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Winter 2001
  From The Editor

Estrogen and Alzheimer's

A Storm in the Brain

Smell Test for Alzheimer's?

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  Editor's Note

A few years ago, the press reported findings from a research study showing that listening to classical music could improve academic performance. Across the country, mothers embraced the "Mozart effect" by playing symphonies to their newborn children. Hospitals handed out CDs in the maternity ward. The state of Georgia even launched a program to provide classical recordings to new parents.

This was an over-reaction. The original research study was conducted on college students, not newborn infants. It showed that students who listened to Mozart before taking a test scored higher. It did not show that the music had any long-term effects on intelligence or scholarship.



 
 

Could listening to classical music make newborns smarter? Possibly. Has this been scientifically proven? Absolutely not.

In this particular case, little harm was done. Intensive classical music therapy may not make children smarter, but it is hardly likely to hurt them. But other research hype can have potentially dangerous consequences, particularly when the focus of the hoopla is a new form of medication or health treatment that has not been scientifically proven to be effective or even safe for long-term use. In this issue's cover story, we consider the case of estrogen, which has been hyped as a means of preventing Alzheimer's disease.

Estrogen is the basis for hormone replacement therapy, a daily regimen of medication prescribed to remedy the symptoms of menopause. In recent years, a few preliminary studies suggested that post-menopausal women who take estrogen are less likely to develop Alzheimer's than women who do not. Unfortunately, as the findings of large-scale, scientifically-rigorous tests have been reported, these early results are not holding up: There is not yet any good evidence that estrogen itself prevents Alzheimer's. The article in this issue attempts to clarify what the research does and does not show, and where it is going.

Often the news media report the findings of small, preliminary studies that have generated intriguing results. Preliminary results may make interesting reading, and they may eventually lead to important scientific breakthroughs; the trouble starts when people forget that preliminary results are just that: preliminary. Then, when a large-scale, rigorous scientific study is conducted, the early results are sometimes shown to be wrong.

If hormone replacement therapy were as innocuous as Mozart, there would be no cause for alarm over the hype surrounding the use of estrogen for preventing Alzheimer's disease. On the one hand, estrogen has some important benefits, such as decreasing a woman's risk for osteoporosis. But estrogen is also known to have some serious side-effects, including increased risk of stroke, gallbladder disease, and some kinds of cancer. For this reason, doctors do not generally prescribe estrogen solely for prevention of Alzheimer's. And until research establishes otherwise, women deciding whether to take hormone replacement therapy should not allow concern over Alzheimer's disease to outweigh other proven considerations.

Meanwhile, the preliminary studies of estrogen and Alzheimer's have helped to drive sales of dietary supplements containing "plant-based" estrogen products, called phytoestrogens. Although phytoestrogens have a chemical structure similar to estrogen, there is no good evidence that phytoestrogens have the same effects as estrogen in the human body. (For instance, there's no proof that they fight osteoporosis.) Nor have there been long-term studies establishing whether the supplements are safe in large doses, or whether phytoestrogen use carries the same risk of cancer as estrogen use.

Even with these caveats, however, phytoestrogens could still be part of an alternative to hormone replacement therapy for post-menopausal women. Phytoestrogens are found not only in supplement pills, but also in foods such as soy products, whole grains, and vegetables. Whether or not phytoestrogens prove to be an effective treatment for the symptoms of menopause, there is little doubt that eating more whole grains and vegetables is a good idea. Like the Mozart effect, it might not help prevent Alzheimer's-but it can't hurt either.  


Further Reading: [ ISSUE #3: "ESTROGEN AND ALZHEIMER'S" ]

"Estrogen Replacement Therapy for Treatment of Mild to Moderate Alzheimer's Disease: A Randomized Controlled Trial," by Ruth A. Mulnard and others. Journal of the American Medical Association, Vol. 283, No. 8 (February 23, 2000), pp. 1007-1015.

The National Institute on Aging (NIA) offers a comprehensive and easily understandable primer about menopause, including a concise explanation of the known risks and benefits associated with hormone replacement therapy. Browse the publication, "Menopause" at: http://www.nih.gov/nia/health/pubs/menopause.

The "Mozart Effect": Various studies have suggested that brief (around 10 minutes) exposure to classical music can slightly improve college students' subsequent performance on cognitive tests. For example:

"Prelude or requiem for the 'Mozart effect'?" by F. Chabris and others. Nature, vol. 400 (August 1999), pp. 826-828. "Enhanced spatial performance following 10 minutes exposure to music: a replication," by B. Rideout & J. Taylor. Perceptual and Motor Skills, vol. 85 (August 1997), pp. 112-114.

"An experimental test of 'the mozart effect': does listening to his music improve spatial ability?" by J. Newman and others. Perceptual and Motor Skills, vol. 81 (December 1995), pp. 1379-1387.

"Another failure to generalize the Mozart effect," by L. McCutcheon. Psychological Reports, vol. 87 (August, 2000), pp. 325-330.

Copyright 2001 Memory Loss and the Brain



 
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