Estrogen Not Protective Against Brain Decline

New findings refute the notion that estrogen replacement therapy (ERT) protects women from age-related cognitive decline. Researchers found that, at the beginning of the study, women who used or had used estrogen scored higher than others on a modified Mini-Mental Status Exam. However, these subjects did not perform better on the Trails B test and did not consistently perform better on the digit symbol substitution tests. Moreover, women who were current users at the time of initial assessment did not exhibit less decline in their test scores than did never users, adjusting for their initial performance. Researchers did find that education, even when completed decades earlier, may help women remain mentally sharp well into advanced old age. With respect to one’s mental function test with a high score of 25, the authors report that 92% of women with a high school or college education scored 23 or above -- compared with just 8% of women with an 8th-grade education.

J Am Geriatr Soc May 1999;47:518-523.

COMMENT: A few years ago estrogen was commonly heralded as a solution to the age associated decline in mental function for women. Many thought it would help decrease the risk of Alzheimer’s disease. The truth eventually comes to the surface. It does not appear that estrogen is what is was purported to be. Remember, estrogen does not increase the risk for cancer, it actually causes cancer. Clearly, there are times when it should be used in the perimenopausal period. But, overall, about 95% of estrogen currently being prescribed should be stopped. I find the association that education seems to be highly protective against mental decline quite fascinating.

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