||A report in the Journal of the American Medical Association (May 28, 2003), has shown an association between HRT use and an increased risk of Alzheimer dementia. The report publishes results of the Women's Health Initiative Memory Study(WHIMS) which enrolled women from the Women's Health Initiative study (WHI) and aimed to evaluate the effect of oestrogen plus progestogen on the incidence of dementia compared with placebo. 4532 women were entered into the study and were aged 65 years or over. Participants received either a daily tablet of 0.625mg conjugated equine oestrogen plus 2.5mg medroxyprogesterone acetate or placebo.
Results showed an increased risk of dementia in women taking HRT compared with placebo of the order of an extra 23 cases per 10,000 women per year (increase from 22 per 10,000 women per year to 45 per 10,000 women per year).
For some time it has been suggested that HRT may reduce the risk of Alzheimer dementia. Results from this large study indicate that HRT should not be used in older women in the hope of reducing the risk of dementia and that a small increased risk has been demonstrated. In the UK, HRT is mostly prescribed to younger women for either control of menopausal symptoms or for treatment or prevention of osteoporosis. For these 2 licensed indications, the benefits of HRT outweigh the risks for many women. It seems unlikely that HRT is beneficial to older women who are asymptomatic and who are not thought to be at risk of osteoporosis and indeed may be harmful.
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