Impact of a premature menopause on cognitive function in later life.

Abstract

OBJECTIVE:

To determine whether premature menopause (≤40 years) can have long-lasting effects on later-life cognition and investigate whether this association varies depending on the type of menopause and use of hormone treatment (HT).

DESIGN:

Population-based cohort study.

SETTING:

The French Three-City Study.

POPULATION:

Four thousand eight hundred and sixty-eight women aged at least 65 years.

METHODS:

Multivariable-adjusted logistic regression models were used to determine the association between age at menopause, type of menopause (surgical, natural), and the use of menopausal HT and later-life cognitive function.

MAIN OUTCOME MEASURES:

Performance on a cognitive test battery (at baseline and over 7 years) and clinical dementia diagnosis.

RESULTS:

Menopause at or before the age of 40 years, both premature bilateral ovariectomy and premature ovarian failure (non-surgical loss of ovarian function), was associated with worse verbal fluency (OR 1.56, 95%CI 1.12-1.87, P=0.004) and visual memory (OR 1.39, 95%CI 1.09-1.77, P=0.007) in later life. HT at the time of premature menopause appeared beneficial for later-life visual memory but increased the risk of poor verbal fluency. Type of menopause was not significantly associated with cognitive function. Premature menopause was associated with a 30% increased risk of decline in psychomotor speed and global cognitive function over 7 years.

CONCLUSION:

Both premature surgical menopause and premature ovarian failure were associated with long-term negative effects on cognitive function, which are not entirely offset by menopausal HT. In terms of surgical menopause, these results suggest that the potential long-term effects on cognitive function should form part of the risk/benefit ratio when considering ovariectomy in younger women.

• Authors: J Ryan, J Scali, I Carrière, H Amieva, O Rouaud, C Berr, K Ritchie, M-L Ancelin
• Journal: BJOG : an international journal of obstetrics and gynaecology (BJOG) Vol. 121 Issue 13 Pg. 1729-39 (Dec 2014) ISSN: 1471-0528 [Electronic] England
• PMID: 24802975 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 Royal College of Obstetricians and Gynaecologists.

Chemical References

• Estrogens
• Estradiol

Topics

• Aged
• Aged, 80 and over
• Cognition
• Dementia (epidemiology, psychology)
• Estradiol (therapeutic use)
• Estrogen Replacement Therapy (psychology, statistics & numerical data)
• Estrogens (therapeutic use)
• Female
• Humans
• Logistic Models
• Menopause (psychology)
• Menopause, Premature (psychology)
• Multivariate Analysis
• Neuropsychological Tests
• Ovariectomy (psychology, statistics & numerical data)
• Primary Ovarian Insufficiency (epidemiology, psychology)
• Psychomotor Performance
• Risk Factors
• Transdermal Patch