Article

The menopause and HRT. HRT and cognitive decline.

Laboratory of Personality and Cognition, Gerontology Research Center, National Institute on Aging, NIH, 5600 Nathan Shock Drive, Baltimore, MD 21224, USA.
Bailli&egrave re s Best Practice and Research in Clinical Endocrinology and Metabolism (impact factor: 4.12). 04/2003; 17(1):105-22.
Source: PubMed

ABSTRACT It is biologically plausible that hormone replacement therapy (HRT) would be protective against cognitive decline and Alzheimer's disease (AD). We review observational and randomized trials to determine whether HRT might protect against cognitive decline in cognitively unimpaired and demented women. We also address issues of clinical relevance, including duration and type of treatment and patient characteristics, including type of menopause (surgical versus natural), age, education and menopausal symptoms. Differences in participant characteristics and testing methods limit the ability to draw conclusions across randomized studies of HRT in non-demented women. The available evidence suggests no detrimental effect of HRT on cognitive function and inconsistent benefits on verbal memory and reasoning, frontal functions and speeded attention. Meta-analyses of observational trials suggest that HRT protects against the development of AD, but randomized trials indicate no long-lasting benefit in patients with AD. Evidence is insufficient to recommend HRT to maintain cognitive function.

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Keywords

available evidence
 
clinical relevance
 
cognitive decline
 
cognitive function
 
cognitively unimpaired
 
demented women
 
detrimental effect
 
frontal functions
 
inconsistent benefits
 
long-lasting benefit
 
menopausal symptoms
 
non-demented women
 
observational trials
 
participant characteristics
 
patient characteristics
 
randomized studies
 
randomized trials
 
speeded attention
 
testing methods limit
 
verbal memory
 

Pauline Maki