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Cited by 205Menopause: Health Impacts and TreatmentsEstrogen and related hormone effectsDementia and Cognitive Impairment Research

Estrogen replacement therapy in older women: a neuropsychological and brain MRI study

Schmidt, R., Fazekas, F., Reinhart, B., Kapeller, P., Fazekas, G., Offenbacher, H., Eber, B., Schumacher, M. +1 more·1996·Journal of the American Geriatrics Society
DOI 10.1111/j.1532-5415.1996.tb01400.x
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Abstract

OBJECTIVE: To determine if postmenopausal women receiving estrogen perform better on demanding cognitive tests than women without estrogen replacement and if this beneficial effect on cognition is caused by estrogen‐related prevention of silent ischemic brain damage. DESIGN: Cross‐sectional study comparing postmenopausal estrogen users and non‐users. SETTING: Austrian Stroke Prevention Study PARTICIPANTS: A total of 70 women currently using estrogen and 140 women who have never used estrogen from a subset of 222 postmenopausal women without neuropsychiatric or general disease undergoing extensive diagnostic work‐up in a large‐scale stroke prevention study among randomly selected community members. MEASUREMENTS: Neuropsychological test scores and focal brain abnormalities as well as size of ventricles and cortical sulci as assessed by 1.5 Tesla MRI. RESULTS: Estrogen users performed better than non‐users on almost all neuropsychological tests administered. When ANCOVA was used to correct for slight differences between groups in age, length of education, mean arterial blood pressure and self‐reported activation, values of P < .05 were noted on tasks assessing conceptualization, attention, and visuopractical skills. After adjustment for multiple comparisons, the differences in conceptualization and visuopractical skills remained significant. MRI showed a lower rate and extent of white matter hyperintensities and a significantly smaller total white matter hyperintensity area in women treated with estrogen ( P = .043). The total white matter hyperintensity area was inversely related to the duration of estrogen replacement therapy ( P = .040). However, there was no difference in neuropsychological performance between estrogen users with and without white matter abnormalities, and this was also supported by the lack of an association between cognitive test results and the extent of white matter disease. CONCLUSIONS: Our study demonstrated an association between estrogen replacement therapy and better cognitive functioning and a lower rate of clinically unsuspected ischemic brain damage in postmenopausal women. J Am Geriatr Soc 44:1307–1313, 1996 .

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  • Decreased estradiol reduces executive function.

    “Associations between low E2 and increased ADHD symptoms are in line with evidence that decreased E2 reduces EF (Jacobs et al., 1998; Schmidt et al., 1996; Sherwin, 1997), perhaps particularly among women with genotypic risk for low prefrontal dopamine and elevated trait impulsivity (Jacobs & D’Esposito, 2011).”

    From Reproductive steroids and ADHD symptoms across the menstrual cycle (2018) · cites this paper as Schmidt et al., 1996

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Authors
Schmidt, R., Fazekas, F., Reinhart, B., Kapeller, P., Fazekas, G., Offenbacher, H., Eber, B., Schumacher, M., & Freidl, W.
Affiliations
University of Graz (AT)
Corresponding author
Schmidt, R.
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
1996-11
Volume
44
Issue
11
Pages
1307-1313
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/j.1532-5415.1996.tb01400.x
OpenAlex
W2009060563
Cited by
205
References
43
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2022: 5 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 4 · 2014: 3 · 2013: 3 · 2012: 3
FWCI
6.96
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6751 d)
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
estrogen replacement therapy, postmenopausal women, cognitive function, white matter hyperintensities, brain MRI, ventricular size, cortical sulci, stroke prevention, older women
MeSH terms
Analysis of Variance, Brain Ischemia, Cerebrovascular Disorders, Cognition, Cross-Sectional Studies, Estrogens, Conjugated (USP), Female, Humans, Magnetic Resonance Imaging, Menopause, Middle Aged, Neuropsychological Tests, Estrogen Replacement Therapy

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