Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Overview
- Part II Hormones and mental health in the elderly
- 3 The hypothalamic–pituitary–adrenal axis in aging: preclinical and clinical studies
- 4 The hypothalamic–pituitary–thyroid axis
- 5 Estrogen and depression in aging women
- 6 The role of testosterone in male depression
- 7 Dehydroepiandrosterone in aging and mental health
- 8 Sex hormones, cognition, and dementia in the elderly
- 9 Effects of estrogen on basal forebrain cholinergic neurons and cognition: implications for brain aging and dementia in women
- 10 Gender and schizophrenia
- 11 Sex steroids and anxiety disorders
- 12 Gender and hormonal factors in pain and pain inhibition
- Part III Effects of hormones and behavior on immune function
- Part IV Hormones and gender differences in psychotropic drug metabolism
- Index
8 - Sex hormones, cognition, and dementia in the elderly
from Part II - Hormones and mental health in the elderly
Published online by Cambridge University Press: 18 September 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Overview
- Part II Hormones and mental health in the elderly
- 3 The hypothalamic–pituitary–adrenal axis in aging: preclinical and clinical studies
- 4 The hypothalamic–pituitary–thyroid axis
- 5 Estrogen and depression in aging women
- 6 The role of testosterone in male depression
- 7 Dehydroepiandrosterone in aging and mental health
- 8 Sex hormones, cognition, and dementia in the elderly
- 9 Effects of estrogen on basal forebrain cholinergic neurons and cognition: implications for brain aging and dementia in women
- 10 Gender and schizophrenia
- 11 Sex steroids and anxiety disorders
- 12 Gender and hormonal factors in pain and pain inhibition
- Part III Effects of hormones and behavior on immune function
- Part IV Hormones and gender differences in psychotropic drug metabolism
- Index
Summary
Introduction
At least 10% of persons over 65 years old and 50% of persons over 85 years old have some form of cognitive impairment ranging from mild deficits to dementia (Evans, 1990). Alzheimer's disease (AD), the most common cause of dementia, is estimated to affect 4 million people in the United States and to cost $70 billion annually (Ernst & Hay, 1994). AD affects women disproportionately to men with women having a slightly higher increased risk of AD, even after adjusting for age (Payami et al., 1996a, b). Despite the severity and prevalence of dementia and mild cognitive impairment, there are few effective treatments or prevention strategies.
Recent studies have suggested that postmenopausal estrogen therapy might improve cognition in nondemented perimenopausal and postmenopausal women, that it might prevent the development of dementia, or that it might improve the severity of dementia. While less studied, interest is growing in the role of testosterone in cognition and dementia treatment. In this chapter, the basic science on sex hormones and cognition, the clinical studies of estrogen for the prevention and treatment of dementia, and the studies of testosterone and cognitive function are reviewed.
Possible biological mechanisms of estrogen's effect on cognition
Estrogen receptors are found in the hypothalamus, the preoptic area, the anterior pituitary, the CA1 region of the hippocampus, and several other brain regions (McEwen & Woolley, 1994). How estrogens may affect neuropsychologic function remains unknown, but several mechanisms have been suggested. One mechanism is the modulation of neurotransmitters, particularly acetylcholine.
- Type
- Chapter
- Information
- Hormones, Gender and the Aging BrainThe Endocrine Basis of Geriatric Psychiatry, pp. 168 - 182Publisher: Cambridge University PressPrint publication year: 2000