Effects of hormone replacement therapy on cognitive performance in elderlywomen

Objective: To determine the effects of 9 months of hormone replacement ther apy (HRT) on cognitive performance in women aged 75 years and older. Method s: A 9-month randomized, double-blinded, placebo-controlled parallel trial. Fifty-two elderly postmenopausal women (age range 75-91 years) without kno wn contraindications to HRT or evidence of dementia or depression were enro lled. Participants were randomly assigned in a 1:2 ratio to placebo or conj ugated estrogens at 0.625 mg/d plus trimonthly medroxyprogesterone acetate at 5 mg/d for 13 days (HRT). Main outcome measures were change from baselin e and rate of change from baseline for the following psychometric tests: Ve rbal Fluency Test, Weschler Paired Associate Learning and 20 min Delayed Re call, Trailmaking A and B Tests, Cancellation Random Letter and Random Form Tests. Results: At baseline, women in the HRT group reported a younger age of onset of menopause and a higher prevalence of hysterectomy, but otherwi se did not differ from women in the placebo group. After 9 months of treatm ent, there were no significant group differences for any of the cognitive p erformance measures. The lack of an observed group-by-time difference for a il cognitive tests remained after controlling for age of onset of menopause , education, and previous hysterectomy. Conclusions: Although conclusions a re limited by small sample size and the relatively short duration of treatm ent, results suggest that I months of estrogen replacement in combination w ith trimonthly progestin does not improve cognitive performance in women ov er 7-5 years who do not have dementia or depression. (C) 2001 Elsevier Scie nce Ireland Ltd. Ali rights reserved.