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Hormone und Gehirnfunktion im Alter

Hormones and brain function in the elderly

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Frauen erkranken im Vergleich zu Männern doppelt so häufig an einer Demenz. Hormonelle Unterschiede könnten hierbei eine Rolle spielen. Es gibt zahlreiche Hinweise auf einen neurotropen sowie neuro- und psychoprotektiven Effekt der Östrogene. Klinische Studien zum Einfluss von Östrogenen auf die Kognition sind jedoch umstritten. Einen Grund hierfür könnte der Zeitpunkt der Östrogeninitiierung („window of opportunity“) darstellen, einen anderen der Zustand des Expositionsubstrats, die Neuronengesundheit („healthy cell bias“). Demnach ist möglicherweise eine hormonelle Primärprävention des Kognitionsverlusts bei Frauen möglich, eine Sekundär- oder Tertiärprävention der Demenz jedoch nicht. Bis zur abschließenden Klärung der Frage, ob eine hormonelle Primärprävention der Demenz sinnvoll ist, gelten die Empfehlungen der Neurologie, welche auf den Ausschluss von inneren und äußeren Risikofaktoren abzielen.

Abstract

In comparison to men, women are twice as frequently affected by dementia. Hormonal sex differences might be one reason. There is a tremendous body of scientific evidence that estrogens are neurotrophic, neuroprotective, and psychoprotective. However, clinical trials investigating the effect of estrogens on cognition are controversial. This might be due to the time point (“window of opportunity”) and the neuronal health status (“healthy cell bias”), respectively, when estrogens are initiated. Therefore, primary hormonal prevention of cognitive decline might be possible, but secondary and tertiary prevention of dementia is not. However, until further research has revealed clear evidence that estrogens are effective in primary prevention the recommendations of the neurological society should be followed aiming to avoid intrinsic and extrinsic risk factors of dementia.

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Literatur

  1. Alvarez-de-la-Rosa M, Silva I, Nilsen J et al (2005) Estradiol prevents neural tau hyperphosphorylation characteristic of Alzheimer’s disease. Ann N Y Acad Sci 1052:210–224

    Article  CAS  PubMed  Google Scholar 

  2. Bagger YZ, Tankó LB, Alexandersen P et al (2005) Early postmenopausal hormone therapy may prevent cognitive impairment later in life. Menopause 12:12–17

    Article  PubMed  Google Scholar 

  3. Binder EF, Schectman KB, Birge SJ et al (2001) Effects of hormone replacement therapy on cognitive performance in elderly women. Maturitas 38:137–146

    Article  CAS  PubMed  Google Scholar 

  4. Burgmans S, van Boxtel MP, Vuurman EF et al (2009) The prevalence of cortical gray matter atrophy may be overestimated in the healthy aging brain. Neuropsychology 23:541–550

    Article  PubMed  Google Scholar 

  5. Clarkson TB (2007) Estrogen effects on arteries vary with stage of reproductive life and extent of subclinical atherosclerosis progression. Menopause 14:373–384

    Article  PubMed  Google Scholar 

  6. Day M, Sung A, Logue S et al (2005) Beta estrogen receptor knockout (BERKO) mice present attenuated hippocampal CA1 long-term potentiation and related memory deficits in contextual fear conditioning. Behav Brain Res 164(1):128–131

    Article  CAS  PubMed  Google Scholar 

  7. Dhandapani KM, Brann DW (2002) Protective effects of estrogen and selective estrogen receptor modulators in the brain. Biol Reprod 67:1379–1385

    Article  CAS  PubMed  Google Scholar 

  8. Ditkoff EC, Crary WG, Cristo M, Lobo RA (1991) Estrogen improves psychological function in asymptomatic postmenopausal women. Obstet Gynecol 78:991–995

    CAS  PubMed  Google Scholar 

  9. Drummond ES, Harvey AR, Martins RN (2009) Androgens and Alzheimer’s disease. Curr Opin Endocrinol Diabetes Obes 16:254–259

    Article  CAS  PubMed  Google Scholar 

  10. Ferrari E, Magri F (2008) Role of neuroendocrine pathways in cognitive decline during aging. Ageing Res Rev 7:225–233

