The association of serum oestradiol level, age, and education with cognitive performance in peri- and late postmenopausal women

Objectives

To evaluate whether healthy women show cognitive changes after menopause and whether the possible changes are oestrogen-, age- or education-dependent.

Methods

Forty-eight women, 21 perimenopausal (aged 43–51 years) and 27 late postmenopausal (aged 59–71 years), participated in the study. Verbal and visuomotor functions, visuoconstructive skills, visual and verbal episodic memory as well as attention were evaluated.

Results

Perimenopausal women performed better than postmenopausal women. Serum oestradiol (E₂) level was included in the model in perimenopausal women only given the lack of endogenous oestrogen in postmenopausal women who were also not using hormone therapy (HT). In perimenopausal women, lower E₂ was associated with better visual episodic memory (p < .05), and older age was related to poorer verbal episodic memory (p < .05). In postmenopausal women, more education was associated with better performance in verbal and visuomotor functions, attention as well as verbal episodic memory (p < .05), older age was related to poorer performance in the visuoconstructive test and visual episodic memory (p < .05).

Conclusions

Perimenopausal women had better cognitive performance compared to late postmenopausal women. In perimenopausal women the effect of E₂ was minor. In both groups, age modified cognitive performance, but more so in postmenopausal women. Education did not have any effect on cognitive performance in perimenopausal women, whereas in postmenopausal women education exceeded age as a source of variation. Thus the relevance of education for better cognition was accentuated after menopause.     

Digitized assessment of mammographic breast density--effects of continuous combined hormone therapy, tibolone and black cohosh compared to placebo

Objectives

To determine the effects of continuous combined hormone therapy, tibolone, black cohosh, and placebo on digitized mammographic breast density in postmenopausal women.

Study design

A prospective, double-blind, placebo-controlled study of 154 postmenopausal women randomized to estradiol 2 mg/norethisterone acetate 1 mg (E2/NETA), tibolone 2.5 mg or placebo and a prospective, open, uncontrolled drug safety study, of which 65 postmenopausal women were treated with black cohosh. Mammograms, at baseline and after six months of treatment, were previously classified according to visual quantification scales.

Main outcome measures

Reanalysis of assessable mammograms by digitized quantification of breast density.

Results

Treatment groups were comparable at baseline. During treatment, both E2/NETA and tibolone significantly increased breast density (mean increase 14.3%, p < 0.001 and 2.3%, p < 0.001, respectively), while black cohosh and placebo did not. Twenty-four out of the 43 women on E2/NETA had an increase in density exceeding 10% and 6 women had an increase of 30% or more. In the tibolone group, only one woman had an increase in density of more than 10%. The difference in increase in breast density between E2/NETA on the one hand and tibolone, black cohosh and placebo on the other was highly significant (p < 0.0001).

Conclusions

Digitized mammographic breast density is a highly sensitive method confirming significant increase in density by standard E2/NETA treatment and to a lesser extent by tibolone, whereas black cohosh does not influence mammographic breast density during six months treatment. Digitized assessment also yields data on individual variation and small increases left undetectable by visual classification.     

Prospective evaluation of bone mineral density among middle-aged HIV-infected and uninfected women: Association between methadone use and bone loss

Objective

We undertook a prospective study to assess the impact of HIV infection on BMD in a cohort of HIV-infected and uninfected women that included illicit drug users, and to measure the contribution of traditional risk factors as well as HIV-related factors to loss of BMD over time.

Methods

We analyzed BMD at baseline and after ≥18 months in 245 middle-aged HIV-infected and 219 uninfected women, and conducted linear regression analysis to determine factors associated with annual BMD change at the femoral neck, total hip and lumbar spine.

Results

HIV-infected women had lower baseline BMD at the femoral neck and total hip compared with controls; unadjusted rates of BMD change did not differ by HIV status at any site. In multivariable analyses, we found that HIV seropositivity without protease inhibitor (PI) use was associated with BMD decline at the lumbar spine (−.009 g/cm² per year, p = .03). Additional factors associated with BMD decline were: postmenopausal status, lower BMI, and methadone use at the lumbar spine; postmenopausal status and hepatitis C seropositivity at the femoral neck; and postmenopausal status, age, smoking, and lower BMI at the total hip (all p < .05). Among HIV-infected women, ≥3 years of PI use was associated with an increase in lumbar spine BMD (.013 g/cm² per year, p = .008).

