Does estrogen improve memory in women with Alzheimers’?

In a small but carefully designed study, a Medical School geriatrics researcher has found that high doses of a particular form of estrogen are associated with measurable improvements in both attention and memory in women who already have Alzheimer’s Disease.

Sanjay Asthana, associate professor of medicine and a practicing geriatrician, published the findings of his research team in the Aug. 28 issue of Neurology, the journal of the American Academy of Neurology. Asthana joined the faculty earlier this month from the VA Puget Sound Health Care System and the University of Washington, where the research was conducted.

The primary goal of the study was to discover whether giving women with Alzheimer’s a high dose of estradiol (the most potent form of estrogen) via a skin patch would improve their cognitive abilities, particularly attention and memory.

Twenty post-menopausal women with Alzheimer’s were randomly assigned to receive either .10 mg of estradiol per day (a dose commonly used in treatment for menopause symptoms) or a placebo. Both the active medication and the placebo were delivered through a patch applied to the skin. The study was double-blind, meaning that neither the women nor the researchers knew if the study participants were on estradiol or the placebo. Women were excluded from the study if they had depression or other disorders that might account for cognitive symptoms.

The women were assessed at several points during the eight-week study and again eight weeks after it concluded. They underwent a battery of tests designed to measure, among other things, how long they needed to perform various mental tasks and how well they remembered word lists, geometric designs and other material. Blood levels of various estrogens were also measured.

As a group, the women who received the estrogen patch performed significantly better than the placebo group in both verbal and visual recent memory (remembering words and figures). They were also able to name more pictures on a memory test.

“A great deal more research must be done before we can recommend estrogen as a treatment for memory problems in Alzheimer’s patients,” says Asthana. “However, these findings suggest that giving a high dose of estrogen via the patch is associated with significant improvements in some important measures of memory.”

Previous findings about the role of estrogen in women with Alzheimer’s have reached various conclusions. “This study, I believe, keeps the area of estrogen research alive for its possible value in Alzheimer’s treatment,” Asthana says. “Now there should be studies with larger groups of subjects and a longer treatment period.”

Asthana’s work was supported by funds from the Department of Veterans Affairs and from the Ciba-Geigy Corp.