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Clinical Manifestations.

Jasper F E U Crockford1, Dylan X Guan1, Maryam Ghahremani1

  • 1Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

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Summary
This summary is machine-generated.

Postmenopausal estradiol levels and hormone therapy (HT) use are linked to reduced mild behavioral impairment (MBI) symptoms, not improved cognitive scores. Neuropsychiatric symptoms like MBI may reflect estradiol changes more sensitively than cognitive tests.

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Area of Science:

  • Neuroscience
  • Endocrinology
  • Gerontology

Background:

  • Estradiol, a key ovarian hormone, declines during menopause, potentially impacting cognitive and behavioral health.
  • Estrogen-based hormone therapies (HT) show inconsistent effects on cognitive decline and Alzheimer's disease (AD).
  • Mild behavioral impairment (MBI) is an early dementia marker, but its association with postmenopausal estradiol is not well understood.

Purpose of the Study:

  • To investigate the relationship between postmenopausal estradiol levels, HT use, and cognitive and behavioral symptoms.
  • To determine if estradiol levels influence cognitive function (assessed by MoCA) and MBI symptom severity (assessed by MBI-C).
  • To examine the interaction between estradiol levels and HT use on cognitive and behavioral outcomes.

Main Methods:

  • Utilized data from 333 postmenopausal females from the Comprehensive Assessment of Neurodegeneration and Dementia study.
  • Measured serum estradiol levels and assessed cognition using the Montreal Cognitive Assessment (MoCA) and MBI symptoms using the Mild Behavioral Impairment Checklist (MBI-C).
  • Employed linear and negative-binomial regressions, adjusting for relevant demographic and menopausal factors, including an estradiol*HT-use interaction term.

Main Results:

  • Estradiol levels were not significantly associated with MoCA scores, and this relationship was not modified by HT use.
  • Higher estradiol levels were independently associated with lower (better) MBI-C scores (p=0.05).
  • Hormone therapy (HT) use was independently associated with lower MBI-C scores (p<0.01), but not with MoCA scores.

Conclusions:

  • Both higher estradiol levels and HT use are independently linked to reduced MBI symptom severity in postmenopausal women.
  • Neuropsychiatric symptoms, such as MBI, may be more sensitive indicators of postmenopausal estradiol changes than standard cognitive assessments.
  • Further longitudinal studies are required to fully elucidate the underlying mechanisms connecting estradiol, HT use, and neuropsychiatric symptoms.