The Mount Sinai Journal of Medicine

 

Volume 73 Number 7
November 2006
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Women’s Cognitive and Affective Health and Neuropsychiatry 967-975
Amy Aloysi, M.D.1, Kathleen Van Dyk, B.A.2, and Mary Sano, Ph.D.2

1The Alzheimer Disease Research Center of Mount Sinai School of Medicine, New York, NY and 2James J. Peters VA Medical Center, Bronx, NY.

Address all correspondence to Mary Sano, Ph.D., James J. Peters VA Medical Center, 130 Kingsbridge Road, Room 1F01, Bronx, NY 10468.

Grants: The authors’ work is supported by AG05138, AG10483 and AG15922.

Abstract

Recent interest in women’s health has focused on the cognitive consequences of aging and hormonal changes. Based on hypotheses about estrogenic effects in the central nervous system (CNS), large-scale clinical trials were designed to address the efficacy of hormone replacement on protection against dementia and cognitive decline. Surprisingly, an absence of risk reduction for dementia and cognitive loss was found and much reanalysis of these findings has focused on timing of hormone replacement. Here we take a broad perspective to address a fuller range of psychological health. Gender differences in other psychiatric conditions including depression and anxiety have been attributed to hormones, and the neurotransmitter systems that are implicated in affective disorders may have an impact on cognitive impairment as well. Hormonal influences on neurotrophic mechanisms, as well as neurotransmitter effects, may be responsible for a breadth of neuropsychiatric conditions, particularly in aging.

This review will focus on cognition, mood and anxiety issues among women with an emphasis on changes associated with aging. We will review data on the epidemiology of these entities and examine the biological mechanisms, which may be involved, with an emphasis on those mechanisms that may contribute to the multiple aspects of neuropsychiatry and women’s health.

Key Words

Women’s health, cognition, affect, estrogen.


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