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HRT ‘has no effect on cognitive function'

Postmenopausal women taking equine oestrogens can be ‘reassured’ that they have no long-term impact on their cognitive function, claim researchers.

The study

A previous analysis found conjugated equine oestrogen (CEE) HRT therapy reduced global and domain-specific cognitive functioning in women aged 65 years and older, compared with placebo. This follow-on study looked at 1,373 postmenopausal women aged 50 to 55 years compared 0.625mg CEE with or without 2.5mg medroxyprogesterone acetate (MPA) over an average of seven years, compared with placebo. Global cognitive function was assessed with the Telephone Interview for Cognitive Status-modified (TICS-m) score and verbal memory, attention, executive function, verbal fluency, and working memory were secondary outcomes.

The findings

There were no significant differences between the mean cognitive function scores of women who had active hormonal therapy versus placebo as measured by TICS-m, whether the women were prescribed CEE and MPA or CEE only. Similar results were obtained for all other cognitive measures and composite individual tests with the exception of verbal fluency which was negatively affected in the CEE-alone therapy group, compared with the CEE with MPA therapy group, with mean changes in score of 0.17 and 0.07 respectively.

What this means for GPs

The authors concluded: ‘Our findings provide reassurance that CEE-based therapies when administered to women earlier in the postmenopausal period do not seem to convey long-term adverse consequences for cognitive function’.

JAMA Intern Med 2013, online 24 June

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