Conclusions

Bone loss among HIV-infected middle-aged women was modest, and possibly mitigated by PI use. Methadone use was associated with BMD decline, and should be considered when evaluating women for osteoporosis risk.     

The effects of motor learning on clinical isokinetic performance of postmenopausal women

Objective

To analyze the effects of motor learning on knee extension–flexion isokinetic performance during clinical isokinetic evaluation of postmenopausal women.

Methods

One-hundred and twenty postmenopausal women (60.3 ± 3.2 years; BMI = 27.6 ± 4.7 kg/m²) without knee pain or injury and that never underwent isokinetic testing, were submitted to two bilateral knee extension–flexion (concentric–concentric) isokinetic evaluation (5 repetitions) at 60°/s (Biodex™ Multi-Joint System 3 dynamometer). The tests were first performed in the dominant leg, with a 1-min recovery between them, and after a standardized warm-up that included 3 submaximal isokinetic repetitions. The same procedure was repeated in the non-dominant leg. Peak torque (PTQ) was adjusted for body weight (PTQ/BW), total work (TW), coefficient of variation (CV) and agonist/antagonist (agon/antag) ratio was compared between tests.

Results

Subjects showed greater levels (P < 0.001) of PTQ, PTQ/BW and TW, and lower CV levels (P < 0.01) in test 2 of both legs. Agon/antag ratio did not change significantly between tests.

Conclusions

PTQ, PTQ/BW, TW and CV improved in the second knee extension flexion isokinetic testing of postmenopausal women. The results suggests that performing two tests, even with a short period of recovery between them, could be considered for reducing motor learning effects on clinical isokinetic evaluation of knee joint in postmenopausal women.     

Working Memory and New Learning Following Pediatric Traumatic Brain Injury

Working memory (WM), the ability to monitor, process and maintain task relevant information on-line to respond to immediate environmental demands, is controlled by frontal systems (D'Esposito et al., 2006 D'Esposito, M., Cooney, J. W., Gazzaley, A., Gibbs, S. E. and Postle, B. R. 2006. Is the prefrontal cortex necessary for delay task performance? Evidence from lesion and fMRI data.. Journal of the International Neuropsychological Society, 12: 248–260.  [Google Scholar]), which are particularly vulnerable to damage from a traumatic brain injury (TBI). This study employed the adult-based Working Memory model of Baddeley and Hitch (1974) Baddeley, A. D. and Hitch, G. 1974. “Working memory”. In The psychology of learning and motivation, Vol. VIII Edited by: Bower, G. H. 47–90. New York: Academic Press. [Crossref] , [Google Scholar] to examine the relationship between working memory function and new verbal learning in children with TBI. A cross-sectional sample of 36 school-aged children with a moderate to severe TBI was compared to age-matched healthy Controls on a series of tasks assessing working memory subsystems: the Phonological Loop (PL) and Central Executive (CE). The TBI group performed significantly more poorly than Controls on the PL measure and the majority of CE tasks. On new learning tasks, the TBI group consistently produced fewer words than Controls across the learning and delayed recall phases. Results revealed impaired PL function related to poor encoding and acquisition on a new verbal learning task in the TBI group. CE retrieval deficits in the TBI group contributed to general memory dysfunction in acquisition, retrieval and recognition memory. These results suggest that the nature of learning and memory deficits in children with TBI is related to working memory impairment.     

