Aging, estrogens, and episodic memory in women.
Aging, estrogens, and episodic memory in women.
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DOI：
10.1097/wnn.0b013e3181a74ce7
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发表时间：
2009-12
期刊：
影响因子：
--
通讯作者：
Henderson VW
中科院分区：
文献类型：
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作者：
Henderson VW
回顾中年及以后女性雌激素暴露与情景记忆之间的关系。情节记忆的表现会随着年龄的增长而下降，情节记忆的损伤通常预示着阿尔茨海默病的发展。在实验室中，雌二醇影响海马功能和动物学习。然而，雌激素是否会影响女性生育后的记忆力仍存在争议。重点文献综述，包括雌激素临床试验的系统检索总结，其中结局包括情景记忆的客观测量。自然绝经过渡期与情景记忆的客观变化无关。强有力的临床试验证据表明，在60岁左右开始含雌激素的激素治疗对情景记忆没有好处。在60岁之前的中年女性中进行的临床试验结果受到样本量较小和治疗持续时间较短的限制，但这些也并不表明有实质性的记忆效应。然而，有限的短期证据表明，雌激素可以改善手术绝经后的言语记忆。虽然老年时开始激素治疗会增加痴呆症的风险，但观察性研究提出了一个早期关键窗口的问题，在此期间，中年雌激素治疗可以减少老年痴呆症。然而，几乎没有数据说明中年雌激素治疗是否会影响老年人的情景记忆。60岁以后，自然绝经过渡或使用含雌激素的激素治疗对情景记忆没有实质性影响。需要进一步的研究来确定手术绝经后的结果是否不同，或者中年雌激素暴露是否会改变以后生活中的情景记忆。
To review the relation in midlife and beyond between estrogen exposures and episodic memory in women. Episodic memory performance declines with usual aging, and impairments in episodic memory often portend the development of Alzheimer's disease. In the laboratory, estradiol influences hippocampal function and animal learning. However, it is controversial whether estrogens affect memory after a woman's reproductive years. Focused literature review, including a summary of a systematic search of clinical trials of estrogens in which outcomes included an objective measure of episodic memory. The natural menopause transition is not associated with objective changes in episodic memory. Strong clinical trial evidence indicates that initiating estrogen-containing hormone therapy after about age 60 years does not benefit episodic memory. Clinical trial findings in middle-age women before age 60 are limited by smaller sample sizes and shorter treatment durations, but these also do not indicate substantial memory effects. Limited short-term evidence, however, suggests that estrogens may improve verbal memory after surgical menopause. Although hormone therapy initiation in old age increases dementia risk, observational studies raise the question of an early critical window during which midlife estrogen therapy reduces late-life Alzheimer's disease. However, almost no data address whether midlife estrogen therapy affects episodic memory in old age. Episodic memory is not substantially impacted by the natural menopause transition or improved by use of estrogen-containing hormone therapy after age 60. Further research is needed to determine whether outcomes differ after surgical menopause or whether episodic memory later in life is modified by midlife estrogenic exposures.