Home › Research › Prevention and risk
The epidemiology of estrogen replacement therapy and Alzheimer's disease
Henderson VW.. Neurology, 1997-05-01
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
The burden of Alzheimer's disease (AD) falls more heavily on women than men. It is hypothesized that plummeting levels of circulating estrogens after the menopause increase a woman's risk for this disorder and, conversely, that estrogen replacement therapy may lower the risk for dementia due to AD. A number of estrogenic properties support the biological credibility of this hypothesis. Estrogen interacts with neurotrophins and neurotransmitter systems relevant to AD and in some model systems estrogen modulates synaptic plasticity. Effects on beta-amyloid and apolipoprotein E may be especially germane to putative effects. Estrogen also may blunt neurotoxic consequences of the stress response mediated by the hypothalamic-pituitary-adrenal axis, augment cerebral glucose utilization, and enhance cerebral blood flow. Clinical studies of postmenopausal women suggest beneficial estrogen effects on specific cognitive skills, and small preliminary trials of estrogen replacement in women with AD support claims of clinical meaningful efficacy. Consistent with the estrogen hypothesis, cross-sectional studies imply that postmenopausal estrogen use could be associated with a lower risk for AD. Several recent epidemiologic studies in which information on estrogen replacement therapy was collected prospectively further support this contention, with a dose-response relation evident in some reports. Because estrogen users tend to differ from nonusers in a number of lifestyle characteristics, convincing demonstration of putative protective effects could best some from randomized, placebo-controlled, primary intervention trials. For the present, however, the issue of estrogen efficacy in lowering a woman's risk for AD remains unsettled.
What this study adds
Evidence grade: High
This is a cross-sectional study. This review discusses the hypothesis that falling estrogen levels after menopause raise Alzheimer's risk and that estrogen replacement therapy may lower it, with cross-sectional studies suggesting postmenopausal estrogen use could be associated with lower risk. These are associations from observational studies, not proof that estrogen prevents or treats Alzheimer's disease.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Henderson, V. W. (1997). The epidemiology of estrogen replacement therapy and Alzheimer's disease. Neurology. https://doi.org/10.1212/wnl.48.5_suppl_7.27s
Vancouver
Henderson VW. The epidemiology of estrogen replacement therapy and Alzheimer's disease. Neurology. 1997. doi:10.1212/wnl.48.5_suppl_7.27s. PMID: 9153164.
BibTeX
@article{henderson1997-9153164,
author = {Henderson, V. W.},
title = {{The epidemiology of estrogen replacement therapy and Alzheimer's disease}},
journal = {Neurology},
year = {1997},
doi = {10.1212/wnl.48.5_suppl_7.27s},
pmid = {9153164},
url = {https://doi.org/10.1212/wnl.48.5_suppl_7.27s}
}
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.
Key findings
- Consistent with the estrogen hypothesis, cross-sectional studies imply that postmenopausal estrogen use could be associated with a lower risk for AD.
Why it matters
This review discusses the hypothesis that falling estrogen levels after menopause raise Alzheimer's risk and that estrogen replacement therapy may lower it, with cross-sectional studies suggesting postmenopausal estrogen use could be associated with lower risk. These are associations from observational studies, not proof that estrogen prevents or treats Alzheimer's disease.
New to this subject? Start with our plain-English guide: Prevention →
Study details
- Study designcross-sectional
- Evidence strengthHigh
How this study scored 56/100
Published in a leading specialty journal, and it is a snapshot of people at one point in time. Scored zero for sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| 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 | 1997 — 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) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 226 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.3 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 4 / 6 | Cited 17.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Victor W. Henderson: h-index 79 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | National Institutes of Health: institution h-index 2,723 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9153164) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 56 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Related
Studies in the library that share something with this one. The line above each title says what.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
5 studies in the alzhub library list this one in their references.
Related studies in Prevention and risk from nearby years
Also in Prevention and risk
265 studies in the library are filed under Prevention and risk with no topic tag they share with another; these are this study's neighbours in a fixed tour of them. The Prevention and risk hub.