Hormone replacement promises no cognitive fountain of youth

In the 11 years that researchers, physicians and womens’ health advocates have been skirmishing over the benefits and risks of hormone replacement therapy, one hope had proved tantalizingly persistent: that newly menopausal women who used the therapy might gain some cognitive edge over those who did not, and perhaps lower their longer-term risk of dementia. A new study suggests that benefit may be more wish than reality.

The research draws upon a group of younger women recruited late to the landmark Women’s Health Initiative, and included a battery of cognitive function tests when the women were on average 67 years old, and then a year later. All the women had taken either hormone replacement therapy or a placebo for about five years starting in their early to mid-50s. About seven years after the women ended their doses, researchers reached the women by phone and gauged each participant’s verbal memory, working (or short-term) memory, verbal fluency and executive function and attention.

On “global cognitive function” and all the specialized measures of memory and mental acuity, the researchers found no difference between those who got the therapy and those who did not. Among a small group of participants who took an estrogen-progesterone mix because they had not had hysterectomies, the researchers found one small signal -- a decline in verbal fluency. But they acknowledged the finding may have been a statistical fluke.

For many women, the study’s finding should offer reassurance. In the Women’s Health Initiative Memory Study, which studied women who took hormone replacement therapy at ages 65 and older, researchers found evidence of declines in cognitive functioning in those who got the hormones. The current study suggests that when women take hormones for around five years just after they reach menopause, they do not seem to be in danger of losing any mental edge.

The latest research was published by JAMA Internal Medicine Online First.