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July 19, 2000

Estrogen as a Treatment for Alzheimer Disease

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(3):307-308. doi:10.1001/jama.284.3.303

To the Editor: The study by Dr Mulnard and colleagues1 investigated the role of estrogen replacement therapy (ERT) in the treatment of Alzheimer disease (AD). The conclusion that ERT produces no global changes in the cognition of women with AD is supported by the recent study by Henderson et al.2 However, estrogen may affect cognition in a domain-specific manner. For instance, estrogen might specifically improve verbal explicit memory.3 To assess this effect, Mulnard et al used the Alzheimer's Disease Assessment Scale–Cognitive (ADAS-Cog), a broad test that reflects many more domains than verbal explicit memory, as well as other unpublished or little-used tests whose psychometric properties are unknown. This use of nonstandardized tests has been a problem in other studies of ERT.4