Researchers tracking over 180,000 postmenopausal women in the UK discovered associations between hormone replacement therapy use and reduced dementia risk, according to findings published in the journal Alzheimer’s & Dementia. Women who had used HRT for at least one year showed a 10% lower likelihood of developing any form of dementia and a 16% reduced risk of Alzheimer’s disease specifically, compared with those who never used the treatment.
The protective effect appeared strongest in certain subgroups. Women who underwent surgical menopause and used HRT experienced a 26% lower risk of developing any type of dementia. Additionally, women with naturally lower estrogen exposure during their lifetime—due to starting menstruation late or experiencing early menopause—showed a 16% reduced risk. The analysis also identified a genetic component, with stronger associations between HRT use and dementia protection observed in women carrying the Apoe4 gene variant, a group typically considered at higher risk for cognitive decline.
The study analyzed data from the UK Biobank, following 183,450 postmenopausal women over an average of 13 years, during which approximately 4,000 dementia cases were identified. Researchers examined whether HRT use of any kind altered women’s dementia risk and investigated potential differences in response among various demographic groups.
However, researchers emphasized important limitations of the work. The findings derive from observational data rather than randomized-controlled trials, preventing definitive proof of a causal relationship. HRT users demonstrated higher average education levels than non-users, and although socioeconomic factors were considered in the analysis, unmeasured differences between groups may have influenced results. Experts noted that additional research establishing whether HRT itself causes the observed protective effects and identifying which HRT formulations may be beneficial remains necessary before clinical recommendations change.
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