Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: In their Research Letter, Dr
Gandy and colleagues1 found that serum concentrations
of amyloid protein paralleled those of testosterone and 17-β estradiol.
In attempting to associate levels of sex hormones with Alzheimer disease (AD),
the authors make several incorrect assumptions.
First, by focusing only on sex hormones, Gandy et al discount the role
of the other hormones involved in the hypothalamic-pituitary-gonadal axis.
My colleagues and I have shown that, compared with age-matched controls, individuals
with AD have significantly elevated serum gonadotropin concentrations.2,3 I contend that it is an increase
in gonadotropin concentrations and not the decrease in estrogen/testosterone
concentrations seen after menopause/andropause that results in an increased
risk of developing AD. I am aware of 5 anecdotal cases of individuals with
AD who, when treated with leuprolide acetate, experienced no further cognitive
decline for periods of up to 5 years.
Bowen RL. Sex Hormones, Amyloid Protein, and Alzheimer Disease. JAMA. 2001;286(7):790-791. doi:10.1001/jama.286.7.790