The effect of hormone replacement on physical performance in community-dwelling elderly women

Purpose Our aim was to determine the effect of hormone replacement on physical performance measures, functional ability, physical activity, falls, and cognitive function in elderly women. Subjects and methods Following a 3-month, open-label, run-in phase, we randomized 373 community-dwelling women aged 65 years and older to receive conjugated equine estrogen 0.625 mg/day plus or minus medroxyprogesterone 2.5 mg/day vs placebo for 3 years in a double-blind fashion. We assessed time to rise from a chair, timed walking, balance, Instrumental Activities of Daily Living, Physical Activity Scale of the Elderly, Folstein Mini-Mental State Examination, and falls. Results Over 3 years, except for balance scores, performance measures declined significantly (all P<.05). There were no significant mean differences between women on hormone replacement versus placebo for rising time (0.1, −0.5 to 0.7 seconds [mean, 95% confidence interval]), walking normal (0.0, −0.4 to 0.4 seconds), and walking fast (0.2, −0.1 to 0.6 seconds). There were no significant mean differences between the two groups for the Instrumental Activities of Daily Living (0.1, −0.1 to 0.3 points), Physical Activity Scale of the Elderly (−3, −15 to 8 points), Folstein Mini-Mental State Examination (−0.1, −0.3 to 0.3 points), or the proportion of participants reporting falls (−1, −11 to 9%). Conclusion In elderly women, hormone replacement had no statistically significant effect on cognition or balance, nor did it prevent the age-related decline in physical measures of mobility, ability to rise from a chair, self-reported activities of daily living, physical activity scores, or falls.