NEW YORK, Nov 11 (Reuters Health) -- Estrogen therapy safely reduces
aggression among elderly patients who have dementia, according to preliminary
study findings.
A month-long study of the hormone in aggressive, demented elderly patients
suggests that estrogen may be a good second-line therapy for aggression in these
patients, used where other medications have failed.
Patients with dementia -- a serious decline in mental function seen in
illnesses such as Alzheimer's disease -- sometimes hit, yell, grab people, or
engage in other aggressive behaviors, Dr. Helen H. Kyomen, from Harvard Medical
School in Boston, Massachusetts, and colleagues explain.
Such behaviors are important to treat because they can have "dramatic and
pervasive impacts on patient care and well-being," the Massachusetts team points
out in the Fall issue of the American Journal of Geriatric Psychiatry.
Aggressive patients are often difficult for their caregivers to manage, so
they are likely to be institutionalized and often must be moved from unit to
unit or from facility to facility. Sedatives or other drugs can reduce
aggressive behaviors, but some patients do not respond to them or are unable to
tolerate the drugs.
In previous studies, estrogen has been shown to reduce hostility and
aggression, for example when administered to male sex offenders. Therefore,
Kyomen's group investigated whether estrogen could reduce aggressive behaviors
in elderly patients with dementia.
The researchers randomly assigned 12 women and 2 men, average age 84, to
take either a low to moderate dose of estrogen or a placebo (an inactive pill)
for 4 weeks.
At the end of the treatment period, the average total aggression score was
significantly lower in the estrogen group (2.05) than in the placebo group
(4.74), according to the report. The average physical aggression scores were
also significantly different, 0.37 and 1.32 for the two groups, respectively.
Verbal aggression, sexual aggression, and self-aggression were not
significantly improved by estrogen therapy. Side effects did not develop in
either group.
This was the first scientific study to evaluate the effects of estrogen
therapy on aggressive behaviors, Kyomen and colleagues note. They believe that
further research may prove estrogen to be useful as an alternative therapy for
aggressive behaviors in patients with dementia, or when used in addition to
behavioral therapy.