Estrogen therapy selectively enhances prefrontal cognitive processes: a randomized, double-blind, placebo-controlled study with functional magnetic resonance imaging in perimenopausal and recently postmenopausal women

OBJECTIVE: Estrogen therapy (ET) seems to differentially effect cognitive processes in younger versus older postmenopausal women, suggesting a window of opportunity when ET is most beneficial. Cognitive improvement in younger postmenopausal women has been attributed to ET's influence on hot flushes and sleep, but empiric examination of the mediating role of menopause symptoms versus direct effects of ET on the brain is limited. DESIGN: In a double-blind trial, 52 women were randomly assigned to estradiol 0.05 mg/day (n = 26) or placebo transdermal patches (n = 26) for 12 weeks. Women completed tests of memory, learning, and executive functioning, and hot flush and sleep assessments at baseline and study end. A subset of women (five ET treated, six placebo treated) also underwent blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) studies. RESULTS: Nondepressed perimenopausal and postmenopausal women were studied. The majority had hot flushes and sleep impairment. Compared with placebo, ET selectively reduced errors of perseveration during verbal recall (P = 0.03), a frontal system-mediated function, but did not influence other cognitive processes. Women with baseline hot flushes had greater cognitive benefit with ET (P < 0.05). Cognitive benefit was not associated with sleep problems or its improvement. Measures of fMRI BOLD activation during tests of verbal and spatial working memory showed significant increases in frontal system activity with ET (P < 0.001). CONCLUSIONS: Estrogen therapy selectively improves executive functioning as demonstrated by reduced perseverative errors and prefrontal cortex activation during verbal recall tasks. Cognitive improvement with ET is associated with hot flushes, but not with sleep, suggesting that ET has a direct central nervous system effect, rather than an indirect effect mediated through improvement of sleep.     

Serum levels of ischemia modified albumin in overweight/obese postmenopausal women: a potential biomarker of atherosclerotic burden associated with oxidative stress

Objective

Menopause is associated with weight gain and an increase of cardiovascular risk. The aim of the present study was to estimate serum ischemia-modified albumin (IMA) levels in postmenopausal women and evaluate their association with body mass index (BMI) and coronary artery disease (CAD).

Methods

The study included 130 non-smoker postmenopausal women aged 43–80: 40 with BMI 26–32 kg/m² (Group A), 60 with BMI 21–25 kg/m² (Group B), and 30 with documented CAD and BMI 23–29 kg/m² (Group C). Serum IMA, albumin, hsCRP and NT-proBNP, glucose and insulin were measured. Homeostasis assessment model score (HOMA) and Quantitative insulin sensitivity index (QUICKI) were co-estimated.

Results

Serum IMA and IMA to albumin ratio were significantly elevated in Group A as compared to Group B (p < 0.001) and similar to those of Group C. hsCRP and NT-proBNP did not differ between Groups A and B while they were lower in comparison to Group C (p < 0.001). Glucose, insulin and HOMA were elevated in Group A compared to Group B (p < 0.001) while QUICKI was lower (p < 0.001). In Group A, IMA was positively correlated with BMI, hsCRP, insulin, HOMA and negatively with QUICKI. In postmenopausal women, multivariable regression analysis revealed that obesity was the strongest significant determinant of circulating IMA levels (p < 0.001) contributing, therefore, to the elevated serum IMA concentration.

Conclusions

Postmenopausal obesity is associated with elevated serum IMA possibly due to obesity associated oxidative stress. IMA measurement could provide an assessment of atherosclerotic burden in postmenopausal women. Further clinical evaluation is under investigation.     

Verbal episodic memory deficits in remitted bipolar patients: A combined behavioural and fMRI study

Background

Episodic memory deficits affect the majority of patients with bipolar disorder (BD).

Aims

The study investigates episodic memory performance through different approaches, including behavioural measures, physiological parameters, and the underlying functional activation patterns with functional neuroimaging (fMRI).

Methods

26 Remitted BD patients and a matched group of healthy controls underwent a verbal episodic memory test together with monitored autonomic response, psychopathological ratings and functional magnetic resonance imaging (fMRI) during the verbal episodic memory test.

Results

Compared to healthy controls, BD patients performed significantly worse during the episodic memory task. The results further indicate that verbal episodic memory deficits in BD are associated with abnormal functional activity patterns in frontal, occipital and limbic regions, and an increase in stress parameters.

Limitations

We aimed to minimise sample heterogeneity by setting clear criteria for remission, based on the scores of a depression (BDI II) and mania scale (BRMAS) and on the DSM IV criteria. However, our patients were not symptom-free and scored higher on BDI II scores than the control group.

