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To the Editor: Dr Zandi and colleagues¹ argue that underreporting of HRT use among women who subsequently develop AD is unlikely because of the "notable nature of a decision to use HRT and the tendency of women to use HRT for an extended period of time." Furthermore, the authors note no relationships between "control exposures" (ie, calcium and multivitamins) and the incidence of AD. The authors conclude it is unlikely that women who later developed dementia would have selectively forgotten making a "carefully considered decision to use HRT."

We question this conclusion for 2 reasons. First, it is unclear whether recollection of calcium and multivitamin use provides a valid exposure control. If one accepts the authors' assertions regarding the gravity of a decision to take HRT, it is unlikely that the decision to use these readily available supplements was undertaken in a similar manner. Therefore, use may be underreported in . . . [Full Text of this Article]

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