American Journal of Epidemiology Vol. 144, No. 11: 1048-1057
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Estrogen Replacement Therapy and Cognitive Functioning in the Atherosclerosis Risk in Communities (ARIC) Study
1Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD
2Department of Preventive Medicine and Environmental Health, The University of Iowa Iowa City, IA
3Collaborative Studies Coordinating Center, Department of Bio-statlstlcs, School of Public Health, University of North Carolina at Chapel Hill Chapel Hill, NC
4National Heart, Lung, and Blood Institute, National Institutes of Health, Division of Epidemiology and Clinical Applications Be-thesda, MD
5Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis, MN
6The Weich Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins Health Institutions Baltimore, MD
7Department of Neurology, University of Minnesota Minneapolis, MN
Reprint requests to Dr. Moyses Szklo, Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205.
The association of estrogen replacement therapy (ERT) with cognitive functioning was assessed in 6,110 women aged 48–67 years participating in the Atherosclerosis Risk in Communities (ARIC) study, a multicenter longitudinal investigation. ERT was evaluated in relation to results of three cognitive tests (the Delayed Word Recall (DWR) Test, the Digit Symbol Subtest of the Wechsler Adult Intelligence Scale-Revised (DSS/WAIS-R), and the Word Fluency (WF) Test) using data from the first follow-up visit of the cohort (1990–1992). No consistent associations were seen between ERT and either the DWR test or the DSS/WAIS-R after adjusting for age, education, and additional covariates previously found to be associated with cognitive function scores. Among surgically menopausal women aged 48–57 years, adjusted mean WF scores were slightly greater in ERT current users (mean WF 35.9) than in never users (mean WF 33.5) (p < 0.02); and within current users, adjusted WF scores increased with duration of ERT use. However, the finding that ERT was associated with a slightly higher level of performance on only one of three measures offers little support for the hypothesis that ERT has a major protective effect on cognitive function in women less than 68 years of age. The generaJizability of these findings to older women who are more likely to experience cognitive decline and who may be using ERT for longer periods of time is limited by the relatively young age of the cohort. Am J Epidemiol 1996;144:1048-57.
cognition; cognition disorders; estrogen replacement therapy; menopause; women's health
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