    Article  CAS  PubMed  Google Scholar 

  11. Fuh JL, Wang SJ, Lee SJ et al (2006) A longitudinal study of cognition change during early menopausal transition in a rural community. Maturitas 53:447–453

    Article  PubMed  Google Scholar 

  12. Gibbs RB (2000) Long-term treatment with estrogen and progesterone enhances acquisition of a spatial memory task by ovariectomized aged rats. Neurobiol Aging 21:107–116

    Article  CAS  PubMed  Google Scholar 

  13. Gillies GE, McArthur S (2010) Estrogen actions in the brain and the basis for differential action in men and women: a case for sex-specific medicines. Pharmacological Rev 62:155-198

    Article  CAS  Google Scholar 

  14. Grimley Evans J, Malouf R, Huppert F, van Niekerk JK (2006) Dehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people. Cochrane Database Syst Rev 4:CD006221

    Google Scholar 

  15. Henderson VW (2000) Hormone therapy and the brain: a clinical perspective on the role of estrogen. Parthenon Publishing, New York

  16. Henderson VW, Guthrie JR, Dudley EC et al (2003) Estrogen exposures and memory at midlife: a population-based study of women. Neurology 60:1369–1371

    Article  CAS  PubMed  Google Scholar 

  17. Herlitz A, Thilers P, Habib R (2007) Endogenous estrogen is not associated with cognitive performance before, during, or after menopause. Menopause 14:425–431

    Article  PubMed  Google Scholar 

  18. Lethaby A, Hogervorst E, Richards M et al (2008) Hormone replacement therapy for cognitive function in postmenopausal women. Cochrane Database Syst Rev 1:CD003122

    PubMed  Google Scholar 

  19. Hickman SE, Howieson DB, Dame A et al (2000) Longitudinal analysis of the effects of the aging process on neuropsychological test performance in the healthy young-old and oldest-old. Dev Neuropsychol 17:323–337

    Article  CAS  PubMed  Google Scholar 

  20. Hodis HN, Mack WJ, Lobo RA et al (2001) Estrogen in the Prevention of Atherosclerosis Trial Research Group. Estrogen in the prevention of atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 135:939–953

    CAS  PubMed  Google Scholar 

  21. Hodis HN, Mack WJ, Azen SP et al (2003) Women’s Estrogen-Progestin Lipid-Lowering Hormone Atherosclerosis Regression Trial Research Group. Hormone therapy and the progression of coronary-artery atherosclerosis in postmenopausal women. N Engl J Med 349:535–545

    Article  CAS  PubMed  Google Scholar 

  22. Janowsky JS, Chavez B, Orwoll E (2000) Sex steroids modify working memory. J Cogn Neurosci 12:407–414

    Article  CAS  PubMed  Google Scholar 

  23. Kok HS, Kuh D, Cooper R et al (2006) Cognitive function across the life course and the menopausal transition in a British birth cohort. Menopause 13:19–27

    Article  PubMed  Google Scholar 

  24. Lacreuse A, Verreault M, Herndon JG (2001) Fluctuations in spatial recognition memory across the menstrual cycle in female rhesus monkeys. Psychoneuroendocrinology 26:623–639

    Article  CAS  PubMed  Google Scholar 

  25. Landauer N, Kohama SG, Voytko ML, Neuringer M (2004) Effects of menstrual cycle status on visuospatial attention in aged rhesus monkeys. Soc Neurosci Abstr 34:779.2

    Google Scholar 

  26. Diener HC, Putzki N (Hrsg) (2008) Leitlinien für Diagnostik und Therapie in der Neurologie; 4. Aufl. Georg Thieme Verlag, Stuttgart S 654 ff

  27. Luetters C, Huang MH, Seeman T et al (2007) Menopause transition stage and endogenous estradiol and follicle-stimulating hormone levels are not related to cognitive performance: cross-sectional results from the study of women’s health across the nation (SWAN). J Womens Health (Larchmt) 16:331–344

