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Estrogen Therapy and Aggressive Behavior in Elderly Patients With Moderate-to-Severe Dementia

Results From a Short-Term, Randomized, Double-Blind Trial

Received August 14, 1998; revised December 21, 1998; accepted January 27, 1999. From the Harvard Medical School Division on Aging and Consolidated Department of Psychiatry, Boston, MA; McLean Hospital, Belmont, MA; and MetroWest Medical Center, Framingham and Natick, MA. Address correspondence to Dr. Kyomen, McLean Hospital, 115 Mill Street, Belmont, MA 02478-9106; e-mail: helen_kyomen{at}hms.harvard.edu

The authors used a randomized, double-blind, placebo-controlled clinical trial study design to investigate the efficacy and safety of short-term estrogen therapy in decreasing aggressive behaviors in elderly patients with moderate-to-severe dementia. Estrogen therapy was associated with lower total aggression scores (P<0.030) and with decreased frequency of physical aggression (P<0.019) over the 4-week trial. Verbally aggressive behaviors were decreased relative to control subjects, although this effect was not statistically significant. No drug-vs.-placebo differences were found for resistive, sexual, or self-directed aggressive behaviors. No adverse effects from the estrogen were observed during the course of the study.

Key Words: Alzheimer's Disease • Violence/Aggression • Hormone Therapy

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