Cognitive Function In Postmenopausal Women Research Articles

Postmenopausal Cognitive Function and Steroid Hormone Levels

Introduction: Most studies on the impact of sex hormones on the postmenopausal brain have focused on the lack of estrogen, with conflicting evidence. The influence of androgens on cognitive function is not well understood. This study aimed to assess the association between steroid hormones and cognitive function in postmenopausal women.

DNA Methylation of BDNF and RASA2 Genes Is Associated With Cognitive Function in Postmenopausal Women With Breast Cancer.

To determine associations among DNA methylation of brain-derived neurotrophic factor (BDNF) and RAS p21 protein activator 2 (RASA2) genes with processing speed and perceived cognitive function. This was a cross-sectional, secondary analysis of baseline data from a randomized controlled trial, the Exercise Program in Cancer and Cognition Study. Data included M values for DNA methylation of the BDNF and RASA2 genes; processing speed, objectively measured using the Grooved Pegboard and Digit Vigilance Test scores; and perceived cognitive function, self-reported using the Patient Assessment of Own Functioning Inventory. Regression analysis was conducted. Greater methylation of cg21291635 of the BDNF gene (p = 0.01) and cg20247102 of the RASA2 gene (p = 0.013) were associated with poorer processing speed, whereas greater methylation of cg20108357 of the BDNF gene (p < 0.001) and cg00567892 of the RASA2 gene (p = 0.019) were associated with better perceived cognitive function. Gene methylation variations were demonstrated, suggesting the genes' potential roles and two possible distinct mechanisms of cognitive function in cancer.&nbsp.

Cognitive Function in Urban and Rural Postmenopausal Women.

Menopause is a well-known risk factor for decreasing cognitive function in women. Postmenopausal women are increasing in number but relevant studies are very scarce. This study compared the cognitive function between urban and rural postmenopausal women and assessed the influence of socio-demographic factors on cognitive function. The aim of the study was to assess the association between the cognitive function of urban and rural postmenopausal women. This comparative cross-sectional study was conducted among 87 urban and 87 rural postmenopausal women who were selected by purposive sampling method from the Nakhalpara and Dhamrai area of Dhaka district during the period from January to December 2020. Data were collected with a semi-structured questionnaire based on the Bengali version of the Mini-Mental State Examination (MMSE) scale through face-to-face interviews and record reviewing with a checklist. Statistical analyses of the results were obtained using Microsoft Excel (Microsoft Corporation, Redmond, WA) and SPSS version 24 (IBM Corp., Armonk, NY). The mean age of postmenopausal women was 58.09 ± 8.163years in urban areas and 60.00 ± 7.562years in rural areas. The majority (31, 35.6%) of urban women were primary school pass whereas 58 (66.7%) rural women were illiterate. The mean family income of the women was 43022.99 ± 10992.57 Bangladeshi taka (BDT) in the urban group and 14022.99 ± 5023.14 BDTin the rural group. The study revealed that 31 (35.6%) women in the urban group and 53 (60.9%) women in the rural group had abnormal cognitive function. The percentage of abnormal cognitive function was higher in rural postmenopausal women. Cognitive function has an association with monthly family income, housing condition, family type, age at the time of marriage, lifestyle, and co-morbidities. Policymakers can take the findings as a guide to formulate policies and programs for the improvement of cognitive function of postmenopausal women.

Early menopause and premature ovarian insufficiency are associated with increased risk of dementia: a systematic review and meta-analysis

Background / Aims: As estrogens play a neuroprotective role, the decline in their concentrations during menopause may compromise cognitive function in postmenopausal women. Whether early menopause (EM) is associated with an increased risk of dementia remains unclear. The purpose of this study was to systematically review and meta-analyze current evidence regarding the association between EM or premature ovarian insufficiency (POI) and the risk of dementia of any type.

Relationship of vitamin D blood concentration with muscle mass and cognitive function in postmenopausal women.

