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Estrogen has the potential to influence brain physiology
associated with the pathogenesis of dementia.
Hormone replacement therapy (HRT) may affect the risk of
dementia.
Observational data suggest that HRT is associated with a reduced risk of dementia, but experimental evidence suggests that HRT increases the incidence
of dementia.
To determine the effect of hormone replacement therapy on dementia risk, a study published in Neurology conducted a retrospective cohort study
using Taiwan's national claims dataset.
A population-based longitudinal study was conducted
using information from the Taiwan Longitudinal Health Insurance Database.
A total of 35,024 women with HRT served as the exposure cohort, while 70,048 women without HRT were selected as control cohorts
based on predisposition matching.
All participants were followed until diagnosis of dementia, death, or the end of 31 December 2013, whichever occurred earlier
.
Overall, the mean follow-up time (±SD) between the hypertension and control groups was 12.
3 (± 2.
3) and 12.
2 (± 2.
4),
respectively.
The hazard ratio (HR) was calculated with 95% confidence intervals (CI) using a COX proportional hazards regression model to assess the correlation
between HRT and dementia risk.
During the follow-up period, the cumulative incidence of dementia in the HRT cohort (20.
04/1000) was significantly higher than the corresponding cumulative incidence in the control cohort (15.
79/1000), and the adjusted hazard ratio was 1.
35 (95% confidence interval, 1.
13 to 2.
62).
The higher the cumulative dose prescribed for hormone replacement therapy, the higher the risk of dementia (trend P<0.
0001).
Conclusions: This cohort study demonstrates that hormone replacement therapy is associated
with an increased risk of dementia.
The clinical significance of this study deserves further investigation
.
Source: Sung YF, Tsai CT, Kuo CY, et al.
Use of Hormone Replacement Therapy and Risk of Dementia: A Nationwide Cohort Study [published online ahead of print, 2022 Sep 2].
Neurology.
2022; 10.
1212/WNL.
0000000000200960.
doi:10.
1212/WNL.
0000000000200960