Menopausal symptoms, menopausal stage and cognitive functioning in black urban African women

Abstract

Objective: Studies, conducted largely in North America and Europe, demonstrate that menopausal symptoms and menopausal stage influence cognitive function. Here, we evaluate these associations in a large cohort of sub-Saharan African women, a population where these associations are understudied. We hypothesized that premenopausal women would show better cognitive performance than women later in the transition, and that menopausal symptoms would be inversely related to cognition.

Methods: This cross-sectional study included 702 black urban South African women between the ages of 40 and 60 years from the Study of Women Entering and in Endocrine Transition. Participants completed the Symbol Digit Modalities Test, a measure of processing speed and incidental recall. Menopausal stage was ascertained using the Stages of Reproductive Aging Workshop+ 10 criteria and symptoms using the Menopause Rating Scale. Multivariable linear regression analyses were used to examine adjusted associations between menopausal stage and menopausal symptoms on cognitive performance.

Results: In adjusted analyses, menopausal stage was not associated with processing speed (p = 0.35) or incidental recall (p = 0.64). However, more severe symptoms of hot flushes and anxiety were associated with slower processing speed (all p < 0.05), and more severe mood symptoms were associated with worse incidental recall (p = 0.008).

Conclusion: Menopausal symptoms, but not menopausal stage, were associated with cognitive function in this cross-sectional study of sub-Saharan African women.

摘要

目的：大量在北美和欧洲进行的研究表明, 更年期症状和更年期影响认知功能。在这里, 我们在撒哈拉以南非洲妇女的一大群人中评估了它们之前的关系, 在这些人群中, 他们的关系还未被研究。我们假设绝经前的女性比处于过渡期的女性表现出更好的认知能力, 并且绝经症状与认知呈负相关。

方法：这项横断面研究包括702名40-60岁的南非城市黑人妇女, 研究对象是进入和处于内分泌过渡期的妇女。参与者完成了符号-数字模式测试, 这是一种测量处理速度和附带回忆的方法。更年期采用生殖衰老分期工作量表+10级标准, 症状采用更年期评定量表。采用多变量线性回归分析探讨更年期与更年期症状对认知功能的调节关系。

结果：在校正分析中, 更年期与处理速度（p<0.35）或偶然回忆（p<0.64）无关。而更为严重的潮热和焦虑症状则与治疗速度较慢（P＜0.05）有关, 更严重的情绪症状与偶发性不良反应有关（P＜0.008）。

结论：在这项对撒哈拉以南非洲妇女的横断面研究中, 更年期症状与认知功能有关, 而更年期与认知功能无关。

Keywords:

• Menopausal symptoms
• cognition
• anxiety
• cross-cultural

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Source of funding

This study was funded by grants from Medical Research Council of South Africa (MRC); National Health Laboratory Service (NHLS) Research Trust; University of the Witwatersrand Iris Ellen Hodges Cardiovascular Research Trust; National Research Foundation (NRF) of South Africa. S.A.N. is supported by the DST-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg, South Africa.