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ORIGINAL RESEARCH article

Front. Dement.
Sec. Aging and Risk Factors for Dementia
Volume 3 - 2024 | doi: 10.3389/frdem.2024.1496051
This article is part of the Research Topic Lifestyle and Healthy Aging to Prevent Cognitive Decline and Dementia View all 23 articles

Hormone replacement therapy, menopausal age and lifestyle variables are associated with better cognitive performance at follow-up but not cognition over time in older-adult women irrespective of APOE4 carrier status and co-morbidities

Provisionally accepted
Tamlyn J Watermeyer Tamlyn J Watermeyer 1,2*Sarah Gregory Sarah Gregory 1,3Emmi Leetham Emmi Leetham 2Chinedu Theresa Udeh-Momoh Chinedu Theresa Udeh-Momoh 4,5,6,7,8Graciela Muniz-Terrera Graciela Muniz-Terrera 1,9
  • 1 Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, United Kingdom
  • 2 Northumbria University, Newcastle upon Tyne, United Kingdom
  • 3 Scottish Brain Sciences, Edinburgh, England, United Kingdom
  • 4 Department of Epidemiology and Prevention, School of Medicine, Wake Forest University, Winston Salem, North Carolina, United States
  • 5 Brain and Mind Institute, Aga Khan University, Nairobi, Kenya, Nairobi, Kenya
  • 6 School of Medicine and Population Health, The University of Sheffield, Sheffield, England, United Kingdom
  • 7 Global Brain Health Institute, University of California San Francisco, San Francisco, United States
  • 8 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet (KI), Huddinge, Stockholm, Sweden
  • 9 Ohio University, Athens, West Virginia, United States

The final, formatted version of the article will be published soon.

    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.

    Keywords: Hormone replacement therapy (HRT), Menopausal age, Cognition, ApoE4, cognitive aging, lifestyle factors, postmenopausal women, comorbidities

    Received: 13 Sep 2024; Accepted: 19 Dec 2024.

    Copyright: © 2024 Watermeyer, Gregory, Leetham, Udeh-Momoh and Muniz-Terrera. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tamlyn J Watermeyer, Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH4 2XU, Scotland, United Kingdom

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