Department of Psychology, McGill University, Montreal, Quebec, Canada H3A 1B1
Correspondence: Address all correspondence and requests for reprints to: Barbara B. Sherwin, Ph.D., James McGill Professor, Department of Psychology and Department of Obstetrics/Gynecology, McGill University, 1205 Doctor Penfield Avenue, Montreal, Quebec, Canada H3A 1B1. E-mail: bsherwin{at}ego.psych.mcgill.ca
Research in basic neuroscience has provided biological plausibilityfor the hypothesis that estrogen replacement therapy (ERT) wouldprotect against cognitive aging in healthy women. The weightof the evidence from randomized controlled trials of estrogenand cognition in women shows that this hormone preferentiallyprotects verbal memory in postmenopausal women, whereas findingsfrom observational studies are less consistent and show a morediffuse effect of estrogen on a range of cognitive functions.There is fairly consistent evidence from epidemiological studiesthat ERT significantly reduces the risk of Alzheimer’sdisease (AD) in women. On the other hand, findings from controlledtreatment trials of women diagnosed with probable AD failedto show that physiological doses of ERT ameliorate existingdeficits in cognitive functioning and/or prevent further deteriorationin memory that inevitably occurs in these women over time.
Finally, an accumulating body of evidence is beginning to suggestthat the immediate postmenopausal period may constitute a criticalwindow for treatment with ERT that maximizes its potential toprotect against cognitive decline with aging and/or to reducethe risk of AD.
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