Conclusions

The results are of interest for the treatment of cognitive symptoms in BD patients, as persistent cognitive impairment may hamper full rehabilitation.     

Effects of Sleep Deprivation on Dissociated Components of Executive Functioning

Study Objectives:

We studied the effects of sleep deprivation on executive functions using a task battery which included a modified Sternberg task, a probed recall task, and a phonemic verbal fluency task. These tasks were selected because they allow dissociation of some important executive processes from non-executive components of cognition.

Design:

Subjects were randomized to a total sleep deprivation condition or a control condition. Performance on the executive functions task battery was assessed at baseline, after 51 h of total sleep deprivation (or no sleep deprivation in the control group), and following 2 nights of recovery sleep, at fixed time of day (11:00). Performance was also measured repeatedly throughout the experiment on a control task battery, for which the effects of total sleep deprivation had been documented in previously published studies.

Setting:

Six consecutive days and nights in a controlled laboratory environment with continuous behavioral monitoring.

Participants:

Twenty-three healthy adults (age range 22–38 y; 11 women). Twelve subjects were randomized to the sleep deprivation condition; the others were controls.

Results:

Performance on the control task battery was considerably degraded during sleep deprivation. Overall performance on the modified Sternberg task also showed impairment during sleep deprivation, as compared to baseline and recovery and compared to controls. However, two dissociated components of executive functioning on this task—working memory scanning efficiency and resistance to proactive interference—were maintained at levels equivalent to baseline. On the probed recall task, resistance to proactive interference was also preserved. Executive aspects of performance on the phonemic verbal fluency task showed improvement during sleep deprivation, as did overall performance on this task.

Conclusion:

Sleep deprivation affected distinct components of cognitive processing differentially. Dissociated non-executive components of cognition in executive functions tasks were degraded by sleep deprivation, as was control task performance. However, the executive functions of working memory scanning efficiency and resistance to proactive interference were not significantly affected by sleep deprivation, nor were dissociated executive processes of phonemic verbal fluency performance. These results challenge the prevailing view that executive functions are especially vulnerable to sleep loss. Our findings also question the idea that impairment due to sleep deprivation is generic to cognitive processes subserved by attention.

Citation:

Tucker AM; Whitney P; Belenky G; Hinson JM; Van Dongen HPA. Effects of sleep deprivation on dissociated components of executive functioning. SLEEP 2010;33(1):47-57.     

Effect of temporal lobe structure volume on memory in elderly depressed patients

Objective

To compare the volume of the hippocampus and parahippocampal gyrus in elderly individuals with and without depressive disorders, and to determine whether the volumes of these regions correlate with scores on memory tests.

Method

Clinical and demographic differences, as well as differences in regional gray matter volumes, were assessed in 48 elderly patients with depressive disorders and 31 control subjects. Brain (structural MRI) scans were processed using statistical parametric mapping and voxel-based morphometry. Cognitive tests were administered to subjects in both groups.

Results

There were no between-group gray matter volume differences in the hippocampus or parahippocampal gyrus. In the elderly depressed group only, the volume of the left parahippocampal gyrus correlated with scores on the delayed naming portion of the visual-verbal learning test. There were also significant direct correlations in depressed subjects between the volumes of the left hippocampus, right and left parahippocampal gyrus and immediate recall scores on verbal episodic memory tests and visual learning tests. In the control group, there were direct correlations only between overall cognitive performance (as assessed with the MMSE) and the volume of right hippocampus, and between the total score on the visual-verbal learning test and the volume of the right and left parahippocampal gyrus.

Conclusions

These findings highlight different patterns of relationship between cognitive performance and volumes of medial temporal structures in depressed individuals and healthy elderly subjects. The direct correlation between delayed visual-verbal memory recall scores with left parahippocampal volumes specifically in elderly depressed individuals provides support to the view that depression in elderly populations may be a risk factor for dementia.     

