Szklo M, Cerhan J, Diez-Roux A V, Chambless L, Cooper L, Folsom A R, Fried L P, Knopman D, Nieto F J
Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Epidemiol. 1996 Dec 1;144(11):1048-57. doi: 10.1093/oxfordjournals.aje.a008877.
The association of estrogen replacement therapy (ERT) with cognitive functioning was assessed in 6,110 women aged 48-67 years participating in the Atherosclerosis Risk in Communities (ARIC) study, a multicenter longitudinal investigation. ERT was evaluated in relation to results of three cognitive tests (the Delayed Word Recall (DWR) Test, the Digit Symbol Subtest of the Wechsler Adult intelligence Scale-Revised (DSS/WAIS-R), and the Word Fluency (WF) Test) using data from the first follow-up visit of the cohort (1990-1992). No consistent associations were seen between ERT and either the DWR test or the DSS/WAIS-R after adjusting for age, education, and additional covariates previously found to be associated with cognitive function scores. Among surgically menopausal women aged 48-57 years, adjusted mean WF scores were slightly greater in ERT current users (mean WF 35.9) than in never users (mean WF 33.5) (p < 0.02); and within current users, adjusted WF scores increased with duration of ERT use. However, the finding that ERT was associated with a slightly higher level of performance on only one of three measures offers little support for the hypothesis that ERT has a major protective effect on cognitive function in women less than 68 years of age. The generalizability of these findings to older women who are more likely to experience cognitive decline and who may be using ERT for longer periods of time is limited by the relatively young age of the cohort.
在一项多中心纵向研究——社区动脉粥样硬化风险（ARIC）研究中，对6110名年龄在48至67岁的女性进行了雌激素替代疗法（ERT）与认知功能关联的评估。利用该队列首次随访（1990 - 1992年）的数据，对ERT与三项认知测试（延迟单词回忆（DWR）测试、韦氏成人智力量表修订版数字符号分测验（DSS/WAIS - R）和单词流畅性（WF）测试）的结果进行了评估。在调整年龄、教育程度以及先前发现与认知功能评分相关的其他协变量后，未发现ERT与DWR测试或DSS/WAIS - R之间存在一致的关联。在48至57岁的手术绝经女性中，ERT当前使用者的调整后平均WF得分（平均WF 35.9）略高于从未使用者（平均WF 33.5）（p < 0.02）；并且在当前使用者中，调整后的WF得分随ERT使用时间的延长而增加。然而，ERT仅与三项测量中的一项表现水平略高相关这一发现，几乎无法支持ERT对68岁以下女性认知功能有主要保护作用这一假设。由于该队列相对年轻，这些研究结果对更可能经历认知下降且可能使用ERT时间更长的老年女性的可推广性有限。