Low levels of vitamin D have been associated with muscle mass loss and cognitive function alteration. To find out the relationship of vitamin D blood levels with muscle mass and cognitive function in postmenopausal women. Ninety-nine postmenopausal women aged ≥ 50 years were studied. Calf circumference, and tricipital, bicipital, subscapular and suprailiac skinfolds were measured. Arm muscle area, bone-free arm muscle area, and muscle mass were calculated. The short physical performance battery (SPPB) was performed, and the sarcopenia rapid diagnostic questionnaire (SARC-F), as well as the Mini Mental State Examination (MMSE) were applied. A blood sample was taken to measure vitamin D blood concentration. For statistical analysis, Mann-Whitney's U-test and Spearman's correlation analysis were used. It was found that, the older the age, the higher the vitamin D levels, as well as higher SARC-F score. Vitamin D levels were negatively correlated with grip strength and SPPB. There was a negative correlation between vitamin D levels and MMSE global score. Vitamin D did not have a positive influence on muscle mass. A better MMSE performance was observed in those with lower vitamin D levels.

ODP406 Effects of hormone replacement therapy on memory cognitive function in postmenopausal women: a systematic review and meta-analysis

Abstract Objective To investigate the effect of hormone replacement therapy (HRT) on memory cognitive function in postmenopausal women. Methods PubMed, Cochrane, Embase, Chinese Biomedical Literature Database (CBM)and web of ClinicalTrials.gov were systematically searched for randomized controlled trials comparing the effect of HRT on memory function in postmenopausal women to Placebo. The primary outcome of interest is memory cognitive function (measured by tests used in the study). We assessed pooled data by using random-effects model. Results Ten studies with 2818 participants were finally eligible for inclusion in the analysis. Compared with placebo, HRT showed no significant differences on logical memory including both immediate (weighted mean difference [WMD] 0.34, 95% CI: -0.73, 1.40) and delayed(0.99, 95% CI: -0.51, 2.48) recall in postmenopausal women, also no differences on short-delay (-0. 00, 95% CI: -0.37, 0.37) or long-delay (-0.19, 95% CI: -0.69, 0.31) recall of California Verbal Learning Test, but yielded an a mean reduction in digit span forward of -0.20 (95%CI: -0.36,-0. 03), with no significant difference in digit span total scores (-0.67, 95% CI: -1.58, 0.24) or backward (-0.10, 95%CI: -0.26, 0. 05). In women within 5 years of menopause, HRT still shows no harmful or beneficial effects on immediate (WMD 0.45, 95% CI: -0.75, 1.65) or delayed recall (WMD 1. 03, 95% CI: -0.93, 3. 00) of logical memory, but no detrimental effects on digit span forward (WMD -0.11, 95% CI: -0.72, 0.50). Conclusion This review suggests that HRT do not improve verbal memory in postmenopausal women, may even impair some domains of short-term memory. HRT may thus not be a potential therapeutic strategy to prevent memory decline in postmenopausal women. Presentation: No date and time listed

Association between physical and cognitive function in post menopause: a cross-sectional study

Functional tests have been performed to predict cognitive decline in postmenopausal women and may be an important tool to identify early reductions in cognitive performance in this population. However, it is still unclear which functional test is more sensitive for detecting cognitive decline in the investigated sample. The aim of this study was to verify the association between functional performance and cognitive function in postmenopausal women and to analyze whether the gait speed of 400 meters (400wt) and Timed Up and Go (TUG) tests are predictors of cognitive function in this sample. One hundred and twenty eight postmenopausal women (60.8 ± 7.9 years) participated in this cross-sectional study. Body composition was assessed using Dual Energy X-ray Absorptiometry (DXA), functional performance by the TUG and 400wt tests, cognitive performance by the Montreal Cognitive Assessment (MoCA) test and muscle strength by maximum voluntary isometric contraction (MVIC) in lower limbs. An association between functional performance and cognitive function was observed in middle-aged postmenopausal women. The TUG test was associated with the MoCA test (B = -0.79; SE = 0.29; p = 0.008). However, no association was observed between 400wt with the MoCA test (B = 3.03; SE = 1.92; p = 0.117). These results show that the TUG test is a good predictor of cognitive decline in postmenopausal middle-aged women.

The effect of using adjuvant aromatase inhibitors on cognitive functions in postmenopausal women with hormone receptor-positive breast cancer.

