It is unknown whether cognitive status or diagnosed cognitive decline affects estrogen use.
We assessed how common systemic estrogen use was among community-dwellers with Alzheimer’s disease (AD) and a matched comparison cohort without AD.
This study included an exposure-matched cohort of all Finnish community-dwelling women who received a clinically verified diagnosis of AD in 2005–2011 (N = 46,116; index cases) and an equally sized matched comparison cohort without AD. Follow-up began on the matching date (date of the AD diagnosis of the index case). Data on systemic estrogen use were obtained from the prescription register. Use initiation and discontinuation were assessed.
Altogether 3.1% of women with AD and 4.3% of women without AD used estrogen during the follow-up period. Only < 0.5% initiated use during the follow-up period, but 3.7% continued use until death. The prevalence of estrogen use 1 year after the AD diagnosis declined in 2005–2011.
There were no major differences in systemic estrogen use among Finnish women with AD when compared to those without AD. Although some persons initiated estrogen use after AD diagnosis and/or at an advanced age, the observed use patterns were mainly consistent with the current recommendations.
The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The hormone therapy position statement of the North American Menopause Society. Menopause. 2017. https://doi.org/10.1097/GME.0000000000000921. CrossRef
Boardman HM, Hartley L, Eisinga A, Main C, Roque i Figuls M, Bonfill Cosp X, et al. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev. 2015;3:CD002229.
Marjoribanks J, Farquhar C, Roberts H, Lethaby A, Lee J. Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2017;1:CD004143. PubMed
Gleason CE, Dowling NM, Wharton W, Manson JE, Miller VM, Atwood CS, et al. Effects of hormone therapy on cognition and mood in recently postmenopausal women: findings from the randomized, controlled KEEPS-Cognitive and Affective Study. PLoS Med. 2015. https://doi.org/10.1371/journal.pmed.1001833. CrossRefPubMedPubMedCentral
Henderson VW, St John JA, Hodis HN, McCleary CA, Stanczyk FZ, Shoupe D, et al. Cognitive effects of estradiol after menopause: a randomized trial of the timing hypothesis. Neurology. 2016. https://doi.org/10.1212/WNL.0000000000002980. CrossRefPubMedPubMedCentral
de Villiers TJ, Hall JE, Pinkerton JV, Perez SC, Rees M, Yang C, et al. Revised global consensus statement on menopausal hormone therapy. Maturitas. 2016;91:153–5. CrossRef
Sprague BL, Trentham-Dietz A, Cronin KA. A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999–2010. Obstet Gynecol. 2012;120(3):595–603. CrossRef
Jewett PI, Gangnon RE, Trentham-Dietz A, Sprague BL. Trends of postmenopausal estrogen plus progestin prevalence in the United States between 1970 and 2010. Obstet Gynecol. 2014;124(4):727–33. CrossRef
Tolppanen AM, Taipale H, Koponen M, Lavikainen P, Tanskanen A, Tiihonen J, et al. Cohort profile: the Finnish Medication and Alzheimer’s disease (MEDALZ) study. BMJ Open. 2016;6(7):012100. CrossRef
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34(7):939–44. CrossRef
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington DC: American Psychiatric Association; 1994.
WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment 2012. In: 2011. http://www.whocc.no/atc_ddd_publications/guidelines/. Accessed 15 Mar 2012.
Taipale H, Tanskanen A, Koponen M, Tolppanen AM, Tiihonen J, Hartikainen S. Agreement between PRE2DUP register data modeling method and comprehensive drug useinterview among older persons. Clin Epidemiol. 2016;8:363–71. CrossRef
Hodis HN, Mack WJ. Hormone replacement therapy and the association with coronary heart disease and overall mortality: clinical application of the timing hypothesis. J Steroid Biochem Mol Biol. 2014;142:68–75. CrossRef
Rikala M, Hartikainen S, Sulkava R, Korhonen MJ. Validity of the Finnish Prescription Register for measuring psychotropic drug exposures among elderly Finns: a population-based intervention study. Drugs Aging. 2010;27(4):337–49. CrossRef
Neele SJ, Evertz R, De Valk-De Roo G, Roos JC, Netelenbos JC. Effect of 1 year of discontinuation of raloxifene or estrogen therapy on bone mineral density after 5 years of treatment in healthy postmenopausal women. Bone. 2002;30(4):599–603. CrossRef
- Systemic Estrogen Use and Discontinuation After Alzheimer’s Disease Diagnosis in Finland 2005–2012: A Nationwide Exposure-Matched Cohort Study
- Springer International Publishing
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II