Overview
- Researchers pooled one randomized trial and nine observational studies covering 1,016,055 participants to assess dementia and mild cognitive impairment outcomes.
- Analyses showed no significant association across timing of initiation, duration of use, HRT formulation, or after early menopause.
- The authors advise prescribing hormone therapy for symptom relief based on individual benefits and risks rather than for dementia prevention.
- The evidence base remains constrained by few randomized trials and low-to-moderate certainty, prompting calls for long-term studies in underrepresented groups and those with early menopause or mild cognitive impairment.
- The findings follow the FDA’s removal of black-box warnings and its suggestion of a possible Alzheimer’s benefit, a claim the review does not support, as some clinicians continue to question the conclusiveness of the evidence.