Breast cancer is the most frequently diagnosed cancer in women worldwide. Aromatase inhibitors (AIs) are effective treatment options for both early-stage and advanced hormone receptor-positive breast cancer. Because of AIs are used long term in adjuvant therapy, side effects are also very important. It is considered that AIs may affect cognitive functions by decreasing the level of estrogen in the brain. The purpose of our study is that evaluate the relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy. Two-hundred patients diagnosed with breast cancer who were treated with AIs as adjuvant treatment were included. The patients were surveyed for demographic characteristics. Montreal Cognitive Assessment (MoCA) and Standardized Mini-Mental State Examination (SMMT) tests were performed to evaluate patients' cognitive functions. The total scores of the tests and the orientation, short-time memory, visuospatial functions, attention, language, executive functions which are the MoCA subscales were evaluated separately. Patients were grouped as 0-6, 6-12, 12-24, 24-36, 36, and more months according to the duration of AIs using time. The total MoCA and SMMT scores were affected by factors such as age, education level, and employment status. There was no relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy (P > 0.05). In addition, no statistically relationship was found in the evaluation of MoCA subscales (P > 0.05). Prolonged adjuvant treatment with AIs does not affect cognitive functions in hormone receptor-positive breast cancer patients.

Inflammatory Potential of Diet Is Associated with Biomarkers Levels of Inflammation and Cognitive Function among Postmenopausal Women.

In postmenopausal women (PW), estrogen depletion may predispose to cognitive decline through an increased risk of chronic inflammation. Unhealthy diets also appear to have an impact on the cognitive health of these women. The aim of this study was to investigate the association between inflammatory potential of the diet, levels of inflammatory biomarkers, and cognitive function in PW. In a population of 222 PW, energy intake-adjusted Dietary Inflammatory Index (E-DII) was used to assess the dietary inflammatory potential. Cognitive function was estimated using the Polish version of Mini-Mental State Examination (MMSE), corrected by age and educational level. Selected biochemical inflammatory markers (C-reactive protein, CRP; interleukin-6, IL-6; and tumor necrosis factor alpha, TNF-α) were measured by ELISA tests. PW with an anti-inflammatory diet (first tercile) had significantly higher MMSE, while BMI, percentage fat mass and TNFα concentration were significantly lower compared to those with the most proinflammatory diets (third tercile). Women with cognitive impairment had significantly higher IL-6 concentrations (4.1 (0.8) pg/mL vs. 2.5 (0.2) pg/mL, p = 0.004), and were less educated (12.7 (0.7) years vs. 14.1 (0.2) years, p = 0.03) and less physically active compared to cognitively normal women. PW with the most proinflammatory diets had increased odds of cognitive impairment compared to those with the most anti-inflammatory diets, even after adjustment (OR = 11.10, 95% confidence level; 95%CI: 2.22; 55.56; p = 0.002). Each one-point increase in E-DII (as a continuous value) was also associated with 1.55-times greater odds of cognitive impairment (95%Cl: 1.19; 2.02 p = 0.003) in this population. Dietary inflammation may increase the risk of cognitive impairment in PW, but future studies should include a more sensitive battery of tests to assess cognitive function in this population. Implementation of an anti-inflammatory dietary pattern in PW may help prevent cognitive decline.

Cerebrovascular reactivity is related to peripheral endothelial function among healthy postmenopausal women but not midlife and older men

