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Effects of hormone therapy on depressive symptoms and cognitive functions in women with Alzheimer disease: a 12 month randomized, double-blind, placebo-controlled study of low-dose estradiol and norethisterone.
Am J Geriatr Psychiatry. 2010 Jan; 18(1):11-20.AJ

Abstract

OBJECTIVE

To elucidate the effects of low-dose 17beta-estradiol and norethisterone (hormone therapy [HT]) versus placebo in women with Alzheimer Disease (AD) on cognition, depressive symptoms, and activities of daily living.

DESIGN

A 12-month randomized, double-blind, placebo-controlled study, stratified by apolipoprotein E (ApoE) genotype (with versus without the epsilon4 allele), duration of education (< or =9 versus >9 years), and age (< or =75 versus >75 years) performed during 2000-2004.

SETTING

Ambulatory memory clinic in a general hospital.

PARTICIPANTS

Sixty-five female outpatients aged 65-89 years who met criteria for probable AD according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition and International Classification of Diseases, tenth edition. Ten patients were excluded, resulting in 55 participants who had at least one posttreatment efficacy evaluation.

INTERVENTION

Randomly assigned to receive either 1-mg estradiol and 0.5-mg norethisterone or placebo once daily.

MEASUREMENTS

Cognitive variables were the Dementia Rating Scale, tests from Consortium to Establish a Registry for AD, Global Deterioration Scale (GDS) and Barthel Index.

RESULTS

When only treatment effects were compared by analysis of variance, there were nonsignificant differences between treatment groups for all efficacy variables. A linear model analysis, including stratifying factors in addition to treatment in the model, revealed a significant main effect on mood. The depressive symptoms were lower in the HT group than in the placebo group. Those treated with HT without the ApoE epsilon4 allele had better mood, Word Learning Memory score, and GDS score. Those in the HT group with a higher level of education obtained a better GDS score. Adverse events did not differ between the groups.

CONCLUSION

HT interacts with ApoE genotype in women with AD. Women without an ApoE epsilon4 allele may get better mood and cognition with HT. HT may reduce depressive mood and give less cognitive decline.

Authors+Show Affiliations

Lovisenberg Diaconal Hospital, Clinic of Internal Medicine, Memory Unit, Oslo, Norway. Arnhild.Valen-Sendstad@lds.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20094015

Citation

Valen-Sendstad, Arnhild, et al. "Effects of Hormone Therapy On Depressive Symptoms and Cognitive Functions in Women With Alzheimer Disease: a 12 Month Randomized, Double-blind, Placebo-controlled Study of Low-dose Estradiol and Norethisterone." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 18, no. 1, 2010, pp. 11-20.
Valen-Sendstad A, Engedal K, Stray-Pedersen B, et al. Effects of hormone therapy on depressive symptoms and cognitive functions in women with Alzheimer disease: a 12 month randomized, double-blind, placebo-controlled study of low-dose estradiol and norethisterone. Am J Geriatr Psychiatry. 2010;18(1):11-20.
Valen-Sendstad, A., Engedal, K., Stray-Pedersen, B., Strobel, C., Barnett, L., Meyer, N., & Nurminemi, M. (2010). Effects of hormone therapy on depressive symptoms and cognitive functions in women with Alzheimer disease: a 12 month randomized, double-blind, placebo-controlled study of low-dose estradiol and norethisterone. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 18(1), 11-20. https://doi.org/10.1097/JGP.0b013e3181beaaf4
Valen-Sendstad A, et al. Effects of Hormone Therapy On Depressive Symptoms and Cognitive Functions in Women With Alzheimer Disease: a 12 Month Randomized, Double-blind, Placebo-controlled Study of Low-dose Estradiol and Norethisterone. Am J Geriatr Psychiatry. 2010;18(1):11-20. PubMed PMID: 20094015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of hormone therapy on depressive symptoms and cognitive functions in women with Alzheimer disease: a 12 month randomized, double-blind, placebo-controlled study of low-dose estradiol and norethisterone. AU - Valen-Sendstad,Arnhild, AU - Engedal,Knut, AU - Stray-Pedersen,Babill, AU - ,, AU - Strobel,Carsten, AU - Barnett,Liv, AU - Meyer,Nicolay, AU - Nurminemi,Minna, PY - 2010/1/23/entrez PY - 2010/1/23/pubmed PY - 2010/4/23/medline SP - 11 EP - 20 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 18 IS - 1 N2 - OBJECTIVE: To elucidate the effects of low-dose 17beta-estradiol and norethisterone (hormone therapy [HT]) versus placebo in women with Alzheimer Disease (AD) on cognition, depressive symptoms, and activities of daily living. DESIGN: A 12-month randomized, double-blind, placebo-controlled study, stratified by apolipoprotein E (ApoE) genotype (with versus without the epsilon4 allele), duration of education (< or =9 versus >9 years), and age (< or =75 versus >75 years) performed during 2000-2004. SETTING: Ambulatory memory clinic in a general hospital. PARTICIPANTS: Sixty-five female outpatients aged 65-89 years who met criteria for probable AD according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition and International Classification of Diseases, tenth edition. Ten patients were excluded, resulting in 55 participants who had at least one posttreatment efficacy evaluation. INTERVENTION: Randomly assigned to receive either 1-mg estradiol and 0.5-mg norethisterone or placebo once daily. MEASUREMENTS: Cognitive variables were the Dementia Rating Scale, tests from Consortium to Establish a Registry for AD, Global Deterioration Scale (GDS) and Barthel Index. RESULTS: When only treatment effects were compared by analysis of variance, there were nonsignificant differences between treatment groups for all efficacy variables. A linear model analysis, including stratifying factors in addition to treatment in the model, revealed a significant main effect on mood. The depressive symptoms were lower in the HT group than in the placebo group. Those treated with HT without the ApoE epsilon4 allele had better mood, Word Learning Memory score, and GDS score. Those in the HT group with a higher level of education obtained a better GDS score. Adverse events did not differ between the groups. CONCLUSION: HT interacts with ApoE genotype in women with AD. Women without an ApoE epsilon4 allele may get better mood and cognition with HT. HT may reduce depressive mood and give less cognitive decline. SN - 1545-7214 UR - https://www.unboundmedicine.com/medline/citation/20094015/Effects_of_hormone_therapy_on_depressive_symptoms_and_cognitive_functions_in_women_with_Alzheimer_disease:_a_12_month_randomized_double_blind_placebo_controlled_study_of_low_dose_estradiol_and_norethisterone_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1064-7481(12)60268-1 DB - PRIME DP - Unbound Medicine ER -