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Extended Estrogen Therapy Aids Late-Life Cognition

Benefit seen especially in older women and women initiating treatment within five years of menopause

menopausal woman and doctor

FRIDAY, Oct. 18, 2019 (HealthDay News) -- Longer use of estrogen hormone therapy is associated with higher cognitive status in late life, according to a study published online Oct. 14 in Menopause.

Joshua M. Matyi, from Utah State University in Logan, and colleagues examined the association between estrogen and cognitive decline in more than 2,114 older adult women (mean age, 74.9 years) participating in the 12-year Cache County Study. Women who were free of dementia at baseline completed a women's health questionnaire and a modified version of the Mini-Mental State Examination at four triennial waves.

The researchers found that endogenous estrogen exposure was positively associated with cognitive status (β = 0.03; P = 0.054). Longer duration of hormone therapy use was positively associated with cognitive status (β = 0.02; P = 0.046). Older women showed greater benefit from hormone therapy compared with younger women. Timing of hormone therapy initiation was significantly associated with Mini-Mental State Examination scores (β = 0.55; P = 0.048), with higher scores seen for women who initiated treatment within five years of menopause versus those initiating at least six years later.

"Although the assessment of the risk-to-benefit balance of hormone therapy use is complicated and must be individualized, this study provides additional evidence for beneficial cognitive effects of hormone therapy, particularly when initiated early after menopause," Stephanie Faubion, M.D., medical director of the North American Menopause Society, said in a statement. "This study also underscores the potential adverse effects of early estrogen deprivation on cognitive health in the setting of premature or early menopause without adequate estrogen replacement."

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