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Am J Epidemiol 2002; 156:785.
Copyright © 2002 by the Johns Hopkins Bloomberg School of Public Health

LETTERS TO THE EDITOR

TWO AUTHORS REPLY

Suzana Alves de Moraes and Moyses Szklo

We appreciate the interest that Dr. Maki (1) has shown in our paper (2). We agree with Dr. Maki that our tests may not have been sensitive enough to detect age-related cognitive declines, and, indeed, we suggested in our discussion that "additional tests may have revealed different effects" (2, p. 738). We pointed out in our conclusions that the adjustment for confounding and the lack of a consistent pattern of associations would seem to indicate (our emphasis) that, at least in the relatively younger women included in the analyses, use of estrogen replacement therapy is not associated with age-related cognitive changes. The discussion of the study’s limitations that came before these carefully worded conclusions and the inference that this therapy is not associated (our emphasis) with cognitive declines are a far cry from our concluding, as Dr. Maki erroneously implies, that hormone replacement therapy has no effect (our emphasis) on verbal memory. Obviously, as Dr. Maki underscores, only well-designed clinical trials warrant conclusions about effects.

REFERENCES

  1. Maki PM. Re: "Prospective assessment of estrogen replacement therapy and cognitive functioning: Atherosclerosis Risk in Communities Study." (Letter). Am J Epidemiol 2002;156:785.[Free Full Text]
  2. de Moraes SA, Szklo M, Knopman D, et al. Prospective assessment of estrogen replacement therapy and cognitive functioning: Atherosclerosis Risk in Communities Study. Am J Epidemiol 2001;154:733–9.[Abstract/Free Full Text]

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TWO AUTHORS REPLY
Am. J. Epidemiol., October 15, 2002; 156(8): 785 - 785.
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