Many studies have ground that estr...

Many studies have ground that estrogen therapy in postmenopausal women may intercept or slow the decline in cognitive function. A meta-analysis of these studies conclud that there is a 34 percent reduction in the risk of dementia in patients treated with estrogen However, fresh randomized controlled trials have not shown consistently that estrogen therapy has a positive impact onward cognitive function. In two larger trials evaluating estrogen and progesterone therapy, no benefits in cognition were originate between treated and untreated women Viscoli and colleagues evaluated estrogen therapy and its impact forward cognitive decline in postmenopausal women with cerebrovascular disease.

The authors carriageed a randomized, double-blind trial of 17 [beta]-estradiol (Estrace) versus placebo in postmenopausal women who had a nondisabling ischemic shock or transient ischemic attack (TIA). The participants were randomized to receive 1 mg of 17 [beta]-estradiol daily or placebo. Women with an intact uterus were given a progestin for 12 days each year to cloak for hyperplasia. Patients' cognitive function was evaluated at the start and extremity of the study. The primary issue measure was patients' scores onward the Mini-Mental State Examination (MMSE) Secondary issues were measured using five cognitive domain tests: the Modified Boston Naming standard for language function and naming ability; Digit Span for attention, short-term verbal memory, and storage capacity; Word List Generation for verbal readiness of speech and semantic memory; Disk Spatial Recognition for visual recognition memory and the ability to learn fresh visual information; and Delayed Naming for incidental memory. In addition, a depression scale was administered to each patient.

A total of 461 women met the inclusion criteria and complet the inquiry with an average age of 70 years and an average education duration of 12 years. Thirty-nine percent of the participants had a baseline score upon the depression scale that was indicative of depression. The meditation lasted a median of 38 month in the estradiol cluster and 40 months in the placebo cluster The median baseline MMSE score was 28 for the couple groups, with an average decline of les than single in kind point. There was no significant difference between the estradiol and placebo arranges with regard to decline in MMSE scores, although the decline in the estradiol assign places to was slightly less. There were stretchs towards less decline in the estradiol collection in all five assessment domains save for delayed recall. Participants who had normal MMSE scores of 28 to 30 and were treated with estradiol did have a significantly smaller decline in MMSE score compared with the placebo group

The authors terminate that estradiol did not have significant drifts on cognitive measures in postmenopausal women They add that there may be about benefit to estradiol in reducing the risk of cognitive decline in women who have normal cognitive function before beginning therapy.

KARL E MILLER, MD

Viscoli CM et al. Estrogen therapy and risk of cognitive decline: accrues from the Women's Estrogen for rap Trial (WEST). Am J Obstet Gynecol February 2005;192:387-93

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