Memory Clinic, Department of Neurology, Rigshospitalet, Copenhagen, Denmark.
Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark.
Alzheimers Dement. 2022 Apr;18(4):625-634. doi: 10.1002/alz.12417. Epub 2021 Jul 28.
Use of systemic hormone therapy has been positively associated with development of dementia. Little is known about the dose-dependent effect of vaginal estradiol on dementia risk.
We assessed associations between cumulative dose of vaginal estradiol tablets and dementia in a case-control study nested in a nationwide Danish cohort of women aged 50 to 60 years at study initiation, who did not use systemic hormone therapy. Each case was age-matched to 10 female controls.
A total of 4574 dementia cases were matched to 45,740 controls. Cumulative use of vaginal estradiol tablets was not associated with all-cause dementia; adjusted hazard ratio 1.02 (95% confidence interval [CI] 0.89-1.18) for low dose (< 750 mcg), 1.07 (0.94-1.21) for medium dose (750-2000 mcg), and 0.93 (0.84-1.03) for high dose (> 2000 mcg). Similarly, Alzheimer's disease (AD) only was not associated with vaginal estradiol.
Exposure to vaginal estradiol tablets was not associated with all-cause dementia or AD only.
全身激素疗法的使用与痴呆的发生呈正相关。关于阴道用雌二醇剂量依赖性对痴呆风险的影响知之甚少。
我们在一项巢式病例对照研究中评估了阴道用雌二醇片累积剂量与 50 至 60 岁女性（研究开始时未使用全身激素疗法）痴呆之间的关联。每个病例与 10 名年龄匹配的女性对照相匹配。
共匹配了 4574 例痴呆病例和 45740 名对照。阴道用雌二醇片的累积使用与所有原因导致的痴呆无关；低剂量（<750 mcg）的调整后危害比为 1.02（95%置信区间 [CI] 0.89-1.18），中剂量（750-2000 mcg）为 1.07（0.94-1.21），高剂量（>2000 mcg）为 0.93（0.84-1.03）。同样，阴道用雌二醇与阿尔茨海默病（AD）也没有关联。
接触阴道用雌二醇片与全因痴呆或 AD 无关。
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