Reproduction events modify the effects of estrogen replacement therapy on cognition in healthy postmenopausal women
Reproduction events modify the effects of estrogen replacement therapy on cognition in healthy postmenopausal women
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DOI：
10.1016/j.psyneuen.2004.09.002
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发表时间：
2005-04-01
影响因子：
3.7
通讯作者：
Rapkin, A
中科院分区：
文献类型：
--
作者：
Dunkin, J;Rasgon, N;Rapkin, A
雌激素替代疗法（ERT）是否有益于绝经后妇女的认知功能的问题在过去几年中一直存在争议。早期的研究表明，ERT可以改善认知功能，降低患阿尔茨海默病的风险，但最近的研究未能发现任何益处。然而，研究在参与者的年龄，所使用的雌激素制剂，是否同时给予黄体酮以及研究设计方面有所不同。本研究采用随机、安慰剂对照设计，并使用由17-β雌二醇组成的经皮雌激素制剂。在基线和10周试验完成后进行神经心理学测试，使用心理测量技术将测试分数分为四个综合分数。使用多元回归技术分析基线至随访的变化。结果表明，白色很少发现雌激素的总体有益作用，绝经后的年数与雌激素组而不是安慰剂组的执行功能的变化显著相关，例如最近绝经后的妇女比老年妇女表现出更大的积极变化。身体质量指数，循环雌激素的粗略估计，显着正相关的注意力和心理过程的变化，无论治疗组，在较弱的程度上，言语记忆，但只有在雌激素治疗组。这些结果表明，生殖事件和内源性雌激素水平与ERT的临床反应有关，但需要更长随访期的大型研究来确定这些影响的强度。(C)2004 Elsevier Ltd.保留所有权利。
The question of whether estrogen replacement therapy (ERT) is beneficial to cognitive functioning in postmenopausal women has become controversial in the past several years. Early studies suggested that ERT improved cognitive functioning and decreased the risk of Alzheimer's disease, but recent studies have failed to find any benefit. However, studies have varied in terms of the age of participants, the estrogen preparation used, whether progesterone is administered concurrently, and the study design. The present study used a randomized, placebo-controlled design and a transdermal estrogen preparation composed of 17-beta estradiol. A neuropsychological battery was administered at baseline and after completion of the 10-week trial, and test scores were grouped into four composite scores using psychometric techniques. Baseline to follow-up change was analyzed using multiple regression techniques. Results indicate that white little overall beneficial effect of estrogen was found, years since menopause was significantly related to change in executive functioning in the estrogen but not the placebo group, such that more recently postmenopausal women demonstrated greater positive change than older women. Body mass index, a gross estimate of circulating estrogen, was significantly positively related to change in attentional and psychomotor processes regardless of treatment group, and to a weaker extent, verbal memory, but only in the estrogen-treated group. These results suggest that reproductive events and levels of endogenous estrogen are related to the clinical response to ERT, but larger studies with longer follow-up periods are needed to determine the strength of these effects. (C) 2004 Elsevier Ltd. All rights reserved.