Hormone Therapy, Diabetes, and Mental Health
What to Know
People with type 2 diabetes have a higher risk for dementia and cognitive impairment later in life. Dementia refers to memory loss and other impairments that affect your ability to think. Cognitive impairment is similar but less severe. However, it can lead to dementia. Because many women undergo hormone therapy after menopause, researchers wanted to determine if such therapy would affect their risk of dementia or cognitive decline.
The researchers recruited 7,233 women between the ages of 65-80. They were randomly divided into two groups. For nearly six years, one group received the hormone estrogen, while the other group took a placebo, which looked like the estrogen pill but had no active ingredients. Nobody knew who was in which group. The researchers tracked the women for the next 18 years to see who developed dementia or cognitive decline.
Women with type 2 diabetes who took estrogen had the highest likelihood of developing either dementia or cognitive impairment, followed by women with type 2 diabetes who received a placebo. The least likely to develop either were women without type 2 diabetes who took a placebo. The effect of the estrogen treatment continued throughout the 18-year follow-up period.
Estrogen therapy appears to further elevate the risk of dementia or cognitive impairment for women with type 2 diabetes who are 65 to 80 years old. The researchers can’t say whether younger women taking estrogen also would be at higher risk. It’s also possible that the researchers underestimated the number of women who developed dementia and cognitive decline. A more accurate test might better distinguish between the two disorders.
Impact of type 2 diabetes and postmenopausal hormone therapy on incidence of cognitive impairment in older women, by Espeland and Associates. Diabetes Care 2015 Dec; 38(12): 2316-2324 http://dx.doi.org/10.2337/dc15-1385