Asthana Sanjay, Brinton Roberta Diaz, Henderson Victor W, McEwen Bruce S, Morrison John H, Schmidt Peter J
Department of Medicine and Geriatric Research, Education and Clinical Center (GRECC), University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
Age (Dordr). 2009 Sep;31(3):199-210. doi: 10.1007/s11357-009-9087-2. Epub 2009 Mar 10.
On 28-29 September 2004, the National Institute on Aging (NIA) convened scientists for a workshop on the aging female brain focused on translating into clinical practice discoveries concerning estrogens and progestogens. Workshop objectives were to examine effects of estrogen and progestogen on brain and cognitive function in relation to aging, to examine consistencies and apparent discrepancies between Women's Health Initiative Memory Study findings and other research on cognitive function, to determine whether additional hormone interventions could be developed in this area, and to offer advice on design of clinical trials for other interventions that might ameliorate cognitive aging. Following the workshop, participants joined by other interested scientists organized into regional work groups to continue the dialogue begun in Bethesda and to propose recommendations for NIA. The resulting recommendations, referred to as the "Frontiers Proposal for Estrogen and Cognitive Aging", acknowledge the persistence of critical gaps in our understanding of how decline in ovarian steroid secretion during reproductive aging and use of ovarian steroid hormone therapy affect normal brain function and risk for late-life neurodegenerative disorders such as Alzheimer's disease. There is a pressing need for preclinical, human, and integrated studies on the relationship between the menopausal transition and midlife exposures to estrogens, progestogens and related compounds, and risks for age-associated cognitive disorders. Research is also needed on better predictors of adverse cognitive outcomes, valid biomarkers for risks associated with hormone therapy use, enhanced tools for monitoring brain function and disease progression, and novel forms of therapy for improving long-term cognitive outcomes.
2004年9月28日至29日,美国国立衰老研究所(NIA)召集科学家举办了一场关于衰老女性大脑的研讨会,重点是将有关雌激素和孕激素的研究成果转化为临床实践。研讨会的目标是研究雌激素和孕激素对与衰老相关的大脑和认知功能的影响,审视妇女健康倡议记忆研究结果与其他认知功能研究之间的一致性和明显差异,确定该领域是否可以开发其他激素干预措施,并就可能改善认知衰老的其他干预措施的临床试验设计提供建议。研讨会结束后,与会者与其他感兴趣的科学家组成了区域工作组,继续在贝塞斯达开始的对话,并向NIA提出建议。由此产生的建议,即“雌激素与认知衰老前沿提案”,承认在我们对生殖衰老期间卵巢类固醇分泌下降以及卵巢类固醇激素疗法的使用如何影响正常脑功能和晚年神经退行性疾病(如阿尔茨海默病)风险的理解方面,仍然存在关键差距。迫切需要开展关于绝经过渡与中年时期接触雌激素、孕激素及相关化合物之间的关系以及与年龄相关的认知障碍风险的临床前、人体和综合研究。还需要研究更好的不良认知结果预测指标、与激素疗法使用相关风险的有效生物标志物、监测脑功能和疾病进展的增强工具,以及改善长期认知结果的新型治疗方法。