Combination therapy increases dementia.

• Position: Hormones

Older women taking combination hormone therapy have twice the rate of dementia, including Alzheimer's disease, compared with those who do not take the medication, according to the Women's Health Initiative Memory Study conducted by the National Institute on Aging, Bethesda, Md. Moreover, combination therapy does not protect against the development of Mild Cognitive Impairment, or MCI, a form of cognitive decline less severe than dementia.

"Because of possible harm in some areas and lack of a demonstrated benefit in others, we have concluded that combination hormone therapy should not be prescribed at this time for older, postmenopausal women to maintain or improve cognitive function," stresses Judith A. Salerno, deputy director of the National Institute on Aging.

The findings on women 65 and older showed that over a five-year period:

* The risk for dementia among women taking estrogen and progestin was twice that of women taking placebo pills. This represents an increase per year from 22 women per 10,000 at risk of dementia in the placebo group to 45 per 10,000 in the combination therapy group--an additional 23 cases per 10,000 per year among women taking combination therapy. Sixty-one cases of dementia were diagnosed among the 4,500 women participating in the study; 66% occurred among...