Posted by on September 24, 2010 - 2:47pm

Older men may be at risk of developing mild cognitive impairment (MCI), often a precursor to Alzheimer’s disease, earlier in life than older women, according to a study appearing today in Neurology. The study raises the question of whether there may be a gender difference in the development and progression of MCI.

Scientists evaluated the cognitive health of 1,969 dementia-free older people and found 16 percent showed signs of MCI, a condition usually marked by memory problems or other cognitive problems greater than those expected for their age. Prevalence was greater among the older participants, and it was consistently higher in men than women across all age ranges.

Ronald C. Petersen, Ph.D., M.D., and his team at the Mayo Clinic, Rochester, Minn., conducted the research.

"Because evidence indicates that Alzheimer's disease may cause changes in the brain one or two decades before the first symptoms appear, there is intense interest in investigating MCI and the earliest stages of cognitive decline," said National Institute on Aging (NIA)  Director Richard J. Hodes, M.D. "While more research is needed, these findings indicate that we may want to investigate differences in the way men and women develop MCI, similar to the way stroke and cardiovascular disease risk factors and outcomes vary between the sexes."

The researchers conducted in-person evaluations of 1,969 randomly selected people from all 70- to 89-year-olds living in Olmsted County, Minn. Results of the study indicated that:

  • Overall, MCI was more prevalent in men (19 percent) than in women (14 percent), even after adjusting for several demographic variables and clinical factors, such as hypertension and coronary artery disease.
  • Of the 16 percent affected with MCI, over twice as many people had the amnestic form that usually progresses to Alzheimer’s disease and the prevalence rate was higher in men than in women.
  • MCI prevalence was higher among people with the APOE e4 gene, a known risk factor for late-onset Alzheimer's, a form of the disease that usually occurs at age 65 or older.
  • A greater number of years spent in school was significantly associated with decreased MCI prevalence, from 30 percent among participants with less than nine years of education to just 11 percent in those with more than 16 years of education.
  • MCI prevalence was higher in participants who never married, as opposed to those currently or previously married.

The researchers noted that estimates of MCI prevalence vary in studies conducted around the world but generally fall into a range of 11 to 20 percent. The Mayo team's evaluation of participants included detailed in-person assessments that helped to capture the subtle changes in daily function that may mark the onset of MCI, Petersen said. The researchers also noted that the study’s limitations include a relatively low participation rate by Olmstead County residents and the fact that the population is predominantly white. Thus, these findings may not apply to other ethnic groups.

Source:  NIH National Institute on Aging

Posted by on August 30, 2010 - 8:47am

A study by researchers at the National Institutes of Health (NIH) and the University of Oxford supports the widespread belief that stress may reduce a woman's chance of becoming pregnant.  The study is the first of its kind to document, among women without a history of fertility problems, an association between high levels of a substance that is indicative of stress and a reduced chance of becoming pregnant.

The researchers showed that women who had higher levels of alpha-amylase were less likely to get pregnant than were women with lower levels of the substance.   Alpha-amylase is secreted into saliva by the parotid gland, the largest of the salivary glands.    Although alpha-amylase digests starch, in recent years it has been used as a barometer of the body's response to physical or psychological stress.  The substance is secreted when the nervous system produces catecholamines, compounds that initiate a type of stress response.

Researchers tracked the ovulation cycles of 274 English women ages 18-40 who were trying to conceive.  On the sixth day of their cycles, each woman collected a sample of her saliva, which was subsequently tested for alpha-amylase.  The researchers found that, all other factors being equal, women with high alpha-amylase levels were less likely to conceive than were women with low levels.  A larger study is currently underway to confirm these findings.  If these finding hold up, health providers will need to find appropriate ways to help women alleviate stress while trying to conceive.

To view the NIH Press release, click here.

Posted by on August 24, 2010 - 9:34am

Study finds association between stress level in early cycle, severity of symptoms

Women who report feeling stressed early in their monthly cycle were more likely than those who were less stressed to report more pronounced symptoms before and during menstruation, according to a study by researchers at the National Institutes of Health and other institutions. The association raises the possibility that feeling stressed in the weeks before menstruation could worsen the symptoms typically associated with premenstrual syndrome and menstruation.

Women who reported feeling stressed two weeks before the beginning of menstruation were two to four times more likely to report moderate to severe symptoms than were women who did not feel stressed.

