Estrogen has been shown to have une...

Estrogen has been shown to have unequivocal positive neuronal general intents and to enhance neurotransmitters. However, modern critical reviews have not supported estrogen supplementation for improvement of cognitive performance. Buckwalter and colleagues waysed a study to compare cognitive performance in a population of aging women who were receiving hormone therapy compared with those who were not.

Women were recruited from the Women's Memory inquiry Women who were receiving hormone therapy were randomly single outed and matched with women who were not receiving hormone therapy in three age categories (75 to 79 years, 80 to 84 years, and 85 to 89 years). A total of 210 patients were assessed with a battery of proofs that focused mainly on memory, which is reported to be greatest in number sensitive to estrogen exposure.

Fifty-eight of those receiving hormone therapy and 47 of those not receiving hormone therapy agreed to participate in the consideration There were no significant differences between the brace groups on any aspects of the California Verbal Learning proof or the Logical Memory subtest and no differences forward any of the neuropsychologic experiments Separate analyses did not change these terminates There were no differences when nonusers of hormone therapy were subdivided into past users and never-users of hormone therapy. Nor did it make any differences if users were taking estrogen alone or estrogen plus progestin.

In spite of previous studies that have institute a positive effect of estrogen onward cognition, this study suggests that hormone therapy does not improve cognitive performance. A possible explanation for the lack of benefit in this inquiry compared with several studies showing positive findings may relate to the aging brain, which may be les responsive to estrogen The circulating study's findings are consistent with a previous randomized trial that showed no benefit of hormone therapy forward cognition in very old women

EDITOR'S NOTE: new studies of the cognitive benefits of hormone therapy are not encouraging, although the terminates of larger, definitive trials are not owing until 2010. One Cochrane review of the immediate events of hormone therapy on cognition in postmenopausal women with dementia showed no benefit. (1) Another inquiry showed benefit if hormone therapy had been used for 10 years or longer nevertheless not within 10 years before the attack of Alzheimer's disease. (2) It appears almost certain that short-term hormone therapy use near the assault of dementia or in the treatment of dementia is not effective. unruffled if long-term preventive benefits are construct they may not be clinically compelling.--C.W.

REFERENCES

(1) Hogervorst E Yaffe K Richards M Huppert F Hormone replacement therapy to maintain cognitive function in women with dementia (Cochrane Review). In: The Cochrane Library, Issue 2 2004 Chichester, UK: John Wiley & Son Ltd

(2) Zandi PP Carlson MC Plassman BL Welsh-Bohmer KA, Mayer L Steffen DC et al. Hormone replacement therapy and incidence of Alzheimer disease in older women The Cache shire Study. JAMA 2002;288:2123-9.

CAROLINE WELLBERY, MD

Buckwalter JG et al. Hormone use and cognitive performance in women of advanced age. J Am Geriatr Soc February 2004;52:182-6

COPYRIGHT 2004 American Academy of Family Physicians

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