Reboussin B A, Greendale G A, Espeland M A
Wake Forest University School of Medicine, Department of Public Health Sciences, Winston-Salem, NC 27157, USA.
Climacteric. 1998 Sep;1(3):172-9. doi: 10.3109/13697139809085538.
To describe self-reported cognitive changes in 875 postmenopausal women aged 45-64 years and assigned randomly to hormone therapy (either estrogen alone or estrogen in combination with a progestin).
A 3-year placebo-controlled trial which included self-report data on problems with forgetfulness, concentration and distraction in groups of women assigned randomly to placebo, estrogen alone or estrogen plus one of three progestin regimens.
Women assigned to any active treatment were consistently less likely to report cognitive symptoms than women assigned to placebo, but these results were not statistically significant. When compared with women assigned to estrogen plus any progestin, women assigned to estrogen alone had a significant increased risk for reporting problems with forgetfulness at follow-up (odds ratio, OR = 1.47). In the absence of problems with distraction at baseline, women assigned to estrogen alone were significantly less likely to report problems with distraction at follow-up, compared to women assigned to estrogen plus any progestin (OR = 0.36). Assignment to a continuous progestin regimen in combination with estrogen was marginally associated with an increased risk for reporting concentration problems at follow-up, compared to cyclic progestin regimens (OR = 1.63).
These results provide some evidence to support the hypothesis that estrogen improves memory, but findings are not statistically significant in this healthy middle-aged cohort. These data suggest that estrogen in combination with any progestin confers a decreased risk for reporting forgetfulness at follow-up, compared to estrogen alone. However, there is evidence that distraction problems reported at follow-up were side-effects of progestin. There is also some evidence that women administered progestins cyclically were at lower risk for reporting cognitive symptoms at follow-up, particularly concentration problems.
描述875名年龄在45 - 64岁的绝经后女性自我报告的认知变化情况，这些女性被随机分配接受激素治疗（单独使用雌激素或雌激素与孕激素联合使用）。
一项为期3年的安慰剂对照试验，其中包括了随机分配到安慰剂组、单独使用雌激素组或雌激素加三种孕激素方案之一的女性群体中关于健忘、注意力不集中和分心问题的自我报告数据。
与分配到安慰剂组的女性相比，接受任何一种活性治疗的女性报告认知症状的可能性始终较低，但这些结果无统计学意义。与分配到雌激素加任何孕激素组的女性相比，单独使用雌激素组的女性在随访时报告健忘问题的风险显著增加（优势比，OR = 1.47）。在基线时无分心问题的情况下，与分配到雌激素加任何孕激素组的女性相比，单独使用雌激素组的女性在随访时报告分心问题的可能性显著降低（OR = 0.36）。与周期性孕激素方案相比，雌激素与持续性孕激素方案联合使用在随访时报告注意力不集中问题的风险略有增加（OR = 1.63）。
这些结果提供了一些证据支持雌激素改善记忆力的假设，但在这个健康的中年队列中，研究结果无统计学意义。这些数据表明，与单独使用雌激素相比，雌激素与任何孕激素联合使用在随访时报告健忘的风险降低。然而，有证据表明随访时报告的分心问题是孕激素的副作用。也有一些证据表明，接受周期性孕激素治疗的女性在随访时报告认知症状的风险较低，尤其是注意力不集中问题。
