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Estrogen therapy in postmenopausal women: effects on cognitive function and dementia
Yaffe K, Sawaya G, Lieberburg I, Grady D.. JAMA, 1998-03-01
Topic: Risk, prevention and care in population studies
Context Several studies have suggested that estrogen replacement therapy in postmenopausal women improves cognition, prevents development of dementia, and improves the severity of dementia, while other studies have not found a benefit of estrogen use. Meta-analysis of these studies suggests a 29% decreased risk of developing dementia among estrogen users, but the findings of the studies are heterogeneous. Four trials of estrogen therapy in women with Alzheimer disease have been conducted and have had primarily positive results, but most have been small, of short duration, non-randomized, and uncontrolled. Studies conducted in women, however, have substantial methodologic problems and have produced conflicting results.
Key findings
- Context Several studies have suggested that estrogen replacement therapy in postmenopausal women improves cognition, prevents development of dementia, and improves the severity of dementia, while other studies have not found a benefit of estrogen use.
- Meta-analysis of these studies suggests a 29% decreased risk of developing dementia among estrogen users, but the findings of the studies are heterogeneous.
- Four trials of estrogen therapy in women with Alzheimer disease have been conducted and have had primarily positive results, but most have been small, of short duration, non-randomized, and uncontrolled.
- Studies conducted in women, however, have substantial methodologic problems and have produced conflicting results.
Why it matters
This meta-analysis reports a 29% decreased risk of developing dementia among estrogen users, but notes the findings of the studies are heterogeneous and that studies in women have substantial methodological problems and conflicting results. Trials of estrogen therapy in women with Alzheimer disease had mainly positive results but most were small, of short duration, non-randomised and uncontrolled, so the evidence is preliminary and inconsistent.
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Study details
- Study designmeta-analysis
- Evidence strengthHigh
How this study scored 70/100
Published in a top-tier journal, and it is a meta-analysis pooling many studies. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1998 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 947 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 31.6 citations a year over 30 year(s) since 1998 |
| Impact for its field and year | 6 / 6 | Cited 56.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 23 other studies in this library |
| Still being cited | 2 / 4 | Cited 44 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Deborah G. Grady: h-index 71 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9496988) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 70 / 100 | — |
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Read the original
May need a subscription Unpaywall, Europe PMC and OpenAlex found no free copy of the full text (checked 10 Oct 2026), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Yaffe, K., Sawaya, G., Lieberburg, I., & Grady, D. (1998). Estrogen therapy in postmenopausal women: effects on cognitive function and dementia. JAMA. https://doi.org/10.1001/jama.279.9.688
Vancouver
Yaffe K, Sawaya G, Lieberburg I, Grady D. Estrogen therapy in postmenopausal women: effects on cognitive function and dementia. JAMA. 1998. doi:10.1001/jama.279.9.688. PMID: 9496988.
BibTeX
@article{yaffe1998-9496988,
author = {Yaffe, K. and Sawaya, G. and Lieberburg, I. and Grady, D.},
title = {{Estrogen therapy in postmenopausal women: effects on cognitive function and dementia}},
journal = {JAMA},
year = {1998},
doi = {10.1001/jama.279.9.688},
pmid = {9496988},
url = {https://doi.org/10.1001/jama.279.9.688}
}
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