Higher levels of plasma estradiol and testosterone in healthy elderly men compared with age-matched women may protect aspects of explicit memory

Objective: To assess longitudinally the relationships between plasma levels of estradiol (E-2) and free testosterone (T) and cognitive functioning in elderly men, women who use estrogen, and women who do not use estrogen. Design: At two test times 18 months apart (time 1 and time 2), men (time 1, n = 31; time 2, n = 23), women who were using estrogen (time 1, n = 14; time 2, n = 10), and women who were not using estrogen (time 1, n = 41; time 2, n = 27), whose average age was 72.1 and 73.4 years at time 1 and time 2, respectively, were administered a battery of neuropsychological tests that measured verbal memory, visual memory, concentration and attention, language fluency, and semantic memory. Plasma levels of E-2 and free T were assessed by radioimmunoassay. Results: The men had higher free T levels than both groups of women at both test times. Although women who were using estrogen had higher E-2 levels than those of the men and of the women who were not using estrogen, the men's E-2 levels were also significantly higher than those of the women who were not using estrogen. Moreover, the women who were using estrogen and the men had higher Forward Digit Span scores compared with the women who were not using estrogen at both test times, and women who were using estrogen had higher Backward Digit Span scores than those who were not using estrogen. Both groups of women performed better than the men on the Category Retrieval Test (verbal fluency). The performance of women who were using estrogen on the Delayed Selective Reminding Test (long-term rote memory) improved over time compared with that of the men and of the women who were not using estrogen. Conclusions: These findings raise the possibility that higher E-2 levels in elderly men and in women who use estrogen may protect against some declines in explicit memory with normal aging. (Menopause 2000,7:168-177. (C) 2000, The North American Menopause Society.).