Estrogen Use in Protection From Cognitive Decline

Inclusion Criteria:

• Women between the ages of 45 and 65
• Currently on hormone replacement
• One year or more post complete cessation of menses
• Willing to sign the Human Subject Protection Consent form prior to enrollment in the study
• Willing to be randomized to continue or discontinue estrogen therapy
• Adequately visually and auditorially acute to allow neuropsychological testing
• Beyond 8 years of educational achievement to allow adequate neuropsychological testing
• Willing to undergo brain imaging
• At risk for cognitive decline, as defined by one or more of the following: Personal or family history of mood disorder, Hypothyroidism, Diabetes, Family history of Alzheimer's, APOE-4 allele

Exclusion Criteria:

• Diagnosis of possible or probable Alzheimer's disease or dementia
• Cerebrovascular disease or uncontrolled hypertension (systolic BP >170 or diastolic BP >100)
• History of myocardial infarction within previous year or unstable heart disease
• History of significant liver disease, pulmonary disease, or current cancer
• Contraindication for MRI (metal in body, claustrophobia, etc.)