Estrogens, Selective Estrogen Receptor Modulators, and Dementia: What Is the Evidence?



    Corresponding author
    1. Departments of Psychiatry, Neurology and Epidemiology, University of California, San Francisco and the San Francisco VA Medical Center, San Francisco, California 94121, USA
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Address for correspondence: Kristine Yaffe, M.D., University of California, San Francisco, Box 111G, 4150 Clement Street, San Francisco, California 94121. Voice: 415-750-6625; fax: 415-750-6641;


Abstract: At least 10% of people aged 65 or older have some form of cognitive impairment, increasing to around 50% by age 85. Several studies have suggested that estrogen may improve cognitive function or prevent the development of dementia, but other studies have not shown a benefit, and results from large randomized trials are lacking. Fortunately, further trials are currently being conducted. With the recognition that selective estrogen receptor modulators (SERMs) have differential tissue-dependent effects on estrogen receptor function, there is recent interest in the effects of raloxifene, tamoxifen, and other SERMs on cognition. In this paper, the current state of knowledge of the role of estrogen for preventing dementia in postmenopausal women will be reviewed. In addition, the status of ongoing and recently completed trials of estrogen and SERMs on cognitive function or on Alzheimer's disease severity will be summarized.