Background/Study Context: A number of longitudinal randomized controlled trials (LRCT) have used free verbal recall tests to study the effects of post-menopausal estrogen hormone therapy (HT) on episodic memory, but none have explicitly explored contrasts between list and story recall, in spite of cognitive differences between the tasks. For example, list recall provides little support for the use of gist, while story recall emphasizes it, and there is evidence that estrogen produces gist bias. Moreover, we present a literature tabulation that also suggests a task-specific HT effect.

Methods

In an LRCT with up to eight yearly test sessions, post-menopausal women were randomly assigned either to placebo (N = 56) or to an estrogen formulation (N = 44); subgroups received either estrogen alone (hysterectomy; E-alone; N = 16) or with progestin (intact uterus; E + P; N = 28). Participants were tested on the immediate and delayed list and story recall at each session.

Results

Linear mixed effects analyses of longitudinal trajectories showed that relative to placebo, the HT group declined significantly faster on immediate list recall and slower on immediate story recall. Separate analyses produced a sharpened version of this pattern for the E-alone subgroup but found no significant effects for the E + P subgroup. No significant effects were found in delayed testing.

Conclusion

The dissociation we found for immediate list and story recall is similar to the pattern of results in our literature tabulation. Fuzzy-Trace Theory posits parallel verbatim and gist traces plus a meta-cognitive review which becomes more gist-biased with age. Our results suggest that: (1) estrogen increases gist bias, hastening the normal age-related decline of list recall but slowing the decline of story recall relative to placebo; (2) decay of the verbatim trace over time generally causes a shift to gist, thereby accounting for the absence of a delayed recall difference; and (3) progestin weakens the effects of estrogen, thereby accounting for why the dissociation found in E-alone was absent in the E + P subgroup.

Seniors are at greater risk than other adults for foodborne illness, poor nutrition and high rates of nutrition- and lifestyle-related chronic diseases. They also represent a major underserved segment of the UC Cooperative Extension client population. The Make Food Safe for Seniors (MFSFS) initiative assessed food safety and nutrition education needs of fixed-income seniors and food handlers and caregivers serving seniors in 10 California counties. Baseline survey results found unsafe practices by over 50% of the participants in six areas — and by over 65% of participants in three of those areas. After one food safety training, a post-test showed an average knowledge gain of 18.1%; seniors had gained the least knowledge, food handlers had gained some knowledge, and caregivers had gained the most. The unsafe food handling practices of a majority of the study group, as well as poor food behaviors, suggested areas in which education could reinforce or improve food safety, healthy eating and disease prevention practices of seniors, caregivers and food handlers serving seniors.