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Research

HRT Use Linked to Lower Dementia Risk in Largest Study of Its Kind

A major UK study of 183,450 women found HRT users had 10% lower dementia risk, with greater benefits for surgical menopause and Apoe4 carriers.

AI News Feed · 2026-08-27 01:12

The study, led by Prof Anne-Marie Minihane of the University of East Anglia, is the largest of its kind to examine the link between HRT and dementia. Among the 183,450 women followed, nearly 4,000 cases of dementia were recorded. The greatest reduction was seen in women who had undergone surgical menopause, who showed a 26% lower risk of developing any type of dementia than non-users.

Women who naturally had lower oestrogen exposure over their lifetime, such as those who started menstruating late or entered menopause early, also appeared to benefit more from HRT, with a 16% lower risk of any type of dementia. Genetics played a role as well: the association between HRT use and lower dementia risk was stronger in women carrying the Apoe4 gene variant, which is known to increase Alzheimer’s risk. “This is really important because Apoe4 carriers are typically considered at higher risk and have fewer established prevention options,” said Minihane.

While HRT has long been prescribed mainly to relieve menopausal symptoms such as hot flushes and night sweats, Minihane said the findings suggest it may also contribute to long-term cognitive health in some women. The researchers used data from the UK Biobank and defined HRT use as any type of therapy taken for at least one year.

The study is observational, not a randomised controlled trial, so it cannot prove that HRT directly prevents dementia. The authors noted that women using HRT had a higher average level of education than non-users, and although socioeconomic factors were accounted for, other differences between the groups may have influenced the results.

Dr Susan Kohlhaas, executive director of research and partnerships at Alzheimer’s Research UK, said the study alone is not enough to recommend HRT for reducing dementia risk, but it adds evidence that the timing of HRT and a woman’s hormonal history may matter. She called for further research to establish whether HRT itself is responsible for the observed differences and which forms of HRT might have an effect. “Anyone considering starting or stopping HRT should speak to their GP about the potential benefits and risks for them,” she added.