ESTROGEN USE IN PROTECTION FROM COGNITIVE DECLINE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 雌激素用于预防认知能力下降的目的是评估雌激素治疗对有认知能力下降风险的绝经后女性的效果。我们收集了试点数据，这些数据表明，根据18-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)的测量，在有阿尔茨海默病风险的老年人中使用雌激素可能会保护局部大脑代谢。共有72名年龄在60-65岁的绝经后女性服用雌激素，她们将被随机分为继续或停止使用，并将在两年内接受跟踪，了解大脑新陈代谢和认知表现的变化。受试者将在最初和两年的随访期结束时接受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绝经后妇女在基线和随机继续与停止雌激素治疗时的局部，特别是顶叶、颞叶和后扣带回的脑葡萄糖代谢以及认知表现。被随机安排停止使用雌激素的受试者被假设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对雌激素影响的现有知识：(1)确定有认知能力下降风险的绝经后女性使用雌激素是否对大脑新陈代谢具有保护作用；(2)确定认知能力下降的早期预测因素；以及(3)制定绝经后女性使用雌激素的指南。

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-Fluorodeoxygluocse (FDG-PET). A total of 72 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-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 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 women.