title: Estrogen therapy and risk of cognitive decline: results from the Women's Estrogen for Stroke Trial (WEST).
abstract: OBJECTIVE
  This study was undertaken to assess whether estrogen therapy (ET) reduces the risk of cognitive decline in women with cerebrovascular disease.
  
  
  METHODS
  We conducted a randomized, double-blind trial of estradiol 17beta versus placebo for secondary stroke prevention in 664 postmenopausal women with a recent stroke or transient ischemic attack. The Mini-Mental State Examination (MMSE) and 5 domain measures were obtained at baseline and exit.
  
  
  RESULTS
  Among 461 women withdrawn alive without stroke, ET did not have a significant effect on cognitive measures after an average of 3 years (relative risk of MMSE decline: 0.74, 95% CI, 0.49-1.13). In women with normal MMSE at entry, estrogen was associated with less decline (relative risk, 0.46, 95% CI, 0.24-0.87).
  
  
  CONCLUSIONS
  In this study, estradiol did not have significant effects on cognitive measures. However, in women with normal function at baseline, there may be a benefit for ET in reducing the risk for cognitive decline.
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, 333 Cedar St, Room IE 61 SHM, PO Box 208025, New Haven, CT 06520-8025, USA. Catherine.Viscoli@yale.edu
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Viscoli
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Brass
authors.forename: Walter N
authors.initials: WN
authors.lastname: Kernan
authors.forename: Philip M
authors.initials: PM
authors.lastname: Sarrel
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
authors.forename: Ralph I
authors.initials: RI
authors.lastname: Horwitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects*; D004311:Double-Blind Method; D004958:Estradiol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D020521:Stroke / Q000517:prevention & control*
chemical_list: D004958:Estradiol