Background Age is the primary risk factor for cardiovascular diseases (CVD), cognitive decline, Alzheimer's disease and related dementias. Young women are at a lower risk for the above-mentioned diseases compared to age-matched men; however, their risk becomes greater than men after menopause. Age-related declines in peripheral and cerebral vascular function are thought to play a role in the increased risk for CVD and related chronic conditions. It is often assumed that changes in peripheral vascular function are directly indicative of changes in cerebrovascular function. However, in young, healthy adults, there does not appear to be an association between peripheral and cerebral vascular function. There is still limited evidence for whether peripheral vascular function is indicative of cerebrovascular function in postmenopausal (PM) women and midlife and older (ML/O) men. Purpose To determine the relation between cerebrovascular reactivity (CVR; an index of cerebrovascular function) and vascular endothelial function (brachial artery flow-mediated dilation [FMDBA]) in PM women and ML/O men and to determine if cerebrovascular function is associated with cognitive function in these groups. Methods CVR, FMDBA, and cognitive function were assessed in 17 PM women (67±6 years) and 26 men (66±7 years). Middle cerebral artery velocity (MCAv; cm/s) using a 2-MHz transcranial Doppler probe and end-tidal CO2 (etCO2; mmHg) were measured during 5 minutes of normocapnia and 5 minutes of hypercapnia (5% CO2). CVR was calculated as ΔMCAv/ΔetCO2. FMDBA was determined with the forearm cuff method and data expressed as Δ% from baseline diameter. The NIH Toolbox Cognition Battery of tests was used to assess global cognitive function, as well as specific cognitive domains. Results CVR was correlated with FMDBA (r=0.33, p=0.02) in PM women but was not correlated with FMDBA in ML/O men (r<0.01, p=0.85). There was a significant difference in this relation between sexes (p=0.04). Stepwise linear regression identified CVR and body mass index (BMI), but not age, blood pressures, LDL and HDL cholesterol, triglycerides or glucose, as significantly related to FMD­BA in PM women; correcting for BMI strengthened the relation between CVR and FMDBA in PM women (r=0.62, p<0.01). In contrast, only plasma LDL cholesterol and triglycerides were significantly related to FMD­BA in ML/O men. There were no relations between CVR and cognitive function in PM women (all p>0.05). In men there was a significant positive relation between CVR and the picture vocabulary test measure of language (r=0.56, p<0.01), but no other measures of cognitive function (all p>0.05). Conclusions These findings suggest cerebrovascular function is associated with peripheral vascular endothelial function in PM women, but not ML/O men, while cerebrovascular function has no to minimal relation to cognitive function in these groups. Controlling for BMI increased the strength of the relation between CVR and FMD­BA in PM women, indicating that body composition may be an important factor influencing cerebrovascular function in these women.

Late Menarche, Not Reproductive Period, Is Associated with Poor Cognitive Function in Postmenopausal Women in Taiwan.

Female sex hormones such as estrogen and progesterone play an important role in the regulation of a woman’s body, including cognition and neurogenesis. However, the effects of age at menarche and reproductive period on cognitive function are still controversial. The aim of this study was to investigate the relationships between age at menarche and reproductive period with cognitive impairment. Data were obtained from the Taiwan Biobank. Cognitive function was assessed using the Mini Mental State Examination (MMSE) and its five subdomains. Multivariable linear regression analysis revealed that an old age at menarche (per one year; coefficient β, −0.189; p = 0.020) was significantly associated with a low total MMSE score, whereas reproductive period (p = 0.733) was not significantly associated with total MMSE score. Furthermore, an old age at menarche was significantly associated with low MMSE G2 (registration) (per one year; coefficient β, −0.022; p = 0.035) and G5 (language, construction and obey) scores (per one year; coefficient β, −0.054; p = 0.047). However, age at menarche was not significantly associated with MMSE G1 (orientation), G3 (attention and calculation) and G4 (recall) scores. In addition, reproductive period was not significantly associated with any MMSE subscores. Late menarche was associated with poor cognitive function, including low total MMSE score and low MMSE G2 and G5 scores. However, reproductive period was not associated with cognitive function in postmenopausal women.

Abstract PS9-71: The effect of using adjuvant aromatase inhibitors on cognitive functions in postmenopausal women with hormone receptor-positive breast cancer

