雌激素替代治疗与老年痴呆

老年性痴呆症是随年龄增长发生的由于智力和记忆力严重受损而影响到生活不能自理的综合症。随着人口的老龄化，老年性痴呆在许多发达国家已成为严重的社会卫生难题，从而受到重视。近年发现，绝经后妇女雌激素替代治疗（ＥｓｔｒｏｇｅｎＲｅｐｌａｃｅｍｅｎｔＴｈｅｒａ...

Estrogen Replacement Therapy and Alzheimer''''s Disease

Alzheimer's disease is a major public health concern.The emotional,physical and financial cost to patients,family and society are tremendous.Women constitute the majority of persons with the disease.Diagnosis is founded on the recognition of clinical features and exclusion of other causes of dementia.The etiology of the disease remains unknown Although a variety of genetic factors is increasingly suspected,no diagnostic genetic test is currently recommended.An intervention strategy that might delay the onset of Alzheimer's disease symptoms or reduce its mortality would be important.Estrogen replacement therapy might be helpful to prevent or delay its occurrence.Several epidemiological studies and clinical trials are suggestive of beneficial effects.Caution is advised,however, until the results from a long term randomized clinical trial are available.Hence,more prospective,randomized,large scale research in older,nondemented women are required to substantiate the findings that ERT could lower the risk of Alzheimer's disease.Some proposed mechanisms include the suppression of ApoE levels,the stimulation of cholinergic neurons,interactions with neurotrophins the regulation of spine density of hippocampal neurons and the improvement of cerebral profusion.Additional basic laboratory work is needed to elucidate mechanisms by which estrogens might exert preventive or ameliorative effects.