A comparison of the effects of oral conjugated equine estrogen and transdermal estradiol-17β combined with an oral progestin on quality of life in postmenopausal women

Objective:

To compare the effect of transdermal estradiol-17β and oral conjugated equine estrogen when combined with an oral progestin on quality of life in post-menopausal women. Design: Randomized controlled double-blind trial. A randomization error lead to the exclusion of six subjects but the soundness of the remaining randomization was confirmed. Setting: Large urban community. Patients: Women 2–7 years after menopause with a uterus and ovaries, and not currently using hormone replacement therapy. Seventy-four women completed the trial. Interventions: After baseline measures of quality of life, subjects were randomly assigned to either continuous oral conjugated equine estrogen 0.625 mg daily or continuous transdermal estradiol-17β 50 mcg twice weekly, for four 4-week cycles. Medroxyprogesterone acetate 10 mg oral tablets was administered to both groups for the last 12 days of each cycle.

Outcomes measured:

Quality of life was determined using the Menopause-Specific Quality of Life Questionnaire. Tolerability was determined by a specifically designed list of adverse effects. Both measures were recorded at base-line and in mid-cycle during the second, third and fourth cycles of treatment.

Results:

There were no statistically significant differences in any of the domains at baseline between the oral and transdermal treatment groups. In the vasomotor domain, scores for the oral and transdermal groups improved from baseline levels of 3.14 and 3.09, respectively, to 1.32 and 1.23; physical domain scores improved from 2.45 and 2.73 to 2.04 and 1.78; psychosocial domain scores improved from 2.72 and 3.04 to 2.21 and 1.94; sexual domain scores improved from 2.32 and 2.16 to 1.64 and 1.30. There were no statistically significant group differences or time/group interactions. Both forms of therapy were equally well tolerated.

Conclusions:

Improvement in all domains, measured by the Menopause-Specific Quality of Life Questionnaire, was observed in both the oral and transdermal groups. In the absence of a placebo control group, the improvements observed cannot be attributed solely to the therapy. Neither form of therapy offered an advantage over the other in respect to improvement in quality of life.     

The association of serum C-reactive protein, uric acid and magnesium with insulin resistance in Chinese postmenopausal women with prediabetes or early untreated diabetes

Objectives

This study aimed to evaluate the association of serum inflammatory markers (C-reactive protein (CRP) and uric acid (UA)), magnesium and other CVD risk factors with insulin resistance (IR) among Chinese postmenopausal women with prediabetes.

Study design and main outcomes measures

This is a cross-sectional analysis of baseline data among 180 postmenopausal women with prediabetes or early untreated diabetes. Major anthropometric and biochemical measures included body mass index (BMI), waist to hip ratio (WHR), fasting and postload glucose and insulin, serum CRP, UA, lipids profile, and magnesium. IR was estimated using fasting glucose and insulin by homeostasis model assessment (HOMA).

Results

Multivariate linear regression analyses indicated that Lg CRP, WHR, serum triglycerides (TGs) and magnesium were the major predictors of HOMA-IR. A multivariate logistic analyses showed that a CRP level above 3.0 mg/l was significantly associated with a 2.8-fold risk of having higher HOMA-IR (>2.52). BMI plays a key role in mediating the relationship of CRP and IR. Elevated serum TG (>1.71 mmol/l), WHR (>0.88), UA (>357 mmol/l) and lower serum magnesium (<0.78 mg/l) were associated with 5.26 (95%CI: 2.52–10.98, P < 0.05), 3.02 (95%CI: 1.64–5.55, P < 0.05), 1.97 (95%CI: 1.02–3.83, P = 0.05) and 0.51 (95%CI: 0.28–0.81) folds risk of higher HOMA-IR, respectively in the unadjusted model. Serum magnesium, but not UA was an independent risk factor of HOMA-IR.

Conclusion

The present study in prediabetic or early untreated diabetic Chinese postmenopausal women indicated that IR is significantly associated with increased inflammation (CRP and UA), serum TG, WHR and lower serum magnesium.     

Is sleep‐related verbal memory consolidation impaired in sleepwalkers?