Abstract Background:Aromatase inhibitors (AIs) are used for the adjuvant treatment of early breast cancer. Although generally well-tolerated, they have some adverse effects. Because of AIs are used long term in adjuvant treatment, side effects are also very important. Preclinical and a little clinic data indicate that estrogens exert neurotrophic and neuroprotective actions in the brain. So estrogen appears to play an important role in cognitive function and memory. We know that AIs reduce circulating estrogen to very low levels. For this reason, there has been concern that these agents may have a negative effect on cognitive functions. However, this situation is still unclear. The purpose of our study is to evaluate the relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy. Methods:Patients diagnosed with breast cancer who use AIs as adjuvant treatment and followed up at the Akdeniz University Medical Oncology Clinic were included. The patients were surveyed for demographic characteristics. Montreal Cognitive Assessment (MoCA) and Standardized Mini-Mental State Examination (SMMT) tests were applied to patients by the same investigator to evaluate their cognitive functions. The total scores of the tests and the orientation, naming, short-time memory, visuospatial functions-executive functions, attention, abstract thinking, language which are the MoCA subscales were evaluated separately. In the Turkish population, the normal range of the MoCA and SMMT tests are 21-30 points and 24-30 points, respectively. Patients were grouped as 0-6, 6-12, 12-24, 24-36, 36 and more months according to the duration of AIs using time. 200 patient’s data were analyzed with SPSS package program. This study was approved by the Akdeniz University Faculty of Medicine Clinical Research Ethnics Committee and was conducted in accordance with declaration of Helsinki. Results:The median follow-up time was 55.5 months. The median duration of AIs treatment was 36.5 months. The mean age of patients was 61.3 years-old. There was no relationship between duration of treatment and MoCA and SMMT scores which indicates cognitive functions (p&amp;gt;0.05). In addition, no statistically relationship was found in the evaluation of MoCA subscales (p&amp;gt;0.05). As expected, the total MoCA and SMMT scores were affected by factors such as age, education level, and employment status. Interestingly, although it was not our main purpose, a causal relationship between the presence of hypertension and cognitive decline was shown in our study (p: 0.004). A statistically strong correlation was found between the MoCA and SMMT scores. So, our data are reliable. The duration of treatment with AIs and MoCA and SMMT scores of the patients were given in Table 1. Conclusions:As a result, despite conflicting results in the literature, we showed with 200 patients that adjuvant treatment with AIs does not affect cognitive functions in post-menopausal hormone receptor-positive breast cancer patients. Table 1: Relationship between the duration of treatment with AIs and MoCA and SMMT scoresDuration of AInMoCA*Mean±SDMoCAMed (min-max)SMMT**Mean±SDSMMTMed (min-max)0-6 m2319,7±5,221 (10-26)25±425 (15-30)6-12 m2420,7±5,421,5 (8-28)24,7±3,624 (16-30)12-24 m1418,2±4,118,5 (13-27)24,3±425 (13-29)24-36 m2920,3±4,920 (11-29)24,1±3,225 (17-30)36 m and more11020,3±4,521 (8-29)25±3,225 (14-30)Total20020.1±4,721 (8-29)24,8±3,425 (13-30)AI: Aromatase inhibitors, m: Mounths, n: Number, MoCA: Montreal Cognitive Assessment, SMMT: Standardized Mini-Mental State Examination, SD: Standart Deviation, Med: Median*p: 0.550 **p:0.533 Citation Format: Rukiye Guler Ilhan, Yusuf Ilhan, Sema Sezgin Goksu, Ali Murat Tatli, Hasan Senol Coskun. The effect of using adjuvant aromatase inhibitors on cognitive functions in postmenopausal women with hormone receptor-positive breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-71.

A Comparative Study of Memory, Attention, Cognition and Oestradiol in Pre and Postmenopausal Women in Bangladesh

Memory, attention, and cognitive dysfunction are psychopathological conditions which most commonly occur after menopause. Different clinical studies revealed a shred of substantial evidence that oxidative stress and estrogen are interlinked in various cognitive dysfunction, including memory impairment, age-related dementia, and Alzheimer's disease. There is a higher chance of developing cardiovascular disease after menopause. Sharp declines in concentrations of circulating estradiol and estrone are associated with menopause. Estrogen replacement therapy (ERT) enhances the blood circulation to the hippocampus and cortex, providing the optimum environment for the growth and survival of cholinergic neurons. Hence, it improves hippocampal neuron density and ultimately contributes to synaptic plasticity in the hippocampus enhances short and long-term memory. In this study, we assessed memory, attention, and cognition function between pre- and post-menopausal groups. After preliminary screening and applying exclusion criteria, fifteen premenopausal women and fifteen postmenopausal women were finally selected. Different neuropsychological tests such as logical memory test, digit span test, letter cancellation test, trail making test and Stroop test were performed to evaluate the memory, attention, and cognition status. Blood estradiol level was also assessed by using commercial kits. Significant difference (p&lt;0.05) was found in LM-II in logical memory test, digit span test (backward), letter cancelation test, TMT-B in trail making test, the score of part C in stroop test between premenopausal and postmenopausal women. Serum oestradiol concentration (pg/ml) was significantly lower (p&lt;0.001) in postmenopausal women (44.18±10.52) than premenopausal women (175.48 ± 43.20). The current study demonstrates the memory decline and cognitive dysfunction in postmenopausal women and there is a significant difference in estradiol level between pre and postmenopausal women. Estrogen has many neurotrophic actions in the brain and helps to improve memory and cognition. Therefore, estrogen replacement therapy, dietary supplements or a drug having an agonistic effect on estrogen receptors might improve the status of memory, attention, and cognitive function in postmenopausal women. Bangladesh Pharmaceutical Journal 24(1): 26-32, 2021

