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To the Editor: In their Research Letter, Dr Gandy and colleagues¹ found that serum concentrations of amyloid protein paralleled those of testosterone and 17- estradiol. In attempting to associate levels of sex hormones with Alzheimer disease (AD), the authors make several incorrect assumptions.

First, by focusing only on sex hormones, Gandy et al discount the role of the other hormones involved in the hypothalamic-pituitary-gonadal axis. My colleagues and I have shown that, compared with age-matched controls, individuals with AD have significantly elevated serum gonadotropin concentrations.^2-3 I contend that it is an increase in gonadotropin concentrations and not the decrease in estrogen/testosterone concentrations seen after menopause/andropause that results in an increased risk of developing AD. I am aware of 5 anecdotal cases of individuals with AD who, when treated with leuprolide acetate, experienced no further cognitive decline for periods of up to 5 years.

Second, the authors measured A40. It . . . [Full Text of this Article]

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