Cognition and mood in perimenopause: A systematic review and meta-analysis

Abstract

Objective It is suggested that declines in estrogen around menopause are associated with declines in cognitive functioning as well as increased risk of depressive symptoms and depressive disorders. Existing studies of objective cognitive function and mood have differed in the criteria used to stage the menopausal transition and in the outcome measures used. The purpose of this review was to synthesize the existing studies of the relationship between menopausal stage and neuropsychological performance and depression. Design A search of the literature of observational studies was performed using PubMed. Four cross-sectional studies on menopausal transition stage and cognitive function and four longitudinal studies on menopausal transition stage and risk of depression, as measured by symptom inventories and structured clinical interviews, were selected. For the cognitive outcomes, fixed effects models were used to estimate overall standardized effect sizes. For the depression outcomes, the results of group comparisons were summarized using the log odds ratio and its estimated standard error. Results Postmenopausal women performed significantly worse than pre- and perimenopausal women on delayed verbal memory tasks, and significantly worse than perimenopausal women on phonemic verbal fluency tasks. Peri- and postmenopausal women were at significantly increased risk of depression, as measured by standard symptom inventories and structured clinical interviews, than premenopausal women. Conclusions The menopausal transition is a time of increased vulnerability to cognitive declines and increased risk of depressive symptoms and depressive disorders. However, these results cannot necessarily be generalized beyond the studies included in this review.

Impact of a premature menopause on cognitive function in later life

“…2 These changes in estrogen levels have been speculated to account for the increased reporting of memory complaints during this period. 3,4 In support of this, experimental evidence indicates that estrogen has neuroprotective and neurotrophic effects 5 and, after the menopause, brain atrophy in women accelerates at a faster rate than in men. 6 Although it remains under debate, 7,8 positive correlations between endogenous estrogen levels and cognitive function 9,10 have been reported, and supplementing estrogen through hormone treatment (HT) may help reduce cognitive decline and dementia risk in postmenopausal women.…”

In Vivo Imaging of Brain Estrogen Receptors in Rats: A 16α-18F-Fluoro-17β-Estradiol PET Study

“…Postmenopausal women may experience psychologic changes and cognitive deficits and may develop depression (5). A prolonged deficiency of estrogens has also been associated with an increased risk of developing dementia, including Alzheimer disease (5,6).…”

“…Postmenopausal women may experience psychologic changes and cognitive deficits and may develop depression (5). A prolonged deficiency of estrogens has also been associated with an increased risk of developing dementia, including Alzheimer disease (5,6). Hormonal treatment with estradiol was found to enhance or facilitate cognition and reduce depression in postmenopausal women and in animal models of reproductive senescence, that is, ovariectomized (OVX) rats (7)(8)(9).…”

The influence of menopause on life of working women: the problem without necessary attention

“…Женщины в пери-и постменопаузе с вазомотор-ными симптомами испытывают снижение многих когнитивных функций, включая трудности с плани-рованием рабочего времени, вниманием, организа-цией труда, памятью и решением проблем, характер-ных для этого периода времени в целом [15,16]. В ходе SMWHS (Seattle Midlife Women's Health Study), забывчивость и трудности с концентрацией внима-ния тесно коррелировали с приливами, тревогой, де-прессивным настроением, снижением стрессоустой-чивости, негативным восприятием своего здоровья и нарушением сна [17].…”