Menopausal hormone therapy and dementia: nationwide, nested case-control study
An erratum to this article was published (BMJ, 29 Jun 2023 ↗)
Main finding · All cause dementiaResult — go to the resultHazard ratio 1.24 95% CI 1.17–1.33Authors' conclusion
Menopausal hormone therapy was positively associated with development of all cause dementia and Alzheimer's disease, even in women who received treatment at the age of 55 years or younger. The increased rate of dementia was similar between continuous and cyclic treatment. Further studies are warranted to determine whether these findings represent an actual effect of menopausal hormone therapy on dementia risk, or whether they reflect an underlying predisposition in women in need of these treatments.
Study context
- Population
- Danish women aged 50–60 years in 2000 with no history of dementia or contraindications for MHT; cases and controls identified 2000–2018, Denmark national registries5,589 cases · 55,890 controls
- Comparison
- Oestrogen-progestogen therapy vs never use of MHT
- Outcome
- All cause dementia (first time diagnosis or first time use of dementia specific medication); adjusted HRs with 95% CI
Methodological detailsnationwide, age matched controls, national registries
- Nationwide
- Age matched controls
- National registries
Main finding
All cause dementia
Hazard ratio
1.24
95% CI 1.17–1.33
As reported in the abstract
Observational data: associations, not effects.
Further findings
All cause dementia by duration of oestrogen-progestogen therapy
- Increasing durations of use yielded higher HRs; ≤1 year of use
- 1.21 (1.09 to 1.35)
- >12 years of use
- 1.74 (1.45 to 2.10)
All cause dementia by oestrogen-progestogen regimen
- Continuous regimen
- 1.31 (1.18 to 1.46)
- Cyclic regimen
- 1.24 (1.13 to 1.35)
All cause dementia in women treated at age ≤55 years
- Association persisted
- 1.24 (1.11 to 1.40)
Late onset dementia
- Findings persisted
- 1.21 (1.12 to 1.30)
Alzheimer's disease
- Findings persisted
- 1.22 (1.07 to 1.39)
Original publication
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