Hormone therapy and physical function change among older women in the Women's Health Initiative: a randomized controlled trial.
OBJECTIVE
Although estrogen may be linked to biological pathways that maintain higher physical function, the evidence is derived mostly from observational epidemiology and therefore has numerous limitations. We examined whether hormone therapy affected physical function in women 65 to 79 years of age at enrollment.


METHODS
This study involves an analysis of the Women's Health Initiative randomized controlled trials of hormone therapy in which 922 nondisabled women who had previous hysterectomies were randomized to receive estrogen therapy or a placebo and 1,458 nondisabled women with intact uteri were randomized to receive estrogen + progestin therapy or a placebo. Changes in physical function were analyzed for treatment effect, and subgroup differences were evaluated. All women completed performance-based measures of physical function (grip strength, chair stands, and timed walk) at baseline. These measures were repeated after 1, 3, and 6 years.


RESULTS
Overall, participants' grip strength declined by 12.0%, chair stands declined by 3.5%, and walk pace slowed by 11.4% in the 6 years of follow-up (all P values <0.0001). Hormone therapy, as compared with placebo, was not associated with an increased or decreased risk of decline in physical function in either the intention-to-treat analyses or in analyses restricted to participants who were compliant in taking study pills.


CONCLUSIONS
Hormone therapy provided no overall protection against functional decline in nondisabled postmenopausal women 65 years or older in 6 years of follow-up. This study did not address the influence of hormone therapy for women of younger ages.
Department of Epidemiology, Drexel University School of Public Health, Philadelphia, PA 19102, USA. michaely@drexel.edu
Yvonne L
YL
Michael
Rachel
R
Gold
JoAnn E
JE
Manson
Erin M
EM
Keast
Barbara B
BB
Cochrane
Nancy F
NF
Woods
Robert G
RG
Brzyski
S Gene
SG
McNeeley
Robert B
RB
Wallace
D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000627:therapeutic use*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D008875:Middle Aged; D011372:Progestins / Q000627:therapeutic use*; D011788:Quality of Life; D016896:Treatment Outcome; D016387:Women's Health
D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D011372:Progestins; D017258:Medroxyprogesterone Acetate