Estrogen therapy and risk of cognitive decline: results from the Women's Estrogen for Stroke Trial (WEST).
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Among 461 women withdrawn alive without stroke, ET did not have a significant effect on cognitive measures after an average of 3 years (relative risk of MMSE decline: 0.74, 95% CI,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.
Viscoli
Catherine M
CM
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
Brass
Lawrence M
LM
Kernan
Walter N
WN
Sarrel
Philip M
PM
Suissa
Samy
S
Horwitz
Ralph I
RI
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*
D004958:Estradiol