In order to evaluate verbal memory consolidation during sleep in subjects experiencing sleepwalking or sleep terror, 19 patients experiencing sleepwalking/sleep terror and 19 controls performed two verbal memory tasks (16‐word list from the Free and Cued Selective Reminding Test, and a 220‐ and 263‐word modified story recall test) in the evening, followed by nocturnal video polysomnography (n = 29) and morning recall (night‐time consolidation after 14 h, n = 38). The following morning, they were given a daytime learning task using the modified story recall test in reverse order, followed by an evening recall test after 9 h of wakefulness (daytime consolidation, n = 38). The patients experiencing sleepwalking/sleep terror exhibited more frequent awakenings during slow‐wave sleep and longer wakefulness after sleep onset than the controls. Despite this reduction in sleep quality among sleepwalking/sleep terror patients, they improved their scores on the verbal tests the morning after sleep compared with the previous evening (+16 ± 33%) equally well as the controls (+2 ± 13%). The performance of both groups worsened during the daytime in the absence of sleep (?16 ± 15% for the sleepwalking/sleep terror group and ?14 ± 11% for the control group). There was no significant correlation between the rate of memory consolidation and any of the sleep measures. Seven patients experiencing sleepwalking also sleep‐talked during slow‐wave sleep, but their sentences were unrelated to the tests or the list of words learned during the evening. In conclusion, the alteration of slow‐wave sleep during sleepwalking/sleep terror does not noticeably impact on sleep‐related verbal memory consolidation.     

Isoflavones and cognitive function in older women: the SOy and Postmenopausal Health In Aging (SOPHIA) Study

OBJECTIVE: This study examines the effects of a dietary supplement of isoflavones on cognitive function in postmenopausal women. DESIGN: Participants for this 6-month, double-blind, randomized, placebo-controlled clinical trial were women who were in good health, were postmenopausal at least 2 years, and were not using estrogen replacement therapy. Between July 24, 2000, and October 31, 2000, 56 women aged 55 to 74 years were randomized; 2 in the placebo group and 1 in the active treatment group did not complete the 6-month evaluation, and none withdrew because of adverse effects. Women randomized to active treatment (n = 27) took two pills per day, each containing 55 mg of soy-extracted isoflavones (110 mg total isoflavones per day; Healthy Woman: Soy Menopause Supplement, Personal Products Company, McNeil-PPC Inc., Skillman, NJ, USA). Women assigned to placebo (n = 26) took two identical-appearing pills per day containing inert ingredients. Cognitive function tests administered at baseline and follow-up included the following: Trails A and B, category fluency, and logical memory and recall (a paragraph recall test assessing immediate and delayed verbal memory). RESULTS: At baseline, all women were cognitively intact; there were no significant differences by treatment assignment in age, education, depressed mood, or cognitive function (all P values > 0.10). Compliance was 98% and 97%, respectively, in the placebo and treatment groups; all women took at least 85% of their pills. The women in the treatment group did consistently better, both as compared with their own baseline scores and as compared with the placebo group responses at 6 months. Comparisons of percentage change in cognitive function between baseline and follow-up showed greater improvement in category fluency for women on active treatment as compared with the case of those on placebo (P = 0.02) and showed (nonsignificantly) greater improvement on the two other tests of verbal memory and Trails B. CONCLUSION: These results suggest that isoflavone supplementation has a favorable effect on cognitive function, particularly verbal memory, in postmenopausal women.     

Zinc,vitamin A,and glutamine supplementation in Brazilian shantytown children at risk for diarrhea results in sex-specific improvements in verbal learning

OBJECTIVE:

To identify the impact of supplemental zinc, vitamin A, and glutamine, alone or in combination, on long-term cognitive outcomes among Brazilian shantytown children with low median height-for-age z-scores.

METHODS:

A randomized, double-blind, placebo-controlled trial was conducted in children aged three months to nine years old from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for cognitive testing (total of 167 children) were: (1) placebo, n = 25; (2) glutamine, n = 23; (3) zinc, n = 18; (4) vitamin A, n = 19; (5) glutamine+zinc, n = 20; (6) glutamine+vitamin A, n = 21; (7) zinc+vitamin A, n = 23; and (8) glutamine+zinc+vitamin A, n = 18. Neuropsychological tests were administered for the cognitive domains of non-verbal intelligence and abstraction, psychomotor speed, verbal memory and recall ability, and semantic and phonetic verbal fluency. Statistical analyses were performed using SPSS, version 16.0. ClinicalTrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT00133406","term_id":"NCT00133406"}}NCT00133406.

