Hormone replacement therapy and Alzheimer's disease: an update on the issues

Alzheimer's disease (AD) is a significant personal, family, social, and public health problem. Currently there is no way to prevent or cure AD. The latest opinions on the possibility of hormone replacement therapy (HRT)/estrogen replacement therapy (ERT) as a means to prevent and treat AD are reviewed. Although prevention and treatment of AD cannot yet be added to the list of HRT/ERT's benefits, research in the area is promising. The potential benefits and problems of HRT for the woman with or at risk for AD are examined. The potential benefits include improved interest and compliance with HRT, improved quality of life, and cost savings. The problems include difficulties in monitoring and managing clients with AD, assuring compliance with the therapeutic regimen, and deciding when to withdraw therapy. Clinical trials have not yet been able to determine the appropriate dosages, to standardize or predict the magnitude of the therapeutic effect, or to determine the safety of ERT/HRT as a long-term therapy, particularly when continued in the elderly years. Implications for practitioners are addressed.