Emily Kontaris

Importance: Many midlife women report cognitive issues when they transition through menopause. These cognitive complaints affect women's mental health and quality of life. However, the current understanding of women's cognitive experiences during the menopause transition has been limited by the lack of validated self-reported cognitive measures.

Objective: This systematic review aimed to identify existing self-reported, or subjective, cognitive measures used in menopause research and evaluate their psychometric properties and applicability.

Evidence review: Three databases, Medline, Embase, and PsycINFO, were searched in March 2024 with no restriction on publication year. Studies investigating women transitioning into postmenopause and with cognitive experiences measured using validated subjective cognitive measures were selected. The assessment of psychometric properties and applicability of included measures was conducted based on their development process and their performance in the menopause studies selected.

Finding: Twenty-eight menopause studies involving 15 measures were included. Included measures showed adequate content validity, internal consistency, and construct validity when they were developed, yet other psychometric properties were either poor or not reported. Hence, the overall performance of included measures was generally moderate to poor. Information relating to psychometric properties of included measures in menopause studies was also lacking, indicating doubtful applicability.

Conclusions and relevance: Poor psychometric properties or the lack of psychometric assessment of existing subjective cognitive measures may indicate doubt or uncertainty regarding their applicability in women transitioning through menopause. This review recommends the use of subjective cognitive measures that assess more than one cognitive domain, as well as further assessment of the psychometric properties of these measures before their use in menopause research or clinical settings, particularly those measures initially developed for clinical practice. It also highlights the need for future development of a subjective cognitive measure for women transitioning through menopause to improve the current understanding of their cognitive challenges.

Advancements in brain imaging technologies have facilitated the development of “real-world” experimental scenarios. In this study, participants engaged in a household chore – completing a laundry cycle – while their frontal lobe brain activity was monitored using fNIRS. Participants completed this twice using both fragranced and unfragranced detergent, to explore if fNIRS is able to identify any differences in brain activity in response to subtle changes in stimuli. Analysis was conducted using Automatic IDentification of functional Events (AIDE) software and fNIRS correlation-based signal improvement (CBSI). Results indicated that brain activity, particularly in the right frontopolar and occasionally the left dorsolateral prefrontal cortex, was more pronounced and frequent with the unfragranced detergent than the fragranced. This suggests that completing tasks in an environment where a pleasant and relaxing fragrance is present might be less effortful compared to an odourless environment.

Background and Objectives: Decreased olfactory function commonly occurs alongside the aging process. Research suggests olfactory training (OT) has the potential to improve olfactory and cognitive function in individuals with and without olfactory dysfunction. The degree to which these benefts extend into older age and among those with cognitive impairment (i.e., people with dementia and mild cognitive impairment) is less clear. The purpose of the current review was to investigate the extent to which OT affects olfactory function, cognition, and well-being among older people. 

Research Design and Methods: A scoping review of the literature was conducted in PubMed, Embase, EbscoHost, and SCOPUS. Articles were considered eligible for original research studies with human populations, included adults aged 55 and older, performed any type of OT, and included a form of olfactory testing. The data from the included studies were synthesized and presented narratively. 

Results: A total of 23 studies were included. The results suggest that OT provides multiple benefts to older adults, including those with cognitive impairment. Particularly, OT was associated with measurable changes in olfactory function, improved cognitive function, specifcally semantic verbal fuency and working memory, reduced depressive symptoms, and protection from cognitive decline. 

Discussion and Implications: The fndings suggest that benefts from OT extend beyond changes in olfactory function and include improved cognitive function, amelioration of depressive symptoms, and protection from cognitive decline. Future research is needed across specifc participant groups, including those with differentiated types of dementia, to investigate the olfactory and cognitive benefts of OT.

Olfaction is understudied in neuroimaging research compared to other senses, but there is growing evidence of its therapeutic benefits on mood and well-being. Olfactory imagery can provide similar health benefits as olfactory interventions. Harnessing crossmodal visual-olfactory interactions can facilitate olfactory imagery. Understanding and employing these cross-modal interactions between visual and olfactory stimuli could aid in the research and applications of olfaction and olfactory imagery interventions for health and wellbeing. This review examines current knowledge, debates, and research on olfaction, olfactive imagery, and crossmodal visual-olfactory integration. A total of 56 papers, identified using the PRISMA method, were evaluated to identify key brain regions, research themes and methods used to determine the suitability of fNIRS as a tool for studying these topics. The review identified fNIRS-compatible protocols and brain regions within the fNIRS recording depth of approximately 1.5 cm associated with olfactory imagery and crossmodal visual-olfactory integration. Commonly cited regions include the orbitofrontal cortex, inferior frontal gyrus and dorsolateral prefrontal cortex. The findings of this review indicate that fNIRS would be a suitable tool for research into these processes. Additionally, fNIRS suitability for use in naturalistic settings may lead to the development of new research approaches with greater ecological validity compared to existing neuroimaging techniques.

Extensive research has been carried out to investigate the effect of context (such as the external environment) on product perception, with previous studies focusing on food or beverage products using naïve consumers. However, it is still unclear whether context affects assessments made by trained panellists when testing fragranced stimuli. Options for conducting sensory testing outside of traditional sensory booths would allow for greater ecological validity and enable sensory testing to become more agile and flexible, with this need becoming even more important as a result of the Covid-19 pandemic. The current research set out to establish whether context has an effect on the perception of fragranced products using a trained sensory panel by testing 5 laundry market products under different context environments (No Context, Imagine, Visual Cue, Priming, Immersive). Statistically significant contextual effects were only observed for two out of the eleven attributes tested (Overall intensity and Herbal). Additional analyses using PCA showed that the same products were grouped together, whereas groupings by context were not observed. These findings suggest that perception of fragranced laundry products is not significantly impacted by different contexts when assessed by trained panellists. One possible explanation is that panellist training removes any influence of the external environment on product perception. Future studies could explore whether other contextual parameters have a greater influence on fragrance perception for trained panellists.

Cognitive training aiming at improving learning is often successful, but what exactly underlies the observed improvements and how these differ across the age spectrum are currently unknown. Here we asked whether learning in young and older people may reflect enhanced ability to integrate information required to perform a cognitive task or whether it may instead reflect the ability to inhibit task-irrelevant information for successful task performance. We trained 30 young and 30 aging human participants on a numerosity discrimination task known to engage the parietal cortex and in which cue-integration and inhibitory abilities can be distinguished. We coupled training with parietal, motor, or sham transcranial random noise stimulation, known for modulating neural activity. Numerosity discrimination improved after training and was maintained long term, especially in the training + parietal stimulation group, regardless of age. Despite the quantitatively similar improvement in the two age groups, the content of learning differed remarkably: aging participants improved more in inhibitory abilities, whereas younger subjects improved in cue-integration abilities. Moreover, differences in the content of learning were reflected in different transfer effects to untrained but related abilities: in the younger group, improvements in cue integration paralleled improvements in continuous quantity (time and space), whereas in the elderly group, improvements in numerosity-based inhibitory abilities generalized to other measures of inhibition and corresponded to a decline in space discrimination, possibly because conflicting learning resources are used in numerosity and continuous quantity processing. These results indicate that training can enhance different, age-dependent cognitive processes and highlight the importance of identifying the exact processes underlying learning for effective training programs.