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| References
- Testosterone, the brain and psyche |
7.
Tang MX, Jacobs D, Stern Y, Marder K, Schofield P, Gurland
B et al. Effect of oestrogen during menopause
on risk and age at onset of Alzheimer's disease. Lancet
1996;348:429-32.
Abstract: BACKGROUND: Oestrogen use by postmenopausal women
has many health benefits, but findings on the effect of oestrogen
in Alzheimer's disease are conflicting. Oestrogen promotes
the growth and survival of cholinergic neurons and could decrease
cerebral amyloid deposition, both of which may delay the onset
or prevent Alzheimer's disease. To investigate whether use
of oestrogen during the postmenopausal period affects the
risk of Alzheimer's disease, we studied 1124 elderly women
who were initially free of Alzheimer's disease, Parkinson's
disease, and stroke, and who were taking part in a longitudinal
study of ageing and health in a New York City community. METHODS:
Relative risks and age-at-onset distributions were calculated
from simple and adjusted Cox proportional hazards models.
Standard annual clinical assessments and criterion-based diagnoses
were used in follow-up (range 1-5 years). FINDINGS: Overall,
156 (12.5%) women reported taking oestrogen after onset of
menopause. The age at onset of Alzheimer's disease was significantly
later in women who had taken oestrogen than in those who did
not and the relative risk of the disease was significantly
reduced (9/156 [5.8%] oestrogen users vs 158/968 [16.3%] nonusers;
0.40 [95% Cl 0.22-0.85], p < 0.01), even after adjustment
for differences in education, ethnic origin, and apolipoprotein-E
genotype. Women who had used oestrogen for longer than 1 year
had a greater reduction in risk; none of 23 women who were
taking oestrogen at study enrolment has developed Alzheimer's
disease. INTERPRETATION: Oestrogen use in postmenopausal women
may delay the onset and decrease the risk of Alzheimer's disease.
Prospective studies are needed to establish the dose and duration
of oestrogen required to provide this benefit and to assess
its safety in elderly postmenopausal women
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