Evidence map›Paper›PMID 26486190›Full record

Trial reportDiabetes care2015

Impact of Type 2 Diabetes and Postmenopausal Hormone Therapy on Incidence of Cognitive Impairment in Older Women.

Mark A Espeland, Roberta Diaz Brinton, Christina Hugenschmidt, JoAnn E Manson, Suzanne Craft, Kristine Yaffe, Julie Weitlauf, Leslie Vaughan, Karen C Johnson, Claudia B Padula and 3 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 3 pooled it
3.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 59 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Long-term hormone therapy for perimenopausal and postmenopausal women.The Cochrane database of systematic reviews · 2017
    Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Long-term Effects on Cognitive Trajectories of Postmenopausal Hormone Therapy in Two Age Groups.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017
    Trial
  10. Article
  11. Then and Now: What We Have Learned From the WHI.The Journal of clinical endocrinology and metabolism · 2026
    Review
  12. Observational
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 1 country.

Mark A EspelandDepartment of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC mespelan@wakehealth.edu.
Roberta Diaz BrintonDepartments of Pharmacology and Pharmaceutical Sciences, Biomedical Engineering, and Neurology, University of Southern California, Los Angeles, CA.
Christina HugenschmidtDepartment of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
JoAnn E MansonDivision of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Suzanne CraftDepartment of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Kristine YaffeDepartments of Epidemiology and Biostatistics, Psychiatry, and Neurology, University of California, San Francisco, San Francisco, CA.
Julie WeitlaufVeterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, Stanford, CA Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
Leslie VaughanDepartment of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC.
Karen C JohnsonDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
Claudia B PadulaVeterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, Stanford, CA Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
Rebecca D JacksonDepartment of Internal Medicine, Ohio State University, Columbus, OH.
Susan M ResnickLaboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD.
WHIMS Study Group
Wake Forest University · USVA Palo Alto Health Care System · USBrigham and Women's Hospital · USNational Institutes of Health · USThe Ohio State University · USUniversity of California, San Francisco · USUniversity of Southern California · USUniversity of Tennessee Health Science Center · US

Funding

Translational Bioimaging Core Shared ResourceP30CA015704 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Eric Collisson · 1985 to 2026
$296.4M
Women's Health Initiative Suite of Studies - Extension StudyZIAAG000190 · NIA · NATIONAL INSTITUTE ON AGING · PI RESNICK, SUSAN · 2009 to 2024
$1.5M
Cognitive/Brain Effects of Adding Weight Loss to Exercise in Obese Older AdultsK01AG043547 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HUGENSCHMIDT, CHRISTINA E · 2013 to 2017
$609k
NCI NIH HHS P30 CA015704NIA NIH HHS K01 AG043547PHS HHS HHSN-271-2011-00004C
6 · The paper itself

Abstract

objectiveIn older women, higher levels of estrogen may exacerbate the increased risk for cognitive impairment conveyed by diabetes. We examined whether the effect of postmenopausal hormone therapy (HT) on cognitive impairment incidence differs depending on type 2 diabetes. RESEARCH DESIGN AND

methodsThe Women's Health Initiative (WHI) randomized clinical trials assigned women to HT (0.625 mg/day conjugated equine estrogens with or without [i.e., unopposed] 2.5 mg/day medroxyprogesterone acetate) or matching placebo for an average of 4.7-5.9 years. A total of 7,233 women, aged 65-80 years, were classified according to type 2 diabetes status and followed for probable dementia and cognitive impairment (mild cognitive impairment or dementia).

resultsThrough a maximum of 18 years of follow-up, women with diabetes had increased risk of probable dementia (hazard ratio [HR] 1.54 [95% CI 1.16-2.06]) and cognitive impairment (HR 1.83 [1.50-2.23]). The combination of diabetes and random assignment to HT increased their risk of dementia (HR 2.12 [1.47-3.06]) and cognitive impairment (HR 2.20 [1.70-2.87]) compared with women without these conditions, interaction P = 0.09 and P = 0.08. These interactions appeared to be limited to women assigned to unopposed conjugated equine estrogens.

conclusionsThese analyses provide additional support to a prior report that higher levels of estrogen may exacerbate risks that type 2 diabetes poses for cognitive function in older women. The role estrogen plays in suppressing non-glucose-based energy sources in the brain may explain this interaction.

Indexed as

AgedAged, 80 and overBrainCognitionCognition DisordersDementiaDiabetes Mellitus, Type 2Estrogen Replacement TherapyEstrogensEstrogens, Conjugated (USP)FemaleGlucoseHumansIncidenceMedroxyprogesterone AcetatePostmenopauseEstrogensEstrogens, Conjugated (USP)GlucoseMedroxyprogesterone Acetate

Identifiers

PMID26486190
PMCPMC4657616
OpenAlexW2180873472

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.