Effect of interactions between APOE and ESR1 polymorphisms on cognitive functions in postmenopausal women.

IntroductionDuring menopause the level of estrogens is decreased, which may lead to cognitive impairment or dementia. Some forms of genetic polymorphism were found to be related to cognitive functions, including APOE and ESR1 (PvuII and XbaI) polymorphisms. In the present study we aimed to analyze the impact of interactions between APOE and ESR1 polymorphisms on cognitive functions in the group of postmenopausal women.Material and methodsThe study group consisted of 266 postmenopausal women aged 50–65 years without symptoms of dementia. A computerized battery of the Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. APOE and ESR1 polymorphisms were genotyped using multiplex PCR and PCR-RFLP methods, respectively. Statistical analysis was performed using two-way analysis of variance in Statistica software.ResultsThe best memory, visual memory, processing and psychomotor speeds were found in women carrying the C allele of the PvuII polymorphism (TC + CC genotypes) in the presence of the APOE ε2/ε3 genotype, while a lower outcome was noted in women with ε3/ε3, and the lowest if they had the ε4 allele. In the case of women with TT genotype of the PvuII polymorphism, cognitive functioning did not decrease in women with the ε4 allele. A similar effect on cognitive functions was observed for AG + GG genotypes of the XbaI and APOE polymorphisms. Women who simultaneously carried CC PvuII and GG XbaI genotypes had the lowest cognitive functions.ConclusionsInteractions of polymorphic variants of APOE and ESR1 genes influenced cognitive functions in postmenopausal women.

Physical activity, cardiorespiratory fitness, and cognitive function in postmenopausal women with breast cancer.

Physical activity may improve cognitive function in women with breast cancer. In a cross-sectional study, we explored the relationship between cognitive function and physical activity (actigraph) and cardiorespiratory fitness (sub-maximal graded exercise test) in 73 postmenopausal women with early stage breast cancer prior to the initiation of systemic adjuvant therapy. Cognitive function was assessed with a standardized battery of neurocognitive measures assessing eight domains. Data were analyzed using partial correlations, controlling for age and total hours of actigraph wear-time. Women were, on average, 63.71 (± 5.3) years of age with 15.47 (± 2.48) years of education. For physical activity, greater average number of steps per day were associated with better attention (r = .262, p = .032) and psychomotor speed (r = .301, p = .011); greater average hours of moderate and moderate/vigorous intensity physical activity were associated with better visual memory (r = .241, p = .049; r = .241, p = .049, respectively); and greater average daily energy expenditure was associated with better visual memory (r = .270, p = .027) and psychomotor speed (r = .292, p = .017). For fitness, higher peak maximum VO2 was associated with better concentration (r = .330, p = .006), verbal memory (r = .241, p = .048), and working memory (r = .281, p = .019). These results suggest that higher levels of physical activity and cardiorespiratory fitness are associated with better cognitive function in postmenopausal women with breast cancer. Randomized controlled trials (RCT) to examine whether physical activity improves cognitive function in women with breast cancer are warranted. These RCTs should also determine the mechanisms of the influence of physical activity on cognitive function. CLINICAL TRIALS REGISTRATION NUMBER: NCT02793921; Date: May 20, 2016.

