The Relationship Between Menopause Related Hormone Therapy And Cognitive Function: A Meta-analysis

OBJECTIVE: To investigate the relationship between menopause hormone therapy(MHT)and cognitive function in menopausal women.METHODS: We systematically searched published literature related to menopausal hormone therapy and cognition in the following databases to November 2016:PubMed,Embase,Cochrane library,China Biomedical Document Database(CBM),China National Knowledge Infrastructure(CNKI),WANFANG DATA and Chinese Scientific Journals Database(VIP).Two researchers independently assessed trial quality by the modified Jadad score and extracted data.The effective size was estimated by hazard ratio and mean difference(MD).The meta-analysis was performed with STATA software(version 12.0;Stata Corp.,College Station,TX).RESULTS: Only 8 articles which had sufficient analysable data associated with probable dementia or mild cognitive impairment(MCI),global cognitive function and specific-domain cognitive function,were included in this meta-analysis.Analysis indicated:(1).Menopause hormone therapy increases the risk of probable dementia(HR=1.78 95%,CI(1.20,2.62)),the difference was statistically significant,the combined hormone therapy treatment group including estrogen and progesterone(HR=2.05,95% CI(1.21,3.48))is more obvious compared with estrogen alone treatment group(HR=1.49,95% CI(0.83,2.66));(2)The effects of hormone therapy on increasing the risk of mild cognitive impairment(HR=1.21,95% CI(0.94,1.55))had no significant difference;(3)The effects of hormone therapy on mean difference in change from baseline in modified Mini-Mental State Examination(3MSE)Scores is negative(WMD=-0.21,95% CI(-0.33,-0.09));subgroup analysis showed that the adverse effects of estrogen alone treatment group on changes was more significant(WMD=-0.30,95% CI(-0.50,-0.11)).(4).The effects of hormone therapy on mean difference in change from baseline in CVLT short delay free and Category fluency had no significant difference.CONCLUSIONS: The meta-analysis has revealed that hormone therapy had an adverse impact on global cognitive function and increased the risk of dementia or mild cognitive impairment in postmenopausal women in America and Canada over 60 years of age,and had no significant difference in specific cognitive functions...