Alzheimer's disease in women


      The progressive and irreversible dementia of Alzheimer's disease affects both men and women, but women constitute the majority of persons with the disease. Women may also have relatively more language impairment and a tendency for greater psychiatric involvement. Diagnosis is founded on the recognition of clinical features and exclusion of other causes of dementia. The etiology of the disease remains unknown. Although a variety of genetic factors is increasingly suspected, no diagnostic genetic test is currently recommended. Recent basic science and clinical data suggest the possibility that estrogen may be helpful both in preventing and in treating Alzheimer's disease, and these potential effects may encourage the use of estrogen in postmenopausal women. Standard treatment for Alzheimer's disease involves counseling and support, as well as consideration of tacrine, a cholinergic agent that may stabilize the course in some patients. Until the cause of the disease is elucidated, however, the development of curative treatment is unlikely. (Am J Obstet Gynecol 1997;176:1-7.)


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        • Alzheimer A.
        About a peculiar disease of the cerebral cortex. Allgemeine Z Psychiatrie Psychisch-Gerichtliche Med 1907;64:146-8. (Translated by Jarvik L, Greenson H.
        Alzheimer Dis Assoc Disord. 1987; 1: 7-8
        • Katzman R
        Alzheimer's disease.
        N Engl J Med. 1986; 314: 964-973
        • Filley CM
        • Kelly J
        • Heaton RK
        Neuropsychologic features of early- and late-onset Alzheimer's disease.
        Arch Neurol. 1986; 43: 574-576
        • Weiler PG
        The public health impact of Alzheimer's Disease.
        Am J Public Health. 1987; 77: 1157-1158
        • Rocca WA
        • Amaducci LA
        • Schoenberg BS
        Epidemiology of clinically diagnosed Alzheimer's disease.
        Ann Neurol. 1986; 19: 415-424
        • Evans DA
        • Funkenstein HH
        • Albert MA
        • et al.
        Prevalence of Alzheimer's disease in a community population of older persons: higher than previously reported.
        JAMA. 1989; 262: 2551-2556
        • Bachman DL
        • Wolf PA
        • Linn RT
        • et al.
        Incidence of dementia and probable Alzheimer's disease in a general population: the Framingham study.
        Neurology. 1993; 43: 515-519
        • Bachman DL
        • Wolf PA
        • Linn R
        • et al.
        Prevalence of dementia and probable senile dementia of the Alzheimer type in the Framingham study.
        Neurology. 1992; 42: 115-119
        • Jorm AF
        • Korten AE
        • Henderson AS.
        The prevalence of dementia: a quantitative integration of the literature.
        Acta Psychiatr Scand. 1987; 76: 465-479
        • Heyman A
        • Peterson B
        • Fillenbaum G
        • Pieper C
        The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part XIV. Demographic and clinical predictors of survival in patients with Alzheimer's disease.
        Neurology. 1996; 46: 656-660
        • Harris Y
        • Gorelick PB
        • Freels S
        • et al.
        Epidemiology of vascular and Alzheimer's dementia among African-American women.
        J Natl Med Assoc. 1995; 87: 741-745
        • Cummings JL
        • Benson DF.
        Dementia: a clinical approach.
        in: Butterworth Heinemann, Boston1992: 46-75
        • Folstein MF
        • Folstein SE
        • McHugh PR
        “Mini-Mental State”: a practical method for grading the cognitive status of patients for the clinician.
        J Psychiatr Res. 1975; 12: 189-198
        • Buckwalter JG
        • Sobel E
        • Dunn ME
        • et al.
        Gender differences on a brief measure of cognitive functioning in Alzheimer's disease.
        Arch Neurol. 1993; 50: 757-760
        • Henderson VW
        • Buckwalter JG
        Cognitive deficits of men and women with Alzheimer's disease.
        Neurology. 1994; 44: 90-96
        • Ripich DN
        • Petrill SA
        • Whitehouse PJ
        • Ziol EW.
        Gender differences in language of AD patients: a longitudinal study.
        Neurology. 1995; 45: 299-302
        • Cohen D
        • Eisdorfer C
        • Gorelick P
        • et al.
        Sex differences in the psychiatric manifestations of Alzheimer's disease.
        J Am Geriatr Soc. 1993; 41: 229-232
        • McKhann G
        • Drachman D
        • Folstein M
        • et al.
        Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease.
        Neurology. 1984; 34: 939-944
        • Wisniewski KE
        • Dalton AJ
        • Crapper McLachlan DR
        • et al.
        Alzheimer's disease in Down's syndrome: clinicopathologic studies.
        Neurology. 1985; 35: 957-961
        • Clark RF
        • Goate AM
        Molecular genetics of Alzheimer's disease.
        Arch Neurol. 1993; 50: 1164-1172
        • St. George-Hyslop PH
        • Tanzi RE
        • Polinsky RJ
        • et al.
        The genetic defect causing familial Alzheimer's disease maps on chromosome 21.
        Science. 1987; 235: 885-890
        • Schellenberg GD
        • Bird TD
        • Wijsman EM
        • et al.
