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Effect of postmenopausal hormone therapy on cognitive function: the Heart and Estrogen/progestin Replacement Study.

Abstract

PURPOSE

To determine if hormone therapy results in better cognitive function in older postmenopausal women.

SUBJECTS AND METHODS

The Heart and Estrogen/progestin Replacement Study (HERS) was a randomized, placebo-controlled trial involving 2763 women with coronary disease. Women were assigned randomly to conjugated estrogen (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) in one tablet daily or identical placebo; they were followed for a mean (+/- SD) of 4.2 +/- 0.4 years. Participants at 10 of the 20 HERS centers were invited to enroll in the cognitive function substudy. At the end of the trial, we measured cognitive function in 517 women in the hormone group and 546 in the placebo group using six standard tests: the modified Mini-Mental Status Examination, Verbal Fluency, Boston Naming, Word List Memory, Word List Recall, and Trails B. Cognitive function was not measured at baseline.

RESULTS

The mean age of participants at the time of cognitive function testing was 71 +/- 6 years. There were no differences in age-adjusted cognitive function test scores between the two treatment groups, except that women assigned to hormones scored worse on the Verbal Fluency test than women assigned to placebo (15.9 +/- 4.8 vs. 16.6 +/- 4.8, P = 0.02). Adjustment for other potential confounders and restriction of the analyses to women who had been adherent to study medication did not change the results.

CONCLUSION

Among older postmenopausal women with coronary disease, 4 years of treatment with postmenopausal hormone therapy did not result in better cognitive function as measured on six standardized tests. Whether these results also apply to elderly women without coronary disease cannot be determined from this study.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Biostatistics, University of California-San Francisco, 1635 Divisidero Street, Suite 600, San Francisco, CA 94115, USA. dgrady@itsa.ucsf.edu

    , , , ,

    Source

    The American journal of medicine 113:7 2002 Nov pg 543-8

    MeSH

    Administration, Oral
    Aged
    Cognition
    Cognition Disorders
    Coronary Disease
    Drug Administration Schedule
    Drug Combinations
    Estrogen Replacement Therapy
    Estrogens, Conjugated (USP)
    Female
    Humans
    Medroxyprogesterone Acetate
    Memory
    Middle Aged
    Postmenopause
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    12459399

    Citation

    Grady, Deborah, et al. "Effect of Postmenopausal Hormone Therapy On Cognitive Function: the Heart and Estrogen/progestin Replacement Study." The American Journal of Medicine, vol. 113, no. 7, 2002, pp. 543-8.
    Grady D, Yaffe K, Kristof M, et al. Effect of postmenopausal hormone therapy on cognitive function: the Heart and Estrogen/progestin Replacement Study. Am J Med. 2002;113(7):543-8.
    Grady, D., Yaffe, K., Kristof, M., Lin, F., Richards, C., & Barrett-Connor, E. (2002). Effect of postmenopausal hormone therapy on cognitive function: the Heart and Estrogen/progestin Replacement Study. The American Journal of Medicine, 113(7), pp. 543-8.
    Grady D, et al. Effect of Postmenopausal Hormone Therapy On Cognitive Function: the Heart and Estrogen/progestin Replacement Study. Am J Med. 2002;113(7):543-8. PubMed PMID: 12459399.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of postmenopausal hormone therapy on cognitive function: the Heart and Estrogen/progestin Replacement Study. AU - Grady,Deborah, AU - Yaffe,Kristine, AU - Kristof,Margaret, AU - Lin,Feng, AU - Richards,Cynthia, AU - Barrett-Connor,Elizabeth, PY - 2002/12/3/pubmed PY - 2002/12/20/medline PY - 2002/12/3/entrez SP - 543 EP - 8 JF - The American journal of medicine JO - Am. J. Med. VL - 113 IS - 7 N2 - PURPOSE: To determine if hormone therapy results in better cognitive function in older postmenopausal women. SUBJECTS AND METHODS: The Heart and Estrogen/progestin Replacement Study (HERS) was a randomized, placebo-controlled trial involving 2763 women with coronary disease. Women were assigned randomly to conjugated estrogen (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) in one tablet daily or identical placebo; they were followed for a mean (+/- SD) of 4.2 +/- 0.4 years. Participants at 10 of the 20 HERS centers were invited to enroll in the cognitive function substudy. At the end of the trial, we measured cognitive function in 517 women in the hormone group and 546 in the placebo group using six standard tests: the modified Mini-Mental Status Examination, Verbal Fluency, Boston Naming, Word List Memory, Word List Recall, and Trails B. Cognitive function was not measured at baseline. RESULTS: The mean age of participants at the time of cognitive function testing was 71 +/- 6 years. There were no differences in age-adjusted cognitive function test scores between the two treatment groups, except that women assigned to hormones scored worse on the Verbal Fluency test than women assigned to placebo (15.9 +/- 4.8 vs. 16.6 +/- 4.8, P = 0.02). Adjustment for other potential confounders and restriction of the analyses to women who had been adherent to study medication did not change the results. CONCLUSION: Among older postmenopausal women with coronary disease, 4 years of treatment with postmenopausal hormone therapy did not result in better cognitive function as measured on six standardized tests. Whether these results also apply to elderly women without coronary disease cannot be determined from this study. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/12459399/Effect_of_postmenopausal_hormone_therapy_on_cognitive_function:_the_Heart_and_Estrogen/progestin_Replacement_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002934302012706 DB - PRIME DP - Unbound Medicine ER -