Endogenous and Exogenous Estrogen, Cognitive Function, and Dementia in Postmenopausal Women: Evidence from Epidemiologic Studies and Clinical Trials

Elizabeth Barrett-Connor, M.D.; Gail A. Laughlin, Ph.D.


Semin Reprod Med. 2009;27(3):275-282. 

In This Article


Most studies of endogenous estrogen and cognitive decline or dementia fail to show protection, and some suggest harm. Failure to find any consistent association might reflect the limitations of a single assay or poor assay sensitivity. More than half of the observational studies of hormone therapy suggest benefit. Failure to adequately adjust for self-selection of healthier and wealthier women and publication bias could account for some, or all, of the protective effect attributed to estrogen. Nearly all long-term clinical trials fail to show benefit, and the longer trials tend to show harm. Overall, the evidence does not convincingly support early or late postmenopausal estrogen therapy to preserve cognitive function or prevent dementia.


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