Zec Ronald F, Trivedi Mehul A
Department of Neurology, Center for Alzheimer Disease and Related Disorders, Southern Illinois University School of Medicine, Springfield 62794-9230, USA.
Neuropsychol Rev. 2002 Jun;12(2):65-109. doi: 10.1023/a:1016880127635.
We review 42 studies examining the effects of estrogen replacement therapy (ERT) on memory and cognition in nondemented postmenopausal women. Although there are an appreciable number of nonsignificant findings, the number of significant findings favoring ERT users considerably outnumbers the rare findings of better performance in controls. Experimental studies demonstrate a consistent beneficial effect on verbal memory, but these are short-term studies of the more acute effects of ERT. The observational studies suggest that there may be a long-lasting effect of continued ERT on cognitive functioning, but these studies need to be interpreted with caution because of the lack of random assignment and a possible "healthy user bias." We also summarize findings from studies on the effects of ERT on Alzheimer's disease (AD). ERT is associated with a decreased risk for dementia, but there is little evidence for a positive effect on cognition in women with AD. Definitive answers to questions about the long-term effects of ERT on cognitive aging and risk of developing AD should be provided by 3 ongoing clinical trials.
我们回顾了42项研究，这些研究探讨了雌激素替代疗法（ERT）对未患痴呆症的绝经后女性记忆力和认知能力的影响。尽管有相当数量的研究结果不显著，但支持ERT使用者的显著结果数量大大超过了对照组中表现更好的罕见结果。实验研究表明，ERT对言语记忆有持续的有益影响，但这些都是关于ERT更急性效应的短期研究。观察性研究表明，持续使用ERT可能对认知功能有长期影响，但由于缺乏随机分配以及可能存在的“健康使用者偏差”，这些研究需要谨慎解读。我们还总结了关于ERT对阿尔茨海默病（AD）影响的研究结果。ERT与痴呆风险降低有关，但几乎没有证据表明其对患有AD的女性认知能力有积极影响。关于ERT对认知衰老和患AD风险的长期影响问题的明确答案应由3项正在进行的临床试验提供。
