Prospective assessment of estrogen replacement therapy and cognitive functioning - Atherosclerosis risk in communities study

Studies of humans have not confirmed the suggestion from animal studies tha t estrogen replacement therapy may have an inverse relation with cognitive function decline. Because many of these studies have been marred by design or methodological problems, such as a small sample size, failure to control for confounding variables, or the use of a cross-sectional design, the pre sent study was conducted in a large cohort of middle-aged postmenopausal wo men participating in the Atherosclerosis Risk in Communities (ARIC) Study. The study population consisted of 2,859 women aged 48-67 years, whose cogni tive function was tested at the second (1990-1992) and fourth (1996-1998) v isits of the ARIC Study using three instruments: the Delayed Word Recall Te st, Digit Symbol Subtest of the Wechsler Adult Intelligence Scale-Revised, and Word Fluency Test. After multiple adjustment, no consistent patterns of cognitive changes between the two cohort visits could be detected accordin g to current use or duration of use of estrogen replacement therapy. Thus, the results of the present study do not support the hypothesis that estroge n replacement therapy may slow age-related cognitive decline, at least as i t applies to relatively young postmenopausal women.