Estrogen improves cognitive function in women with Alzheimer's disease

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WESTPORT, CT (Reuters Health) – High doses of estradiol delivered by skin patch appear to be able to improve memory and attention skills in women with Alzheimer's disease, according to the results of a pilot study reported in the August 28th issue of Neurology.

There have been conflicting findings of estrogen effects in women with Alzheimer's disease, Dr. Sanjay Asthana, of the University of Wisconsin School of Medicine in Madison, told Reuters Health. While some studies have shown positive results, three recent studies have shown negative results, he noted.

Dr. Asthana and colleagues at the VA Puget Sound Health Care System in Tacoma and elsewhere randomly assigned 20 postmenopausal women diagnosed with probable Alzheimer's disease to receive 0.10 mg/day of 17-beta-estradiol by skin patch or placebo. Neuropsychologic tests were given at baseline and during weeks 3, 5 and 8 of treatment, and again 16 weeks after treatment ended.

Women receiving estradiol showed an improvement from baseline in selective attention as demonstrated by results of the Stroop Color World Interference Test, which they were able to complete more quickly than patients receiving placebo, the researchers report.

Improved performance from baseline in verbal and visual recent memory was also observed in estradiol-treated patients compared with placebo patients. In addition, women on estradiol were able to name more pictures on the Boston Naming Test compared with women on placebo, the researchers found.

However, there was no general improvement in cognition; the beneficial effects of estrogen were targeted only to certain domains of cognition, Dr. Asthana said. The gains in attention, verbal, visual and semantic memory seen in the estradiol group deteriorated after treatment was stopped and most women returned to their pretreatment level, he added.

Dr. Asthana believes that the form of estrogen used is important, and may explain the various findings of previous studies. He also suggests that the results of this small study may be used to develop larger trials.

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