Premenstrual syndrome is a group of physical and psychological symptoms occurring around the time of ovulation, which may extend into the early days of menstruation. Symptoms include feelings of anger, anxiety, mood swings, depression, fatigue, decreased concentration, breast swelling and tenderness, general aches, and abdominal bloating.

The study was conducted by researchers in the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the University of Massachusetts-Amherst, and the State University of New York, Buffalo. The study was published online in the Journal of Women's Health.

To read more on the study, click here.

Posted by on August 12, 2010 - 2:46pm

The most recent statistics on the women who participate in our Illinois Women’s Health Registry, indicate that sleep is a significant issue in their lives.  Among the most current women who are enrolled in our registry, 11% report difficulties getting to sleep, 12% have a hard time staying asleep, 15% wake up feeling fatigued, 13% report they are getting too little sleep for what they need, and 8% wake too early and cannot get back to sleep.

Our limited knowledge in sex differences is due to the fact that women are underrepresented in studies of sleep and its disorders.  The National Sleep Disorders Research Plan, released in 2004 by the National Center on Sleep Disorders Research reported that 75% of sleep research has been conducted in men.   While more recent sleep studies have included women, the small sample sizes limit sex comparisons.  However, there is a growing body of evidence that sex hormones influence sleep and circadian rhythms, and further neuroendocrine studies are needed.

To read more on women and sleep on the Institute for Women's Health Research, click here.

Posted by on July 14, 2010 - 12:05pm

CHICAGO --- The more an older woman weighs, the worse her memory, according to new research from Northwestern Medicine. The effect is more pronounced in women who carry excess weight around their hips, known as pear shapes, than women who carry it around their waists, called apple shapes.  The study of 8,745 cognitively normal, post-menopausal women ages 65 to 79 from the Women's Health Initiative hormone trials is the first in the United States to link obesity to poorer memory and brain function in women and to identify the body-shape connection.

"The message is obesity and a higher Body Mass Index (BMI) are not good for your cognition and your memory," said lead author Diana Kerwin M.D., an assistant professor of medicine and a physician at Northwestern Medicine. "While the women's scores were still in the normal range, the added weight definitely had a detrimental effect."

For every one-point increase in a woman's BMI, her memory score dropped by one point. The women were scored on a 100-point memory test, called the Modified Mini-Mental Status Examination. The study controlled for such variables as diabetes, heart disease and stroke.   The study will be published July 14 in the Journal of the American Geriatric Society.

The reason pear-shaped women experienced more memory and brain function deterioration than apple-shaped women is likely related to the type of fat deposited around the hips versus the waist. "Obesity is bad, but its effects are worse depending on where the fat is located," Kerwin said.

Cytokines, hormones released by the predominant kind of fat in the body that can cause inflammation, likely affect cognition, Kerwin said. Scientists already know different kinds of fat release different cytokines and have different effects on insulin resistance, lipids and blood pressure.

"We need to find out if one kind of fat is more detrimental than the other, and how it affects brain function," she said. "The fat may contribute to the formation of plaques associated with Alzheimer's disease or a restricted blood flow to the brain."    In the meantime, the new findings provide guidance to physicians with overweight, older female patients.

"The study tells us if we have a woman in our office, and we know from her waist-to-hip ratio that she's carrying excess fat on her hips, we might be more aggressive with weight loss," Kerwin said. "We can't change where your fat is located, but having less of it is better."

Kerwin's research is funded by the T. Franklin Williams Award from Atlantic Philanthropies and Association of Specialty Professors and the Wisconsin Women's Health Foundation Faculty Scholar Award. The Women's Health Initiative was funded by a grant from the National Heart, Lung and Blood Institute.

Marla Paul is the health sciences editor. Contact her at marla-paul@northwestern.edu

Posted by on July 7, 2010 - 4:50pm

Many people assume that brain differences between men and women result from sex hormones like estrogen and testosterone. This is not true. In fact, increasing numbers of studies find large reliable distinctions between the sexes. These effects are often seen early in development and before sex hormones are expressed. The research examining sex-specific brain mechanisms finds variability in structure, neurotransmitters, and the expression of specific genes in males and females.

Sex differences in size, shape, and function occur in every region of the brain. For example, sex divergence is seen in the hippocampus, an area of the brain that is important for learning and memory. The hippocampus makes up a larger portion of total brain size in women than in men. But that doesn’t necessarily mean that women learn better than men. Interestingly, some sub-regions of the hippocampus are larger and contain more cells in men. Further studies will be needed to fully understand the implications of such sex differences.

