Journal article
Long Term Effects on Cognitive Function of Postmenopausal Hormone Therapy Prescribed to Women Aged 50–55 Years
JAMA internal medicine, Vol.173(15), pp.1-8
08/12/2013
DOI: 10.1001/jamainternmed.2013.7727
PMCID: PMC3844547
PMID: 23797469
Abstract
IMPORTANCE Postmenopausal hormone therapy with conjugated equine estrogens (CEEs) may adversely affect older women's cognitive function. It is not known whether this extends to younger women. OBJECTIVE To test whether prescribing CEE-based hormone therapy to postmenopausal women aged 50 to 55 years has longer-term effects on cognitive function. DESIGN Trained, masked staff assessed participants with an annual telephone-administered cognitive battery that included measures of global and domain-specific cognitive functions. Cognitive testing was conducted an average of 7.2 years after the trials ended, when women had a mean age of 67.2 years, and repeated 1 year later. Enrollment occurred from 1996 through 1999. SETTING Forty academic research centers. PARTICIPANTS The study population comprised 1326 postmenopausal women, who had begun treatment in 2 randomized placebo-controlled clinical trials of hormone therapy when aged 50 to 55 years. INTERVENTION The clinical trials in which the women had participated had compared 0.625 mg CEE with or without 2.5 mg medroxyprogesterone acetate over a mean of 7.0 years. MAIN OUTCOMES AND MEASURES The primary outcomewas global cognitive function. Secondary outcomes were verbal memory, attention, executive function, verbal fluency, and working memory. RESULTS Global cognitive function scores from women who had been assigned to CEE-based therapies were similar to those from women assigned to placebo: mean (95%CI) intervention effect of 0.02 (-0.08 to 0.12) standard deviation units (P = .66). Similarly, no overall differences were found for any individual cognitive domain (all P > .15). Prespecified subgroup analyses found some evidence that CEE-based therapiesmay have adversely affected verbal fluency among women who had prior hysterectomy or prior use of hormone therapy: mean treatment effects of-0.17 (-0.33 to-0.02) and-0.25 (-0.42 to-0.08), respectively; however, this may be a chance finding. CONCLUSIONS AND RELEVANCE CEE-based therapies produced no overall sustained benefit or risk to cognitive function when administered to postmenopausal women aged 50 to 55 years. We are not able to address whether initiating hormone therapy during menopause and maintaining therapy until any symptoms are passed affects cognitive function, either in the short or longer term.
Details
- Title: Subtitle
- Long Term Effects on Cognitive Function of Postmenopausal Hormone Therapy Prescribed to Women Aged 50–55 Years
- Creators
- Mark A. Espeland - Wake Forest UniversitySally A. Shumaker - Wake Forest UniversityIris Leng - Wake Forest UniversityJoAnn E. Manson - Brigham and Women's HospitalCandice M. Brown - Wake Forest UniversityErin S. LeBlanc - Kaiser Permanente Center for Health ResearchLeslie Vaughan - Wake Forest UniversityJennifer Robinson - Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157 Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157 Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215 Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 Center for Health Research, Kaiser-Permanente Northwest, Portland, OR 97227 Departments of Epidemiology and Medicine, Division of Cardiology, University of Iowa, Iowa City, IA 52242 Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53226 Department of Preventive Medicine, Stony Brook University, State University of New York, NY 11794 Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, NY 14214 Department of Medicine, Stanford University, Palo Alto, CA Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01695 Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD 21224Stephen R. Rapp - Wake Forest UniversityJoseph S. Goveas - Medical College of WisconsinDorothy Lane - State University of New YorkJean Wactawski-Wende - University at Buffalo, State University of New YorkMarcia L. Stefanick - Stanford UniversityWenjun Li - Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157 Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157 Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215 Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 Center for Health Research, Kaiser-Permanente Northwest, Portland, OR 97227 Departments of Epidemiology and Medicine, Division of Cardiology, University of Iowa, Iowa City, IA 52242 Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53226 Department of Preventive Medicine, Stony Brook University, State University of New York, NY 11794 Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, NY 14214 Department of Medicine, Stanford University, Palo Alto, CA Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01695 Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD 21224Susan M. Resnick - National Institute on AgingWHIMSY Study Group
- Resource Type
- Journal article
- Publication Details
- JAMA internal medicine, Vol.173(15), pp.1-8
- DOI
- 10.1001/jamainternmed.2013.7727
- PMID
- 23797469
- PMCID
- PMC3844547
- NLM abbreviation
- JAMA Intern Med
- ISSN
- 2168-6106
- eISSN
- 2168-6114
- Grant note
- Z01 AG000190-01 || AG / National Institute on Aging : NIA
- Language
- English
- Date published
- 08/12/2013
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984364434602771
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