Hormone Replacement Therapy For Cognition In Postmenopausal Women—Meta Analysis

Objectives This study sought to evaluate the potential risks and benefits of Hormone Replacement Therapy(HRT)for cognitive function in perimenopausal and postmenopausal woman and assess the factors that might influence the therapeutic efficacy of HRT on cognitive function.Methods Databases including Pub Med,Embase,Cochrane Central Register of Control Trials,and a clinical trial registration center(Clinicaltrials.gov)were searched.Eligible randomized controlled trials(RCT)were selected.Main outcomes were the effects of HRT on cognitive function(global cognitive function,executive function,verbal memory,nonverbal memory,language ability and attention).Predetermined subgroup analysis was conducted according to the factors of age,menopause years and medication types(estrogen alone or estrogen plus progestin).Results Fourteen literatures with a total of 7515 patients were included.All of the participants were postmenopausal women;no perimenopausal women were reported.The main outcomes of meta-analysis showed no significant differences between the HRT group and the placebo group in global cognitive function[SMD=-0.01,95%CI(-0.11,0.09)],executive function [SMD=0.01,95%CI(-0.10,0.12)],verbal memory [SMD=-0.02,95%CI(-0.12,0.09)],nonverbal memory [SMD=-0.04,95%CI(-0.22,0.14)],language ability [SMD=0.08,95%CI(-0.06,0.22)] and attention [SMD=0.13,95%CI(-0.06,0.32)].Interestingly,the age subgroup analysis revealed that HRT groups had better performance than controls in executive functions in postmenopausal women younger than65 years[SMD=0.27,95%CI(0.02,0.52)],but no significant difference was observed in women aged 65 years or older[SMD=0.22,95 % CI(-0.17,0.61)].The subgroups analysis based on menopause years and medication types did not significantly affect the overall result.Conclusions No evidence was found that HRT impaired cognitive function.The age of the patients at the start of HRT may be an influencing factor that changes the effect of HRT on cognitive function.The executive function of healthy postmenopausal women younger than 65 years may benefit from HRT.Healthy perimenopausal women who received HRT need not be overly concerned about the damage of cognitive function within five years.Further research is required in order to explore the potential influencing factors that change the effect of HRT,and to provide necessary support for the prevention and personalized treatment of women’s cognitive decline and dementia.Figure4;Table6;Reference 248...