Connection between Alzheimer’s Dementia and Postmenopausal Women: A Literature Review Assessing the Impact of Hormone Replacement Therapy on Cognition

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Date
2024-05-15
Authors
Zamonsky, Arianna
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Abstract
Background: Dementia has been labelled an epidemic by the Alzheimer’s Society of Canada and is a significant public health concern for the aging population. Compared to the rest of the population, postmenopausal women are significantly impacted by Alzheimer’s Dementia (AD). Estrogen is a protective factor for brain atrophy, and low estrogen levels have been linked to a decline in cognition. Although studies have identified hormone replacement therapy (HRT) to be helpful for vasomotor symptoms (i.e. hot flashes) and genitourinary syndrome, there is no clear answer as to whether improving estrogen levels with HRT in postmenopausal women will prevent cognitive decline. Methods: The literature review includes English text articles from the PubMed database using the search terms ‘Hormone Replacement Therapy’ AND ‘Dementia’ AND ‘Post menopause’. Only RCT and clinical trials from 1999-2024 were included in this study. A total of ten articles were included and analyzed for this study, Results: Most studies used a reliable and valid cognitive assessment tool to assess cognitive function pre-and post-treatment. Conjugated equine estrogen (CEE) and 17 beta-estradiol were the most common. The studies have mixed results on how HRT impacts cognitive function. Conclusions: Given the number of mixed results from each study, the variability of HRT (i.e. dose, route, duration) and uncontrolled variable risk factors for dementia, the outcomes of this relationship need to be further investigated. Due to the heterogeneity of each study, further clinical trials will need to explore how HRT impacts cognitive performance in postmenopausal women.
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