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Long-term estrogen replacement therapy in female patients with dementia of the Alzheimer type: 7 case reports.

Abstract
Seven female patients with mild to moderate dementia of the Alzheimer type (DAT) were treated with long-term, low-dose estrogen replacement therapy (ERT) over a period of 5-45 months. Five of the 7 patients were cases who had responded well to short-term ERT with 1.25 mg/day of conjugated equine estrogens (CEE) for 6 weeks. The 7 patients from 56 to 77 years of age received 0.625 mg/day of CEE for 21 days, followed by a pause of 7 days. A 28-day cycle of low-dose ERT was performed repeatedly. In 4 cases, these patients received 5 mg/day of medroxyprogesterone acetate (MPA) during the last 10-12 days of estrogen treatment. Therapeutic efficacy of estrogen was evaluated by psychometric assessments such as the Mini-Mental State Examination (MMSE) and the Hasegawa Dementia Scale (HDS) and a behavior rating scale of the Gottfries-Bråne-Steen geriatric rating scale (GBS). The MMSE and HDS evaluations were performed principally once in 2-4 weeks. In 4 out of the 7 patients, the MMSE and HDS scores were elevated above the pretreatment levels during ERT. The termination of ERT resulted in a decrease in both scores. Furthermore, the GBS scores and daily activities of the same 4 patients were improved during ERT. In these 4 patients cognitive functions were markedly improved throughout the treatment period, while the other 2 patients responded moderately well and another patient did not respond at all. These observations suggest that long-term, low-dose ERT improves cognitive functions, dementia symptoms and daily activities in women with mild to moderate DAT.(ABSTRACT TRUNCATED AT 250 WORDS)
AuthorsT Ohkura, K Isse, K Akazawa, M Hamamoto, Y Yaoi, N Hagino
JournalDementia (Basel, Switzerland) (Dementia) 1995 Mar-Apr Vol. 6 Issue 2 Pg. 99-107 ISSN: 1013-7424 [Print] Switzerland
PMID7606287 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Estrogens, Conjugated (USP)
  • Medroxyprogesterone
Topics
  • Activities of Daily Living
  • Age Factors
  • Aged
  • Alzheimer Disease (drug therapy, psychology)
  • Cognition Disorders (drug therapy, psychology)
  • Estrogen Replacement Therapy
  • Estrogens, Conjugated (USP) (therapeutic use)
  • Female
  • Humans
  • Medroxyprogesterone (therapeutic use)
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Treatment Outcome

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