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Am J Obstet Gynecol. 2005 Feb;192(2):387-93.

Estrogen therapy and risk of cognitive decline: results from the Women's Estrogen for Stroke Trial (WEST).

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  • 1Yale University School of Medicine, Department of Internal Medicine, 333 Cedar St, Room IE 61 SHM, PO Box 208025, New Haven, CT 06520-8025, USA. Catherine.Viscoli@yale.edu



This study was undertaken to assess whether estrogen therapy (ET) reduces the risk of cognitive decline in women with cerebrovascular disease.


We conducted a randomized, double-blind trial of estradiol 17beta versus placebo for secondary stroke prevention in 664 postmenopausal women with a recent stroke or transient ischemic attack. The Mini-Mental State Examination (MMSE) and 5 domain measures were obtained at baseline and exit.


Among 461 women withdrawn alive without stroke, ET did not have a significant effect on cognitive measures after an average of 3 years (relative risk of MMSE decline: 0.74, 95% CI, 0.49-1.13). In women with normal MMSE at entry, estrogen was associated with less decline (relative risk, 0.46, 95% CI, 0.24-0.87).


In this study, estradiol did not have significant effects on cognitive measures. However, in women with normal function at baseline, there may be a benefit for ET in reducing the risk for cognitive decline.

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