Severe menopause symptoms linked to increased risk of cognitive decline in postmenopausal women

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A significant connection has been identified between severe menopause symptoms and cognitive impairment in postmenopausal women, according to findings from a study published in Menopause, the journal of The Menopause Society.¹

As the global population ages, dementia rates are rising rapidly, with 4.6 million new cases diagnosed annually, with 1 person being diagnosed with dementia every 7 seconds. This trend is expected to result in 81.1 million dementia cases worldwide by 2040.¹

Study design

The study was a subanalysis of a cross-sectional, observational survey conducted across 9 Latin American countries. Researchers evaluated 1,287 postmenopausal women with a mean age of 55.5 years. The research aimed to assess the relationship between menopausal symptoms and cognitive decline.²

Participants completed a general questionnaire and the Menopause Rating Scale (MRS) to evaluate menopausal symptoms, while cognitive function was measured using the Montreal Cognitive Assessment (MoCA). A MoCA score of less than 21 was used to identify women with mild cognitive impairment (MCI).²

Results

Results revealed that 15.3% of the women had MCI, and those with MCI exhibited significantly more intense menopausal symptoms compared to those without MCI (MRS total score 15.24 ± 12.58 vs. 10.53 ± 8.84, respectively, P < 0.001). Logistic regression analysis further demonstrated a significant association between severe menopausal symptoms (MRS total score ≥14 points) and MCI, with an odds ratio (OR) of 1.74 (95% CI, 1.25-2.42).²

Conversely, several factors were associated with a lower risk of MCI. These included 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).²

Conclusion

The study's findings underscore the importance of addressing severe menopausal symptoms as a potential risk factor for cognitive decline.

"This study showed a potential link between severe menopause symptoms and cognitive impairment in midlife women,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society. “The results also suggest a protective effect of lower body mass index, higher educational level, physical exercise, hormone therapy use, and sexual activity on cognition, highlighting the potential for targeted interventions to protect and preserve cognitive function in menopausal women.”¹

The research emphasizes the complex relationship between hormonal changes, lifestyle factors, and sociodemographic influences on cognitive health in postmenopausal women. With dementia cases on the rise globally, identifying and addressing risk factors like severe menopause symptoms could play a crucial role in preventing or delaying cognitive impairment and dementia in women.

References:

1. The Menopause Society. Severe menopause symptoms may take toll on brain health. Eureka Alert. August 14, 2024. Accessed August 22, 2024. https://www.eurekalert.org/news-releases/1054418#:~:text=Severe%20menopause%20symptoms%20may%20take%20toll%20on%20brain%20health&text=A%20new%20study%20suggests%20that,journal%20of%20The%20Menopause%20Society.

2. Calle A, Blümel JE, Chedraui P, et al. Severe menopausal symptoms linked to cognitive impairment: an exploratory study. Menopause. Published online August 13, 2024. doi:10.1097/GME.0000000000002422