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Menopausal hormone therapy and dementia

A causal link remains unlikely

In a linked paper, Pourhadi and colleagues(doi:10.1136/bmj‑2022‑072770) investigated the associations of menopausal hormone therapy with dementia later in life.1 Their observational study of data from Danish national registries reported that hormone treatment was associated with an increased risk of dementia with either short term or long term use (risk of all cause dementia associated with exposure to oestrogen plus progestin v never use: hazard rate ratio of 1.24 (95% confidence interval of 1.17 to 1.35)). Alzheimer’s disease is twice as common in women than in men; therefore, midlife exposures that might influence its risk in women are of considerable interest.2

Menopausal hormone therapy has been in the spotlight as a potential risk factor contributing to this disparity in Alzheimer’s disease. Treatment was widely prescribed before the 2003 Women’s Health Initiative Memory Study (WHIMS) a randomised trial reported that oestrog ....

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