Artikel
Hormones and dementia – pharmacoepidemiological analyses of German health insurance data
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Autoren
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Jeanette Hoffmann
- German Center for Neurodegenerative Diseases e.V. (DZNE), Bonn, Germany
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Willy Gomm
- German Center for Neurodegenerative Diseases e.V. (DZNE), Bonn, Germany
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Klaus Weckbecker
- Institute for General Practice, Medical Faculty, University of Bonn, Bonn, Germany
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Britta Hänisch
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| Veröffentlicht: | 19. November 2019 |
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Gliederung
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Background: Risk factor research is a relevant aspect of dementia prevention. Hormone therapy – intake as well as suppression of hormones – is widely used in the treatment of diseases such as benign prostatic hyperplasia (BPH), menopausal symptoms, and thyroid disorders. Existing population-based studies analyzing hormone therapy with the outcome dementia show controversial results. In this study, we analyze the association of hormone therapies and risk of dementia.
Materials and methods: For the study, we used a dataset of the Allgemeine Ortskrankenkasse (AOK) containing prescription and diagnosis data, and applied a case-control-design, matching on age and gender. Three main hormone therapies were analyzed: female sexual hormones for menopausal symptoms, 5α-reductase-inhibitors for BPH and treatment of thyroid disorders (hypothyroidism and hyperthyroidism). The analyses were adjusted for covariates such as relevant comorbidities (e.g. depression, diabetes, stroke) and polypharmacy.
Results: Neither female sexual hormones nor 5α-reductase-inhibitors were associated with incident dementia. A use of thyroid hormones showed a protective effect on the dementia risk while intake of thyreostatic drugs showed a tendency towards a risk increase. A diagnosis of menopausal symptoms was associated with a risk reduction for incident dementia and a similar effect could be observed for a diagnosis of BPH. Diagnosed hypothyroidism was associated with a reduced dementia risk whereas a slight risk increase could be observed for hyperthyroidism.
Conclusion: This case-control-study in a large German dataset showed no association between the hormone therapy with female sexual hormones or 5α-reductase-inhibitors and incident dementia. An influence on the dementia risk was observed with hormone therapy for thyroid disorders. The observed risk changes of the diagnoses menopausal symptoms and BPH could be caused by increased awareness of the patients. Further research is needed to investigate the results in detail.
