Study suggests HRT use linked to lower dementia risk in women
A large UK study found postmenopausal women who used hormone replacement therapy had a lower risk of developing dementia than non-users, with the strongest protective effect seen after surgical menopause.
A new study suggests hormone replacement therapy (HRT) may lower the risk of dementia in postmenopausal women. It is the largest study of its kind, following more than 183,000 women in the UK Biobank for an average of 13 years.
During that period, almost 4,000 dementia cases were recorded. Compared with women who had never used HRT, those who had used it were 10% less likely to develop any type of dementia and 16% less likely to be diagnosed with Alzheimer's disease, the most common form of dementia.
The strongest effect was found among women who had undergone surgical menopause, who showed a 26% lower risk of developing any type of dementia compared with non-users.
Who benefits most
Professor Anne-Marie Minihane of the University of East Anglia, who led the research, noted that HRT has traditionally been prescribed mainly to relieve menopausal symptoms such as hot flushes, but the findings suggest it may also play a role in long-term brain health.
Women with naturally lower lifetime oestrogen exposure — due to starting periods late or entering menopause early — appeared to benefit more from HRT, showing a 16% lower risk of any type of dementia. Genetics also mattered: the link between HRT use and reduced dementia risk was stronger in women carrying the Apoe4 gene variant, which is usually associated with higher risk and fewer prevention options.
Researchers cautioned that the study is based on observational data rather than a randomised controlled trial, so a causal link cannot be proven. Women who used HRT had, on average, higher levels of education than non-users, and although socioeconomic factors were accounted for, other differences between the groups could still have influenced the results.
Experts advised anyone considering starting or stopping HRT to discuss the potential benefits and risks with their doctor. The findings were published in the journal Alzheimer's & Dementia.
