ESTROGEN USE IN PROTECTION FROM COGNITIVE DECLINE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心机构，不一定为研究者机构。雌激素用于防止认知能力下降旨在评估雌激素治疗对有认知能力下降风险的绝经后妇女的影响。我们收集了试点数据，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，正电子发射断层扫描与18-氟脱氧葡萄糖（FDG-PET）测量。共有71名年龄在60-65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，并将在两年内随访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、MRI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与认知性能在绝经后妇女在基线和随机继续与停止雌激素治疗。假设随机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作用的认识：（1）确定在有认知能力下降风险的绝经后妇女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。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Estrogen use in protection from cognitive decline is designed to assess the effects of estrogen therapy among postmenopausal women at risk for cognitive decline. We 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 positron emission tomography with 18-Flurodeoxygluocse (FDG-PET). A total of 71 postmenopausal women ages 60-65, estrogen users, will be randomized to continue or discontinue use and will be followed up in two years for changes in cerebral metabolism and cognitive performance. Subjects will undergo FDG-PET scans, MRI scans, and neuropsychological assessments, initially and at the end of the two-yr 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 therapy. Subjects who are randomized to discontinue estrogen use are hypothesized to show more evidence of decline than those who continue estrogen use. This project will expand the current knowledge of the 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 wome