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O1‐08‐06: Long Term Effects on Cognitive Trajectories of Early Versus Late Postmenopausal Hormone Therapy
Author(s) -
Espeland Mark A.,
Rapp Stephen R.,
Manson JoAnn E.,
Goveas Joseph S.,
Shumaker Sally A.,
Hayden Kathleen M.,
Weitlauf Julie,
Gaussoin Sarah A.,
Baker Laura D.,
Padula Claudia B.,
Hou Lifang,
Resnick Susan M.
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.340
Subject(s) - hormone therapy , medicine , cognition , medroxyprogesterone acetate , menopause , randomized controlled trial , hormone replacement therapy (female to male) , verbal memory , cognitive decline , effects of sleep deprivation on cognitive performance , pediatrics , dementia , hormone , psychiatry , cancer , breast cancer , disease , testosterone (patch)
age as the underlying time-scale and stratification on gender and main French regions.Results:Of 1,257,931 dementia cases identified in France, 76,264 (6.1%) and 133,029 (10.6%) occurred in patients aged <65 and 65-74 years, respectively. Besides rare causes of early-onset dementia, dementia was significantly associated with an earlier onset for: male gender (<65: 62.7%; 65-74: 50.1%; 75: 33.2%); AUDs (<65: 47.5%; 65-74: 17.2%; 75: 3.7%); hemorrhagic and non-ischemic stroke (<65: 4.8%; 65-74: 4.4%; 75: 3.4%). AUDs were significantly associated with male gender and hemorrhagic and non-ischemic stroke in all age groups. AUDs were also significantly associated with ischemic stroke in age groups 65 and other cardiovascular diseases in all age groups. 336,715 (26.8%) of the cohort died at hospital at a median (IQR) age of 85 (80-89). Among 97,352 patients identified with AUDs, 29.7% died at hospital at a median (IQR) age of 74 (63-81) leading to an adjusted hazard ratio for death of 1.21 (95% CI, 1.19-1.22). Conclusions:AUDs were the most important modifiable risk factor identified in early-onset dementia in France. The study results suggest that AUDs impact the burden of dementia through alcohol-related dementia and increased risks for vascular dementia.