Victor W. Henderson

Publication Details

• Estrogen and Alzheimer's disease

  Henderson VW, Paganini-Hill A. J Soc Obstetr Gynaecol Canada. 1997: 19 [suppl] 21-28

  Objective: to review associations (1) between post-menopausal estrogen use and Alzheimer’s disease risk, and (2) between estrogen use and the symptomatic amelioration of dementia in women with Alzheimer’s disease. Data sources: publications since 1994 on the epidemiology of estrogen and Alzheimer’s disease risk, and publications since 1986 on estrogen and cognition in Alzheimer’s disease patients. Results: primary analyses from all but one recent epidemiological study indicated that estrogen replacement reduced the risk of Alzheimer’s disease. For the six studies in which information on estrogen use had been collected prospectively, risk estimates ranged from 0.4 to 1.1. Studies of estrogen and Alzheimer’s disease symptoms are limited by small sample sizes, and most have been uncontrolled and of short duration. Only one randomized controlled trial of estrogen in Alzheimer’s disease patients has been reported in full. However, each study suggests that estrogen is associated with better performance. Conclusions: epidemiological findings imply that estrogen replacement therapy will reduce a woman’s risk of Alzheimer’s disease by about one-third to one-half. Randomized, placebo-controlled studies of estrogen and Alzheimer’s risk, although difficult to undertake, would provide more convincing evidence for this contention. Preliminary findings of treatment efficacy, although encouraging, remain to be confirmed or refuted in larger randomized, placebo-controlled trials.