RESULTS:

Girls receiving a combination of glutamine, zinc, and vitamin A had higher mean age-adjusted verbal learning scores than girls receiving only placebo (9.5 versus 6.4, p = 0.007) and girls receiving zinc+vitamin A (9.5 versus 6.5, p = 0.006). Similar group differences were not found between male study children.

CONCLUSIONS:

The findings suggest that combination therapy offers a sex-specific advantage on tests of verbal learning, similar to that seen among female patients following traumatic brain injury.     

Sleep benefits emotional and neutral associative memories equally

Background

Emotions modulate memory. It has been suggested that sleep contributes to improved memory of emotional events by preferentially consolidating emotional memories, presumably because of a selective off-line reactivation of information relevant to future behavior.

Objectives

We aimed to validate sleep-dependent memory consolidation in a new associative emotional memory paradigm suitable for inducing memory reactivations during sleep. We hypothesized that sleep preferentially might benefit the consolidation of emotional associations independently of their negative vs positive emotional valence.

Methods

Seventy-two healthy young participants performed an associative emotional memory task in either the evening or the morning. During the task, they were asked to associate neutrally spoken words to neutral, negative or positive pictures. Cued recall was tested after a 12-h retention interval filled with either night-time sleep or daytime wakefulness.

Results

Generally, emotional associations were better remembered than neutral ones. However, we were not able to replicate a selective benefit of sleep on emotional memory. Sleep robustly improved the cued recall performance of all picture types compared with wakefulness, without any modulating influence of emotional arousal or valence.

Conclusions

We conclude that the consolidation of explicitly learned associations benefits from sleep, independent of emotional arousal or valence. Selective emotional memory consolidation during sleep may be restricted to non-associative item memory or incidentally learned emotional associations.

     

Process outcomes from a randomized controlled trial comparing tailored mammography interventions delivered via telephone vs. DVD

Objective

Tailored, interactive mammography-promotion interventions can increase adherence if women are exposed to and find them usable. We compare exposure to and usability of interventions delivered via telephone vs. DVD.

Methods

Process evaluation measures from 926 women randomly assigned to telephone or DVD intervention and completing post-intervention surveys.

Results

∼83% of each group reported exposure to all content. Partial exposure was higher for DVD (9% vs. 0.4%; p < .01); no exposure was higher for phone (15% vs. 8%; p < .01). There were no differences in exposure by age or race. Full phone exposure was less likely for women who already made mammography appointments. Usability rating was higher for DVD (p < .05), driven by ratings of understandability and length. Usability of both interventions was correlated with lower baseline barriers, and higher fear, benefits, and self efficacy. Higher ratings for phone were associated with lower knowledge and contemplating mammography. Non-whites rated DVD better than whites.

Conclusion

Both tailored interactive interventions had wide reach and favorable ratings, but DVD recipients had greatest exposure to at least partial content and more favorable ratings, especially among non-white women.

Practice implications

This first evaluation of a tailored, interactive DVD provides promise for its use in mammography promotion.     

Estrogen replacement therapy and cognitive functions in healthy postmenopausal women: a randomized trial

This study aimed to evaluate the effect of estrogen replacement therapy on verbal cognitive performance of middle-aged postmenopausal women. Middle-aged (40 to 59 years) hysterectomized, oligosymptomatic women receiving 0.625 mg/day of conjugated equine estrogens (N = 27) or placebo (N = 32) in a double-blind parallel group design were compared according to their performance on a verbal memory battery before and after six 28-day cycles of treatment. Both groups had similar age and educational level. The estrogen group performed better on digit span-forward and on the recall of the easy stimuli on the verbal-paired associates test regardless of age, education, physical symptoms, number of years of menopause, or blood estradiol levels. However, the small magnitude of difference in the effect on attentional span suggests that the estrogen-related improvement is unlikely to be of clinical relevance. Estrogen replacement therapy did not improve verbal memory in middle-aged, hysterectomized, postmenopausal, asymptomatic women.