Cognitive decline among female estrogen users in nursing homes

Background. Clinical and epidemiological research has been done regarding the potential therapeutic benefit of estrogen in outpatients with and without dementia; however, the effects of estrogen therapy on cognition in elderly nursing home patients have not been previously examined. Methods. This retrospective cohort study compared 191 women estrogen users with 663 women nonestrogen users, matched according to age, nursing home facility, year of assessment, and baseline level of cognitive function. The outcome was decline in cognition, measured by the Cognitive Performance Scale, over a minimum follow-up period of 6 months. Results. No significant difference was found in the rate of cognitive decline among estrogen users and nonusers. Conclusions. Estrogen therapy administered to nursing home residents is not associated with a reduction in cognitive decline. This study lends further support to recent controlled clinical trials that found no benefit for estrogen treatment on cognition in outpatients with dementia.