Postmenopausal hormone therapy and Alzheimer disease: A prospective cohort study

Neurology. 2017 Mar 14;88(11):1062-1068. doi: 10.1212/WNL.0000000000003696. Epub 2017 Feb 15.


Objective: To explore the association between postmenopausal hormone therapy (HT) and Alzheimer disease (AD).

Methods: Twenty-year follow-up data from the Kuopio Osteoporosis Risk Factor and Prevention study cohort were used. Self-administered questionnaires were sent to all women aged 47-56 years, residing in Kuopio Province starting in 1989 until 2009, every 5th year. Register-based information on HT prescriptions was available since 1995. Probable AD cases, based on DSM-IV and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, were identified from the special reimbursement register (1999-2009). The study population included 8,195 women (227 cases of incident AD).

Results: Postmenopausal estrogen use was not associated with AD risk in register-based or self-reported data (hazard ratio/95% confidence interval 0.92/0.68-1.2, 0.99/0.75-1.3, respectively). Long-term self-reported postmenopausal HT was associated with reduced AD risk (0.53/0.31-0.91). Similar results were obtained with any dementia diagnosis in the hospital discharge register as an outcome.

Conclusions: Our results do not provide strong evidence for a protective association between postmenopausal HT use and AD or dementia, although we observed a reduced AD risk among those with long-term self-reported HT use.

MeSH terms

  • Aged
  • Alzheimer Disease / chemically induced
  • Alzheimer Disease / epidemiology*
  • Chi-Square Distribution
  • Cohort Studies
  • Estrogen Replacement Therapy / adverse effects*
  • Estrogens / adverse effects
  • Exercise
  • Female
  • Finland
  • Humans
  • Middle Aged
  • Outcome Assessment, Health Care
  • Postmenopause*
  • Registries
  • Surveys and Questionnaires


  • Estrogens