitner, JCS; Whitmer, RA; Wang, J; Hayden, K; Wengreen, H; Corcoran, C; Tschanz, J; Norton, M; Munger, R; Welsh-Bohmer, K; Zandi, PP; Cache County Investigators,

Published Date

  • October 30, 2012

Published In

Volume / Issue

  • 79 / 18

Start / End Page

  • 1846 - 1852

PubMed ID

  • 23100399

Pubmed Central ID

  • 23100399

Electronic International Standard Serial Number (EISSN)

  • 1526-632X

Digital Object Identifier (DOI)

  • 10.1212/WNL.0b013e318271f823

Language

  • eng

Conference Location

  • United States