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He X, Hou F, Shen X, Zhao D, Zhao X, Qi M, Li P. Individual and additive-effect relationships of menopausal symptoms and subjective cognitive decline among nurses during menopausal transition: a cross-sectional study. Menopause 2024; 31:617-625. [PMID: 38860940 DOI: 10.1097/gme.0000000000002368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE This study aimed to examine the individual and additive-effect relationships between menopausal symptoms and subjective cognitive decline among nurses during menopausal transition. METHODS Between February and September 2019, a convenience sampling strategy was used, involving 1,335 Chinese nurses undergoing menopausal transition. A general information survey that included the Subjective Cognitive Decline Scale and the Menopause Rating Scale was completed. Based on a cut-off point of the subjective cognitive decline score of 7.5, the overall sample was divided into mild and severe groups. Propensity score matching was performed to balance covariates of mild and severe subjective cognitive decline. The individual and cumulative effects of menopausal symptoms and subjective cognitive decline were analyzed using binary logistic regression and the Cochran-Armitage trend test, respectively. RESULTS After propensity score matching, none of the parameters showed significant differences between the groups. Logistic regression analysis revealed that four menopausal symptoms were closely associated with severe subjective cognitive decline. The Cochran-Armitage trend test indicated odds ratios linking the presence of these symptoms with increased severe subjective cognitive impairment. In addition, nurses simultaneously experiencing two or more core menopausal symptoms were over six times more likely to have severe subjective cognitive decline than nurses experiencing none or one core menopausal symptom during menopausal transition. CONCLUSIONS Individual and additive numbers of menopausal symptoms significantly influenced subjective cognitive decline in nurses during their menopausal transition. These findings suggest that interventions aimed at enhancing the cognitive performance of nurses experiencing menopause should consider menopausal symptoms.
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Affiliation(s)
- Xudong He
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Fangyan Hou
- Shandong Youth Political College, Jinan, Shandong, China
| | - Xiaona Shen
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Di Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiangyu Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Meiling Qi
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Ping Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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Zangirolami-Raimundo J, Raimundo RD, Silva Noll PRE, Dos Santos WS, Leone C, Baracat EC, Sorpreso ICE, Soares Júnior JM. Postmenopausal women's cognitive function and performance of virtual reality tasks. Climacteric 2023; 26:445-454. [PMID: 36999579 DOI: 10.1080/13697137.2023.2190511] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE This study aimed to assess whether prior knowledge of computer use determines performance of virtual reality tasks by postmenopausal women and whether menopausal symptoms, sociodemographic factors, lifestyle and cognition modify or interfere with their performance. METHOD This cross-sectional study included 152 postmenopausal women divided into two groups: computer users and non-users. Age, ethnicity, time of menopause, menopausal symptoms, female health status, level of physical activity and cognitive function were considered. The participants played a virtual reality game and were assessed for hits, errors, omissions and game time. The Mann-Whitney, chi-square and Fisher exact tests and multivariate linear regression analysis were used. RESULTS Postmenopausal computer users play virtual reality games (p = 0.005) better than postmenopausal non-users of computers. Vasomotor symptoms were high in women who used computers compared to those who did not (p = 0.006). Multivariate linear regression analysis found that the best-fitting predictors for the number of hits - that is, age (p = 0.039), Mini-Mental State Examination score (p = 0.006) and the headache symptom (p = 0.021) - influence the performance of virtual reality tasks. CONCLUSION Computer users performed virtual reality tasks better than non-users. Headache and age but not vasomotor symptoms negatively affected the postmenopausal women's performance.
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Affiliation(s)
- J Zangirolami-Raimundo
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Centro Universitário FMABC, São Paulo, Brazil
| | - R D Raimundo
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Centro Universitário FMABC, São Paulo, Brazil
| | - P R E Silva Noll
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - W S Dos Santos
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Centro Universitário FMABC, São Paulo, Brazil
| | - C Leone
- Centro Universitário FMABC, São Paulo, Brazil
| | - E C Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - I C E Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - J M Soares Júnior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Peterson A, Gottesman RT, Miler EC, Tom SE. The association of vasomotor symptoms during the menopausal transition and cognition in later life. Menopause 2022; 29:832-839. [PMID: 35728018 PMCID: PMC10204076 DOI: 10.1097/gme.0000000000001986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The majority of women experience vasomotor symptoms (VMS) during the menopausal transition. Whether self-reported VMS are associated with cognitive test performance later in life remains unclear. The goal of this study was to determine whether a greater burden of VMS is associated with poor later-life cognition. METHODS The Wisconsin Longitudinal Study is a prospective study of randomly selected Wisconsin high school graduates of the class of 1957. At ages 65 and 72, a random subset of participants completed six cognitive tests, including similarities, letter and category fluency, immediate and delayed word recall, and digit ordering. Nested regression models were used to examine the association between extent of VMS, assessed at age 54, and baseline cognition at 65, adjusting for early-life socioeconomic status, women's reproductive health variables, intelligence quotient, and midlife income. This series of models was also used to examine the association between VMS and change in cognition score from age 65 to 72. In sensitivity analyses, models were repeated in a sample using multiple imputation for missing covariates. RESULTS Of the 5,326 women enrolled, 874 had data onVMS, covariates, and all cognitive tests. In an unadjusted model, higher VMS were associated with a lower similarities score (b = -0.09 95% CI -0.16 to -0.02) at age 65 but no other cognitive tests. In adjusted models, VMS were not related to cognition at age 65 or change in cognition. Results remained similar with multiple imputation. CONCLUSIONS Our study does not support a relationship between self-reported VMS and cognition later in life.
