Researchers analyzing data from over 180,000 postmenopausal women in the UK found 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 were 10% less likely to develop any form of dementia and 16% less likely to receive an Alzheimer’s diagnosis compared with those who never used the treatment. The study tracked participants over an average of 13 years, during which approximately 4,000 dementia cases were identified.
The protective effect was most pronounced in specific populations. Women who had undergone surgical menopause showed a 26% lower dementia risk if they had used HRT. Those with naturally lower estrogen exposure during their lifetime—either from late menstruation onset or early menopause—demonstrated a 16% lower risk of developing any dementia type. Additionally, associations between HRT use and reduced dementia risk were stronger in women carrying the Apoe4 gene variant, a known Alzheimer’s risk factor.
Researchers note that women are statistically more likely than men to develop dementia, partly due to longer life expectancy and potentially because menopause affects brain metabolism and increases the impact of genetic risk factors. The study examined HRT use of at least one year’s duration across various formulations.
However, scientists acknowledge important limitations. The research is observational rather than a randomized-controlled trial, making it impossible to establish causation definitively. HRT users in the study had higher average education levels than non-users, and despite accounting for socioeconomic factors in analysis, unmeasured differences between groups could influence dementia risk independently of HRT treatment itself.
Experts recommend further research to determine whether HRT itself drives the observed dementia risk reductions and to identify which specific HRT forms may be effective. Medical professionals advise individuals considering HRT to discuss potential benefits and risks with their physicians.
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