Can drug treatments slow the progression of Alzheimer's disease?

For many years, doctors believed that hormone therapy during and after menopause might protect women from Alzheimer's disease, because a handful of studies suggested that women who took estrogen were less likely to develop this type of dementia than those who didn't take supplementary hormones. But a large clinical trial, the Women's Health Initiative Memory Study (WHIMS), challenged this longstanding dogma.

WHIMS researchers reported that women who took combination estrogen-progestin therapy were twice as likely to develop dementia as women who did not use hormones. The following year, the researchers revealed that estrogen therapy by itself also increased the risk. This study and others also found that women as young as 50 who used estrogen therapy, with and without progestin, were more likely to have strokes, which can cause dementia. As a result of such findings, menopausal hormone therapies now carry warning labels stating that they increase the risk of dementia.

The results of the Cognitive Complaints in Early Menopause Trial (COGENT), reported in Neurology, followed in a similar vein. In the largest study to date to look specifically at the issue of hormones and memory, 180 postmenopausal women ages 45 to 55 were given either hormone therapy or a placebo for four months. Researchers found no differences between the two groups on verbal memory tests. Several studies have also investigated estrogen's potential as a treatment for Alzheimer's, but the results have not been encouraging.

Research on the effects of estrogen regularly flows in, so stay tuned. Given the above findings, however, experts do not recommend hormone therapy for women with dementia and caution that it might even be harmful.

Drug treatments for Alzheimer's disease are symptomatic. In other words, they help people deal with their symptoms. They may experience a mild improvement when they start treatment, but their decline over time will be the same as if they had no treatment. Researchers at UCLA and around the world are working hard to find drugs that can slow or arrest the progression of Alzheimer’s disease.

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