# Long‐term amyloid PET and MRI outcomes in a menopausal hormone therapy trial

## TL;DR

A long-term study found no significant effects of menopausal hormone therapy on brain biomarkers for Alzheimer's disease or brain structure in healthy women.

## Contribution

This study provides long-term evidence on the safety of short-term menopausal hormone therapy regarding brain health biomarkers.

## Key findings

- No differences in amyloid beta or MRI biomarkers were found between hormone therapy groups and placebo.
- Apolipoprotein E ε4 carrier status did not influence the outcomes.
- Findings suggest neutral cognitive and cerebrovascular effects of hormone therapy in this cohort.

## Abstract

Associations of short‐term use of menopausal hormone therapy (mHT) with Alzheimer's disease (AD) and structural magnetic resonance imaging (MRI) biomarkers were investigated 10 years after an mHT trial.

Recently menopausal women with good cardiovascular health were randomized to oral conjugated equine estrogens (oCEE) or transdermal 17β‐estradiol (tE2) and micronized progesterone, or placebo for 4 years. Amyloid beta (Aβ) on positron emission tomography, hippocampal atrophy, and dorsolateral prefrontal cortex thickness on MRI were assessed 10 years after completion of the mHT trial (n = 266).

Aβ and structural MRI biomarkers were not different in the oCEE and tE2 groups compared to placebo. Apolipoprotein E ε4 status did not modify the findings.

There was no evidence of adverse effects or benefits associated with 4 years of use of oral or transdermal mHT on Aβ and structural MRI biomarkers in relatively healthy women, 10 years after mHT. Findings support the long‐term safety of short‐term use of mHT on brain health.

NCT00154180 Kronos Early Estrogen Prevention Study (KEEPS)

There were no menopausal hormone therapy–related adverse effects or benefits on amyloid beta and magnetic resonance imaging biomarkers in the long term.Apolipoprotein E ε4 carrier status did not modify these findings.Findings align with neutral cognitive and cerebrovascular outcomes in this cohort.

There were no menopausal hormone therapy–related adverse effects or benefits on amyloid beta and magnetic resonance imaging biomarkers in the long term.

Apolipoprotein E ε4 carrier status did not modify these findings.

Findings align with neutral cognitive and cerebrovascular outcomes in this cohort.