There is no strong link between hormone replacement therapy and dementia, according to the findings of a major UK study published today.
Previous trials of hormone replacement therapy (HRT) have led to conflicting findings about a possible raised risk of dementia. Now, Dr Yana Vinogradova of the University of Nottingham, UK, and colleagues have investigated the risk using two large primary care databases in the UK (QResearch and CPRD).
Information was taken from 118,501 women aged 55 and above, who had a diagnosis of dementia between 1998 and 2020. This group was compared with 497,416 comparable women with no dementia diagnosis. Among both groups, 14% had taken HRT.
Once a number of risk factors were taken into account, there was no overall link between hormone use and dementia, regardless of type of hormone, application method, dose, or duration of treatment.
Only for a small sub-group, women on oestrogen-only therapy for more than ten years, was there a trend towards raised dementia risk.
Findings are published today in BMJ.
They write: “This study provides the most detailed estimates of risk for individual treatments, and results are in line with existing concerns in guidelines about long term exposures to combined hormone therapy treatments.
"These results will inform future national and international guidance for women and for prescribers."
They add that the study "brings clarity to previously inconsistent findings and should reassure women in need of menopausal hormonal therapy".
Dr Vinogradova said: “We are happy to be able to report findings that will facilitate conversations between doctors and patients about the safest treatments. We hope they will also be useful to other health professionals and policy makers.”
Vinogradova, Y. et al. Use of menopausal hormone therapy and risk of dementia: nested case control studies using the QResearch and CPRD databases. BMJ 30 September
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