Summary: Researchers have identified four cognitive profiles associated with menopause. Findings reveal women who experience stronger verbal learning and memory, in addition to better attention and executive function during menopause, are less likely to experience hot flashes and depression. Women who experienced cognitive weakness had an increased risk of depression and sleep disruptions.
Source: University of Rochester
Menopause can mess with your memory, and a new study from the University of Rochester Medical Center has identified four profiles of cognitive function that may help researchers understand why memory declines for some women and not others. This adds to the mounting evidence of the memory changes that can happen when menopause approaches and could lead to better guidance and treatment for patients experiencing memory issues.
“If we understand what goes on cognitively for women during this time, we can help normalize the experience,” said Miriam Weber, Ph.D., associate professor of Neurology and Obstetrics and Gynecology who is the first author of the study published in the journal Climacteric.
Menopause symptoms can include memory issues
Researchers collected data from 85 women ages 40-60 who were approaching or at the beginning of menopause. Women self-reported menopausal symptoms, had hormone levels measured, and took cognitive tests biannually for up to nine years.
The data led investigators to identify four profiles of cognitive function a woman may experience: normal cognition, weakness in verbal learning and memory (the ability to learn new information and retain it over time), strength in verbal learning and memory, and strength in attention and executive function (the ability to multitask).
“This profile analysis could help identify populations that are at risk and enable us to perform prompt interventions,” said Weber. “This may also give us insight into future diagnosis – for example, who may be more likely to develop Alzheimer’s disease in the future. We know that women are most at risk for the disease, and knowing how cognition is impacted at this stage may help us identify who is at an increased risk of cognitive decline in later life.”
Researchers found that women experiencing a strength profile (strength in either verbal learning and memory or attention and executive function) had fewer depressive symptoms and hot flashes, while those experiencing cognitive weakness reported more sleep disturbances and symptoms of depression.
Weber’s previous work found that some women approaching menopause experienced declines in working memory – the ability to take in new information and manipulate it in their heads, and a woman’s ability to keep and focus attention on a challenging task. But these declines were not directly linked to hormones, according to Weber’s studies.
“Rather than just saying what the normative experience is for everyone, we’re sort of saying can we see these different profiles and then what are some of the things that are associated with each – either risk for worse cognitive performance or resilience. But some are doing better than we might expect during a time when many people experience declines.”
Funding: Additional authors include Teresa Steffenella with Rochester School of Nursing, Leah Rubin, John Hopkins University, Robert Schroeder and Pauline Maki of the University of Illinois at Chicago. The research was supported by funding from the National Institute on Aging, National Center for Research Resources, and National Science Foundation Graduate Research Fellowship Program.
When does menopause start?
The average age of menopause is 51. But menopause can happen any time from the 30s to the mid-50s or later. Women who smoke and are underweight tend to have an earlier menopause. Women who are overweight often have a later menopause. Generally, a woman tends to have menopause at about the same age as her mother did.
What are the symptoms of menopause?
Hot flashes, vaginal atrophy, relaxation of the pelvic muscles, cardiac effects including dizziness, numbness/tingling, heart palpitations, and fast heart rhythm, hair growth, mental health. These are the most common symptoms of menopause. Each woman may experience symptoms differently. Some have few and less severe symptoms, while others have more frequent and stressful ones.
Cognitive profiles in perimenopause: hormonal and menopausal symptom correlates
Perimenopause is associated with declines in attention, working memory and verbal memory; however, there are significant individual differences. Further, the contributions of hormones and menopausal symptoms to domain-specific cognitive functions remain unknown. This longitudinal study aimed to determine whether there were distinct cognitive profiles in perimenopause and to identify factors associated with each profile.
In a sample of 85 women evaluated over 400 bi-annual visits, we administered a comprehensive neuropsychological battery, assessed menopausal symptoms and measured 17β-estradiol and follicle stimulating hormone. Multilevel latent profile analysis was used to identify cognitive profiles. Regressions were conducted to determine differences in hormones and symptoms by profile after adjusting for Stages of Reproductive Aging Workshop + 10 (STRAW + 10) stage and demographic factors.
Perimenopausal cognitive profiles consisted of cognitively normal (Profile 1; n = 162), weaknesses in verbal learning and memory (Profile 2; n = 94), strengths in verbal learning and memory (Profile 3; n = 98) and strengths in attention and executive function (Profile 4; n = 61). Profile 2 was differentiated by less hormonal variability and more sleep disturbance than Profile 1 (p < 0.05).
There is significant heterogeneity in cognition during perimenopause. While most women do not develop impairments, a significant minority experience weaknesses in verbal learning and memory. Profile analysis may identify at-risk populations and inform interventions.