    Article  Google Scholar 

  28. Lyons-Warren A, Lillie R, Hershey T (2004) Short- and long-term spatial delayed response performance across the lifespan. Dev Neuropsychol 26:661–678

    Article  PubMed  Google Scholar 

  29. Olcese JM, Cao C, Mori T et al (2009) Protection against cognitive deficits and markers of neurodegeneration by long-term oral administration of melatonin in a transgenic model of Alzheimer disease. J Pineal Res 47:82–96

    Article  CAS  PubMed  Google Scholar 

  30. Petanceska SS, Nagy V, Frail D, Gandy S (2000) Ovariectomy and 17beta-estradiol modulate the levels of Alzheimer’s amyloid beta peptides in brain. Neurology 54:2212–2217

    CAS  PubMed  Google Scholar 

  31. Phillips SM, Sherwin BB (1992) Effects of estrogen on memory function in surgically menopausal women. Psychoneuroendocrinology 17:485–495

    Article  CAS  PubMed  Google Scholar 

  32. Resnick SM, Espeland MA, An Y et al (2009) Effects of conjugated equine estrogens on cognition and affect in postmenopausal women with prior hysterectomy. J Clin Endocrinol Metab 94:4152–61

    Article  CAS  PubMed  Google Scholar 

  33. Resnick SM, Maki PM, Rapp SR et al (2006) Effects of combination estrogen plus progestin hormone treatment on cognition and affect. J Clin Endocrinol Metab 91:1802–1810

    Article  CAS  PubMed  Google Scholar 

  34. Roberts JA, Gilardi KVK, Lasley B, Rapp PR (1997) Reproductive senescence predicts cognitive decline in aged female monkeys. Neuroreport 8:2047–2051

    Article  CAS  PubMed  Google Scholar 

  35. Robertson D, Craig M, van Amelsvoort T et al (2009) Effects of estrogen therapy on age-related differences in gray matter concentration. Climacteric 12:301–309

    Article  CAS  PubMed  Google Scholar 

  36. Rocca WA, Bower JH, Maraganore DM et al (2007) Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology 69:1074–1083

    Article  CAS  PubMed  Google Scholar 

  37. Seshadri S, Wolf PA (2007) Lifetime risk of stroke and dementia: current concepts, and estimates from the Framingham Study. Lancet Neurol 6:1106–1114

    Article  PubMed  Google Scholar 

  38. Sherwin BB (1988) Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women. Psychoneuroendocrinology 13:345–357

    Article  CAS  PubMed  Google Scholar 

  39. Sherwin BB (2006) The critical period hypothesis: Can it explain discrepancies in the Oestrogen-Cognition literature? J Neuroendocrinol 19:77–81

    Article  Google Scholar 

  40. Sherwin BB (2006) Estrogen and cognitive aging in women. Neuroscience 138:1021–1026

    Article  CAS  PubMed  Google Scholar 

  41. Shumaker SA, Legault C, Kuller L et al (2004) Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women. JAMA 291:2947–2958

    Article  CAS  PubMed  Google Scholar 

  42. Shumaker SA, Legault C, Rapp SR et al (2003) Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women. JAMA 289:2651–2662

    Article  CAS  PubMed  Google Scholar 

  43. Spencer JL, Waters EM, Romeo RD et al (2008) Uncovering the mechanisms of estrogen effects on hippocampal function. Front Neuroendocrinol 29:219–237

    Article  CAS  PubMed  Google Scholar 

  44. Zandi PP, Carlson MC, Plassman BL et al (2002) Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study. JAMA 288:2123–2129

    Article  CAS  PubMed  Google Scholar 

  45. Zheng H, Xu H, Uljon SN et al (2002) Modulation of A(beta) peptides by estrogen in mouse models. J Neurochem 80:191–196

    Article  CAS  PubMed  Google Scholar 

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  1. Abteilung für gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinik für Frauenheilkunde, Inselspital Bern, Effingerstr. 102, 3010, Bern, Schweiz

    P. Stute

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Stute, P. Hormone und Gehirnfunktion im Alter. Gynäkologische Endokrinologie 9, 14–18 (2011). https://doi.org/10.1007/s10304-010-0386-6

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