Estrogen replacement therapy and risk of Alzheimer disease
A. Paganini-Hill
Bok Engelsk 1996
| Utgitt | 1996
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|---|---|
| Omfang | Side 2213- 2217
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| Opplysninger | Background: With Alzheimer disease emerging as a major public healthproblem, the identification of factors that might prevent thisdisease are important. Estrogen loss associated with menopause maycontribute to the development of Alzheimer disease.Objective: To evaluate the effects of different estrogenpreparations, varying dosages of estrogen, and duration of estrogenreplacement therapy on the risk of Alzheimer disease inpostmenopausal women.Study Design and Methods: A case-control study nested within aprospective cohort study of residents of Leisure World Laguna Hills,a retirement community in Southern California. The cohort comprised8877 women who were first mailed a health survey in 1981. Of the 3760female cohort members who died between 1981 and 1995, 248 women withAlzheimer disease or other dementia diagnoses likely to representAlzheimer disease (senile dementia, dementia, or senility) mentionedon the death certificate were identified. Five controls wereindividually matched to each case according to year of death and yearof birth (+/-1 year).Results: The risk of Alzheimer disease and related dementia wassignificantly reduced in estrogen users compared with nonusers (oddsratio, 0.65; 95% confidence interval, 0.49-0.88). The risk wasreduced for both oral and nonoral (ie, injections and/or creams)routes of administration. The risk decreased significantly with bothincreasing dosages (P=.01) and increasing duration (P=.01) of oraltherapy with conjugated equine estrogen, the most commonly usedestrogen preparation. Within each dose category, the risk decreasedwith increasing duration of therapy, with the lowest observed risk inlong-term users who received high doses (odds ratio, 0.48; 95%confidence interval, 0.19-1.17).Conclusion: This study suggests that estrogen replacement therapy maybe useful for preventing or delaying the onset of Alzheimer diseasein postmenopausal women.
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