Effects of hormone replacement therapy on cognitive performance in elderly women

• Published in: Maturitas Vol. 38; no. 2; pp. 137 - 146
• Main Authors: Binder, Ellen F., Schechtman, Kenneth B., Birge, Stanley J., Williams, Daniel B., Kohrt, Wendy M.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 20.04.2001; Elsevier Science
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cognition - drug effects; Cognitive performance; Double-Blind Method; Endometrical hyperplasia; Epidemiological research; Estrogen; Estrogens, Conjugated (USP) - pharmacology; Female; Hormone Replacement Therapy; Hormone replacement therapy (HRT); Hormones. Endocrine system; Humans; Medical sciences; Medroxyprogesterone - pharmacology; Pharmacology. Drug treatments; Psychometric tests; Psychometrics; Treatment Outcome; Endometrical hyperplasia; Hormone replacement therapy (HRT); Cognitive performance; Epidemiological research; Psychometric tests; Estrogen; Human; Chemotherapy; Replacement therapy; Postmenopause; Female; Cognition; Sex steroid hormone; Elderly; Progestagen
• ISSN: 0378-5122; 1873-4111
• DOI: 10.1016/S0378-5122(00)00214-0

Objective: To determine the effects of 9 months of hormone replacement therapy (HRT) on cognitive performance in women aged 75 years and older. Methods: A 9-month randomized, double-blinded, placebo-controlled parallel trial. Fifty-two elderly postmenopausal women (age range 75–91 years) without known contraindications to HRT or evidence of dementia or depression were enrolled. Participants were randomly assigned in a 1:2 ratio to placebo or conjugated estrogens at 0.625 mg/d plus trimonthly medroxyprogesterone acetate at 5 mg/d for 13 days (HRT). Main outcome measures were change from baseline and rate of change from baseline for the following psychometric tests: Verbal Fluency Test, Weschler Paired Associate Learning and 20 min Delayed Recall, Trailmaking A and B Tests, Cancellation Random Letter and Random Form Tests. Results: At baseline, women in the HRT group reported a younger age of onset of menopause and a higher prevalence of hysterectomy, but otherwise did not differ from women in the placebo group. After 9 months of treatment, there were no significant group differences for any of the cognitive performance measures. The lack of an observed group-by-time difference for all cognitive tests remained after controlling for age of onset of menopause, education, and previous hysterectomy. Conclusions: Although conclusions are limited by small sample size and the relatively short duration of treatment, results suggest that 9 months of estrogen replacement in combination with trimonthly progestin does not improve cognitive performance in women over 75 years who do not have dementia or depression.