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From The Neurological Institute (Drs. P.N. Wang, Lu, Yu, Wang, and H.C. Liu), Department of Nuclear Medicine (Drs. Liao and R.S. Liu), Department of Obstetrics and Gynecology (Dr. Chao), Taipei Veterans General Hospital & National Yang-Ming University School of Medicine, Taipei; and the Department of Psychiatry (Dr. C.Y. Liu), Chang-Gung Medical College, Taoyuan, Taiwan.
Address correspondence and reprint requests to Dr. Hsiu-Chih Liu, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; e-mail: hcliu{at}vghtpe.gov.tw
OBJECTIVE: To examine the effects of estrogen therapy on cognition, mood, and cerebral blood flow in patients with AD.
BACKGROUND: Some studies have suggested estrogen may be effective in the treatment of AD. However, most of these studies were not controlled adequately.
METHODS: Fifty female AD patients were recruited in a randomized, double-blind, placebo-controlled 12-week trial. Each member of the estrogen-treated group received conjugated estrogen (Premarin) 1.25 mg/day. The primary outcome measures were the Cognitive Ability Screening Instrument (CASI), Clinical Dementia Rating (CDR), and Clinician Interview-Based Impression of Change (CIBIC-plus). The secondary outcome measures were Behavioral Pathology in Alzheimer’s Disease (BEHAVE-AD), Hamilton Anxiety Rating Scale (HARS), Hamilton Depression Rating Scale (HDRS), and 99mTc hexamethylpropylene amine oxime SPECT of the brain.
RESULTS: No meaningful differences were found between the outcome measures (CASI, CDR, CIBIC-plus, BEHAVE-AD, HARS, HDRS, and cerebral blood flow) taken from the estrogen-treated group and those from the control group.
CONCLUSION: A 1.25-mg/day dose of Premarin administered for 12 consecutive weeks does not produce a meaningful effect on cognitive performance, dementia severity, behavior, mood, and cerebral perfusion in female AD patients. Because estrogen therapy has been suspected of yielding adverse effects, and its therapeutic effectiveness is in doubt, additional evaluation of its role in AD treatment ought to be conducted.
Key words: Estrogen—Dementia—AD—Cognition—Depression—Cerebral blood perfusion.
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