Estradiol Hormone Therapy Improves Cognition in Pre-Dementia

TREATMENTS: An important study shows
how hormones may slow cognitive decline in postmenopausal
women, as well as fight MCI (also known as “Pre-Dementia”).

CLEVELAND, Ohio — Hormones affect just about everything that goes on in a woman’s
body, from reproductive function and sexual libido to weight gain and overall mood. A new study shows
how, in the right dosage and combination, hormones also may slow cognitive decline in postmenopausal
women as they age. The study is being published online today in Menopause, the journal of The North
American Menopause Society (NAMS).

It comes as no surprise that cognitive function declines as we age. We recognize memory decline in a
number of ways, such as not being able to remember a grocery list as easily as we once did. Mild
cognitive impairment (MCI) is defined as that intermediate stage between normal aging and dementia.
Persons with MCI have an increased risk of progressing to Alzheimer disease or other dementia, with
roughly 20% of this population crossing over from MCI to a more severe level each year. To date, no
pharmacologic treatment has proven effective in managing MCI.

Hormone Therapy & MCI

The article “Menopausal hormone therapy and mild cognitive impairment: a randomized, placebocontrolled
trial” reviews the results from a recent Korean study regarding the effect of hormone therapy
on cognitive function. The study followed postmenopausal women who were diagnosed with MCI and
taking donepezil over a 24-month period and showed that cognitive test scores for the women who
received hormone therapy significantly increased during that time.

Although the study group was small,
the study offers promising results, demonstrating that the combination of transdermal estradiol and an oral
progesterone can slow down cognitive decline. This is the first known study to evaluate the effect of
hormone therapy on MCI.

Encouraging Trial

“This encouraging, small pilot trial suggests a possible benefit of hormone therapy when given to women
diagnosed with MCI who are also taking donepezil, a cholinesterase inhibitor,” says Dr. JoAnn Pinkerton,
executive director of NAMS. “Higher global cognition was seen in two of the three key evaluation criteria
in those women using estradiol gel plus an oral micronized progesterone compared with those in the
placebo group. Larger trials are needed to evaluate the effect of hormone therapy use before the full onset
of Alzheimer disease.”