Researchers conducted an analysis of postmenopausal women to examine the relationship between hormone replacement therapy and dementia risk. The investigation tracked 183,450 women from the UK Biobank over an average period of 13 years, during which approximately 4,000 dementia cases were identified. Those who had used HRT for at least one year showed reduced dementia risk compared to women who had never used the treatment.
The study found a 10% lower likelihood of developing any type of dementia among HRT users and a 16% lower likelihood of Alzheimer’s diagnosis specifically. The most significant protective effect was observed in women who underwent surgical menopause, who demonstrated a 26% lower risk compared to non-users. Additionally, women with naturally lower oestrogen exposure during their lifetime—either from late menarche or early menopause onset—showed a 16% reduced dementia risk with HRT use.
Genetic factors also emerged as relevant to the findings. Women carrying the Apoe4 gene variant, typically considered at higher dementia risk, showed stronger associations between HRT use and reduced dementia risk. Researchers noted that this genetic group has limited established prevention options available to them.
The research, published in the journal Alzheimer’s & Dementia, came with important methodological limitations. The findings were based on observational data rather than randomised-controlled trials, preventing definitive proof of causation. HRT users had higher average education levels than non-users, and despite accounting for socioeconomic factors, other unmeasured differences between groups may have influenced the results. Experts emphasized the need for additional research to establish whether HRT itself drives the observed dementia risk reductions and to identify which specific HRT formulations may be effective.
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