Watermeyer Tamlyn J, Gregory Sarah, Leetham Emmi, Udeh-Momoh Chinedu T, Muniz-Terrera Graciela
Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, College of Medicine and Veterinary Sciences, University of Edinburgh, Edinburgh, United Kingdom.
Faculty of Health and Life Sciences, Northumbria University, Newcastle, United Kingdom.
Front Dement. 2025 Jan 17;3:1496051. doi: 10.3389/frdem.2024.1496051. eCollection 2024.
The impact of Hormone Replacement Therapy (HRT) on cognitive function in postmenopausal women remains a topic of considerable debate. Although estrogen's neuroprotective effects suggest potential cognitive benefits, empirical findings are mixed.
This study uses data from the Cognitive Function and Ageing Study Wales (CFAS Wales) cohort to explore the relationships between HRT use, age at menopause, APOE4 carrier status, lifestyle factors, comorbidities, and cognitive outcomes in older adult women. Two regression models were employed: one analyzing cognitive performance at follow-up and another examining changes in cognitive scores over time.
Results indicate that while age, education, HRT use, age at menopause, alcohol consumption, and diet were associated with cognitive function at a single later time point, only age remained a significant predictor when modeling cognition over time.
These findings suggest that while HRT, menopausal age and lifestyle factors may support cognitive stability, they do not necessarily predict cognitive decline in post-menopausal older women. A major limitation of the current work is the lack of detail regarding HRT use, such as formulation, timing and duration; caveats that future studies should address. The study underscores the need for longer follow-up periods, consideration of other female-specific risk factors, and more comprehensive lifestyle and health assessments to clarify the complex interplay between HRT use, reproductive history, lifestyle, comorbidities and cognitive aging in women.
激素替代疗法（HRT）对绝经后女性认知功能的影响仍是一个备受争议的话题。尽管雌激素的神经保护作用表明其可能对认知有益，但实证研究结果却参差不齐。
本研究使用来自威尔士认知功能与衰老研究（CFAS Wales）队列的数据，以探讨老年女性中激素替代疗法的使用、绝经年龄、APOE4携带者状态、生活方式因素、合并症与认知结果之间的关系。采用了两个回归模型：一个分析随访时的认知表现，另一个检验认知分数随时间的变化。
结果表明，虽然年龄、教育程度、激素替代疗法的使用、绝经年龄、饮酒量和饮食在单个较晚时间点与认知功能相关，但在对认知随时间进行建模时，只有年龄仍然是一个显著的预测因素。
这些发现表明，虽然激素替代疗法、绝经年龄和生活方式因素可能有助于认知稳定性，但它们不一定能预测绝经后老年女性的认知衰退。当前研究的一个主要局限是缺乏关于激素替代疗法使用的详细信息，如制剂、时间和持续时间；未来研究应解决这些问题。该研究强调需要更长的随访期，考虑其他女性特有的风险因素，以及更全面的生活方式和健康评估，以阐明激素替代疗法的使用、生殖史、生活方式、合并症与女性认知衰老之间的复杂相互作用。