Long-term effects of resveratrol on cognition, cerebrovascular function and cardio-metabolic markers in postmenopausal women: A 24-month randomised, double-blind, placebo-controlled, crossover study

Ageing and menopause contribute to endothelial dysfunction, causing impaired cerebral perfusion, which is in turn associated with accelerated cognitive decline. In a 14-week pilot study, we showed that supplementation with low-dose resveratrol, a phytoestrogen that can enhance endothelial function, improved cerebrovascular and cognitive functions in postmenopausal women. We sought to confirm these benefits in a larger, longer-term trial. A 24-month randomized, placebo-controlled crossover trial was undertaken in 125 postmenopausal women, aged 45-85 years, who took 75mg trans-resveratrol or placebo twice-daily for 12 months and then crossover to the alternative treatment for another 12 months. We evaluated within individual differences between each treatment period in measures of cognition (primary outcome), cerebrovascular function in the middle cerebral artery (cerebral blood flow velocity: CBFV, cerebrovascular responsiveness: CVR) and cardio-metabolic markers as secondary outcomes. Subgroup analyses examined effects of resveratrol by life stages. Compared to placebo, resveratrol supplementation resulted a significant 33% improvement in overall cognitive performance (Cohen's d=0.170, P=0.005). Women ≥65 years of age showed a relative improvement in verbal memory with resveratrol compared to those younger than 65 years. Furthermore, resveratrol improved secondary outcomes including resting mean CBFV (d=0.275, P=0.001), CVR to hypercapnia (d=0.307, P=0.027), CVR to cognitive stimuli (d=0.259, P=0.032), fasting insulin (d=0.174, P=0.025) and insulin resistance index (d=0.102, P=0.034). Regular supplementation with low-dose resveratrol can enhance cognition, cerebrovascular function and insulin sensitivity in postmenopausal women. This may translate into a slowing of the accelerated cognitive decline due to ageing and menopause, especially in late-life women. Further studies are warranted to observe whether these cognitive benefits of resveratrol can reduce the risk of dementia.

Aortic Hemodynamics and Cognitive Performance in Postmenopausal Women: Impact of Pregnancy History.

BACKGROUNDStudies demonstrate an association between aortic hemodynamics and cognitive function. The impact of pregnancy history on this association is unknown.METHODSPostmenopausal women (age 59 ± 5 years; years since last pregnancy 35 ± 3) with either a history of preeclampsia (PE; n = 34) or a history of a normotensive pregnancy (NP; n = 30) underwent cognitive testing: Letter-Number Sequencing, Digit Span, Trail Making Test, and letter and category fluency. Applanation tonometry was used to derive aortic systolic and diastolic blood pressure and augmentation index.RESULTSDistribution of cognitive scores and aortic hemodynamic measures was similar between the PE and NP groups. Principal component (PC) analysis was used to reduce the 3 aortic hemodynamic measures and the 5 cognitive variables to single summary indices, each representing a weighted average of their respective constituent variables. Using a multivariable linear model based on these PCs that adjusted for pregnancy history and body mass index, the composite index of aortic hemodynamics was associated with the summary cognitive index, whether taking into account a potential interaction with pregnancy history (P = 0.035) or not (P = 0.026) (interaction P = 0.178). Multivariable modeling of individual cognitive tests revealed a differential association for letter fluency by pregnancy history (test for interaction P = 0.023); this score correlated with the aortic hemodynamic index in the PE (partial R2 = 0.20), but not the NP (partial R2 = 0.00) group.CONCLUSIONSElevated aortic hemodynamics may negatively impact cognitive function in postmenopausal women with specific executive functions, such as letter fluency, being impacted more by a pregnancy history of PE.

