title: Long-term Effects on Cognitive Trajectories of Postmenopausal Hormone Therapy in Two Age Groups.
abstract: BACKGROUND
  Postmenopausal hormone therapy may have long-term effects on cognitive function depending on women's age.
  
  
  METHODS
  Postintervention follow-up was conducted with annual cognitive assessments of two randomized controlled clinical trial cohorts, beginning an average of 6-7 years after study medications were terminated: 1,376 women who had enrolled in the Women's Health Initiative when aged 50-54 years and 2,880 who had enrolled when aged 65-79 years. Women had been randomly assigned to 0.625mg/d conjugated equine estrogens (CEE) for those with prior hysterectomy (mean 7.1 years), CEE with 2.5mg/d medroxyprogesterone acetate for those without prior hysterectomy (mean 5.4 years), or matching placebos.
  
  
  RESULTS
  Hormone therapy, when prescribed to women aged 50-54 years, had no significant long-term posttreatment effects on cognitive function and on changes in cognitive function. When prescribed to older women, it was associated with long-term mean (SE) relative decrements (standard deviation units) in global cognitive function of 0.081 (0.029), working memory of 0.070 (0.025), and executive function of 0.054 (0.023), all p < .05. These decrements were relatively stable over time. Findings did not vary depending on the hormone therapy regimen, prior use, or years from last menstrual period. Mean intervention effects were small; however, the largest were comparable in magnitude to those seen during the trial's active intervention phase.
  
  
  CONCLUSIONS
  CEE-based hormone therapy delivered near the time of menopause provides neither cognitive benefit nor detriment. If administered in older women, it results in small decrements in several cognitive domains that remain for many years.
authors: Department of Biostatistical Sciences.
authors: Mark A
authors: MA
authors: Espeland
authors: Department of Social Sciences and Health Policy, and.|Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Stephen R
authors: SR
authors: Rapp
authors: Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors: JoAnn E
authors: JE
authors: Manson
authors: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee.
authors: Joseph S
authors: JS
authors: Goveas
authors: Department of Social Sciences and Health Policy, and.
authors: Sally A
authors: SA
authors: Shumaker
authors: Department of Social Sciences and Health Policy, and.
authors: Kathleen M
authors: KM
authors: Hayden
authors: Department of Veterans Affairs, Palo Alto Health Care System and.
authors: Julie C
authors: JC
authors: Weitlauf
authors: Department of Biostatistical Sciences.
authors: Sarah A
authors: SA
authors: Gaussoin
authors: Department of Social Sciences and Health Policy, and.
authors: Laura D
authors: LD
authors: Baker
authors: Department of Veterans Affairs, Palo Alto Health Care System and.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California.
authors: Claudia B
authors: CB
authors: Padula
authors: Department of Preventive Medicine, Northwestern University Fienberg School of Medicine, Chicago, Illinois.
authors: Lifang
authors: L
authors: Hou
authors: Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland.
authors: Susan M
authors: SM
authors: Resnick
mesh_terms: D000368:Aged; D003071:Cognition / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D009483:Neuropsychological Tests; D017698:Postmenopause
chemical_list: D003271:Contraceptive Agents, Female; D004966:Estrogens, Conjugated (USP); D017258:Medroxyprogesterone Acetate
keywords: Cognitive aging; Hormone therapy; Women’s health