An open trial on transdermal estrogen therapy in post-menopausal women with Alzheimer's disease

We tested the effects of a short trial of transdermal estrogen therapy in 2 0 postmenopausal women with mild or moderate probable Alzheimer's disease ( AD). Patients received 50 mu g 17 beta-estradiol plus 2.5 mg medroxy-proges terone daily for three months. They were assessed with gynaecological and n eurological examinations, blood parameter tests, caregiver interviews, func tional rating scales and psychometric tests, during therapy and four weeks after withdrawal. Only minor side effects occurred. Three patients dropped out, only one of which was due to treatment side effects. Cognition assessm ent showed no changes in verbal performance and improvement in visuo-spatia l performance (in particular spatial cognition and visual memory). Function al rating scales showed no worsening and a trend to improvement in one of t hree scales used. Three patients shifted from moderate to mild dementia. Mo st of these positive effects remained one month after wash-out. A favourabl e global impression was reported by the relatives of most patients. Transde rmal estrogen therapy in mild and moderate AD seems to be safe, tolerable, with fairly good compliance and a favourable effect on patients' cognition and on physical and daily living activity self-maintenance.