Cognitive benefits of hormone therapy: Cardiovascular factors and healthy-user bias
| Autor: | Wharton, Whitney, Dowling, Maritza, Khosropour, Christine M., Markgraf, Tamara S., Sachs, Jane F., Carlsson, Cynthia, Asthana, Sanjay, Gleason, Carey E. |
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| Rok vydání: | 2009 |
| Předmět: |
Gerontology
medicine.medical_treatment Hypercholesterolemia Article General Biochemistry Genetics and Molecular Biology Cognition Bias Reference Values Risk Factors Surveys and Questionnaires Prevalence medicine Humans Dementia Effects of sleep deprivation on cognitive performance Cognitive decline Risk factor Aged Aged 80 and over Estrogens Conjugated (USP) business.industry Estrogen Replacement Therapy Age Factors Obstetrics and Gynecology medicine.disease Health Surveys Cognitive test Postmenopause Logistic Models Cardiovascular Diseases Case-Control Studies Educational Status Female Observational study Hormone therapy business |
| Zdroj: | Maturitas. 64:182-187 |
| ISSN: | 0378-5122 |
| DOI: | 10.1016/j.maturitas.2009.09.014 |
| Popis: | The Women's Health Initiative (WHI) study and its ancillary Memory Study (WHIMS) revealed increased rates of cardiovascular risk, cognitive decline and dementia with opposed conjugated equine estrogens (CEE). As a result, previously accepted observational data suggesting cardiovascular and cognitive benefits and reduced risk for dementia with hormone therapy (HT) were largely attributed to 'healthy-user' bias. The present observational, community-based, case-controlled study examined the 'healthy-user' bias theory by comparing cognitive task performance in two groups of postmenopausal women, who were either HT users or non-users.Participants were 213 non-demented, postmenopausal women residing in the community and in assisted-living facilities who completed a self-report health questionnaire and underwent a 1-h cognitive test battery. To study the independent contribution of variables in the prediction of cognitive performance, we employed a series of hierarchical regression models adding terms in three stages. The first stage included only HT, the second stage added demographics, and the last stage added alcohol, depression and a cardiovascular risk factor (CVRF) composite derived from a confirmatory factor analysis. The CVRF composite consisted of: stroke, diabetes, hypertension, and hypercholesterolemia.Although independent samples t-tests revealed no statistically significant differences in the CVRF composite and its individual components between the two groups, HT users tended to possess fewer CVRF than non-users. Conversely, HT users were younger and more educated than non-users. HT users outperformed non-users on 7/9 cognitive variables. The full regression model controlling for CVRF, demographic variables, and mood showed HT users outperformed non-users on measures of verbal memory and abstract reasoning.While there is some evidence HT users possess fewer preexisting CVRF than non-users, the observed positive association between HT and cognition is not completely explained by this trend. |
| Databáze: | OpenAIRE |
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