Effects of hormone replacement therapy on cognitive performance in elderly women

Objective: To determine the effects of 9 months of hormone replacement therapy (HRT) on cognitive performance in women aged 75 years and older. Methods: A 9-month randomized, double-blinded, placebo-controlled parallel trial. Fifty-two elderly postmenopausal women (age range 75-91 years) without known contraindications to HRT or evidence of dementia or depression were enrolled. Participants were randomly assigned in a 1:2 ratio to placebo or conjugated estrogens at 0.625 mg/d plus trimonthly medroxyprogesterone acetate at 5 mg/d for 13 days (HRT). Main outcome measures were change from baseline and rate of change from baseline for the following psychometric tests: Verbal Fluency Test, Weschler Paired Associate Learning and 20 min Delayed Recall, 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 otherwise did not differ from women in the placebo group. After 9 months of treatment, there were no significant group differences for any of the cognitive performance measures. The lack of an observed group-by-time difference for ail cognitive tests remained after controlling for age of onset of menopause, education, and previous hysterectomy. Conclusions: Although conclusions are limited by small sample size and the relatively short duration of treatment, results suggest that I months of estrogen replacement in combination with trimonthly progestin does not improve cognitive performance in women over 7-5 years who do not have dementia or depression. (C) 2001 Elsevier Science Ireland Ltd. Ali rights reserved.