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Estrogen Replacement Therapy May Stave Off Dementia

WebMD Health News

October 27, 1999 (Atlanta) -- A new study shows that estrogen replacement therapy in women after menopause may prevent the onset of dementia and possibly Alzheimer's disease. The results of the study are published in the October issue of the Journal of the American Geriatric Society.

Dementia is a major problem in old age, affecting as many as half of the elderly aged 85 and over. Alzheimer's disease is the leading cause of dementia among the elderly, though not the only cause.

Estrogen replacement therapy, or ERT, is used to maintain a steady estrogen level after menopause. Usually given in combination with progesterone -- to reduce the risk of uterine cancer in women who have not had a hysterectomy -- ERT relieves postmenopausal symptoms such as sleeping problems and hot flashes. Estrogen may be administered orally or by a skin patch.

The researchers interviewed 2,300 women aged 65 or older about their current and past use of estrogen after menopause. They were then classified into three groups: no use, past use, and current use. They found that both current and past users of estrogen scored higher on a test of mental abilities than women who had never used estrogen.

The women who were taking estrogen at the time of the study and had been for at least the last five years had the highest scores on the mental ability test. The longer and more recently that the women had been taking estrogen replacement, the more likely they were to score higher on the test. Also, women who took higher doses of estrogen were found to perform better on the test.

"Through its design, the study was able to eliminate variables that might alter the result such as age, education, health status, genetics, and depression status, according to David C. Steffens, MD, lead researcher involved in the study, and colleagues. By doing this, the researchers were able to hone in on the effect of estrogen alone.

Steffens, who is at Duke University Medical Center in Durham, N.C., says this research has other implications. "Our study did not address the possibility of a protective effect against development against Alzheimer's disease," writes Steffens. But better performance on the mental ability test would be consistent with this hypothesis, he says.

"This is consistent with what we tell people," John Thames, spokesperson for the Georgia chapter of the Alzheimer's Association, in Atlanta, tells WebMD. "That for people whom their doctor's prescribe estrogen, it reduces their likelihood of getting Alzheimer's or at least delays the onset of the disease. We don't say it will prevent the disease but it can be one factor that can help."

Still, Anne B Newman, MD, MPH, at the University of Pittsburgh Medical Center, says the evidence for using estrogen to prevent declining mental abilities is still not sufficient. "Dementia prevention should not be oversold to women as one of the indications for estrogen use in later life," writes Newman in an editorial accompanying the current study.

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