Cognitive profiles in perimenopause: hormonal and menopausal symptom correlates

Abstract

Objective: Perimenopause is associated with declines in attention, working memory and verbal memory; however, there are significant individual differences. Further, the contributions of hormones and menopausal symptoms to domain-specific cognitive functions remain unknown. This longitudinal study aimed to determine whether there were distinct cognitive profiles in perimenopause and to identify factors associated with each profile. Design: In a sample of 85 women evaluated over 400 bi-annual visits, we administered a comprehensive neuropsychological battery, assessed menopausal symptoms and measured 17b-estradiol and follicle stimulating hormone. Multilevel latent profile analysis was used to identify cognitive profiles. Regressions were conducted to determine differences in hormones and symptoms by profile after adjusting for Stages of Reproductive Aging Workshop þ 10 (STRAW þ 10) stage and demographic factors. Results: Perimenopausal cognitive profiles consisted of cognitively normal (Profile 1; n ¼ 162), weaknesses in verbal learning and memory (Profile 2; n ¼ 94), strengths in verbal learning and memory (Profile 3; n ¼ 98) and strengths in attention and executive function (Profile 4; n ¼ 61). Profile 2 was differentiated by less hormonal variability and more sleep disturbance than Profile 1 (p < 0.05). Conclusions: There is significant heterogeneity in cognition during perimenopause. While most women do not develop impairments, a significant minority experience weaknesses in verbal learning and memory. Profile analysis may identify at-risk populations and inform interventions.

Cognition and mental health in menopause: A review

“…However, effects of time since FMP on lowered scores in verbal memory -when chronological aging and learning effects were taken into account-were small. Importantly, recent analyses [21] suggested that only 20% of women show objective lower verbal memory scores when going through the menopausal transition, which was associated with sleep disturbances and less hormonal variation, but that the majority of women did not experience significant objective cognitive decline.…”

Estrogen receptor beta in astrocytes modulates cognitive function in mid-age female mice

“…Sex differences in disease can be mechanistically disentangled at the laboratory bench, with findings translatable to the clinic as treatment trials optimally tailored for women or men 9 – 11 . With regard to neurodegeneration, menopause in healthy women involves cognitive difficulties, termed “brain fog”, that affect hippocampal-dependent verbal memory, attention, and processing speed as quantified by objective cognitive testing 12 , 13 . Also, healthy women have worse brain gray matter atrophy as assessed by magnetic resonance imaging (MRI) after age 65 years 14 , 15 .…”

Severe Obesity in Women Can Lead to Worse Memory Function and Iron Dyshomeostasis Compared to Lower Grade Obesity

“…Also, the data about menstruation cycle and eutrophic group would be helpful to better interpret the iron status of participants. Nonetheless, because age is one of the main predicting factors for menopause, and both groups showed similar distribution of age, we can infer that perimenopause or menopause would not be the main factor that differentiates both groups in the cognitive function, even though previous studies have demonstrated that perimenopause may affect cognitive function [ 47 , 48 ]. On the other hand, our findings add to the literature by showing the impact of obesity on cognitive function and possible involvement of iron deficiency.…”