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Long-Term Systemic Hormone Therapy May Up Alzheimer Risk

THURSDAY, March 7, 2019 -- Long-term use of systemic hormone therapy may be associated with an increased risk for Alzheimer disease, according to a study published online March 6 in The BMJ.

Hanna Savolainen-Peltonen, M.D., Ph.D., from the University of Helsinki, and colleagues conducted a nationwide case-control study involving all 84,739 postmenopausal women in Finland who received a diagnosis of Alzheimer disease from a neurologist or geriatrician between 1999 and 2013. A total of 84,739 age- and hospital district-matched control women, without a diagnosis, were traced from the Finnish national population register.

The researchers observed a 9 to 17 percent increase in the risk for Alzheimer disease in association with use of systemic hormone therapy. No significant difference was noted in the risk for the disease between estradiol-only users and estrogen-progesterone users (odds ratios, 1.09 and 1.17, respectively). In estrogen-progesterone users, the risk increases were not related to different progestogens; these risk increases were associated with hormone therapy exposure over 10 years in women younger than 60 at hormone therapy initiation. The age at initiation of systemic hormone therapy was not a decisive determinant for the increase in Alzheimer disease risk.

"Considering the totality of the evidence, these findings should not influence clinical decision making about the use of hormone therapy for symptom management," write the authors of an accompanying editorial. "Concerns about longer term use of estrogen plus progestin on cognitive outcomes remain."

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: March 2019

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