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Período reproductivo y riesgo de demencia en mujeres posmenopáusicas
M I Geerlings1, A Ruitenberg, J C Witteman
1Department of Epidemiology and Biostatistics, Erasmus University Medical Center, PO Box 1738, 3000 DR Rotterdam, the Netherlands. geerlings@epib.fgg.eur.nl
JAMA
|March 23, 2001
Resumen
Un período reproductivo más largo en mujeres con menopausia natural se asoció con un mayor riesgo de demencia y enfermedad de Alzheimer (EA). Este hallazgo no apoya la hipótesis de que una exposición más larga al estrógeno reduce el riesgo de demencia.
Área de la Ciencia:
- La neurociencia es la neurociencia.
- Epidemiología La epidemiología.
- Endocrinología Reproductiva y Reproducción.
Sus antecedentes:
- El uso de estrógenos exógenos está relacionado con la reducción del riesgo de demencia en mujeres posmenopáusicas.
- El impacto de la exposición a estrógenos endógenos a largo plazo en el riesgo de demencia no ha sido estudiado en gran medida.
Objetivo del estudio:
- Investigar la asociación entre un período reproductivo más largo, como un sustituto de la exposición endógena al estrógeno, y el riesgo de demencia y enfermedad de Alzheimer (EA) en mujeres que han pasado por la menopausia natural.
Principales métodos:
- El Estudio de Rotterdam, un estudio de cohorte prospectivo basado en la población en los Países Bajos.
- Se incluyeron 3.601 mujeres mayores de 55 años sin demencia basal, evaluando la edad en la menarca y la menopausia.
- La demencia y la incidencia de EA fueron monitoreadas y comparadas a través de cuartiles de longitud del período reproductivo.
Principales resultados:
- A lo largo de 21.046 años-persona, 199 mujeres desarrollaron demencia (159 con AD).
- Después de ajustar por covariables, las mujeres con menopausia natural y períodos reproductivos más largos (>39 años) mostraron un mayor riesgo de demencia (RR ajustado, 1.78) y AD (RR ajustado, 1.51).
- Este aumento del riesgo fue más pronunciado en los portadores de APOE ε4.
Conclusiones:
- Los hallazgos del estudio no apoyan la hipótesis de que un período reproductivo más largo protege contra la demencia en mujeres con menopausia natural.
- Por el contrario, un período reproductivo más largo puede estar asociado con un mayor riesgo de demencia y Alzheimer.
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