Cognitive Function In Women Research Articles

Evaluating Estrogen for Alzheimer Disease Poses Ethical and Logistical Challenges

RESEARCHERS who design or conduct treatment or prevention trials for Alzheimer disease (AD) are facing some logistical difficulties and sticky ethical dilemmas. This is especially so for placebocontrolled trials that seek to determine whether estrogen can prevent or treat AD and other dementias. Although laboratory and epidemiologic studies and several small clinical trials suggest that estrogen may help prevent AD and may even improve cognitive function in women with dementia, most experts agree that randomized, double-blind, placebo-controlled trials are needed to establish the benefits and risks of the hormone used for this purpose. Two such national trials are now under way. Both have had trouble recruiting patients, and both raise questions about the ethics of giving postmenopausal women a placebo instead of a hormone that many physicians and patients believe may prevent morbidity and mortality. Although the evidence that estrogen helps prevent bone loss in postmenopausal women is fairly convincing,

Cognitive functioning in premenstrual syndrome

To evaluate cognitive functioning in women with premenstrual syndrome (PMS) and controls during the follicular and luteal phases of the menstrual cycle. Thirty women with PMS and 31 controls were selected on the basis of psychiatric interview and prospective daily diary recordings. Subjects were tested on two occasions, follicular (days 8-10) and luteal (days 24-26), using complex tasks consisting of measures validated previously for the assessment of "executive" frontal-lobe functions. Tests were counterbalanced for order across subjects. The Beck Depression Inventory scores were significantly different between the groups and across time (P < .001). Women with PMS had a mean luteal phase Beck score of 13.3 consistent with mild-to-moderate premenstrual depression. There were no statistically significant score differences in tests for attention, memory, cognitive flexibility, and overall mental agility. The evaluation of our preliminary data with 30 PMS subjects and 31 controls indicated a very small effect size (.02). To detect an effect size this small (if in fact one exists) with a power of .8 would require a sample of more than 1000 subjects per group. Our sample of women with PMS failed to demonstrate objective evidence of diminished cognitive performance, despite subjective feelings of inadequacy.

The effect of a carbohydrate-rich beverage on mood, appetite, and cognitive function in women with premenstrual syndrome

The effect of a carbohydrate-rich beverage on mood, appetite, and cognitive function in women with premenstrual syndrome

The Effect of a Carbohydrate-Rich Beverage on Mood, Appetite, and Cognitive Function in Women With Premenstrual Syndrome

To test the efficacy of a specially-formulated, carbohydrate-rich beverage (one known to increase the serum ratio of tryptophan to other large neutral amino acids) on the mood, cognitive, and appetitive disturbances of premenstrual syndrome (PMS). Twenty-four women with confirmed PMS were enrolled in a double-blind, crossover study to test the efficacy of the specially-formulated beverage compared with two other isocaloric products on PMS symptoms. The study was conducted over three menstrual cycles preceded by a 1-month placebo run-in. Patients were tested at home or work using an interactive computer-telephone system. Standardized measurements of mood, cognitive performance, and food cravings were made before and 30, 90, and 180 minutes after consumption of active and placebo beverages during the late luteal phase of the menstrual cycle. The experimental carbohydrate intervention significantly decreased self-reported depression, anger, confusion, and carbohydrate craving 90-180 minutes after intake. Memory word recognition was also improved significantly compared with scores obtained during the placebo run-in month (P < .05). The isocaloric placebo interventions had no significant effect on any of these measures. The results suggest that the psychological and appetitive symptoms of PMS can be relieved after consuming a specially-formulated, carbohydrate-rich beverage known to increase serum tryptophan levels.

Possible acceleration of age effects on cognition following menopause

Many cognitive functions have been shown to deteriorate with age. Because of the importance of the menopause as a milestone in the life cycles of women, we examined whether the aging-over-time process in some cognitive functions differs between women of reproductive age and postmenopausal women. It is demonstrated here that in some cognitive tests, including driving simulation, reaction time and some visuospatial tests, there is a significant acceleration in deterioration of functioning following menopause. It is suggested that this acceleration might be associated with the lack of gonadal hormones or other reproduction-related factors which may play a protective role against age-related deterioration in some cognitive functions in women.

Estrogenic effects on memory in women.

Sufficient evidence now exists to support the contention that estrogen influences cognitive functioning in women. Moreover, the data strongly suggest that estrogen exerts a specific and not a global effect on cognitive functions. Whereas estrogen enhances and/or maintains aspects of verbal memory, it is without effect, or possibly even has a negative influence on spatial memory. Indeed, there is some preliminary evidence that progesterone may enhance visual-spatial skills in women but this needs to be confirmed. Estrogen also exerts a positive effect on sexually dimorphic cognitive skills in which females typically excel such as verbal articulation and fine motor skills. While the weight of the evidence supports the above conclusion, findings across studies are not entirely consistent. Some of the methodological problems that weaken these studies include generalizing from one or two cognitive tasks to the entire realm of cognitive functions, neglecting to assay plasma levels of estradiol to confirm cycle phase or compliance with hormone administration and neglecting to consider the differential availability to the brain of the various estrogen preparations and the effects of different routes of administration. Although, for the most part, the menstrual cycle studies and the postmenopausal studies in healthy women show that estrogen maintains verbal memory, the effect size is modest. There is no reason to believe, for example, that verbal memory is truly impaired in women during phases of the menstrual cycle marked by low levels of estrogen. Nor are 45-year-old untreated, surgically menopausal women clinically impaired to any degree that affects their daily functioning in the real world. In both cases, however, decrements in performance occur reliably in the laboratory. This raises the issue, therefore, of the clinical meaningfulness of these findings. One way to address the clinical relevance of the relationship between estrogen and memory and thus, on cognitive functioning of the brain, is to examine what is known of estrogenic effects on other physiological systems where we already have substantial information. For example, the vast majority of women experience bone loss following the menopause and many develop osteopenia (bone density more than two standard deviations below mean peak bone mass levels) which is asymptomatic. Then, with advancing age, some women with osteopenia develop osteoporosis, predisposing them to fractures following minimal trauma. It has been estimated that 40 per cent of women who live to age 80 will develop spinal fractures and 33 per cent of women who live to age 90 will experience a hip fracture.(ABSTRACT TRUNCATED AT 400 WORDS)

Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women

The effect of estrogen and/or androgen replacement therapy on several aspects of cognitive functioning in surgically menopausal women was tested in a prospective, crossover design. Women who received either a combined estrogen-androgen preparation, estrogen alone, or androgen alone had scores on two tests of short-term memory, a test of long-term memory and a test of logical reasoning that were not different during the postoperative treatment phase compared to their preoperative performance. However, oophorectomized women who received placebo had lower scores on all four measures of cognitive functioning postoperatively, coincident with their significantly lower concentrations of plasma estradiol and testosterone. Patients who had a hysterectomy but whose ovaries were retained showed stability both in cognitive performance and in circulating sex steroid concentrations. These findings suggest that the drastic change in endocrine milieu following surgical menopause may have a direct, albeit modest, effect on aspects of cognitive functioning. Possible mechanisms of action of the sex hormones on cognitive functioning in women are discussed.

Cerebral blood flow and oxygen consumption in man.

Cerebral blood flow and oxygen consumption in man.