        Genetic linkage evidence for a familial Alzheimer disease locus on chromosome 14.
        Science. 1992; 258: 668-671
        • Levy-Lahad E
        • Wijsman EM
        • Nemens E
        • et al.
        A familial Alzheimer's disease locus on chromosome 1.
        Science. 1995; 269: 970-973
        • Roses AD
        Apolipoprotein E genotyping in the differential diagnosis, not prediction, of Alzheimer's disease.
        Ann Neurol. 1995; 38: 6-14
        • National Institute on Aging/Alzheimer's Association Working Group
        Apolipoprotein E genotyping in Alzheimer's disease.
        Lancet. 1996; 347: 1091-1095
        • Parker WD
        • Filley CM
        • Parks J
        Cytochrome oxidase deficiency in Alzheimer's disease.
        Neurology. 1990; 40: 1302-1303
        • Parker WD
        • Parks J
        • Filley CM
        • Kleinschmidt-DeMasters BK
        Electron transport chain defects in Alzheimer's disease brain.
        Neurology. 1994; 44: 1086-1089
        • Davis RE
        • Miller S
        • Herrnstadt C
        • et al.
        Specific point mutations in mitochondrial cytochrome oxidase genes are associated with sporadic Alzheimer's disease [Abstract].
        Neurology. 1996; 46: A276
        • Blessed G
        • Tomlinson BE
        • Roth M.
        The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects.
        Br J Psychiatry. 1968; 114: 797-811
        • Terry RD
        • Masliah E
        • Salmon DP
        • et al.
        Physical basis of cognitive alterations in Alzheimer's disease: synapse loss is the major correlate of cognitive impairment.
        Ann Neurol. 1991; 30: 572-580
        • Whitehouse PJ
        • Price DL
        • Struble RG
        • et al.
        Alzheimer's disease and senile dementia: loss of neurons in the basal forebrain.
        Science. 1982; 215: 1237-1239
        • Aronson MK
        • Ooi WL
        • Morgenstern H
        • et al.
        Women, myocardial infarction, and dementia in the very old.
        Neurology. 1990; 40: 1102-1106
        • Lobo RA.
        Benefits and risks of estrogen replacement therapy.
        Am J Obstet Gynecol. 1995; 173: 982-989
        • Berlinger WG
        • Potter JF.
        Low body mass index in demented outpatients.
        J Am Geriatr Soc. 1991; 39: 973-978
        • Meldrum DR
        • Davidson BJ
        • Tataryn IV
        • Judd HL.
        Changes in circulating steroids with aging in postmenopausal women.
        Obstet Gynecol. 1981; 57: 624-628
        • Birge SJ
        • Morrow-Howell N
        • Proctor EK.
        Hip fracture.
        Clin Geriatr Med. 1994; 10: 589-609
        • Phillips SM
        • Sherwin BB.
        Effects of estrogen on memory function in surgically menopausal women.
        Psychoneuroendocrinology. 1992; 17: 485-495
        • Gibbs RB.
        Estrogen and nerve growth factor-related systems in brain: effects on basal forebrain cholinergic neurons and implications for learning and memory processes and aging.
        Ann N Y Acad Sci. 1994; 743: 165-196
        • Singh M
        • Meyer EM
        • Simpkins JW.
        The effect of ovariectomy and estradiol replacement on brain-derived neurotrophic factor messenger ribonucleic acid expression in cortical and hippocampal brain regions of female Sprague-Dawley rats.
        Endocrinology. 1995; 136: 2320-2324
        • Paganini-Hill A
        • Henderson VW
        Estrogen deficiency and risk of Alzheimer's disease in women.
        Am J Epidemiol. 1994; 140: 256-261
        • Brenner DE
        • Kukull WA
        • Stergachis A
        • et al.
        Postmenopausal estrogen replacement therapy and the risk of Alzheimer's disease: a population-based case-control study.
        Am J Epidemiol. 1994; 140: 262-267
        • Henderson VW
        • Paganini-Hill A
        • Emanuel CK
        • et al.
        Estrogen replacement therapy in older women: comparisons between Alzheimer's disease cases and nondemented control subjects.
        Arch Neurol. 1994; 51: 896-900
        • Fillit H
        • Weinreb H
        • Cholst I
        • et al.
        Observations in a preliminary open trial of estradiol therapy for senile dementia—Alzheimer's type.
        Psychoneuroendocrinology. 1986; 11: 337-345
        • Honjo H
        • Ogino Y
        • Naitoh K
        • et al.
        In vivo effects by estrone sulfate on the central nervous system—senile dementia (Alzheimer's type).
        J Steroid Biochem. 1989; 34: 521-525
        • Filley CM
        Alzheimer's disease: it's irreversible but not untreatable.
        Geriatrics. 1995; 50: 18-23
        • Schneider LS
        Clinical pharmacology of aminoacridines in Alzheimer's disease.
        Neurology. 1993; 43: S64-S79
        • Thompson TL
        • Filley CM
        • Mitchell WD
        • et al.
        Lack of efficacy of Hydergine in patients with Alzheimer's disease.
        N Engl J Med. 1990; 323: 445-448