Estrogen Reduces PD Dementia

[Barbara Mallut <Barb_MSN@xxxxxxxxxxxxxxx>]

NEW YORK (Reuters) -- Women with Parkinson's disease who also take estrogen
replacement therapy may significantly reduce their risk of developing the
dementia often associated with the disease, according to experts at Columbia
University in New York.

Many patients with Parkinson's disease also develop a form of dementia that is
clinically similar to Alzheimer's disease. Unfortunately, the medications used
to treat parkinsonian tremors often cause confusion in patients with dementia,
so their Parkinson's symptoms often remain untreated. But if doctors could
find a way to prevent or delay the development of dementia in patients with
Parkinson's disease, they "...could have greater flexibility in treating motor
disorders such as tremors, rigidity, slowness and stiffness, and this may
prolong a patient's life," Dr. Karen Marder, a neurologist at Columbia, says
in a statement from the journal Neurology.

Marder and colleagues studied the effect of estrogen use on the risk of
Parkinson's disease-associated dementia in 87 women with Parkinson's disease
without dementia, 80 women with Parkinson's disease with dementia, and almost
1,000 nondemented healthy women, all drawn from the same community.

They found that estrogen replacement therapy in this group "...did not affect
the risk of Parkinson's disease but may have been associated with a lower risk
of dementia in women with Parkinson's disease." In fact, in Parkinson's
patients who used estrogen replacement therapy, the risk of dementia decreased
by more than 75% compared with Parkinson's patients who did not take estrogen
replacement therapy.

Marder says in a related statement, "Women with Parkinson's disease who
reported using estrogen reduced their risk of dementia by almost five times."
She speculates, "Larger doses of estrogen could give women greater protection
against developing dementia."

Since estrogen has been shown to have a protective effect against Alzheimer's
disease, the findings indicate that, at least in a subset of patients,
Parkinson's disease dementia may in fact be coincident Alzheimer's disease.
The authors point out in their report in the April issue of Neurology that
their findings are preliminary and should be confirmed in a larger clinical
trial. SOURCE: Neurology (1998;50:1141-1143)