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Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study.

Publication ,  Journal Article
Zandi, PP; Carlson, MC; Plassman, BL; Welsh-Bohmer, KA; Mayer, LS; Steffens, DC; Breitner, JCS; Cache County Memory Study Investigators,
Published in: JAMA
November 6, 2002

CONTEXT: Previous studies have shown a sex-specific increased risk of Alzheimer disease (AD) in women older than 80 years. Basic neuroscience findings suggest that hormone replacement therapy (HRT) could reduce a woman's risk of AD. Epidemiologic findings on AD and HRT are mixed. OBJECTIVE: To examine the relationship between use of HRT and risk of AD among elderly women. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of incident dementia among 1357 men (mean age, 73.2 years) and 1889 women (mean age, 74.5 years) residing in a single county in Utah. Participants were first assessed in 1995-1997, with follow-up conducted in 1998-2000. History of women's current and former use of HRT, as well as of calcium and multivitamin supplements, was ascertained at the initial contact. MAIN OUTCOME MEASURE: Diagnosis of incident AD. RESULTS: Thirty-five men (2.6%) and 88 women (4.7%) developed AD between the initial interview and time of the follow-up (3 years). Incidence among women increased after age 80 years and exceeded the risk among men of similar age (adjusted hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.22-3.86). Women who used HRT had a reduced risk of AD (26 cases among 1066 women) compared with non-HRT users (58 cases among 800 women) (adjusted HR, 0.59; 95% CI, 0.36-0.96). Risk varied with duration of HRT use, so that a woman's sex-specific increase in risk disappeared entirely with more than 10 years of treatment (7 cases among 427 women). Adjusted HRs were 0.41 (95% CI, 0.17-0.86) for HRT users compared with nonusers and 0.77 (95% CI, 0.31-1.67) compared with men. No similar effect was seen with calcium or multivitamin use. Almost all of the HRT-related reduction in incidence reflected former use of HRT (9 cases among 490 women; adjusted HR, 0.33 [95% CI, 0.15-0.65]). There was no effect with current HRT use (17 cases among 576 women; adjusted HR, 1.08 [95% CI, 0.59-1.91]) unless duration of treatment exceeded 10 years (6 cases among 344 women; adjusted HR, 0.55 [95% CI, 0.21-1.23]). CONCLUSIONS: Prior HRT use is associated with reduced risk of AD, but there is no apparent benefit with current HRT use unless such use has exceeded 10 years.

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Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

November 6, 2002

Volume

288

Issue

17

Start / End Page

2123 / 2129

Location

United States

Related Subject Headings

  • Utah
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Prospective Studies
  • Male
  • Longitudinal Studies
  • Incidence
  • Humans
  • General & Internal Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zandi, P. P., Carlson, M. C., Plassman, B. L., Welsh-Bohmer, K. A., Mayer, L. S., Steffens, D. C., … Cache County Memory Study Investigators, . (2002). Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study. JAMA, 288(17), 2123–2129. https://doi.org/10.1001/jama.288.17.2123
Zandi, Peter P., Michelle C. Carlson, Brenda L. Plassman, Kathleen A. Welsh-Bohmer, Lawrence S. Mayer, David C. Steffens, John C. S. Breitner, and John C. S. Cache County Memory Study Investigators. “Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study.JAMA 288, no. 17 (November 6, 2002): 2123–29. https://doi.org/10.1001/jama.288.17.2123.
Zandi PP, Carlson MC, Plassman BL, Welsh-Bohmer KA, Mayer LS, Steffens DC, et al. Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study. JAMA. 2002 Nov 6;288(17):2123–9.
Zandi, Peter P., et al. “Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study.JAMA, vol. 288, no. 17, Nov. 2002, pp. 2123–29. Pubmed, doi:10.1001/jama.288.17.2123.
Zandi PP, Carlson MC, Plassman BL, Welsh-Bohmer KA, Mayer LS, Steffens DC, Breitner JCS, Cache County Memory Study Investigators. Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study. JAMA. 2002 Nov 6;288(17):2123–2129.
Journal cover image

Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

November 6, 2002

Volume

288

Issue

17

Start / End Page

2123 / 2129

Location

United States

Related Subject Headings

  • Utah
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Prospective Studies
  • Male
  • Longitudinal Studies
  • Incidence
  • Humans
  • General & Internal Medicine