Estrogen replacement therapy and cognitive decline in memory-impaired post-menopausal women.
BACKGROUND
Estrogen replacement therapy (ERT) may delay dementia-related cognitive decline in post-menopausal women, but few studies have longitudinally examined this relationship and none has controlled for baseline functioning or concurrent medication.


METHODS
We report the results of a 1-year retrospective longitudinal study examining cognitive functioning in female estrogen and nonestrogen users (n = 3128) who presented to the state of California memory disorder clinics in a naturalistic multisite study of senile dementia, Alzheimer's type (SDAT), and other cognitive impairments.


RESULTS
At baseline, estrogen users had significantly lower rates of SDAT diagnoses (possible and probable) than nonestrogen users, and significantly higher rates of the lesser diagnoses of "cognitive impairment" and "no dementia." ERT was significantly associated with higher cognitive functioning at baseline and at 1 year follow-up (n = 358). Nonestrogen users deteriorated significantly from baseline to follow-up; estrogen users did not. Results were similar in groups matched on baseline Blessed-Roth Dementia Rating Scale (BRDRS) ratings (n = 32) and in a variety of subpopulations.


CONCLUSIONS
These findings are consistent with estrogen acting as a protective factor against cognitive deterioration in post-menopausal women with SDAT and other cognitive impairments, and may suggest an increased effect in earlier stages of cognitive impairment.
Department of Psychiatry, University of California, San Francisco 94143-0984, USA.
M M
MM
Costa
V I
VI
Reus
O M
OM
Wolkowitz
F
F
Manfredi
M
M
Lieberman
D000368:Aged; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D004958:Estradiol / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008568:Memory / Q000187:drug effects*; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D008875:Middle Aged; D009483:Neuropsychological Tests; D017698:Postmenopause / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index
D004958:Estradiol