title: Long-term estrogen replacement therapy in female patients with dementia of the Alzheimer type: 7 case reports.
abstract: Seven female patients with mild to moderate dementia of the Alzheimer type (DAT) were treated with long-term, low-dose estrogen replacement therapy (ERT) over a period of 5-45 months. Five of the 7 patients were cases who had responded well to short-term ERT with 1.25 mg/day of conjugated equine estrogens (CEE) for 6 weeks. The 7 patients from 56 to 77 years of age received 0.625 mg/day of CEE for 21 days, followed by a pause of 7 days. A 28-day cycle of low-dose ERT was performed repeatedly. In 4 cases, these patients received 5 mg/day of medroxyprogesterone acetate (MPA) during the last 10-12 days of estrogen treatment. Therapeutic efficacy of estrogen was evaluated by psychometric assessments such as the Mini-Mental State Examination (MMSE) and the Hasegawa Dementia Scale (HDS) and a behavior rating scale of the Gottfries-Bråne-Steen geriatric rating scale (GBS). The MMSE and HDS evaluations were performed principally once in 2-4 weeks. In 4 out of the 7 patients, the MMSE and HDS scores were elevated above the pretreatment levels during ERT. The termination of ERT resulted in a decrease in both scores. Furthermore, the GBS scores and daily activities of the same 4 patients were improved during ERT. In these 4 patients cognitive functions were markedly improved throughout the treatment period, while the other 2 patients responded moderately well and another patient did not respond at all. These observations suggest that long-term, low-dose ERT improves cognitive functions, dementia symptoms and daily activities in women with mild to moderate DAT.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Obstetrics and Gynecology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ohkura
authors.forename: K
authors.initials: K
authors.lastname: Isse
authors.forename: K
authors.initials: K
authors.lastname: Akazawa
authors.forename: M
authors.initials: M
authors.lastname: Hamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Yaoi
authors.forename: N
authors.initials: N
authors.lastname: Hagino
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D003072:Cognition Disorders / Q000188:drug therapy / Q000523:psychology; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008525:Medroxyprogesterone / Q000627:therapeutic use; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D004966:Estrogens, Conjugated (USP); D008525:Medroxyprogesterone