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Postmenopausal hormone therapy and Alzheimer’s disease risk: interaction with age
  1. V W Henderson1,
  2. K S Benke2,
  3. R C Green3,
  4. L A Cupples4,
  5. L A Farrer2,
  6. for the MIRAGE Study Group*
  1. 1Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  2. 2Department of Medicine (Genetics Program), Boston University School of Medicine, Boston, MA, USA
  3. 3Department of Neurology, Boston University School of Medicine, Boston, MA, USA
  4. 4Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
  1. Correspondence to:
 Dr Victor W Henderson
 Stanford University School of Medicine, 259 Campus Drive, HRP Redwood Building, Stanford University, Stanford, CA 94305-5405, USA; vhendersonstanford.edu

Abstract

We examined the relation between oestrogen containing hormone therapy (HT) used for more than 6 months and Alzheimer’s disease (AD) risk in 971 postmenopausal women (426 AD patients, 545 relatives without dementia). There was a significant interaction between age and HT use on AD risk (p = 0.03). In stratified analyses, a significant protective association was seen only in the youngest age tertile (50–63 years; odds ratio = 0.35, 95% confidence interval = 0.19 to 0.66). Results must be considered cautiously in light of recent clinical trial evidence that oestrogen plus progestin increases dementia incidence in older postmenopausal women. However, our observational findings are consistent with the view that HT may protect younger women from AD or reduce the risk of early onset forms of AD, or that HT used during the early postmenopause may reduce AD risk.

  • AD, Alzheimer’s disease
  • ApoE, apolipoprotein E
  • CI, confidence interval
  • HT, hormone therapy
  • MIRAGE, Multi-Institutional Research in Alzheimer Genetic Epidemiology
  • NSAID, non-steroidal anti-inflammatory drug
  • OR, odds ratio
  • SD, standard deviation
  • WHIMS, the Women’s Health Initiative Memory Study
  • Alzheimer’s disease
  • hormone therapy
  • oestrogen
  • risk factors

https://doi.org/10.1136/jnnp.2003.024927

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    Footnotes

    • ↵* Other participating investigators from the MIRAGE (Multi-Institutional Research in Alzheimer Genetic Epidemiology) Study Group include Sanford Auerbach, MD, Department of Neurology, Boston University School of Medicine; Helena Chui, MD, Rancho Los Amigos Medical Center and Department of Neurology, University of Southern California, Downey, CA; Ranjan Duara, MD, Wein Center, Mt. Sinai Medical Center and University of Miami School of Medicine, FL; Timi Edeki, MD, PhD, Departments of Medicine and Clinical Pharmacology, Morehouse School of Medicine, Atlanta, GA; Robert Friedland, MD, Department of Neurology, Case Western Reserve University, Cleveland, OH; Rodney Go, PhD, Department of Epidemiology, University of Alabama School of Public Health, Birmingham, AL; Patrick Griffith, MD, Department of Medicine, Morehouse School of Medicine, Atlanta, GA; Walter Kukull, PhD, Department of Epidemiology, University of Washington School of Public Health, Seattle, WA; Alexander Kurz, MD, Department of Psychiatry, Technische Universität, Munich, Germany; Dessa Sadovnick, PhD, Department of Medical Genetics, Vancouver Hospital and University of British Columbia, Canada; and John Wells, PhD, Geriatric Research Education and Clinical Center, VA Medical Center, Bedford, MA

    • This research was supported by National Institutes of Health grants AG09029 and AG13846 and a Merit Award from the Veterans Administration

    • Competing interests: Victor Henderson has received speaker honoraria and consulting fees from the Council on Hormone Education and QED Communications, and has received an unrestricted education grant from Wyeth Laboratories. KSB, RCG, LAC, and LAF have no competing interests