雌激素加孕激素对绝经后妇女全球认知功能的影响:妇女健康倡议记忆研究:一种随机对照试验
Stephen R Rapp1, Mark A Espeland, Sally A Shumaker
1Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. srapp@wfubmc.edu
JAMA
|May 29, 2003
概括
雌激素加孕激素治疗没有改善老年妇女的认知功能. 与安慰剂相比,在雌激素加孕激素组观察到临床意义上的认知衰退风险略有增加.
科学领域:
- 老年学是指老年学的学科.
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
背景情况:
- 观察性研究表明,激素治疗对认知有好处,但临床试验数据有限.
- 妇女健康倡议记忆研究 (WHIMS) 调查了激素治疗的认知效应.
- 由于健康风险,WHI雌激素加孕激素试验被停止.
研究的目的:
- 为了确定雌激素加孕激素治疗是否保护65岁以上绝经后妇女的全球认知功能.
- 评估激素治疗对老年妇女认知能力下降的影响.
主要方法:
- 随机,双盲,安慰剂对照试验 (WHIMS).
- 包括4532名65岁以上的绝经后妇女,没有痴呆症.
- 使用修改型迷你精神状态检查的年度认知评估,平均随访时间为4.2年.
主要成果:
- 与安慰剂相比,雌激素加孕激素在认知得分上没有显示出临床上重要的改善.
- 在雌激素加孕激素组 (6.7%与4.8%) 观察到临床意义上的认知衰退的统计学上显著的,尽管很小的风险增加.
结论:
- 雌激素加孕激素治疗不会改善65岁或以上的绝经后妇女的认知功能.
- 在这种疗法中,临床上有意义的认知衰退的风险略有增加.
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