Hormone therapy and Alzheimer disease dementia

New findings from the Cache County Study

Huibo Shao, John C.S. Breitner, Rachel Whitmer, Junmin Wang, Kathleen Hayden, Heidi Wengreen, Chris Corcoran, Jo Ann Tschanz, Maria Norton, Ron Munger, Kathleen Welsh-Bohmer, Peter P. Zandi

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Objectives: Observational studies suggest reduced risk of Alzheimer disease (AD) in users of hormone therapy (HT), but trials show higher risk. We examined whether the association of HT with AD varies with timing or type of HT use. Methods: Between 1995 and 2006, the population-based Cache County Study followed 1,768 women who had provided a detailed history on age at menopause and use of HT. During this interval, 176 women developed incident AD. Cox proportional hazard models evaluated the association of HT use with AD, overall and in relation to timing, duration of use, and type (opposed vs unopposed) of HT. Results: Women who used any type of HT within 5 years of menopause had 30% less risk of AD (95% confidence interval 0.49-0.99), especially if use was for 10 or more years. By contrast, AD risk was not reduced among those who had initiated HT 5 or more years after menopause. Instead, rates were increased among those who began "opposed" estrogen-progestin compounds within the 3 years preceding the Cache County Study baseline (adjusted hazard ratio 1.93; 95% confidence interval 0.94-3.96). This last hazard ratio was similar to the ratio of 2.05 reported in randomized trial participants assigned to opposed HT. Conclusions: Association of HT use and risk of AD may depend on timing of use. Although possibly beneficial if taken during a critical window near menopause, HT (especially opposed compounds) initiated in later life may be associated with increased risk. The relation of AD risk to timing and type of HT deserves further study.

Original languageEnglish (US)
Pages (from-to)1846-1852
Number of pages7
JournalNeurology
Volume79
Issue number18
DOIs
StatePublished - Oct 30 2012
Externally publishedYes

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Alzheimer Disease
Hormones
Menopause
Therapeutics
Confidence Intervals
Progestins
Proportional Hazards Models
Observational Studies
Estrogens
History

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Shao, H., Breitner, J. C. S., Whitmer, R., Wang, J., Hayden, K., Wengreen, H., ... Zandi, P. P. (2012). Hormone therapy and Alzheimer disease dementia: New findings from the Cache County Study. Neurology, 79(18), 1846-1852. https://doi.org/10.1212/WNL.0b013e318271f823

Hormone therapy and Alzheimer disease dementia : New findings from the Cache County Study. / Shao, Huibo; Breitner, John C.S.; Whitmer, Rachel; Wang, Junmin; Hayden, Kathleen; Wengreen, Heidi; Corcoran, Chris; Tschanz, Jo Ann; Norton, Maria; Munger, Ron; Welsh-Bohmer, Kathleen; Zandi, Peter P.

In: Neurology, Vol. 79, No. 18, 30.10.2012, p. 1846-1852.

Research output: Contribution to journalArticle

Shao, H, Breitner, JCS, Whitmer, R, Wang, J, Hayden, K, Wengreen, H, Corcoran, C, Tschanz, JA, Norton, M, Munger, R, Welsh-Bohmer, K & Zandi, PP 2012, 'Hormone therapy and Alzheimer disease dementia: New findings from the Cache County Study', Neurology, vol. 79, no. 18, pp. 1846-1852. https://doi.org/10.1212/WNL.0b013e318271f823
Shao, Huibo ; Breitner, John C.S. ; Whitmer, Rachel ; Wang, Junmin ; Hayden, Kathleen ; Wengreen, Heidi ; Corcoran, Chris ; Tschanz, Jo Ann ; Norton, Maria ; Munger, Ron ; Welsh-Bohmer, Kathleen ; Zandi, Peter P. / Hormone therapy and Alzheimer disease dementia : New findings from the Cache County Study. In: Neurology. 2012 ; Vol. 79, No. 18. pp. 1846-1852.
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