Hormone therapy with either estrogen or testosterone might not affect women's thinking and memory skills in the years soon after menopause, hints a new study.

The findings are the latest addition to a complicated picture of the possible link between hormones and mental functioning in women. Some researchers think hormone therapy may help improve brain function and prevent Alzheimer's disease after menopause. But then there are studies that show little impact on thinking and memory, or different impacts depending on the age of women being treated.

One recent study of women in surgical menopause - when the uterus and ovaries are removed - suggested that estrogen might provide a memory benefit, but that testosterone canceled out some of that benefit when women took both hormones (see Reuters Health story of July 2, 2010: Testosterone may not help memory after menopause).

"Since many women during the time of menopausal transition complain about cognitive impairment it has been suggested that estrogen may have a beneficial effect on memory and cognitive abilities," while "testosterone is suggested to improve spatial ability but impair verbal memory," Dr. Angelica Linden Hirschberg, one of the current study's authors from the Karolinska Institutet in Stockholm, Sweden, told Reuters Health by email.

Estrogen declines in women as they enter menopause and in the years shortly after, but testosterone levels don't change very much around menopause. Still, both hormones have been used to treat symptoms in postmenopausal women - estrogen to prevent hot flashes and osteoporosis, and testosterone for women who lose their sex drive around this time.

Hormone therapy took a hit in 2002, however, when the Women's Health Initiative study was halted because women taking hormones had higher rates of heart disease, stroke, and breast cancer than women not on hormones.

The pluses and minuses of hormone therapy remain controversial, especially when it comes to its effect on the mind. To try and shed more light on this area, Hirschberg and her colleagues divided 200 women between 50 and 65 years old into three groups. One group took estrogen pills, another took testosterone pills, and a third took placebo pills that didn't contain any hormones. None of the women knew which kind of pill they were taking.

After four weeks of daily treatment, the women were given three thinking and memory tests: in one, they had to list all the words they could think of that started with one letter; in another, they were told to repeat a list of 12 random words; and in the third, they looked at objects on a page and had to choose what that object would look like when it was rotated.

Women in each of the three treatment groups fared similarly on all tests, leading Hirschberg to conclude that short-term treatment with estrogen or testosterone does not affect the mental functions she and her colleagues were evaluating.

The researchers didn't test the women before they started the treatment. But they assumed that because the participants were similar across most other measures, there should be no difference in their thinking and memory skills before some started hormone therapy, they write in the study, which is published in Fertility and Sterility.

Dr. Victor Henderson, an epidemiologist and neurologist at Stanford University, said the study's finding of no relationship between hormone therapy and cognitive skills, at least in the short term, "tend(s) to be consistent with the other studies that are coming out."

However, he said, data are lacking on the longer term effects of estrogen and testosterone in postmenopausal women. "A four-week study may or may not generalize to studies for a longer duration of treatment," Henderson, who was not involved with the current study, told Reuters Health.

"The major unanswered question is whether prolonged hormone exposure...has effects that might show up a decade, two decades, three decades later in terms of things like Alzheimer's risk," he said.

Estrogen pills like the ones used in the study can be purchased over-the-counter for less than 50 cents a day. Testosterone pills cost $2-3 per day, but aren't approved by the Food and Drug Administration for treatment in women. The current study did not mention any side effects from either type of hormone therapy.

While it's still not clear whether hormone therapy can help women improve their brainpower after menopause, Hirschberg said that there are steps women can take to help them stay sharp, including eating a healthy diet and getting regular exercise.

                                                                                                                                                                      2010-08-24

Eating more oily fish like sardines, salmon and yellowtail could help teenage boys feel less blue, suggests a new Japanese study.

The same does not appear to hold for teen girls, however.

Omega-3 fatty acids, including EPA and DHA, are found predominantly in oily fish. Because these nutrients are thought to play a role in brain function, many researchers have wondered whether increased consumption could lower the risk of depression. But studies of such an association among adults have yielded inconclusive results.

Until now, investigators had yet to look for the potential link in youth, a population also prone to the debilitating problem. So Kentaro Murakami of the University of Tokyo and colleagues analyzed the diets and rates of depression in more than 6,500 Japanese junior high school students between the ages of 12 and 15.

Overall, 23 percent of the boys and 31 percent of the girls suffered from symptoms of depression, including feelings of worthlessness, hopelessness and sleep disturbances, they report in the journal Pediatrics.

Based on questionnaires of food intake, and adjusting for factors including age and parents' education level, the investigators found that boys who ate the most fish -- the top fifth based on total consumption -- had a 27 percent lower odds of being depressed compared to those ranked in the bottom fifth.

Similar differences were seen when looking specifically at the EPA and DHA content of the fish consumed.

Meanwhile, no effect of fish oil on depression was seen among the girls.

The investigators admit that the differing effect of fish oil between boys and girls is difficult to explain, although they point to a few possibilities such as a stronger genetic role for depression in women compared to men.

They also caution that their findings do not provide enough evidence to determine if fish oil actually lowers the risk of depression. It might be, for example, that those who are depressed eat less fish.

Although more research is needed to confirm a cause-and-effect link, the researchers conclude that boosting the intake of fish, EPA and DHA "may be an important strategy for the prevention of depression."

                                                                                                                                                            2010-08-23

Developing countries will bear 60 percent of the world's cancer burden by 2020 and 70 percent by 2030, but are not prepared for the looming crisis, cancer experts warned in a report on Thursday.

These countries do not have the infrastructure in place to prevent cancer, diagnose it early or provide long-term treatment, according to CanTreat International, which comprises experts from leading international cancer organizations.

"Developed countries have been setting up plans and systems to cope with cancer all the time, but developing countries are not ready ... treatment, diagnoses are made very late or not at all, so the (death) toll is much, much higher," Joseph Saba, a medical doctor and member of the group, said in an interview.

CanTreat stands for the Informal Working Group on Cancer Treatment in Developing Countries. Its report was unveiled during the World Cancer Congress in the southern Chinese city of Shenzhen.

There were 7.6 million cancer fatalities worldwide in 2008, making it a leading cause of death. The developing world made up 5.3 million, or 70 percent. By 2050, low-income countries alone will account for three-quarters of all cancer deaths.

The economic impact of premature death and disability from cancer worldwide was $895 billion in 2008, excluding treatment costs, according to the American Cancer Society.

With changes in diet, worsening pollution, aging populations, rising obesity rates, tobacco use and alcohol intake, developing countries are now saddled with more non-communicable diseases including heart problems, strokes, diabetes and cancers, in addition to infectious diseases.

There were 12.67 million new cases of cancer worldwide in 2008, with developing nations representing 56 percent of the total. By 2020, there will be an estimated 15 million new cancer cases, 60 percent of which will be in the developing world.

According to the CanTreat report, while a breast cancer patient has an 84 percent chance of surviving for at least five more years in the United States, it is only 12 percent in Gambia.

Cure rates for childhood cancer are 75 percent in high-income countries but 10 to 15 percent in low-income countries.

"We need centers for early diagnoses, trained doctors and nurses, follow-up mechanisms," Saba said.

Saba urged health experts to learn from the experience of managing HIV/AIDS in the last 30 years: people will only come forward for screening if there are proper treatments in place.

"If you don't have proper treatment, why do you want early detection if you can't do anything about it? Treatment becomes the engine of cancer control," he said.

Their report comes days after a group of scientists said in The Lancet journal that many cancers in developing countries could be treated using drugs that are off-patent and manufactured generically at affordable prices.

                                                                                                                                                                      2010-08-23