In postmenopausal women, both the aging process and the hypoestrogenism due
to the loss of ovarian function seem to be related to the progressive impa
irment of cognitive functions and to a higher risk of developing Alzheimer'
s disease (AD). This paper reviews the potentially beneficial effects of ho
rmonal replacement therapy (HRT) on cognition and on the risk of developing
AD. Articles relevant to the topic were selected by reviewing MEDLINE data
and references of previous published reviews on this subject. Epidemiologi
cal studies on the effects of HRT on cognitive functioning have yielded dis
parate results, perhaps because of varying methodology and designs. However
, the available data suggest that the use of HRT could be associated with a
lower risk for AD. This conclusion should be interpreted with caution, sin
ce most of the studies were case-control studies, and thus subjected to sev
eral sources of bias. Further well-designed and conducted clinical trials a
nd longitudinal studies would be required to clarify the effects of estroge
ns on cognition and AD.