Abstract Background: In clinical practice, adjuvant endocrine and targeted (ET) therapy strategies for hormone receptor-positive (HR+) breast cancer are constantly evolving. The long-term cognitive impact of such adjuvant treatment on patients remains unclear. Methods: This study mined data from the FDA Adverse Event Reporting System (FAERS) from 2010Q1 to 2025Q2 to examine the relationship between ET therapy strategies and adverse events (AEs) related to dementia.