Severe menopause symptoms may take toll on brain health

With more than 24 million people globally living with dementia without a cure in sight, there is a lot of focus on ways to prevent and delay cognitive impairment. A new study suggests that severe menopause symptoms such as hot flushes and depression can negatively affect cognitive function in postmenopausal women. 

In conjunction with our ageing population, dementia diagnoses are on the rise. It is estimated that 4.6 million new cases are diagnosed every year, which translates into one person being diagnosed with dementia every 7 seconds. That means dementia cases are expected to double every 20 years, reaching 81.1 million by 2040.

The good news is that medical experts estimate that 40% of cases of Alzheimer disease, the most common form of dementia, can be prevented or, at minimum, delayed. Because of this fact, there is a lot of interest in identifying risk factors. Recent research has focused on the importance of estradiol in female cognitive ageing. Because the menopause transition is characterized by a decline in estrogen, postmenopausal women are at an increased risk of dementia.

A new study involving nearly 1,300 late-postmenopausal women from nine Latin American countries suggests that severe menopause symptoms such as hot flushes, sleep, and mood disturbances were linked with cognitive impairment. Whether effectively treating hot flushes with hormone therapy or other approved therapies can help improve cognition in the form of memory, attention, language, and executive function, is unknown.

Based on these results, the researchers concluded that there is intricate interplay between hormonal, lifestyle, and sociodemographic factors involved with cognitive health.

Abstract

Objective 

To evaluate the association between menopausal symptoms and cognitive decline in postmenopausal women.

Methods 

This was a subanalysis of a cross-sectional, observational study conducted among women attending gynecological consultations across nine Latin American countries. The survey involved late postmenopausal women who were asked to complete a general questionnaire and the Menopause Rating Scale (MRS) to assess menopausal symptoms, with the Montreal Cognitive Assessment used to evaluate cognitive function as an outcome. A Montreal Cognitive Assessment score of less than 21 was used to define women with mild cognitive impairment (MCI).

Results 

The study included 1,287 postmenopausal women with a mean age of 55.5 years and a mean body mass index of 26.3 kg/m2. On average, participants had 13.8 years of education and 2.3 ± 1.8 children, with 72.8% reporting having a partner. Additionally, 36.7% ever used menopausal hormone therapy. Regarding lifestyle factors, 50.3% engaged in a sedentary lifestyle, whereas 70.5% had never smoked. 15.3% of women had MCI exhibited significantly more intense menopausal symptoms compared with those without MCI (MRS total score 15.24 ± 12.58 vs 10.53 ± 8.84, respectively, P < 0.001). Logistic regression analysis revealed a significant association between severe menopausal symptoms (MRS total score ≥14 points) and MCI (odds ratio [OR], 1.74; 95% CI, 1.25-2.42). Conversely, a lower body mass index (OR, 0.96; 95% CI, 0.95-0.98), sexual activity (OR, 0.70; 95% CI, 0.51-0.96), physical exercise (OR, 0.55; 95% CI, 0.39-0.76), menopausal hormone therapy use (OR, 0.36; 95% CI, 0.24-0.55), and higher educational level (OR, 0.31; 95% CI, 0.21-0.46) were associated with lower odds for MCI.

Conclusion 

Severe menopausal symptoms in postmenopausal women were associated with cognitive impairment. This study highlights the intricate interplay between hormonal, lifestyle, and sociodemographic factors and cognitive health.

Reference