Effects of conjugated equine estrogens on cognition and affect in postmenopausal women with prior hysterectomy.
BACKGROUND
Different menopausal hormone therapies may have varied effects on specific cognitive functions. We previously reported that conjugated equine estrogens (CEE) with medroxyprogesterone acetate had a negative impact on verbal memory but tended to impact figural memory positively over time in older postmenopausal women.


OBJECTIVE
The objective of the study was to determine the effects of unopposed CEE on changes in domain-specific cognitive function and affect in older postmenopausal women with prior hysterectomy.


METHODS
This was a randomized, double blind, placebo-controlled clinical trial.


METHODS
The study was conducted at 14 of 40 Women's Health Initiative (WHI) clinical centers.


METHODS
Participants were 886 postmenopausal women with prior hysterectomy, aged 65 yr and older (mean 74 yr), free of probable dementia, and enrolled in the WHI and WHI Memory Study (WHIMS) CEE-Alone trial for a mean of 3 yr and followed up for a mean of 2.70 yr.


METHODS
Intervention was 0.625 mg of CEE daily or placebo.


METHODS
Annual rates of change in specific cognitive functions and affect, adjusted for time since randomization, were measured.


RESULTS
Compared with placebo, unopposed CEE was associated with lower spatial rotational ability (P < 0.01) at initial assessment (after 3 yr of treatment), a difference that diminished over 2.7 yr of continued treatment. CEE did not significantly influence change in other cognitive functions and affect.


CONCLUSIONS
CEE did not improve cognitive functioning in postmenopausal women with prior hysterectomy. CEE was associated with lower spatial rotational performance after an average of 3 yr of treatment. Overall, CEE does not appear to have enduring effects on rates of domain-specific cognitive change in older postmenopausal women.
Laboratory of Personality and Cognition, National Institute on Aging, Biomedical Research Center, Baltimore, Maryland 21224-6825, USA. susan.resnick@nih.gov
Susan M
SM
Resnick
Mark A
MA
Espeland
Yang
Y
An
Pauline M
PM
Maki
Laura H
LH
Coker
Rebecca
R
Jackson
Marcia L
ML
Stefanick
Robert
R
Wallace
Stephen R
SR
Rapp
D000339:Affect / Q000187:drug effects*; D000368:Aged; D003071:Cognition / Q000187:drug effects*; D004311:Double-Blind Method; D004966:Estrogens, Conjugated (USP) / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D010919:Placebos; D017698:Postmenopause; D013028:Space Perception / Q000187:drug effects
D004966:Estrogens, Conjugated (USP); D010919:Placebos