Hormone Replacement Is Linked to Alzheimer’s
Women Who Take Hormones for Years Run a Higher Risk of Dementia

Last summer, hormone replacement drugs were linked to an increased risk of breast cancer, heart disease and stroke. Now, it's Alzheimer's disease and other forms of dementia. Despite this startling new evidence showing that hormone pills cause ailments they once were thought to prevent, some women and doctors say they're still not ready to abandon them.

Last year Government scientists at the National Institutes of Health abruptly halted the nation's biggest study on Hormone Replacement Therapy (HRT), saying long-term use of synthetic estrogen and progestin drugs increase a women's risk of breast cancer by 26%, her risk of a heart attack by 29%, and her risk of stroke by 41% (JAMA. 2002;288:321-333).

Despite these findings, many women vowed to stick with hormone replacement because they felt it helped their memory and mood and made them think and feel better. Unfortunately, most do not know that there are natural plant based estrogen and progesterone hormone supplements that provide the same benefits without the side effects. The belief that hormone replacement drugs could help women keep their minds sharp was based on smaller, less rigorous studies.

The latest data from the Women's Health Initiative that examined 4,532 postmenopausal women over age 65, found that women who took the combination hormone Prempro developed Alzheimer’s or other types of dementia twice as often as women on a placebo.

These findings suggests that estrogen-progestin pills double the risk of dementia in women aged 65 and older, a development that "is very shocking," said Dr. Barbara Soltes, a reproductive endocrinologist at Chicago's Rush-Presbyterian-St. Luke's Medical Center.

Soltes said many of her patients who continued taking hormones after last year's bad news on heart troubles did so thinking they were helping stave off Alzheimer's and other memory problems associated with aging.

In the most recent study, which appears in the May 28, 2003, issue of the Journal of the American Medical Association, participants who took hormones for an average of more than four years faced double the risk of developing Alzheimer's or other forms of dementia, compared with those who took a placebo. That means that for every 10,000 women taking hormones, 23 more cases of dementia will develop every year.
Researchers also found that hormones did not protect against less severe mental decline, such as mild memory loss. "It's another nail in the coffin" for the use of hormones during and after menopause, said gynecologist Dr. Robert Blaskiewicz, a Saint Louis University professor.

Some experts say that based on what is now known about hormone replacement drugs, women past menopause should not take synthetic hormones at all. Nevertheless, some physicians still contend that women needing relief from night sweats and other menopausal symptoms could take a low dose of the drugs for a period of 2-5 years.

The notion that hormone replacement drugs are good for the mind has been around for at least a decade. Doctors have speculated that the body's own estrogen protects against cell damage and improves blood flow.

One possible explanation for the new findings is that hormone supplements raise the risk of strokes and strokes are known to cause brain damage and contribute to dementia, said the research team led by Sally Shumaker, a public health professor at Wake Forest University.

Nevertheless, the increased risk of dementia is very small, said Marilyn Albert, head of the Alzheimer's Association's scientific advisory council and a Johns Hopkins University neurology professor.

Age remains the single greatest risk factor for dementia, and the study suggests that a 65-year woman on estrogen-progestin pills "would have the increased risk profile of a 70-year-old woman not taking hormone replacement therapy," Albert said.

The results from the Women's Health Initiative Memory Study were funded in part by Wyeth Pharmaceuticals, the manufacturer of Prempro, the drug being tested. Probable dementia was diagnosed in 61 women 40 in the hormone group and 21 taking placebo pills.

Dr. Victoria Kusiak of Wyeth says, “It's unknown whether the results apply to women younger than 65, who make up the bulk of hormone users. Still, she said she agrees with those doctors who say that hormones should be used only to treat menopause symptoms such as night sweats and hot flashes “for the shortest duration and the lowest dose.”

Wyeth estimates that 1.2 million women are still taking Prempro pills, down from about 3.4 million before the study was halted last summer. Wyeth’s stocks price tumbled last summer when the first results of the study were released.

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