C. Bacal

Previous reports have suggested that estrogen replacement therapy (ERT) in women may exert a protective effect on their risk of developing Alzheimer's disease (AD). We investigated this relationship in the Baltimore Longitudinal Study of Aging (BLSA), a prospective multidisciplinary study of normal aging conducted by the National Institute on Aging. The sample consisted of 472 post- or perimenopausal women followed for up to 16 years in the BLSA. We documented ERT prospectively at each BLSA visit, and we categorized women who had used oral or transdermal estrogens at anytime as ERT users. We used Cox proportional hazards models with time-dependent covariates to estimate the relative risk of developing AD after ERT as compared with women who had not used estrogen replacement. Approximately 45% of the women in the cohort had used ERT, and we diagnosed 34 incident cases of AD (NINCDS/ADRDA criteria) during follow-up, including nine estrogen users. After adjusting for education, the relative risk for AD in ERT users as compared with nonusers was 0.46 (95% CI, 0.209-0.997), indicating a reduced risk of AD for women who had reported the use of estrogen. Our data did not show an effect for duration of ERT usage. Our finding offers additional support for a protective influence of estrogen in AD. Randomized clinical trials are necessary to confirm this association, which could have significant public health impact.

A comparison of salivary flow rates was made between three groups of female individuals according to their menopausal status. The three groups consisted of healthy, dentate, nonmedicated women (with the exception of the use of estrogen) from the Baltimore Longitudinal Study of Aging. One group consisted of premenopausal women (n = 51), their mean age was 39 years. Another group (n = 26) was perimenopausal with a mean age of 48 years. A third group (n = 76) was postmenopausal with a mean age of 69 years. The groups were evaluated for unstimulated (UPAR) and stimulated parotid gland flow rates (SPAR), unstimulated (USUB) and stimulated submandibular/sublingual gland flow rates (SSUB), and stimulated whole-saliva flow rates (SWHOLE). The parotid flow rates were determined using a Carlson-Crittenden cup, while the submandibular/sublingual flow rates were determined using the National Institute of Dental Research collector. A 2% citrate solution was used for stimulation in glandular collections. Chewing a 1-cm3 cube of paraffin was used to stimulate whole saliva. The results showed no significant differences in UPAR, SPAR, and SWHOLE between the three groups. However, the premenopausal women had higher USUB than the postmenopausal group. The premenopausal women also had higher SSUB than perimenopausal and postmenopausal groups. There were no differences in salivary flow rates between those taking estrogen and those that were not medicated.

Kawas, C.; Resnick, S.; Morrison, A.; Brookmeyer, R.; Corrada, M.; Zonderman, A.; Bacal, C.; Donnell Lingle, D.; Metter, E. Author Information

1550 Results of studies on the efficacy of estrogen replacement therapy (ERT) to improve muscular strength are inconclusive. To determine the relationship of strength and ERT usage, post-menopausal women from the Baltimore Longitudinal Study of Aging (BLSA) were studied cross-sectionally between 1978-1985 (N=86) and 1992-1997 (N=83). Twenty-seven women were studied longitudinally for an average of 13.3 yrs (range 7.3 - 19.1 yrs). During the first test period, 17 women were pre-menopausal, 2 were peri-menopausal, and 8 were post-menopausal and all were post-menopausal during the second test. Upper body strength was measured during both time periods using different testing procedures. Because of these test differences, strength scores were converted to Z scores using 258 and 294 BLSA women (age 17-92 yrs) for the 1st and 2nd time periods respectively. In the cross-sectional analyses there were no significant differences in strength between those who had ever used ERT(users) and those who had never used ERT (non-users). The change in normalized strength between the first and second strength tests in the longitudinal analysis was significantly less in users than in nonusers of ERT (P < 0.05). All 8 nonusers of ERT declined in strength (7 by more than 1 SD), whereas, 10 out of 19 declined, 5 out of 19 increased, and 4 out of 19 maintained their strength in the ERT users. Therefore, ERT use appears to lessen the decline in muscular strength over time in some postmenopausal women.