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Endogenous Sex Hormones as Risk Factors for Dementia in Elderly Men and Women

¹ Department of Internal Medicine, Cardioangiology, and Hepatology, University of Bologna, Italy.
² Department of Experimental Pathology, University of Bologna, Italy.
³ Department of Medicine, McMaster University, Hamilton, Canada.

Address correspondence to Professor Giovanni Ravaglia, MD, Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S. Orsola, Malpighi, Via Massarenti, 9–40138 Bologna, Italy. E-mail: ravaglia{at}med.unibo.it

Background. The associations of endogenous sex hormones with risk of dementia in the elderly population are not well known.

Methods. The relationship of baseline serum total estradiol (E2) and free testosterone (FT) to 4-year risk of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) was examined in a dementia-free, population-based cohort of 433 women (mean age 74 years) and 376 men (mean age 73 years). Multivariable proportional hazards regression was used to adjust for sociodemographic and lifestyle variables, body mass index, apolipoprotein E genotype, cardiovascular conditions, and homocysteinemia.

Results. Dementia developed in 71 women (46 AD, 21 VaD) and 39 men (23 AD, 12 VaD). In women with high E2 (serum E2 10 pg/mL), the multivariable-adjusted hazard ratio (HR) for dementia was 1.75 (95% confidence interval [CI], 1.06-2.89). The corresponding multivariable-adjusted HR for AD was 1.94 (95% CI, 1.04-3.61), whereas no association was found for VaD. No association with dementia was found for serum FT in women and for either serum E2 or FT in men.

Conclusion. High serum E2 is an independent predictor for dementia and AD in elderly women.

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