|Podcast Transcript of Pauline Maki --6/16/08
This is research news from U-I-C – the University of Illinois at Chicago.
Today, Pauline Maki, associate professor of psychiatry and psychology, talks about her study in the journal Menopause that found women in midlife underreport the number of hot flashes that they experience by more than 40 percent and these hot flashes are linked to poor verbal memory.
Here's Dr. Maki:
It's been known for some time that mid-life women, that is, women in their late 40s, 50s and early 60s, report declines in their memory from an earlier period in their life. In fact, if you survey a large representative portion of women who are mid-life in the United States, about 43 percent of them will say that they've become forgetful.
A lot of people have tried to link this to menopause.
In studies where you follow women from pre-menopause to their fertile period, to when they transition through menopause, there's really no objective change in memory. So people have wondered, is there something about transitioning to the menopause that we've missed in previous studies that might explain why women become more forgetful? So, why do women become more forgetful as they transition through mid-life?
A number of studies have looked at the relationship between menopausal symptoms, like vasomotor symptoms, hot flashes and sleep disturbances that accompany hot flashes. They've asked the question, 'Is there a relationship between menopausal symptoms and memory complaints?' in women, particularly memory performance – that is, if you measure memory objectively on cognitive tests that are administered in the laboratory.
Studies to date have found no relationship between hot flashes and objective performance on memory tests in women. And many people have interpreted that as kind of answering the question, 'No, there isn't a relationship between menopausal symptoms and memory dysfunction in women.'
The problem is that the physiology of hot flashes and the science of hot flashes is more complex than we previously understood. Our understanding of hot flashes has greatly increased since the development of tools that objectively measure when and whether a woman is having a hot flash. These, what we call ambulatory hot flash monitors, allow us to objectively measure when a woman is having a hot flash. The monitor is about the size of a Walkman. The monitor measures changes in skin conductance in relation to a hot flash. When a woman has a hot flash, she has a change win skin conductance in association with that hot flash. We know this is a hot flash because some very technical work by a researcher at Wayne State University demonstrated that there is a change in core body temperature when a woman has a hot flash, and these monitors pick up on that change in core body temperature.
It turns out that when you measure hot flashes in women with these monitors, you discover that women underreport the true number of hot flashes that they experience by about 40 percent. So women are experiencing many more hot flashes than they're telling you about.
So this underreporting of true hot flashes by mid-life women, raises the question of whether or not when you use objective hot flashes as your metric, there might be a relationship between menopausal hot flashes and memory dysfunction.
So that's what we did in this study. In this study, we objectively measured hot flashes using ambulatory hot flash monitors and we objectively measured memory performance using standardized, what we call, neuropsychological tests. What we found (was), like in other studies women underreported the true number of hot flashes that they had by about 40 percent. When we looked at the relationship between the hot flashes that the women truly had – that is, the hot flashes that the monitor picked up on – and memory performance on the cognitive tests, we found a very strong relationship. So that the more true hot flashes a woman had, the worse her memory performance. And this memory performance was on tests that measure the ability to remember stories.
Now what was interesting was when we looked at the relationship between to hot flashes women thought they had – that is, their self-reported hot flashes – there was no relationship with memory performance.
So what does that tell us? That tells us there is something about the objective hot flash that's related to memory dysfunction that is not determined by the subjective hot flashes. So in other words, there's some physiological event underlying a hot flash that contributes to memory dysfunction in women.
If it were the stress of having a hot flash or the worry of having a hot flash that related to memory dysfunction, then we would have demonstrated a relationship between self-reported hot flashes and memory dysfunction. But that relationship wasn't significant in our study.
So in other words, the hot flash-memory relationship is not all in a woman's head. It's actually a physiological relationship that you can pick up on, if you measure hot flashes objectively with the monitor.
Now one aspect of the study that's very important is that we also observed a relationship between the total number of hours slept and memory performance the next day. The total number of hours slept predicted worse memory performance, but also the total number of hot flashes during the night when a woman was sleeping predicted memory dysfunction. So, the two together worsen memory in women the next day.
So having less sleep and having more true physiological hot flashes leads to memory dysfunction in mid-life women. But you only really pick up on the relationship between hot flashes and memory dysfunction if you use objective measures of hot flashes. If you use subjective measures of hot flashes, you miss this true relationship.
Pauline Maki is associate professor of psychiatry and psychology.
For more information about this research, go to www-dot-news-dot- uic-dot-edu (www.news.uic.edu) … click on "news releases." … and look for the release dated June 16, 2008.
This has been research news from U-I-C – the University of Illinois at Chicago.