title: Alcohol, estrogen replacement therapy, and visuospatial processes in postmenopausal women.
abstract: BACKGROUND
  Studies suggest that moderate drinking may benefit cognition and the effect may favor women. This study investigated effects of moderate drinking on visuospatial functioning in postmenopausal women. Visuospatial processes are sensitive to alcohol abuse and are thought to be sensitive to hormonal fluctuations. Three questions were posed in order to: explore visuospatial processes in moderate-drinking and abstaining postmenopausal women, assess visuospatial differences in women using no estrogen replacement therapy (No-ERT), ERT alone (ERT-only), and ERT with progestin (ERT+Pro), and identify alcohol/ERT interactions associated with visuospatial performance.
  
  
  METHODS
  Two hundred fourteen postmenopausal women participated (75 No-ERT; 63 ERT-only; 76 ERT+Pro. All were moderate drinkers or teetotalers and all received the Block Design test from the Wechsler Adult Intelligence Scale-Revised. A raw score was calculated and progress at 30-sec intervals was assessed.
  
  
  RESULTS
  ANOVA revealed an alcohol main effect [F(3,202) = 4.74; p < 0.004] on 60- to 120-sec change scores. Teetotalers had significantly smaller change scores (less improvement) compared with all levels of drinkers. ANOVA on design 9 (the most difficult trial) revealed an ERT main effect [F(3,202) = 4.37; p < 0.02]. ERT nonusers scored significantly lower than ERT-only and ERT+Pro groups. A design 9 trend toward an alcohol x ERT interaction was noted [F(6,202) = 1.93; p < 0.08], and a design 9 time x alcohol interaction was revealed [F(6,404) = 2.65; p < 0.02].
  
  
  CONCLUSIONS
  These data suggest that moderate drinking may be positively associated with visuospatial processes in postmenopausal women. They also suggest that ERT, alone and with progestin, is positively associated with visuospatial processes, but only when the task is difficult. These findings support Kaplan's assertion that subtle performance deficits may not be detectible with traditional endpoint measures. A provocative alcohol x ERT trend suggests that alcohol consumption should be considered in studies of ERT effects on cognitive ability.
authors.affiliation: Oklahoma Center for Alcohol and Drug-Related Studies, Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, USA. laura-tivis@ouhsc.edu
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Tivis
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Green
authors.forename: Sara Jo
authors.initials: SJ
authors.lastname: Nixon
authors.forename: Rick D
authors.initials: RD
authors.lastname: Tivis
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects / Q000523:psychology*; D011597:Psychomotor Performance / Q000187:drug effects* / Q000502:physiology; D014888:Wechsler Scales / Q000706:statistics & numerical data*