Pei-Ning Wang
Hsiu-Chih Liu
The Neurological Institute Taipei Veterans General Hospital
Estrogen replacement therapy is widely used among postmenopausal women to relieve the symptoms of postmenopausal syndrome, to prevent osteoporosis, and to reduce the risk of cardiovascular diseases. However, the role of estrogen in prevention or treatment of Alzheimer’s disease(AD) is still inconclusive. Some animal studies have found that estrogen might improve cognitive performance through several mechanisms, including stimulation of neurite outgrowth, modulation of neurotransmitters, and improving cerebral perfusion. However, the results of clinical investigations in the prevention or treatment of AD patient with estrogen are inconsistent. Some studies reported that women who received estrogen had a lower risk in development of AD, but others not. Meta-analysis of these studies suggests a 29% decreased the risk of developing dementia among estrogen users. Several small non-blind and non-randomized estrogen trials revealed that estrogen improved cognitive and psychological symptoms in female AD patients. However, our estrogen trial conducted in Taipei Veterans General Hospital did not disclose significant benefit effect in AD patients. Large randomized trial of estrogen therapy is needed to evaluate the role of estrogen in the treatment of AD.
Keywords: Alzheimer’s disease, estrogen, hormone, cognition