Hormone therapy has mixed effect on mental function

Last Updated: 2006-06-02 15:59:15 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Combination treatment with the hormones estrogen and progestin, often prescribed to control symptoms of menopause, has variable effects on mental function, according to a report in Journal of Clinical Endocrinology & Metabolism.

Dr. Susan M. Resnick from the National Institute on Aging, Baltimore, Maryland and colleagues investigated the effects of combination estrogen plus progestin hormone therapy on the annual rate of changes in specific mental functions in more than 1,400 postmenopausal women 65 years or older who participated in the Women's Health Initiative.

The researchers found some differences in rates of change over time for certain test scores of mental function. For example, women on hormone treatment showed significant declines for learning compared with women assigned to placebo. On the other hand, women assigned to hormone treatment showed a trend for greater improvements on figural memory and visual construction skills; however, there was a trend for less improvement in verbal memory function for short- and long-delay free recall.

These differences persisted after a subgroup of subjects who completed three visits were analyzed. This analysis excluded women with probable dementia, mild mental impairment or stroke, and made adjustments for differences in initial scores on a mental status exam, the report indicates.

The lack of benefit of combination hormone therapy on verbal memory scores and evidence of a modest decrement contradicts predictions based on the results of clinical trials, including studies of women who received estrogen-only treatment after surgery-induced menopause; women whose ovarian hormones were suppressed by drugs; and women who began treatment at the time of menopause, the investigators point out.

The findings of the current study highlight the importance of additional research to better understand the short- and long-term effects of specific hormone regimens on various mental functions, particularly memory, in women with different risks for dementia, the authors conclude. "The challenge to researchers is to further investigate potential neuroprotective benefits of hormone therapy without putting women at increased risk for other negative outcomes."

SOURCE: Journal of Clinical Endocrinology & Metabolism, May 2006.