Estrogen replacement therapy and cognitive functioning in the Atherosclerosis Risk in Communities (ARIC) study

Moyses Szklo, James Cerhan, Ana V. Diez-Roux, Lloyd Chambless, Lawton Cooper, Aaron R. Folsom, Linda P. Fried, David Knopman, F. Javier Nieto

Research output: Contribution to journalArticlepeer-review

78 Scopus citations


The association of estrogen replacement therapy (ERT) with cognitive functioning was assessed in 6,110 women aged 48-67 years participating in the Atherosclerosis Risk in Communities (ARIC) study, a multicenter longitudinal investigation. ERT was evaluated in relation to results of three cognitive tests (the Delayed Word Recall (DWR) Test, the Digit Symbol Subtest of the Wechsler Adult Intelligence Scale-Revised (DSS/WAIS-R), and the Word Fluency (WF) Test) using data from the first follow-up visit of the cohort (1990- 1992). No consistent associations were seen between ERT and either the DWR test or the DSS/WAIS-R after adjusting for age, education, and additional covariates previously found to be associated with cognitive function scores. Among surgically menopausal women aged 48-57 years, adjusted mean WF scores were slightly greater in ERT current users (mean WF 35.9) than in never users (mean WF 33.5) (p < 0.02); and within current users, adjusted WF scores increased with duration of ERT use. However, the finding that ERT was associated with a slightly higher level of performance on only one of three measures offers little support for the hypothesis that ERT has a major protective effect on cognitive function in women less than 68 years of age. The generalizability of these findings to older women who are more likely to experience cognitive decline and who may be using ERT for longer periods of time is limited by the relatively young age of the cohort.

Original languageEnglish (US)
Pages (from-to)1048-1057
Number of pages10
JournalAmerican journal of epidemiology
Issue number11
StatePublished - Dec 1 1996

Bibliographical note

Funding Information:
The ARIC Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, NO1-HC-55O21, and N01-HC-55022. The authors thank the staff at the ARIC centers: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina: Carol Summers, Catherine Burke, Deanna Horwitz, Carmen Woody, Debbie Rubin-Williams, Witold Sieradzan, Louis Wijnberg, George Williams; University of Mississippi Medical Center, Jackson, Mississippi: Agnes L. Hayes, Roberta Howell, Jane G. Johnson, Patricia F. Martin; University of Minnesota, Minneapolis, Minnesota: Carol DeYoung, Jaci Dion, Lowell Hedquist, EUie Justiniano; The Johns Hopkins University, Baltimore, Maryland: Sunny Harrell, Carole Shearer, Pam Grove, Mary A. Cocodrilli; University of Texas Medical School, Houston, Texas: Valerie Stinson, Pam Pfile, Hoang Pham, Teri Trevino; The Methodist Hospital-Houston,. Houston, Texas: Maria L. Messi, Val Creswell, Julita Samoro, Wanda Wright; Bowman-Gray School of Medicine, Winston-Salem, North Carolina: Regina deLacy, Delilah Cook, Carolyn Bell, Teresa Crotts, Suzanne Pillsbury.


  • cognition
  • cognition disorders
  • estrogen replacement therapy
  • menopause
  • women's health


Dive into the research topics of 'Estrogen replacement therapy and cognitive functioning in the Atherosclerosis Risk in Communities (ARIC) study'. Together they form a unique fingerprint.

Cite this