The effects of 3-week estrogen hormone replacement on cognition in elderly healthy females.

RATIONALE: Estrogen concentrations decline with age and menopause is often followed by an acceleration of the age effects on cognition. It is suggested that replacement of estrogen would reinstate, at least in part, cognitive abilities. Effects of estrogens on memory have been reported in studies with women in a clinical setting who either needed or wished to have the estrogen replacement and are mostly in the perimenopausal age-band. OBJECTIVE: The present study investigated the effects of estradiol on memory and on frontal lobe function in elderly female subjects who did not suffer any of the postmenopausal symptoms and had never taken estrogen hormone replacement (EHR) previously. METHODS: EHR (Progynova TS, transdermal estradiol; n=19) or placebo (n=18) was given for a period of 3 weeks to elderly healthy female subjects. Memory, frontal lobe functions (inhibition and planning) and visuospatial abilities (mental rotation) were tested before and after treatment. Estrogen plasma levels were measured to confirm the result of EHR. Cortisol plasma levels were also measured before and after cognitive performance in order to evaluate the effects of EHR on the sensitivity of the hypothalamo-pituitary-adrenal (HPA) axis to mild mental stress. RESULTS: Plasma estradiol levels in the drug group increased to levels equivalent to that of a fertile woman (0.21+/-0.5 nmol/l). Memory function as well as visuospatial abilities as measured by a mental rotation task improved significantly with EHR. However, there was no effect of EHR on frontal lobe functions. The cognitive effects were not dependent on an improvement in mood or general well-being as may be the case with EHR in women at peri- or post-menopausal stage. EHR was found to increase the HPA response to task-induced stress, as indicated by an increase in cortisol plasma levels. CONCLUSIONS: The present study has provided evidence of a beneficial effect of EHR on cognitive abilities given for first time to healthy elderly women. Furthermore, the present study has demonstrated a differential effect of EHR on memory, visuospatial abilities and frontal lobe function.

Hemispheric lateralisation in a manual-verbal task combination: the role of modality and gender.

Differences in hemispheric lateralisation between males and females were tested using a manual-verbal task combination. The manual task was finger tapping and the verbal task required reciting words. Words were presented either visually or aurally in order to examine a possible role of modality of presentation on hemispheric lateralisation. The influence of the verbal task on motor task performance was evaluated by changes in the number of taps from single to dual-task condition. The influence of the motor task performance on the verbal task was examined by changes in the number of words recalled. Cognitive performance differences between males and females were also examined in a mental rotation task. The results showed a greater right finger (RH) tapping than left finger (LH) tapping interference, but only when the verbal task was presented in the visual mode. There was no difference in this pattern between males and females, both showing a greater RH tapping than LH tapping interference. The interference in finger tapping for both RH and LH was greater when the verbal task was presented aurally than when presented visually. Furthermore, females compared to males showed a greater interference in finger tapping when the verbal task was presented aurally than when presented visually. Later recall of verbal information was impaired equally by concurrent RH or LH tapping; however, later recall was better when the verbal task was presented visually than when presented aurally. No gender differences were found in delayed recall. Performance in the mental rotation task was better in males than in females. The data are discussed on the basis of theories of dual task interference and/or of brain asymmetry.

The influence of assertion training on three aspects of assertiveness in alcoholics.

This study examined three outcomes of assertion training considered relevant for alcoholics: (a) assertive behavior in negative situations; (b) discomfort in negative situations that call for assertive behavior; and (c) expectations of assertive behavior in sober vs. intoxicated states. Subjects were 38 male alcoholics in an inpatient treatment program. Although some behavioral competencies were acquired after assertion training, such training did not differentially reduce discomfort in negative situations or the discrepancy between perceptions of assertiveness in sober vs. intoxicated states at posttest or at 6-week follow-up.

Psychological symptoms in primary fibromyalgia syndrome: relationship to pain, life stress, and sleep disturbance.

Twenty-five subjects with primary fibromyalgia syndrome and 22 subjects with rheumatoid arthritis were compared on measures of psychological distress, pain, health status, life stress, sleep disturbance, and coping strategies. Higher levels of psychological distress were found in the primary fibromyalgia syndrome group, but the degree of life stress was shown to be a significant covariate.

Employment factors in outpatient recovery of alcoholics: a multivariate study.

This study examined the effects of patient and treatment variables on alcoholic outpatient recovery over a one year period. One-hundred-seventy-four subjects, dichotomized by age (less than or equal to 42 or greater than 42) and employment status (employed or unemployed), were randomly assigned to one of three treatment groups (medical check-up, medication, or multi-therapy). Seventy-eight percent of these subjects were available for follow-up. Dependent measures included neuropsychological functioning and subject ratings of mood and alcohol consumption. Statistical analysis was by a 2 X 3 X 2 MANOVA. Employment status was a significant variable relative to positive outcome changes on mood and neuropsychological functioning. Moreover, older employed alcoholics showed a significant reduction of confusion. No group differences were noted at outcome with respect to age or treatment. The implications of the results for conventional alcoholism outpatient treatment are discussed.