American Journal of Epidemiology Vol. 153, No. 2 : 137-144
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Impact of Estrogen Use on Decline in Cognitive Function in a Representative Sample of Older Community-resident Women
1 Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC.
2 College of Pharmacy, University of Minnesota, Minneapolis, MN.
3 Department of Medicine, Duke University Medical Center, Durham, NC.
4 Center for Health Services Research in Primary Care, VA Medical Center, Durham, NC.
5 Geriatric Research, Education and Clinical Center, VA Medical Center, Durham, NC.
The authors investigated whether postmenopausal estrogen use helps to maintain cognitive function; a brief screen, the Short Portable Mental Status Questionnaire (SPMSQ), was used. Information was gathered from a stratified, random sample of 1,907 African-American and White women (aged 65–100 years) participating in the longitudinal Duke Established Populations for Epidemiologic Studies of the Elderly project carried out in five urban and rural counties of North Carolina. All women were cognitively unimpaired in 1986–1987 and were evaluated 3 and 6 years later. Decline in cognitive function was measured as an increase of two or more errors on the SPMSQ and crossing of an SPMSQ threshold indicative of cognitive impairment. Recency and continuity of estrogen use were measured. Univariate analyses indicated that recent (crude odds ratio = 0.42, 95% confidence interval: 0.21, 0.86) and continuous (crude odds ratio = 0.32, 95% confidence interval: 0.13, 0.81) estrogen use reduced the risk of cognitive decline but not of cognitive impairment. After adjustment for demographic and health characteristics, protective effects became nonsignificant. While postmenopausal use of estrogen may be protective for Alzheimer's disease, current findings based on a brief cognitive screen suggest that it is not protective for cognitive decline related to aging.
blacks; cognition; estrogen replacement therapy; longitudinal studies; whites; women
Abbreviations: EPESE, Established Populations for Epidemiologic Studies of the Elderly; SPMSQ, Short Portable Mental Status Questionnaire.
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