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Retrospective analysis: estrogen users fare better than nonusers on cognition.

MIAMI BEACH -- Postmenopausal estrogen users performed significantly better on computerized cognitive tests than nonusers, suggesting that the hormone may have a beneficial effect on cognition in some women, Joan Friebely, Ed.D., reported in a poster session at the annual meeting of the North American Menopause Society.

The finding of intact working memory and executive function support the hypothesis that estrogen may help protect cognition when administered to younger, healthy postmenopausal women like those in her retrospective analysis.

Other computerized tests of cognition have not examined similar populations. "We looked at healthy women who were within a relatively short time after their final menstrual period and who started using estrogen early, in that critical period before any [cognitive] damage was done," Dr. Friebely said in an interview.

Her analysis included data from two of her own prior studies. One study compared placebo and soy tablets in non-estrogen users who had hot flashes. The second study compared different hormone regimens.

Both studies used the same computerized tests, which included a continuous performance test of attention, a finger-tapping test of motor speed, and a switching attention test to measure working memory and executive function.

Estrogen users performed significantly better on every test than did nonusers. After adjustment for possible confounders, the difference in performance scores between the estrogen users and nonusers had a mean effect size of 1.13.

Effect size is the standardized difference between two means. An effect size of 0.2-0.3 is considered small, one of 0.3-0.7 is considered moderate, and one of 1.1 is considered large.

"Our results were quite large" and apparently uncompromised by healthy user bias, said Dr. Friebely, who is a researcher at Brigham and Women's Hospital, Boston.

"Very few studies show results with such a substantial effect size."


Mid-Atlantic Bureau
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Title Annotation:Clinical Rounds
Author:Sullivan, Michele G.
Publication:Internal Medicine News
Date:Mar 1, 2004
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