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Than S, Moran C, Beare R, Vincent A, Lane E, Collyer TA, Callisaya ML, Srikanth V. Cognitive trajectories during the menopausal transition. FRONTIERS IN DEMENTIA 2023; 2:1098693. [PMID: 39081973 PMCID: PMC11285668 DOI: 10.3389/frdem.2023.1098693] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/10/2023] [Indexed: 08/02/2024]
Abstract
Aims Female sex is associated with an increased prevalence of dementia. Menopause may have a role to play in explaining sex differences in cognition, and possibly the risk of future dementia. We aimed to determine if the rate of cognitive decline differed between stages of the menopausal transition. Materials and methods Women with data on menopause and longitudinal cognitive function from the UK Biobank study were stratified into three groups: premenopausal, perimenopausal and postmenopausal. We studied associations of these menopause groups with rate of change in reaction time, verbal-numeric reasoning, prospective memory, visual memory and attention/working memory, adjusted for age, education, ethnicity and APOEε4 genotype. We also explored the effect of menopausal hormonal therapy (MHT) use and cross-sectional brain magnetic resonance imaging (MRI) volumes on these models. Results We included 15,486 women (baseline mean age 52 years) over a mean duration of 8 years. An interaction between menopausal group status and time was found for reaction time (p < 0.01). Compared with premenopausal women, the rate of increase (worsening) in reaction time was least in postmenopausal women (β = -1.07, p for interaction = 0.02). In general, compared with premenopausal women, perimenopausal and postmenopausal women had overall poorer performance in fluid intelligence and memory over the study duration, with no difference in rates of change. The models were unaffected by MHT use and brain volume measures. Conclusions Perimenopause and post-menopause are associated with cognitive changes. Psychomotor speed appears to be most sensitive to the menopause transition, whereas other cognitive functions may be less susceptible. More sensitive structural or functional brain imaging may be required to understand the underlying neural basis for these findings.
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Affiliation(s)
- Stephanie Than
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, VIC, Australia
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
| | - Chris Moran
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, VIC, Australia
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Richard Beare
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Amanda Vincent
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
- Department of Endocrinology, Monash Health, Melbourne, VIC, Australia
| | - Emma Lane
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Taya Annabelle Collyer
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
| | - Michele L. Callisaya
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
| | - Velandai Srikanth
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, VIC, Australia
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
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Jaff NG, Maki PM. Scientific insights into brain fog during the menopausal transition. Climacteric 2021; 24:317-318. [PMID: 34240672 DOI: 10.1080/13697137.2021.1942700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N G Jaff
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - P M Maki
- Departments of Psychiatry, Psychology and Obstetrics & Gynecology, University of Illinois at Chicago, Chicago, IL, USA
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Maki PM, Weber MT. A research primer for studies of cognitive changes across the menopause transition. Climacteric 2021; 24:382-388. [PMID: 34240671 DOI: 10.1080/13697137.2021.1905625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There has been a proliferation of studies demonstrating important sex differences in cognitive aging and dementia, and with this an increased interest in the role of menopause and sex steroid hormones in women's brain health. Foundational longitudinal studies of cognitive changes from the premenopause to perimenopause stage have shown reliable declines in verbal memory, with variable findings in processing speed, attention/working memory and verbal fluency. Continued research is needed to advance understanding of the range of cognitive domains affected, the duration of cognitive changes, the generalizability of these changes across cultures, the factors that account for such changes and the factors that can improve cognition at this time. In this article, we briefly review and draw on findings from large longitudinal studies of cognitive changes across the menopause transition to inform the design of future studies on this topic. We focus on key issues such as objective versus subjective cognitive measures; cognitive domains and tests; staging menopause; study design; mediators of cognitive effects (including hormones and menopause symptoms); and consideration of key covariates. We suggest that a more uniform and evidence-based approach to the investigation of these issues can advance the quality of the science in menopause and cognition.
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Affiliation(s)
- P M Maki
- Department of Psychiatry, Psychology and OB/GYN, University of Illinois College of Medicine, Chicago, IL, USA
| | - M T Weber
- Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
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