Posts Tagged ‘premenopause’

Cognitive Symptoms During Midlife

August 15th, 2010    Posted in Cognition

During the menopausal transition, it is common for women to report problems with memory. In cross-sectional analyses of women ages 40 to 55 years in the Study of Women Across America (a multicenter study of the natural history of the menopausal transition1), forgetfulness was reported significantly more often among those in the menopausal transition or postmenopause compared to the premenopause.2 In the Seattle Midlife Women’s Health Study, more than two-thirds of middle-age women (mean age 47 years) reported difficulty recalling names; nearly one-half indicated problems with recalling telephone numbers just checked, whether they had already told someone something, things they had been told by others, where they put things, or what they were doing.3

Despite the frequency of memory complaints, effects of menopause per se on cognitive function has rarely been studied with objective measures. In a recent issue of the journal Neurology, Meyer examined scores on two brief psychometric tests in middle-age women. Eligible women were participants in the Chicago site of the Study of Women’s Health Across the Nation, selected from a geographically defined urban area. They were aged 42 to 52 years, had a uterus and at least one ovary, had menstruated within the past 3 months, were not pregnant or breastfeeding, and had not used hormone therapy in the prior 3 months. Women were assessed with the digit span backward test and the Symbol Digit Modalities Test. The former is an attentional and working memory task that required women to repeat in reverse order an increasingly long string of digits. The latter is a speeded task of complex visual scanning, attention, and working memory in which participants were presented with a key on whichprinted symbols are paired with a digit and with a list of these symbols. Each woman was asked to provide the corresponding number for as many of the listed symbols as she could during 90 seconds.

At baseline, most women were premenopausal or during the early menopausal transition. Over a mean follow-up of slightly over 2 years, women were assessed annually; approximately 600 women were assessed at least twice. During this time, 183 women progressed from premenopause to the early menopausal transition, 171 from early to late menopausal transition (defined as menses within the past year but not within the past 3 months), and 122 from the late transition to the postmenopause (no menses within the past year); 126 of these women changed reproductive stage more than once.

Results indicated no significant incremental change on these two cognitive tasks as women progressed from one menopausal stage to another. Within each reproductive stage, most scores increased slightly over time. Changes were significant for digit span backward during the premenopause (+0.17 items/year) and early menopausal transition (+0.19 items/year), and for the Symbol Digit Modalities Test during the premenopause (+0.52 items/year), early transition (+0.34 items/year), late transition (+1.5 items/year), and postmenopause (-1.1 items/year). Test changes were not accounted for by age, education, family income, ethnicity, or self-reported health. Although statistically significant, the mean magnitude of change on these tasks was not clinically meaningful, and incremental increases probably represented practice effects. The authors concluded that transition through the menopause is not accompanied by declines in cognitive skills assessed by their psychometric tasks.

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