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Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

  • Two reports from 2002 that suggested having hormone replacement therapy after menopause increased the risk of dementia may have been recently disproved
  • Recent studies have shown a link between HRT use and better cognition, blood flow and brain size, and a reduction in all neurodegenerative disease

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HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock
This is the 10th instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
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Does hormone replacement therapy (HRT) affect brain health negatively, as was suggested in Women’s Health Initiative (WHI) reports published 20 years ago? Or is it actually neuroprotective – as the latest studies suggest?

One of the findings of the 2002 WHI reports was that the use of oestrogen and progesterone in hormone therapy after menopause increased the risk of dementia. Three recent studies, though, suggest HRT could protect against it.

A study published this year found a link between HRT use and better cognition and larger brain volumes in later life among women with the APOE4 gene: a gene with the strongest risk factor for Alzheimer’s disease.
If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock
If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

Present in roughly 25 per cent of women in the UK, the gene is a risk factor for Alzheimer’s later in life, says study co-author Professor Craig Ritchie of the University of Edinburgh. But in earlier and midlife it could be good for brain health – improving blood flow and connection between nerve cells.

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