Long-term use of Hormone Therapy Does not Influence the Incidence of Dementia

The long-term use of estrogen or estrogen plus progestin hormone therapy does not reduce the risk of dementia, according to findings published in the American Journal of Epidemiology. The study was by led Dr. Valerie Crooks, of Kaiser Permanente Southern California, Pasadena. The study included 2,900 dementia free women at baseline with 1500 on hormone therapy. The subjects were at least 75 years of age. Tests were conducted annually to measure cognitive ability.

Of the 1500 of the women in the study were hormone users, the average age at the start of hormone therapy was 48.3 years for those who used estrogen alone and 54.9 years for those who used estrogen/progestin. The average duration of hormone use was 30.5 years and 23.2 years for estrogen and estrogen/progestin users, respectively.

283 women developed dementia during over the course of the study. The study controlled for age, education, and medical history. The conclusion is that hormone use did not affect the risk of dementia when the intervention begins near or around post-menopause.

Hormone therapy cannot be fully dismissed as the types of hormones, levels of hormones, and the time of first administration has not been fully examined. Further, the identification of subsets of patients that might benefit from a hormone intervention has not been identified. More work is needed.

The Declining Rates of Breast Cancer in Recent Years are Largely Confined to Caucasians

Research conducted Dr. Dezheng Huo of the University of Chicago illustrates that the sharp drop in U.S. breast cancer cases in recent years was limited to Caucasian women. The decline maybe linked to Caucasian women’s greater use of hormone replacement therapy (HRT) in the late 90’s than other ethnic groups. Many women terminated using hormone replacement therapy after a large study suggested in 2002 that the combination of estrogen and progestin used to treat menopause symptoms raised the risk of breast cancer and heart disease.

According to the American Cancer Society, the overall incidence of female breast cancer fell 3.9 percent a year from 2001 through 2004. The bulk of the decline has been principally among women older than 50 with estrogen-receptor positive cancer.

Rates of change in rates of breast cancer by ethnic are as follows (by the end of 2003):

Caucasians had 2.4 percent decline per quarter;
African Americans had a 0.7 percent increase per quarter;
American Indians and Alaskan Natives had 0.14 percent decline per quarter; and
Asian Americans by 0.46 percent decline per quarter.

This study offers additional evidence that HRT (estrogen therapy) influences the rates of breast cancer in women.