Association of Premenopausal Bilateral Oophorectomy With Cognitive Performance and Risk of Mild Cognitive Impairment

Rocca, Walter A.; Lohse, Christine M.; Smith, Carin Y.; Fields, Julie A.; Machulda, Mary M.; Mielke, Michelle M.

doi:10.1001/jamanetworkopen.2021.31448

Cited by 32 publications

(39 citation statements)

References 30 publications

(96 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early menopause, especially before the age of 40 (either spontaneous or due to bilateral oophorectomy) is associated with an increased risk of MCI, AD, and medial temporal lobe neurodegeneration 89–94 . This risk is most pronounced among women who do not use menopausal hormone therapy (MHT) up until the age of 50.…”

Section: Sex‐specific Risk Factors (Table 3)mentioning

confidence: 99%

Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Mielke

Aggarwal

Vila‐Castelar

et al. 2022

Alzheimer's & Dementia

Self Cite

View full text Add to dashboard Cite

Sex or gender differences in the risk of Alzheimer's disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk.

show abstract

Section: Sex‐specific Risk Factors (Table 3)mentioning

confidence: 99%

Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Mielke

Aggarwal

Vila‐Castelar

et al. 2022

Alzheimer's & Dementia

Self Cite

View full text Add to dashboard Cite

show abstract

“…Assim, é primordial que, nos estudos longitudinais acerca dessa problemática, as variáveis estudadas (idade, tipo de menopausacirúrgica, não cirúrgica -, terapia hormonal pós-menopausa) gerem uma significância estatística para impor que as pesquisas em questão forneçam dados mais confiáveis (CANONICO et al, 2021;ROCCA et al, 2021;CERRI et al, 2019). Em suma, é válido salientar que a redução da prática de ooforectomia bilateral profilática em mulheres na pré-menopausa com risco médio de câncer de ovário pode ter um impacto substancial na redução do risco de parkinsonismo e DP (ROCCA et al, 2022).…”

Section: Resultsunclassified

Associação entre a ooforectomia bilateral precoce e o desenvolvimento do parkinsonismo e Doença de Parkinson em mulheres na pré-menopausa

Ázar¹,

Correia²,

Souza³

et al. 2023

Braz. J. Develop.

View full text Add to dashboard Cite

O parkinsonismo é um distúrbio do sistema nervoso de maior incidência masculina do que feminina, visto que, por mecanismos fisiológicos, o estrogênio possui efeitos neuroprotetores, com funções como aumento da dopamina, um neurotransmissor essencial para o controle das funções motoras. Além disso, previne a formação dos corpúsculos de Lewy e da agregação da α-sinucleína, responsáveis pela progressão da Doença de Parkinson. Por isso, a doença se apresenta diferentemente nas mulheres. A remoção cirúrgica de ambos os ovários em mulheres na pré-menopausa para a prevenção do câncer de ovário parece favorecer o surgimento da doença, tendo em vista a perda da produção do hormônio protetor. Assim, o objetivo do estudo é analisar a associação entre a ooforectomia bilateral precoce e o desenvolvimento de parkinsonismo e Doença de Parkinson em mulheres na pré-menopausa. Trata-se de uma revisão bibliográfica sistemática, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, a ooforectomia bilateral precoce em mulheres na pré-menopausa aumenta o risco do desenvolvimento de parkinsonismo. Desse modo, a diminuição dos procedimentos cirúrgicos profiláticos para câncer de ovário nas pacientes com risco médio de malignidade reduziria o risco dessa condição.

show abstract

“…31 Similar associations have been reported for cognitive decline, dementia, and restless legs syndrome. 34,35 Third, there may be both a confounding effect and an adverse effect of bilateral oophorectomy for the risk of parkinsonism or PD (Figure 2C). Under this more complex hypothesis, bilateral oophorectomy may be partly involved in a chain of adverse events, and a change in surgical practice may have a partial beneficial outcome.…”

