A research primer for studies of cognitive changes across the menopause transition

Abstract

There has been a proliferation of studies demonstrating important sex differences in cognitive aging and dementia, and with this an increased interest in the role of menopause and sex steroid hormones in women’s brain health. Foundational longitudinal studies of cognitive changes from the premenopause to perimenopause stage have shown reliable declines in verbal memory, with variable findings in processing speed, attention/working memory and verbal fluency. Continued research is needed to advance understanding of the range of cognitive domains affected, the duration of cognitive changes, the generalizability of these changes across cultures, the factors that account for such changes and the factors that can improve cognition at this time. In this article, we briefly review and draw on findings from large longitudinal studies of cognitive changes across the menopause transition to inform the design of future studies on this topic. We focus on key issues such as objective versus subjective cognitive measures; cognitive domains and tests; staging menopause; study design; mediators of cognitive effects (including hormones and menopause symptoms); and consideration of key covariates. We suggest that a more uniform and evidence-based approach to the investigation of these issues can advance the quality of the science in menopause and cognition.

摘要

越来越多的研究表明认知衰老和痴呆症存在重要的性别差异, 因此人们对更年期和性类固醇激素在女性大脑健康中的作用越来越感兴趣。对从绝经前到围绝经期认知变化的基础纵向研究表明, 语言记忆确实出现了下降, 处理速度、注意力/工作记忆和语言流畅性方面的结果各不相同。需要继续进行研究, 以加深对受影响的认知领域范围、认知变化的持续时间、这些变化在不同文化中的普遍性、导致这些变化的因素以及此时可以改善认知的因素的理解。在本文中, 我们简要回顾并借鉴了更年期过渡期间认知变化的大型纵向研究的结果, 以指导未来有关该主题的研究设计。我们专注于关键问题, 例如客观与主观认知测量；认知领域和测试；分期更年期；学习规划;认知影响的介质（包括激素和更年期症状）；并考虑关键协变量。我们建议对这些问题的调查采用更统一和基于证据的方法可以提高更年期和认知方面的科学质量。

Keywords:

• Menopause
• cognition
• experimental design
• memory
• neuropsychology

Potential conflict of interest

P.M.M. has received consulting honoraria from Abbvie, Astellas, Balchem, Johnson & Johnson and Pfizer. M.T.W. reports no conflict of interest. The authors alone are responsible for the content and writing of the article.

Source of funding

Nil.