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Affiliation(s)
- Amalia Peterson
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Reena T. Gottesman
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Eliza C. Miler
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Sarah E. Tom
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Abstract
OBJECTIVE Menopause is a natural phenomenon among women during their midlife, which is accompanied by unfavorable physical, physiological, and psychological consequences. Therefore, the major aim of the present cross-sectional study was to examine whether the cognitive performance of women is sensitive to the severity of menopausal symptoms. METHODS A total number of 404 rural women aged between 40 and 65 years were included in the present study. The menopausal symptoms and cognitive performance of the women were assessed using the Greene Climacteric Scale and Hindi Mini-Mental State Examination scale respectively. RESULTS The results of the present study demonstrated that women experiencing severe menopausal symptoms (higher Total Greene climacteric score) presented significantly lower mean values for orientation (8.11 vs 8.90, P < 0.001), registration (2.77 vs 2.91, P < 0.001), attention (4.31 vs 4.48, P < 0.01), recall (2.26 vs 2.53, P < 0.05), and language/visuo-spatial skills (7.13 vs 7.91, P < 0.001) as compared with their counterparts with mild menopausal symptoms. The multivariate linear regression model (after adjustment for age, marital status, and educational status) recorded severe depression and greater sexual dysfunction as the factors significantly associated with lower Mini-Mental State Examination scores. CONCLUSION Hence, the findings of the present study indicated that the cognitive performance of women was sensitive to severe depression and sexual dysfunction.
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Affiliation(s)
- Mankamal Kaur
- Department of Anthropology, Panjab University, Chandigarh, India
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Peterson A, Tom SE. A Lifecourse Perspective on Female Sex-Specific Risk Factors for Later Life Cognition. Curr Neurol Neurosci Rep 2021; 21:46. [PMID: 34227023 DOI: 10.1007/s11910-021-01133-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW The prevalence of Alzheimer's disease and related dementias is greater in women compared to men. We provide a review of female sex-specific risk factors across the lifecourse for cognition in older adulthood, highlighting areas that need further study. RECENT FINDINGS Pregnancy may affect late-life cognition, with adverse pregnancy outcomes associated with an increased risk of cognitive decline but parity providing a protective effect. Cumulative estrogen exposure, influenced by age of menarche, menopause, and exogenous estrogen use, may modify a woman's risk for dementia. Menopause transition-associated symptoms may impact cognitive health at the time of the symptoms, but long-term effects remain unknown. As compared to natural menopause, surgical menopause seems to increase the risk for cognitive impairment. Studies that have assessed the association between women's reproductive health and cognition have produced conflicting results. Future studies that address these inconsistencies among diverse populations are needed to better care for women throughout their lives.
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Affiliation(s)
- Amalia Peterson
- Department of Neurology, College of Physicians and Surgeons, Columbia University, 622 W. 168th Street, New York, NY, 10032, USA.
| | - Sarah E Tom
- Department of Neurology, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Reuben R, Karkaby L, McNamee C, Phillips NA, Einstein G. Menopause and cognitive complaints: are ovarian hormones linked with subjective cognitive decline? Climacteric 2021; 24:321-332. [PMID: 33719785 DOI: 10.1080/13697137.2021.1892627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Subjective cognitive decline (SCD) and the loss of ovarian hormones after menopause have been independently linked to later-life Alzheimer's disease (AD). The objective of this review was to determine whether menopause and the loss of ovarian hormones contribute to cognitive complaints and SCD in women. This would suggest that SCD at the menopausal transition might be an important marker of eventual cognitive decline and AD. We conducted a literature search using PubMed, PsycINFO and Web of Science in July 2020. All English-language studies assessing SCD and cognitive complaints with respect to menopause and ovarian hormones were included. A total of 19 studies were included. Studies found that cognitive complaints increased across the menopause transition and were associated with reductions in attention, verbal and working memory, and medial temporal lobe volume. Women taking estrogen-decreasing treatments also had increased cognitive complaints and reduced working memory and executive function. The current literature provides impetus for further research on whether menopause and the loss of ovarian hormones are associated with cognitive complaints and SCD. Clinicians may take particular note of cognitive complaints after menopause or ovarian hormone loss, as they might presage future cognitive decline.