Additional variation occurs in the levels of neurotransmitters, the chemical messengers, in the brain. Males and females differentially produce serotonin, a neurotransmitter that affects mood. These differences may have significant effects on gender-specific treatment of diseases, such as depression.

Gene expression differences between the sexes are also seen across many species. Scientists have found groups of genes with sex-specific expression that are conserved, or maintained, across primate species, suggesting that such patterns are inherited across evolution.

What is the evolutionary advantage to having sex differences in the brain? While we can only guess, one hypothesis is that such variability is important in the selection animals make in finding mates and raising offspring. Whatever the cause, differences in the brain affect development and health during adulthood. Many of the genes with differential expression are also associated with neurological diseases such as Alzheimer’s disease, schizophrenia, and cerebral ischemia. As such, sex-specific treatments of these diseases should also be studied.

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Kate is also a frequent contributor to the Oncofertility Consortium Blog. Check it out!

Posted by on June 10, 2010 - 12:16pm

According to the World Health Organization, alcohol is one of the most significant risk factors for diseases including chronic conditions like cancer, diabetes, and heart disease.  Compared with men, women become more cognitively impaired by alcohol and are more susceptible to alcohol-related organ damage.    Women develop damage with less intake and  over a shorter period of time than men.   When men and women of the same weight consume equal amounts of alcohol, women have higher blood alcohol concentrations.   This is due in part because women have proportionately more body fat and a lower volume of body water compared with men of similar weight. This leads to women having a higher concentration of alcohol because there is less volume of water to dilute the alcohol.

in women, alcohol metabolizes slower in their stomachs and upper intestines allowing more alcohol to reach the blood stream and other organs than in men, leading to increased organ damage.  Women have more severe complications related to alcohol abuse than men including developing alcohol dependency more quickly.   Damage resulting from alcohol dependency  that is more severe in women includes liver damage (hepatitis/cirrhosis), premature death from cardiovascular conditions, cognitive and motor function decline,  and fertility issues.

Age seems to matter.  Older women have even less body water, a decreased tolerance for alcohol, and an even slower metabolism rate for alcohol.

Source:  Substance Abuse Treatment:  Addressing the Specific needs of Women. HHS Publication No.  (SMA) 09-4426.  2009

Posted by on May 19, 2010 - 8:00am

You may have seen the cover article on our Spring Newsletter titled “Spotlight on Obesity: Is it just your weight?”  This article focuses not only on the epidemic of obesity in the U.S. but also on the serious health conditions that may result from obesity.  Although obesity is on the rise, however, eating disorders such as anorexia and bulimia still continue to be a problem, especially in women.  According to the National Alliance for the Mentally Ill (2003) 90 percent of individuals with eating disorders are women between the ages of 12 and 25.  Eating disorders are closely correlated with depression, substance abuse, and anxiety disorders, so it is important to diagnose and treat early.

The most common disorders are anorexia nervosa, bulimia nervosa, and binge-eating.  You may already be familiar with these disorders, but they are listed below along with some the complications that may arise.

Anorexia nervosa is a disorder categorized by obsession with weight and food causing individuals to starve themselves or to exercise excessively in order to maintain a weight typically far below the normal weight range for their height and age.  Complications of anorexia include, heart problems, anemia, permanent bone loss, malnourishment, absent menstruation and death.

Bulimia nervosa is categorized by periods of binge eating followed by vomiting or excessive exercise to get rid of extra calories or weight.  Individuals with bulimia are similarly obsessed with weight and food.  Both disorders are closely tied to self-image and thus may be difficult to treat.  Complications of bulimia include heart problems, digestive problems, tooth decay, absent menstruation and death.

Binge-eating disorder is still not considered a psychiatric condition, but may be treated similarly to bulimia and anorexia.  Binge-eaters tend to consume unusually large amounts of food on a consistent basis.  This disorder may lead to obesity and complications associate with obesity such as high blood pressure, diabetes, and heart disease.  In addition binge-eating disorder can cause psychological problems such as depression and suicidal thoughts.

