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To the Editor: The WHIMS investigators reported that therapy with continuous combined CEE plus MPA increased the risk for probable dementia¹ and was associated with impaired cognitive function in some women.² These findings are consistent with a study suggesting that MPA might mitigate the positive effect of estrogen on cognition.³

We have reported⁴ that a continuous combination of CEE and micronized progesterone given orally to women with AD produced beneficial effects on cognition and activities of daily living. The apolipoprotein E 4 allele might further influence the hormonal effects combating cognitive decline and dementia. Yaffe et al,⁵ for instance, reported that use of estrogen might be associated with lower cognitive decline among 4–negative but not among 4–positive women. Similarly, we also found that the responses to hormone therapy were different in patients with AD as compared with the use of tacrine, which was preferable for modulating cognition and mood in . . . [Full Text of this Article]

Byung-Koo Yoon, MD
Department of Obstetrics and Gynecology
Sungkyunkwan University School of Medicine
Seoul, Korea

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