Baldereschi M, Di Carlo A, Lepore V, Bracco L, Maggi S, Grigoletto F, Scarlato G, Amaducci L
Progetto Finalizzato Invecchiamento, Italian National Research Council, Rome.
Neurology. 1998 Apr;50(4):996-1002. doi: 10.1212/wnl.50.4.996.
To study the association of estrogen-replacement therapy and other estrogen-related variables with Alzheimer's disease in postmenopausal women.
Postmenopausal estrogen use has been reported to lower the risk of Alzheimer's disease.
A population-based, multicenter survey was carried out in eight Italian municipalities. The sample of 2,816 women, aged 65 to 84 years, was randomly selected from the population register of each municipality and stratified in 5-year age groups. All women were screened using the Mini-Mental State Examination and interviewed concerning risk factors. Those who screened positive underwent a clinical assessment. Dementia syndrome was diagnosed according to DSM-III-R criteria, and Alzheimer's disease was diagnosed according to NINCDS-ADRDA criteria for possible and probable Alzheimer's disease.
The estimated prevalence of postmenopausal estrogen use adjusted to the 1991 Italian female population was 12.3%. The frequency of estrogen use was higher among nonpatients compared with Alzheimer's disease patients (odds ratio, 0.24; 95% confidence interval, 0.07 to 0.77). The inverse association between estrogen therapy and Alzheimer's disease remained significant after adjustment for age, education, age at menarche, age at menopause, smoking and alcohol habits, body weight at the age of 50 years, and number of children (odds ratio, 0.28; 95% confidence interval, 0.08 to 0.98).
Our data from a population-based study support the hypothesis that estrogen-replacement therapy is associated with a reduced prevalence of Alzheimer's disease in postmenopausal women. Prospective clinical trials are required to enable women and their physicians to weigh risks and benefits of estrogen-replacement therapy for the prevention of dementia.
研究绝经后女性中雌激素替代疗法及其他与雌激素相关的变量与阿尔茨海默病之间的关联。
据报道，绝经后使用雌激素可降低患阿尔茨海默病的风险。
在意大利的八个城市进行了一项基于人群的多中心调查。从每个城市的人口登记册中随机抽取了2816名年龄在65至84岁之间的女性样本，并按5岁年龄组进行分层。所有女性均使用简易精神状态检查表进行筛查，并就危险因素接受访谈。筛查呈阳性者接受临床评估。根据《精神疾病诊断与统计手册》第三版修订版标准诊断痴呆综合征，根据美国国立神经疾病和中风研究所 - 阿尔茨海默病及相关疾病协会可能和很可能阿尔茨海默病标准诊断阿尔茨海默病。
根据1991年意大利女性人口调整后的绝经后雌激素使用估计患病率为12.3%。与阿尔茨海默病患者相比，非患者中雌激素使用频率更高（优势比为0.24；95%置信区间为0.07至0.77）。在对年龄、教育程度、初潮年龄、绝经年龄、吸烟和饮酒习惯、50岁时的体重以及子女数量进行调整后，雌激素治疗与阿尔茨海默病之间的负相关仍然显著（优势比为0.28；95%置信区间为0.08至0.98）。
我们基于人群研究的数据支持以下假设：雌激素替代疗法与绝经后女性中阿尔茨海默病患病率降低有关。需要进行前瞻性临床试验，以使女性及其医生能够权衡雌激素替代疗法预防痴呆的风险和益处。
