American Journal of Epidemiology Vol. 140, No. 3: 256-261
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Estrogen Deficiency and Risk of Alzheimer's Disease in Women
1Department of Preventive Medicine, University of Southern California School of Medicine Los Angeles, CA
2Department of Neurology, University of Southern California School of Medicine Los Angeles, CA
Reprint requests to Dr. Annlia Paganini-Hill, Department of Preventive Medicine, University of Southern California School of Medicine 1721 Griffin Avenue #103, Los Angeles, CA 90031
The authors explored the possibility that estrogen loss associated with menopause may contribute to the development of Alzheimer's disease by using a case-control study nested within a prospective cohort study. The Leisure World Cohort includes 8,877 female residents of Leisure World Laguna Hills, a retirement community in southern California, who were first mailed a health survey in 1981. From the 2,529 female cohort members who died between 1981 and 1992, the authors identified 138 with Alzheimer's disease or other dementia diagnoses likely to represent Alzheimer's disease (senile dementia, dementia, or senility) mentioned on the death certificate Four controls were individually matched by birth date (±1 year) and death date (+1 year) to each case. The risk of Alzheimer's disease and related dementia was less in estrogen users relative to nonusers (odds ratio = 0 69, 95 percent confidence interval 0.46=1.03). The risk decreased significantly with increasing estrogen dose and with increasing duration of estrogen use. Risk was also associated with vanables related to endogenous estrogen levels, it increased with increasing age at menarche and (although not statistically significant) decreased with increasing weight. This study suggests that the increased incidence of Alzheimer's disease in older women may be due to estrogen deficiency and that estrogen replacement therapy may be useful for preventing or delaying the onset of this dementia. Am J Epidemiol 1994; 140:256–61.
Alzheimer's disease; body weight; dementia; dementia; senile; estrogens; menarche; menopause; women
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