Association between perimenopausal hormone therapy and risk of neurodegenerative diseases: implications for precision hormone therapy

First published: May 13, 2021 https://doi.org/10.1002/trc2.12174

Commentary

This study investigates the impact of perimenopausal hormone therapy (HT) on age-related Alzheimer's disease and neurodegenerative disorders (NDD).

The study population included women aged 45 years and older, with or without records of HT drug claims, and patients diagnosed with NDDs such as Alzheimer's disease (AD), Parkinson's disease (PD), dementia, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS).

The results included 379,352 women with and without HT billing records, and found that HT use was associated with a significantly lower risk of combined NDD. (RR 0.42, 95% CI 0.40-0.43, P <0.001)

With a mean follow-up of 5.1 years for this intervention, preparations containing the natural steroid 17β-estradiol/progesterone were associated with a significant reduction in NDD risk.

Oral HT users had a substantially lower RR of combined ND compared to controls. The greatest reductions in risk of NDD, AD, and dementia were seen in patients older than 65 years, and the protective effect of long-term therapy (> 1 year) on combined NDD, AD, PD, and dementia was greater than that of short-term therapy (≤ 1 year) was found to be greater than that of short-term therapy (≤ 1 year).

Intervention with HT drugs is associated with a reduced risk of all NDDs, including AD and dementia, with longer treatment duration and greater efficacy of natural steroid preparations. The findings are said to advance high precision HT to prevent NDD including AD.