Long-term effects of conjugated equine estrogen therapies on domain-specific cognitive function: results from the Women's Health Initiative study of cognitive aging extension.
Long-term effects of conjugated equine estrogen therapies on domain-specific cognitive function: results from the Women's Health Initiative study of cognitive aging extension.
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DOI：
10.1111/j.1532-5415.2010.02953.x
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发表时间：
2010-07
影响因子：
6.3
通讯作者：
Women's Health Initiative Study of Cognitive Aging Study Group
中科院分区：
文献类型：
--
作者：
Espeland MA;Brunner RL;Hogan PE;Rapp SR;Coker LH;Legault C;Granek I;Resnick SM;Women's Health Initiative Study of Cognitive Aging Study Group
结合马雌激素（CEE）治疗时，开始在老年妇女已被证明会产生小的整体认知功能下降。我们感兴趣的是，这些症状是否在停止后持续存在，并延伸到特定的认知领域。随机对照临床试验妇女健康倡议的14个临床中心2，304名年龄在65-80岁之间的妇女，在登记时没有可能的痴呆症，CEE为0.625 mg/天，有或没有醋酸甲羟孕酮（MPA，10 mg/天），试验期间和试验后每年进行一组认知测试。治疗组之间的试验和试验后平均标准化测试评分，并对认知障碍的基线风险因素进行了校正。分配至基于CEE的治疗与试验期间总体和几个领域特异性认知功能的平均相对小幅下降相关，这在很大程度上持续至试验后4年。最强的统计学证据是整体认知功能：试验期间（p=0.007）和试验后（p=0.01）均降低0.07标准差。在领域特异性评分中，平均相对递减略小，不太显著，并且倾向于更大的CEE单独治疗。基于CEE的治疗在65岁后开始时，会产生认知功能的小范围衰减，这种衰减在停止使用后仍会持续。然而，认知功能的差异很小，并且不会被检测到或对个体女性具有临床意义。认知领域之间的影响差异表明，可能涉及一种以上的机制。
Conjugated equine estrogen (CEE) therapies when initiated among older women have been shown to produce small decrements in global cognitive function. We are interested whether these persist after cessation and extend to specific cognitive domains. Randomized controlled clinical trial Fourteen clinical centers of the Women's Health Initiative 2,304 women aged 65-80 years and free of probable dementia at enrollment 0.625 mg/day of CEE, with or without medroxyprogesterone acetate (MPA, 10 mg/day), and matching placebos Annual administrations of a battery of cognitive tests during and following the trial General linear models were used to compare on-trial and post-trial mean standardized test scores between treatment groups, with adjustment for baseline risk factors for cognitive impairment. Assignment to CEE-based therapies was associated with small mean relative decrements in global and several domain-specific cognitive functions on-trial, which largely persisted through up to 4 years post-trial. The strongest statistical evidence was for global cognitive function: 0.07 standard deviation decrements both on-trial (p=0.007) and post-trial (p=0.01). Among domain specific scores, the mean relative decrements were slightly smaller, were less significant, and tended to be larger for CEE-alone therapy. CEE-based therapies, when initiated after age 65 years, produce a small broad-based decrement in cognitive function that persists after their use is stopped. The differences in cognitive function however are small and would not be detectable or have clinical significance for an individual woman. Differences in effects among cognitive domains suggest that more than one mechanism may be involved.
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DOI：
10.1191/1740774504cn040oa
发表时间：
2004-01-01
期刊：
Clinical trials (London, England)
影响因子：
--
作者：
Resnick, Susan M;Coker, Laura H;Shumaker, Sally A
通讯作者：
Shumaker, Sally A
DOI：
10.1080/01688638108403111
发表时间：
1981-01-01
期刊：
Journal of Clinical Neuropsychology
影响因子：
--
作者：
BENTON A L;ESLINGER P J;DAMASIO A R
通讯作者：
DAMASIO A R
影响因子：
3.2
作者：
Laughlin GA;Kritz-Silverstein D;Barrett-Connor E
通讯作者：
Barrett-Connor E
影响因子：
120.7
作者：
Ockene, JK;Barad, DH;Hays, J
通讯作者：
Hays, J
影响因子：
2.5
作者：
Rozovsky, I;Hoving, S;Finch, CE
通讯作者：
Finch, CE