Natural Estrogen May Improve Cognition for Alzheimer's Disease Patients

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Madison, Wisconsin - Post-menopausal women who had mild to moderate Alzheimer's disease and who wore a skin patch with natural estrogen for three months did better on cognitive tests than women who did not wear the patch, according to new findings by the University of Wisconsin School of Medicine and Public Health (SMPH).

The findings are published as an early online version of the Journal of Alzheimer's Disease and are scheduled for publication in the September issue

The study shows that using a natural form of estrogen called estradiol, for short periods of time, may be cognitively beneficial for post-menopausal women with mild to moderate Alzheimer's disease," said Whitney Wharton, lead author and researcher at the UW School of Medicine and Public Health's Alzheimer's Disease Research Center (ADRC).



In the study, 43 post-menopausal women with mild to moderate Alzheimer's disease were enrolled at the University of Wisconsin SMPH ADRC or the University of Washington in Seattle.



Women were randomly assigned to one of five different treatment plans in the randomized, placebo-controlled, double-blind parallel group study: low dose estradiol patch with a placebo tablet or a 2.5 mg tablet of progesterone (medroxyprogesterone); high dose patch with placebo tablet or 2.5 mg tablet of progesterone; placebo skin patch with a placebo tablet.



The study participants underwent cognitive testing before, and at various intervals during, the study. The main result of the study was that women who received estradiol performed better on multiple cognitive tests than women who were assigned to the placebo group.



Also, the cognitive improvements were directly related to estradiol levels. Estradiol is a naturally occurring estrogen predominant in women before menopause. Wharton says estrogen is likely associated with the hippocampus, an area of the brain that has many estrogen receptors and is associated with Alzheimer's disease.




Video: Wharton talks about what we can learn from the study.


Wharton said it's important to realize that estradiol is different from a popular hormone-replacement drug that contains a compound called conjugated equine estrogen (CEE). The compound is not naturally occurring in humans like estradiol.

CEE, the most widely used estrogen used for hormone therapy in the U.S., was the estrogen studied in the landmark Women's Health Initiative (WHI) study and the Women's Health Initiative Memory Study (WHIMS).

The WHI and WHIMS found that hormone replacement therapies using CEE might be associated with increased risk of cardiovascular disease and dementia.

"We know that Alzheimer's is associated with a build-up of amyloid plaques in the brain and we know from basic science studies, that estradiol interacts with, and breaks down, those plaques," said Wharton.

In contrast to the currently FDA-approved Alzheimer's disease drugs, estradiol may actually affect the neuropathology of Alzheimer's disease. Wharton says current drugs treat symptoms like memory loss and mood, but do not change brain mechanisms involved in the disease, such as amyloid plaques.

Wharton says because there are different types of estrogens, the findings about CEE should not be generalized to all forms of estrogen, including estradiol. Wharton says the next step for the research is to replicate the findings.

"We can say that an estradiol skin patch, used for three months or less, appears to improve cognition in post-menopausal women with mild to moderate Alzheimer's disease," said Wharton. "But there is a need for larger trials with more women over longer periods of time to see if estradiol could serve as an alternative therapy for Alzheimer's disease, or one day help scientists learn how to prevent the disease."

The study was funded by the National Institutes of Health and used the resources of the universities of Wisconsin and Washington Department of Medicine Division of Geriatrics and Gerontology, and the Geriatric Research Education and Clinical Center (GRECC) of the William S. Middleton Memorial Veterans Hospital in Madison and the Veterans Affairs Puget Sound Health Care System in Seattle

Alzheimer's Disease Research Cure

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eHow

At present there is no cure for Alzheimer's disease (AD). Once the disease develops, treatment only slows its progression. By understanding the causes of the disease, lifestyles changes can be made to reduce the risk of developing AD. The diagnosis and treatment of this disease has improved greatly in recent years, and many scientists are convinced that the next 10 years will bring even better treatments and possibly a cure for those just diagnosed with the disease

Alzheimer's Disease
Alzheimer's Disease is an irreversible, progressive brain disease that over time destroys a person's memory and ability to think. As the disease progresses, even everyday tasks are impossible. Over 5.3 million Americans suffer from Alzheimer's disease, and 35 million people worldwide have this mind-robbing disease.
Causes of Alzheimer's Disease
The initial cause of Alzheimer's disease is still unknown, but damage to the brain starts many years before any symptoms appear. According to the Alzheimer's Association, abnormal structures called plaques and tangles develop deep inside the brain, degrading and killing nerve cells. The damage spreads throughout the brain, especially in an area called the hippocampus. This part of the brain is like a file cabinet for new memories. When it is damaged, new memories are lost. As Alzheimer's progresses, more parts of the brain are invaded by plaques and tangles. These affected areas shrink and become non-functional. In the final stage of AD, damage to brain tissue is severe.
Present Treatment
Some drugs are available that help improve the mental action of people with Alzheimer's disease. Mental and physical exercise, eating right, socializing and eliminating unhealthy habits go along way in slowing the progression of Alzheimer's. A tranquil, orderly setting also helps those with AD. Certain supplements seem to help some people with AD, including vitamins A, B, C, D and E. Also, tumeric and fish oil show some promise in the fight against the disease.
Drug Therapies
Aricept is the most commonly used medication for Alzheimer's disease. This drug works by stopping cholinesterase from breaking down acetylcholine in the brain. Acetylcholine helps one part of the brain communicate with another part. This action keeps the brain intact longer. Aricept is the only drug acknowledged by the Food and Drug Administation for all stages of AD. Eventually this drug is not effective in the progression of AD. Also, this drug has side effects intolerable to some individuals such as trouble sleeping, stomach discomfort, muscle cramps and fatigue. Cognex, is similar to Aricept as a cholinesterase blocker, but it has more serious side effects, including abdominal pain, vomiting and liver damage.

Exelon and Razadyne are newer drugs that stop the breakdown of acetylcholine. The best results occur when they are taken in earlier stages of Alzheimer's. They also have side effects, including severe allergic reactions, depression, tremors and irregular heartbeat.

Namenda is effective for some people with moderate-to-severe Alzheimer's. Its action appears to restore function to damaged nerve cells. This drug only works for some individuals and has several unwanted side effects like increased agitation, severe fatigue, changes in eyesight and severe allergic reactions.
Finding a Cure
From 1999 to 2009 scientists formulated new technologies that will speed up Alzheimer's research. The government and drug companies are putting money into research and new treatments are developed each year.

On April 29, 2009, neuroscientists Frank LaFerla and Mathew Blurton-Jones received $3.6 million for the advancement of AD therapy employing human neural stem cells. Research into a vaccine for protection against Alzheimer's will be started again and researchers from Southampton University will be re-evaluating 80 participants in a trial of a vaccine. Initially the vaccine had some deadly side effects. Hormone replacement therapy also appears to have some promise in lowering the risk of developing AD. The results among oestrogen users in a cohort study of Paganini-Hill and Henderson showed that the relative risk of developing Alzheimer's decreased with increasing doses of this hormone.

Research is also being........read all of Alzheimer's Disease Research Cure