Although the term eating disorder usually means one of the three disorders listed above, the term disordered eating is used to describe a variety of eating abnormalities that do not necessarily fall into, or are not severe enough to be categorized as one of the typical eating disorders.  Disordered eating may not be as serious in terms of complications, but it may lead to more serious eating disorders if left untreated or unaddressed.  According to a survey conducted by Self Magazine and the University of North Carolina, as many as 65% of American women between 25 and 45 exhibit disordered eating behaviors.  Women should not be afraid to seek help for issues they may have with eating, even if they do not think it is a severe eating disorder.  As peers, we should be supportive of women who are suffering from these diseases, and help them to overcome their issues.

Posted by on March 19, 2010 - 9:53am

In recognition of Poison Prevention Week (March 14-20), the Center for Disease Control (CDC) is highlighting the growing issue of unintentional drug poisoning in the United States.   More than 26,000 deaths from unintentional drug poisoning occurred in the U.S. in 2006.  Opioid pain medications (e.g., oxycodones and methadone) were involved in more than half of these deaths.  In recent years, this cause of death has more than doubled between 1999 and 2006.   In 2006, 17,740 drug overdose deaths occurred among males and 8,660 among females.  Male rates exceed females rates in every age group.    However, male rates have doubled and female rates have nearly tripled since 1999.  In response to this growing problem the CDC has developed an issue brief titled Unintentional Drug Poisoning in the United States.

Posted by on January 20, 2010 - 11:20am

We probably all have first hand knowledge of how a bad night's sleep can affect us the next day: we're irritable, in a bad mood, and it can be hard to concentrate. It may not be all that surprising then, that how we sleep can be a very big part of depressive disorders, an incredibly interesting topic covered by Dr. Roseanne Armitage in the most recent installment of the IWHR's Women's Health Research Monthly Forum.

Dr. Roseanne Armitage Photo:www.med.umich.edu

Dr. Roseanne Armitage

Dr. Armitage began her talk by discussing how men and women, even those who do not have depression, sleep in very different ways. Possibly because of the different numbers of hormone receptors  or the over 650 genes that are expressed differently in the brains of males and females, the types of sleep we have also differs. For example, before puberty, boys have more slow wave sleep (stage 3 and 4 sleep, the deep, restorative kind that makes you feel refreshed in the morning) than girls do. After puberty, this changes, and girls are the lucky receivers of more slow wave sleep. Most interestingly, while men have a very slow loss of the amount of slow wave sleep over their lifetimes, women's amount stays relatively level and then drops precipitously during the peri-menopausal years. This is one reason why menopausal women really notice the sudden change in their sleep patterns. In general, women are also more likely to suffer from insomnia and sleep fragmentation than men.

The depression that Dr. Armitage really focused on was untreated MDD (major depressive disorder). MDD is twice as likely to occur in women than in men. Social withdrawal and feelings of worthlessness and guilt are more common in females with depression than in males with depression, who tend to complain more of lack of goal-oriented behavior. Around 80% of people with MDD report sleep problems, and for many people, sleep disturbance is the first presenting symptom of MDD. In adults with MDD, there are increased arousals and episodes of wakefulness, increased stage 1 sleep (the very light sleep), decreased total sleep time, and decreased stage 3 and 4 sleep.

Depression further exacerbates the sex differences in sleep between men and women when faced with a serious change to their normal sleep patterns (such as being asked to stay up for 40 hours consecutively), women with MDD overresponded, staying in slow wave sleep for too long, while men with MDD underresponded.  Sleep in healthy adults also shows a high level of coherence, or a very close association in the activity patterns of the right and left hemispheres of the brain. Women with MDD, however, have a lower coherence during their sleep than other healthy females, healthy males, AND males with MDD.

Dr. Armitage's work also demonstrates the ability to tie sleep disturbances to the likelihood of depression in very young girls. She finds that coherence scores can be a very good predictor of future depressive disorder; girls who were at high-risk for depression because their mothers were depressed demontrate lower coherence in their sleep...even before they have any sign or symptom of depression. Young girls in this high-risk group also had very disorganized sleep-activity patterns, even as disorganized as same aged girls who already suffered from depression. Shockingly, even babies (2 to 30 weeks) of depressed mothers take longer to fall asleep, have decreased total sleep time and sleep efficiency, and spend less time in bright light (known to produce necessary vitamins) than babies of non-depressed mothers.

Our thanks to Dr. Roseanne Armitage for such an eye-opening talk! We encourage you to look at some of Dr. Armitage's published work on the topic:

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