ABSTRACT
Estrogen exposure during menstrual years has been associated with late-life neuroprotection. We explored the presence of an age-sensitive menarche window for cognition in old age and the impact of socioeconomic status and education. We compared neuropsychological performance of 1082 older women [MeanAGE = 72.69 (5.48)] with menarche in childhood, early-, mid-, and late-adolescence and dementia prevalence, severity, and type, including the effects of education and socioeconomic status. Adjusting for covariates, menarche at 11–14 years of age was associated with better memory, executive and global cognitive functioning in old age, and stronger positive effects of education and socioeconomic status on cognition than those with menarche at 15–17 years. We found a critical age window for the neuroprotective effects of estrogens during early adolescence, putting women with later menarche at higher risk for cognitive decline. Effects of socioeconomic status and education in adulthood should be a focus of future research.
Acknowledgments
This paper is a collaborative work of the authors, each making unique contributions. Specifically, S.M. formulated the research hypotheses, conducted background research and statistical analyses. She played a central role in composing the article. N.S. contributed to the design of the study protocol, oversaw primary data collection, and provided a thorough revision of the Introduction, Methods, and Results sections offering valuable insights. M.Y. refined the Introduction, Methods, and Results sections, ensuring their alignment with the research design. E.D., G.M.H., and P.S. contributed to the design of the study protocol, oversaw data collection, and provided domain-specific expertise and insights. Finally, M.H.K. oversaw all aspects of the study, including contribution to the design of the study protocol, primary data collection, and secondary data analysis, as well as proofreading the manuscript ensuring accuracy and coherence. All authors have reviewed and approved the final manuscript. We would like to thank all the professionals and researchers who assisted in the data collection.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available on request from the corresponding author, M.H.K. The data are not publicly available due to privacy restrictions governed by the General Data Protection Regulation.