Section: Discussionmentioning

confidence: 99%

Association of Premenopausal Bilateral Oophorectomy With Parkinsonism and Parkinson Disease

et al. 2022

Self Cite

View full text Add to dashboard Cite

ImportanceThe association of premenopausal bilateral oophorectomy with parkinsonism and Parkinson disease (PD) remains controversial.ObjectiveTo assess whether women who underwent premenopausal bilateral oophorectomy were at increased risk of parkinsonism and PD and whether the associations varied by age at oophorectomy and by receipt of estrogen replacement therapy.Design, Setting, and ParticipantsThis cohort study used data from a combination of 2 independent cohort studies, the Mayo Clinic Cohort Study of Oophorectomy and Aging 1 and 2, which were based on the Rochester Epidemiology Project medical records–linkage system. A population-based sample of 5499 women from Olmsted County, Minnesota, were included; of those, 2750 women underwent bilateral oophorectomy for a benign indication before spontaneous menopause between January 1, 1950, and December 31, 2007 (oophorectomy cohort), and 2749 age-matched women who did not undergo bilateral oophorectomy were randomly sampled from the general population (reference cohort). Data were analyzed from March 1 to April 30, 2022. The date of oophorectomy was considered the index date for both groups.ExposuresMedical record documentation of bilateral oophorectomy abstracted from a medical records–linkage system (Rochester Epidemiology Project).Main Outcomes and MeasuresIncidence and risk of parkinsonism or PD, with diagnoses confirmed by in-person examination or medical record review.ResultsAmong 5499 participants (median [IQR] age, 45.0 [40.0-48.0] years; 5312 [96.6%] White), 2750 women (2679 White [97.4%]) underwent bilateral oophorectomy at a median age of 45.0 years (IQR, 40.0-48.0 years), and 2749 women (2633 White [95.8%]) with a median age of 45.0 years (IQR, 40.0-48.0 years) at the index date were included in the reference cohort. Bilateral oophorectomy was associated with an increased risk of parkinsonism overall (hazard ratio [HR], 1.59; 95% CI, 1.02-2.46) and in women younger than 43 years at oophorectomy (HR, 7.67; 95% CI, 1.77-33.27). There was a pattern of increasing risk with younger age at the time of oophorectomy using 4 age strata (≥50 years: HR, 1.43 [95% CI, 0.50-4.15]; 46-49 years: HR, 1.55 [95% CI, 0.79-3.07]; 40-45 years: HR, 1.36 [95% CI, 0.64-2.89]; &lt;40 years: HR, 8.82 [95% CI, 1.08-72.00]; P = .02 for trend). The number needed to harm was 53 women overall and 27 women younger than 43 years at the time of oophorectomy. Bilateral oophorectomy was also associated with an increased risk of PD in women younger than 43 years at oophorectomy (HR, 5.00; 95% CI, 1.10-22.70), with a number needed to harm of 48 women. Among women who underwent oophorectomy at 45 years and younger, the risk was lower in women who received estrogen after the procedure and through age 50 years compared with women who did not. For parkinsonism, the HRs were 1.72 (95% CI, 0.54-5.53) vs 2.05 (95% CI, 0.80-5.23); for PD, the HRs were 1.53 (95% CI, 0.29-8.23) vs 2.75 (95% CI, 0.84-9.04). However, the differences were not significant.Conclusions and RelevanceIn this study, premenopausal women who underwent bilateral oophorectomy before age 43 years had an increased risk of parkinsonism and PD compared with women who did not undergo bilateral oophorectomy. These findings suggest that a reduction in the practice of prophylactic bilateral oophorectomy in premenopausal women at average risk of ovarian cancer may have substantial benefit for reducing the risk of parkinsonism and PD.

show abstract

Association of Premenopausal Bilateral Oophorectomy With Cognitive Performance and Risk of Mild Cognitive Impairment

Cited by 32 publications

References 30 publications

Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Associação entre a ooforectomia bilateral precoce e o desenvolvimento do parkinsonismo e Doença de Parkinson em mulheres na pré-menopausa

Association of Premenopausal Bilateral Oophorectomy With Parkinsonism and Parkinson Disease

Contact Info

Product

Resources

About