Endogenous sex hormone levels and risk of cognitive decline in an older biracial cohort.
BACKGROUND
Older women treated with conjugated estrogens may have an increased risk of dementia, but the effect of naturally occurring sex hormones on cognition is not certain.


METHODS
Bioavailable estradiol and free testosterone level were obtained from 792 (55% men, 51% black) participants. We assessed cognition with the Modified Mini-Mental State Examination (3MS), Selective Reminding Test (SRT) and CLOX 1 at baseline and 2 years later.


RESULTS
Women in the lowest estradiol tertile were more likely than those in the highest tertile to decline (> or = 1.0 S.D. of change) on 3MS (25% versus 9%, adjusted odds ratio [OR] = 3.9; 95% confidence interval [CI] = 1.6-9.6) and on SRT (28% versus 12%, adjusted OR [95% CI] = 3.3 [1.4-7.9]) but not CLOX 1. There was a borderline association between low estradiol tertile and decline on SRT in men (22% versus 14%, adjusted OR [95% CI] = 1.9 [0.9-3.9]). Testosterone level was not associated with decline in cognition in either men or women. Findings did not differ by race.


CONCLUSIONS
Older women with low estradiol levels were more likely to experience decline in global cognitive function and verbal memory, and a similar trend was observed for verbal memory in men. This supports the hypothesis that endogenous sex hormones may play an important role in the maintenance of cognitive function in older adults.
Yaffe
K
K
Department of Psychiatry, University of California, San Francisco, CA 94121, USA. Kristine.Yaffe@ucsf.edu
Barnes
D
D
Lindquist
K
K
Cauley
J
J
Simonsick
E M
EM
Penninx
B
B
Satterfield
S
S
Harris
T
T
Cummings
S R
SR
D017677:Age Distribution; D000368:Aged; D003072:Cognition Disorders / Q000097:blood* / Q000208:ethnology*; D015331:Cohort Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data
D012739:Gonadal Steroid Hormones