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Letters |

Hormonal Replacement Therapy and Cognition in Postmenopausal Women—Reply

Erin LeBlanc, MD, MPH; Heidi Nelson, MD, MPH
JAMA. 2001;285(23):2974-2975. doi:10.1001/jama.285.23.2974.
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In Reply: As pointed out by Dr Zec and Mr Trivedi, it is problematic to compare studies that use different cognitive measures. Therefore, we first examined the results according to cognitive process (Table 3).1 Because no consistent pattern emerged, we then grouped the results by whether the participants had menopausal symptoms and found a clear distinction: the randomized controlled trials of women with menopausal symptoms found that some cognitive functions were improved with HRT, while improvements were not found in trials of asymptomatic women. Interpretation of this difference is problematic because, as Zec and Trivedi correctly point out, the studies did not use the same cognitive measures. However, symptom relief clearly needs to be ruled out as an explanation for the cognitive improvements.

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