Originally created 09/01/01

Study finds Alzheimer's benefit in estrogen therapy



Add another potential benefit for post-menopausal women to start estrogen replacement therapy - it appears to help those with mild to moderate Alzheimer's disease regain some memory.

For Augusta researchers, it may provide another clue to improving treatment of the devastating and growing disease and further evidence of the hormone's benefit.

A recent study in the journal Neurology followed 20 post-menopausal women suspected of having Alzheimer's; half were given an estrogen patch, half a placebo. Those receiving estrogen improved 20 percent more on an attention test, showed 30 percent more improvement on some verbal memory tests and posted 30 percent better results on visual memory tests.

The results from researchers at the VA Puget Sound Health Care System in Tacoma and University of Wisconsin are the latest salvo in an ongoing controversy over whether estrogen can help female Alzheimer's patients.

"There's no doubt in the literature that estrogen replacement tends to stem the onset of AD (Alzheimer's disease), delay it if you will, or other neurodegenerative diseases such as Parkinson's (disease), for example," said Jerry Buccafusco, the director of Medical College of Georgia Alzheimer's Research Center and a research pharmacologist for the Augusta Department of Veterans Affairs Medical Centers. "But there had been some controversy in the literature in terms of if you already have AD, and you're given estrogen, does this really improve anything."

At least four previous randomized clinical trials found no benefit to estrogen replacement therapy for female Alzheimer's patients.

In the current study, researchers used a stronger form of estrogen called estradiol that is closer to the estrogen women naturally produce, said Alvin V. Terry Jr., an associate professor of pharmacy at the University of Georgia who works at the VA and at the MCG Alzheimer's center.

"It is the most predominant natural estrogen in humans," Dr. Terry said. The other studies used "a cocktail of estrogens rather than a specific estrogen."

Working with aged rhesus monkeys, the MCG researchers had already found a gender difference in response to Alzheimer's drugs, with estrogen-deficient aged females requiring two to three times the dose to get the same effect as males, Dr. Buccafusco said. Adding estrogen may be something that could address that difference, he said.

"The concept becomes if you could add something to the regimen that might make those (drugs), those compounds, more effective at lower doses, this is something that would be very exciting," Dr. Buccafusco said.

For estrogen replacement advocates such as Murray Freedman of Augusta GYN, the study may reflect estrogen's role as a powerful antioxidant or in improving blood flow in the brain. He is more concerned with his own work in sexual dysfunction and is conducting a study on whether low-dose estrogen can prevent genital atrophy and preserve sexual function.

"It's a huge part of quality of life," Dr. Freedman said.

Reach Tom Corwin at (706) 823-3213 or tomc@augustachronicle.com.