Use of hormone supplements now linked to dementia

CHICAGO -- Women who take hormones for years run a higher risk of Alzheimer's or other types of dementia, according to yet another startling study that turns upside down what doctors have long believed about supplements.

"It's another nail in the coffin" for the use of hormones during and after menopause, said St. Louis gynecologist Dr. Robert Blaskiewicz, a St. Louis University professor.

The study appears in today's Journal of the American Medical Association.

The findings in women 65 and older challenge the long-held notion that estrogen-progestin supplements can help women keep their minds sharp -- a belief that was based on smaller, less rigorous studies.

Last summer, a government study was abruptly halted after finding an increased risk of breast cancer, heart attacks and strokes in women who took one type of combined hormone pill.

That finding shattered the conventional thinking about the health benefits of hormones and prompted millions of American women to stop taking supplements.

Varying opinions

Some experts say that based on what is now known about supplements, women past menopause should not take hormones at all. Other experts say that women needing relief from night sweats and other menopausal symptoms should take the lowest possible dose for the shortest time.

The new findings on dementia come from a subset of participants in last summer's study. Despite those earlier findings, many women have continued using supplements to relieve menopausal symptoms and in hopes of preventing memory loss and other mental decline, said Sally Shumaker, a public health professor at Wake Forest University who led the latest research.

Women in the study who took hormones for an average of more than four years faced double the risk of developing Alzheimer's or other forms of dementia, compared with those on dummy pills. That means that in one year, for every 10,000 women taking hormones, there will be 23 more cases of dementia.

Researchers also found that hormones did not protect against less severe mental decline, such as mild memory loss.

One possible explanation for the confounding new findings is that hormones raise the risk of strokes -- and strokes are known to cause brain damage and contribute to dementia, the researchers said.

Nevertheless, the increased risk of dementia is very small, said Marilyn Albert, head of the Alzheimer's Association's scientific advisory council and a Johns Hopkins University neurology professor.

Age remains the single greatest risk factor for dementia.