Menopause and cognitive complaints: are ovarian hormones linked with subjective cognitive decline?

Abstract

Subjective cognitive decline (SCD) and the loss of ovarian hormones after menopause have been independently linked to later-life Alzheimer’s disease (AD). The objective of this review was to determine whether menopause and the loss of ovarian hormones contribute to cognitive complaints and SCD in women. This would suggest that SCD at the menopausal transition might be an important marker of eventual cognitive decline and AD. We conducted a literature search using PubMed, PsycINFO and Web of Science in July 2020. All English-language studies assessing SCD and cognitive complaints with respect to menopause and ovarian hormones were included. A total of 19 studies were included. Studies found that cognitive complaints increased across the menopause transition and were associated with reductions in attention, verbal and working memory, and medial temporal lobe volume. Women taking estrogen-decreasing treatments also had increased cognitive complaints and reduced working memory and executive function. The current literature provides impetus for further research on whether menopause and the loss of ovarian hormones are associated with cognitive complaints and SCD. Clinicians may take particular note of cognitive complaints after menopause or ovarian hormone loss, as they might presage future cognitive decline.

摘要

主观认知能力下降 (SCD) 和绝经后卵巢激素的丧失与晚年阿尔茨海默病 (AD) 独立相关。本综述的目的是确定更年期和卵巢激素的丧失是否会导致女性的认知障碍和 SCD。这表明绝经过渡期的 SCD 可能是最终认知能力下降和 AD 的重要标志。我们于 2020 年 7 月使用 PubMed、PsycINFO 和 Web of Science 进行了文献检索。所有评估 SCD 和与更年期和卵巢激素相关的认知问题的英语研究都包括在内。共纳入 19 项研究。研究发现, 在更年期过渡期间, 认知问题增加, 并且与注意力、语言和工作记忆以及内侧颞叶体积的减少有关。接受降低雌激素治疗的女性的认知问题也有所增加, 工作记忆和执行功能也会降低。目前的文献为进一步研究更年期和卵巢激素的丧失是否与认知障碍和 SCD 相关提供了动力。临床医生可能会特别注意更年期或卵巢激素丧失后的认知问题, 因为它们可能预示着未来的认知能力下降。

Keywords:

• Menopause
• ovarian hormones
• estrogens
• cognitive complaints
• subjective cognitive decline
• Alzheimer’s disease

Potential conflict of interest

The authors report no conflict of interest.

Additional information

Funding

Canadian Consortium on Neurodegeneration in Aging Phase II [CCNA 049-04]; Canadian Institute of Health Research [WJP-150643]; Ontario Brain Institute, Women’s Brain Health Initiative Chair; Wilfred and Joyce Posluns Chair in Women’s Brain Health and Aging: Women’s Brain Health Initiative [WJP-150643].