The Effect of Short-Term Estradiol Therapy on Cognitive Function in Older Men Receiving Hormonal Suppression Therapy for Prostate Cancer

Abstract:

See editorial comments by Dr. Sanjay Asthana on pp 316-318. Objectives:

To determine the effect of estrogen (E) alone (without the influence of testosterone (T)) on cognitive function in older men, using 17-β micronized estradiol versus placebo in older men rendered hypogonadal (low T and E) by treatment for prostate cancer. Design:

Short-term double-blind, randomized, controlled trial. Setting:

An outpatient General Clinical Research Center. Participants:

Twenty-seven community-dwelling men aged 65 and older receiving neoadjuvant or established therapy with luteinizing-hormone releasing-hormone agonists for treatment of prostate cancer enrolled in a short-term randomized, controlled trial of 17-β micronized estradiol versus placebo on the effect on biochemical markers of bone turnover. Measurements:

Hormone levels, including E, T, and sex hormone-binding globulin; standardized neurocognitive tests, including measures of sustained attention, executive function, and memory; and questionnaires to assess subjects' perception of cognitive deficits and symptoms of depression. Results:

There were no significant differences between patients receiving E or placebo on 15 of 17 neurocognitive measures and no significant differences in self-reported cognitive deficits or number of depressive symptoms. Conclusion:

Although studies have suggested that E replacement therapy may improve cognitive function, most notably memory performance in postmenopausal woman, there was no evidence in the present study that the addition of short-term E therapy was more beneficial than placebo in tests of cognitive performance in hypogonadal men.

Keywords: estrogen; cognitive function; older men; estradiol

Document Type: Research article

DOI: 10.1111/j.1532-5415.2004.52067.x

Affiliations: 1: Division of Endocrinology and Metabolism and Center on Aging; 2: Olin Neuropsychiatry Research Center, Yale University School of Medicine, New Haven, Connecticut. 3: General Clinical Research Center, University of Connecticut Health Center, Farmington, Connecticut; and 4: Division of Psychiatry;