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Affiliation(s)
- R Reuben
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - L Karkaby
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Tema Genus, Linköping University, Linköping, Sweden
| | - C McNamee
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - N A Phillips
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - G Einstein
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Tema Genus, Linköping University, Linköping, Sweden.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
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Dotlic J, Radovanovic S, Rancic B, Milosevic B, Nicevic S, Kurtagic I, Markovic N, Gazibara T. Mental health aspect of quality of life in the menopausal transition. J Psychosom Obstet Gynaecol 2021; 42:40-49. [PMID: 32131666 DOI: 10.1080/0167482x.2020.1734789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To evaluate factors associated with mental health quality of life (QOL), such as depressed mood, anxiety, poor memory and sleep, among midlife women according to the menopausal status. MATERIAL AND METHODS Participants were 500 women aged 40-65 years. Data were collected using socio-demographic questionnaire, Women's Health Questionnaire (domains of depressed mood-DEP, anxiety-ANX, memory-MEM and sleep-SLE) and Short Form-36 (Mental Composite Score) for assessment of health-related QOL. Factors associated with poorer DEP, ANX, MEM and SLE were examined using adjusted linear regression models. RESULTS In premenopausal women, lower household monthly income (p = .046) was associated with higher level of DEP; higher body mass index (p = .045) was associated with higher ANX; having gynecological illnesses (p = .017) and menopause-related symptoms (p = .039) were associated with poorer MEM; being married (p = .036), drinking alcohol (p = .036) and having more physical activity (p = .041) was associated with better SLE. In postmenopausal women, worse DEP was more likely among women residing in city outskirts (p = .009), who are not married (p = .038) and with sedentary occupations (p = .049); lower education level (p = .030) was associated with more ANX; lower education level (p = .045) and having menopause-related symptoms (p = .044) were associated with poorer MEM; not engaging in regular recreation (p = .031) was associated with better SLE. CONCLUSIONS To improve QOL, pre- and postmenopausal women should not only be supported in the management of menopause-specific symptoms. Women should also receive recommendations as to the behavioral and personal changes when approaching the midlife period.
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Affiliation(s)
- Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Biljana Rancic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branislav Milosevic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Selmina Nicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ilma Kurtagic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Tatjana Gazibara
- Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Abstract
Objective: Recent evidence suggests that early or induced menopause increases the risk for cognitive impairment and dementia. Given the potential for different cognitive outcomes due to menopause types, it is important that present research on menopause and cognition distinguishes between types. The aim of this project was to determine to what extent research looking at cognition in postmenopausal women published in one year, 2016, accounted for menopausal type. Methods: We searched MEDLINE, EMBASE, and PsychINFO using keywords and MeSH terms for menopause and cognition. We included any research paper reporting a cognitive outcome measure in a menopausal human population. Differentiation between the types of menopause was defined by four categories: undifferentiated, demographic differentiation (menopause type reported but not analyzed), partial differentiation (some but not all types analyzed), and full differentiation (menopause types factored into analysis, or recruitment of only one type). Results: Fifty research articles were found and analyzed. Differentiation was distributed as follows: undifferentiated, 38% (19 articles); demographic differentiation, 16% (8); partial differentiation, 28% (14); and full differentiation, 18% (9). Conclusions: This review revealed that although some clinical studies differentiated between the many menopauses, most did not. This may limit their relevance to clinical practice. We found that when menopause types are distinguished, the differing cognitive outcomes of each type are clarified, yielding the strongest evidence, which in turn will be able to inform best clinical practice for treating all women.
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Armeni E, Apostolakis M, Christidi F, Rizos D, Kaparos G, Panoulis K, Augoulea A, Alexandrou A, Karopoulou E, Zalonis I, Triantafyllou N, Lambrinoudaki I. Endogenous sex hormones and memory performance in middle-aged Greek women with subjective memory complaints. Neurol Sci 2017; 39:259-266. [DOI: 10.1007/s10072-017-3165-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/20/2017] [Indexed: 12/30/2022]
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