Estrogen Use in Protection from Cognitive Decline

描述（由申请人提供）：这是一个新的申请R 01补助金：“雌激素用于保护认知能力下降”，旨在评估雌激素替代疗法对有认知能力下降风险的绝经后妇女的影响。我们已经收集了试点数据，这表明，雌激素的使用老年人在阿尔茨海默病的风险可能是保护区域脑代谢，如测量的位置发射断层扫描与18-氟脱氧葡萄糖（FDG-PET）。共有71名年龄在50-65岁的绝经后女性，雌激素使用者，将被随机分配继续或停止使用，并将随访两年，以观察脑代谢和认知能力的变化。受试者将在最初和两年随访期结束时接受FDG-PET扫描和神经心理学评估。这些程序将使我们能够评估局部，特别是顶叶，颞叶和后扣带回，大脑葡萄糖代谢沿着认知能力在绝经后妇女在基线和随机继续与停止雌激素替代治疗。假设停止使用雌激素的受试者比继续使用雌激素的受试者表现出更多的下降证据。该项目将通过以下方式扩大目前对雌激素影响的认识：（1）确定绝经后妇女在认知能力下降的风险中使用雌激素是否能保护脑代谢;（2）确定认知能力下降的早期预测因子;（3）制定绝经后妇女使用雌激素的指南。

DESCRIPTION (provided by applicant): This is a new application for an R01 grant: "Estrogen use in protection from cognitive decline" designed to assess effects of estrogen replacement therapy among postmenopausal women at risk for cognitive decline. We have collected pilot data, which suggest that estrogen use among older persons at risk for Alzheimer's Disease may be protective of regional cerebral metabolism, as measured by position emission tomography with 18-fluorodeoxyglucose (FDG-PET). A total of 71 postmenopausal women ages 50-65, estrogen users, will be randomized to continue or discontinue use and will be followed up to two years for changes in cerebral metabolism and cognitive performance. Subjects will undergo FDG-PET scans and neuropsychological assessments, initially and at the end of the two-year follow-up period. These procedures will allow us to evaluate regional, especially parietal, temporal, and posterior cingulate, cerebral glucose metabolism along with cognitive performance in postmenopausal women at baseline and upon random continuation vs. discontinuation of estrogen replacement therapy. Subjects who to discontinue estrogen use are hypothesized to show more evidence of decline than those who continue do. This project will expand current knowledge of effects of estrogen, by : (1) determining whether estrogen use among postmenopausal women at risk for cognitive decline is protective of brain metabolism; (2) identifying early predictors for cognitive decline; and (3) developing guidelines for estrogen use in postmenopausal women.