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Fitness counteracts cognitive decline from hormone-replacement therapy

Women pondering hormone-replacement therapy also should consider regular exercise.
A study at the University of Illinois at Urbana-Champaign suggests that being physically fit offsets cognitive declines attributed to long-term therapy.

By using magnetic resonance imaging and voxel-based morphometry ( VBM ), researchers documented the combined effects on specific areas of the brain based on fitness of short- and long-term users of hormone therapy.

Researchers also looked at how well 54 postmenopausal women performed on a computerized version of the Wisconsin Card Sort Test, in which constantly changing rules challenge memory, inhibition and task-switching abilities known as executive functions. The women were divided into groups based on use or non-use and duration of hormone therapy and existing fitness levels.

" We found that higher fitness levels enhance the effects of shorter durations of hormone treatment and offset the declines associated with long-term use," said Arthur F. Kramer, a Beckman researcher. " It may be that a combination of HRT and exercise boosts both cognition and brain structure of older women."

Participants ranged in age from 58 to 80, with a mean age of 70. Hormone status and duration of use were assessed based on their self-reports, and aerobic fitness was measured by monitoring respiration, heart rate and blood pressure during a treadmill test.

MRI images of the participants' brains were taken, segmented into 3-D maps and analyzed by VBM, which allows for high spatial resolution of the volume of gray and white matter. The women also were screened for duration of hormone use, aerobic fitness levels, age, education, socioeconomic status, age at menopause and for dementia.

VBM analysis revealed that four regions of gray matter -- left and right prefrontal cortex, left parahippocampal gyrus and left subgenual cortex -- varied with duration of hormone treatment. Longer hormone usage resulted in significantly less tissue volume in these areas.
However, higher fitness scores were tied to greater tissue volume.

While there were no significant effects of the interaction of hormone duration and fitness on white matter in general, higher fitness levels were tied to greater prefrontal white matter regions and in the genu of the corpus callosum, a key area that interconnects frontal areas of the brain.