An Association Between Large Optic Nerve Cupping and Cognitive Function

To determine if a larger cup-to-disc ratiois associated with poor cognitive function in postmenopausal women without glaucoma or ocular hypertension. We used data from the Women's Health Initiative (WHI) hormone trial, originally designed to test effects of hormone therapy (HT) on various health outcomes. Large cup-to-disc ratio was defined as greater than 0.6 in either eye based on stereoscopic optic nerve photographs. Global cognitive function was assessed annually by Modified Mini-Mental State Examination (3MSE) in the WHI Memory Study. Exclusions were no information on optic nerve grading; no 3MSE scores at the time of the eye examination, ocular hypertension (intraocular pressure >23mm Hg, Goldmann applanation tonometry), or glaucoma medication use. A generalized linear model for log-transformed 3MSE scores was used for determining the association between large cup-to-disc ratio and 3MSE scores, adjusting for age, race, diabetes, body mass index, cardiovascular disease, smoking, HT randomization, education, and diabetic retinopathy. Analyses included 1636 women (mean age ± standard deviation, 69.57 ± 3.64 years; 90.39% white). Of those, 122 women had large cup-to-disc ratio. The mean 3MSE scores in women with vs without large cup-to-disc ratio were 95.4 ± 6 vs 96.6 ± 5. In the adjusted model, women with large cup-to-disc ratio had statistically significantly lower 3MSE scores, compared with those without large cup-to-disc ratio, yielding the predicted mean difference in 3MSE scores of 0.75 with a standard error of 0.05 units (P= .04). Postmenopausal women who had large cup-to-disc ratio without glaucoma or ocular hypertension exhibited lower global cognitive function. Further investigation is warranted. NOTE: Publication of this article is sponsored bythe American Ophthalmological Society.

Consumption of a soy drink has no effect on cognitive function but may alleviate vasomotor symptoms in post-menopausal women; a randomised trial

PurposeCognitive decline is commonly reported during the menopausal transition, with memory and attention being particularly affected. The aim of this study was to investigate the effects of a commercially available soy drink on cognitive function and menopausal symptoms in post-menopausal women.Methods101 post-menopausal women, aged 44–63 years, were randomly assigned to consume a volume of soy drink providing a low (10 mg/day; control group), medium (35 mg/day), or high (60 mg/day) dose of isoflavones for 12 weeks. Cognitive function (spatial working memory, spatial span, pattern recognition memory, 5-choice reaction time, and match to sample visual search) was assessed using CANTAB pre- and post-the 12 week intervention. Menopausal symptoms were assessed using Greene’s Climacteric Scale.ResultsNo significant differences were observed between the groups for any of the cognitive function outcomes measured. Soy drink consumption had no effect on menopausal symptoms overall; however, when women were stratified according to the severity of vasomotor symptoms (VMS) at baseline, women with more severe symptoms at baseline in the medium group had a significant reduction (P = 0.001) in VMS post-intervention (mean change from baseline score: − 2.15 ± 1.73) in comparison to those with less severe VMS (mean change from baseline score: 0.06 ± 1.21).ConclusionsSoy drink consumption had no effect on cognitive function in post-menopausal women. Consumption of ~ 350 ml/day (35 mg IFs) for 12 weeks significantly reduced VMS in those with more severe symptoms at baseline. This finding is clinically relevant as soy drinks may provide an alternative, natural, treatment for alleviating VMS, highly prevalent among western women.

Blood pressure variability and brain morphology in elderly women without cardiovascular disease.

To examine the relationship between blood pressure (BP) variability (BPV), brain volumes, and cognitive functioning in postmenopausal women with few modifiable cardiovascular risk factors. Study participants consisted of postmenopausal women enrolled in the Women's Health Initiative Memory MRI study (WHIMS-MRI) without cardiovascular disease, diabetes mellitus, hypertension, or current smoking at baseline (1996-1999). BP readings were taken at baseline and each annual follow-up visit. BPV was defined as the SD associated with a participant's mean BP across visits and the SD associated with the participant's regression line with BP regressed across visits. Brain MRI scans were performed between 2004 and 2006. Cognitive functioning was assessed at baseline and annually thereafter with the Modified Mini-Mental State Examination (3MSE) scoring until 2008. The final sample consisted of 558 women (mean age 69 years, median follow-up time [interquartile range] 8 [0.8] years). In adjusted models including mean systolic BP, women in the highest tertile of systolic BPV had lower hippocampal volumes and higher lesion volumes compared to women in the lowest tertile. No relationship between BPV and 3MSE scoring was detected. In postmenopausal women with few modifiable cardiovascular risk factors, greater visit-to-visit systolic BPV was associated with reductions in hippocampal volume and increases in lesion volumes at later life. These data add evidence to the emerging importance of BPV as a prognostic indicator even in the absence of documented cardiovascular risk factors.