This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Estrogen use in protection from cognitive decline is designed to assess the effects of estrogen therapy among postmenopausal women at risk for cognitive decline. We collected pilot data, which suggest that estrogen use among older persons at risk for Alzheimer's Disease may be protective of regional cerebral metabolism, as measured by positron emission tomography with 18-Fluorodeoxygluocse (FDG-PET). A total of 72 postmenopausal women ages 60-65, estrogen users, will be randomized to continue or discontinue use and will be followed up in two years for changes in cerebral metabolism and cognitive performance. Subjects will undergo FDG-PET scans, MRI scans, and neuropsychological assessments, initially and at the end of the two-year follow-up period. These procedures will allow us to evaluate regional, especially parietal, temporal, and posterior cingulate cerebral glucose metabolism along with cognitive performance in postmenopausal women at baseline and upon random continuation vs. discontinuation of estrogen therapy. Subjects who are randomized to discontinue estrogen use are hypothesized to show more evidence of decline than those who continue estrogen use. This project will expand the current knowledge of the effects of estrogen, by: (1) determining whether estrogen use among postmenopausal women at risk for cognitive decline is protective of brain metabolism; (2) identifying early predictors for cognitive decline; and (3) developing guidelines for estrogen use in postmenopausal women.
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