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Endogenous estradiol and risk of dementia in women and men: The Rotterdam Study
Author(s) -
Geerlings Mirjam I.,
Launer Lenore J.,
De Jong Frank H.,
Ruitenberg Annemieke,
Stijnen Theo,
Van Swieten John C.,
Hofman Albert,
Witteman Jacqueline C. M.,
Pols Huibert A. P.,
Breteler Monique M. B.
Publication year - 2003
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.10521
Subject(s) - dementia , hazard ratio , rotterdam study , medicine , proportional hazards model , confounding , cohort study , cohort , population , vascular dementia , gerontology , demography , disease , confidence interval , environmental health , sociology
We determined whether higher endogenous estradiol levels were associated with lower risk of dementia in older men and women not using hormonal replacement therapy, using a case‐cohort design within the Rotterdam Study, a population‐based follow‐up study on chronic diseases, including dementia, in 7,983 subjects aged 55 years or older, and ongoing since 1990. The analyses were based on a random subcohort of 508 women and 438 men, and on 76 women and 53 men with incident dementia. Cox proportional hazards models with robustly estimated standard errors showed that in women higher levels of total estradiol were associated with higher risk of dementia (age‐adjusted hazard ratio per standard deviation increase 1.38; 95% CI 1.04–1.84). Age‐adjusted HR's of Alzheimer's disease and vascular dementia associated with higher levels of total estradiol (per SD increase) were 1.24 (95% CI 0.87–1.76) and 2.19 (95% CI 1.22–3.92), respectively. Similar results were observed for bioavailable estradiol. Additional adjustments for potential confounders did not change the results substantially. In men, no clear association was observed between estradiol levels and risk of dementia or its subtypes. The findings do not support the hypothesis that higher levels of endogenous estradiol reduce risk of dementia, neither in women nor in men. Ann Neurol 2003