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Does age at menopause affect memory?

Entering menopause at a later age may be associated with a small benefit to your memory years later, according to a study published in Neurology®, the medical journal of the American Academy of Neurology.

"This study suggests that lifelong hormonal processes, not just short-term fluctuations during menopause, may be associated with memory skills," said study author Diana Kuh, PhD, FFPH, FMedSci, of the University College London in the United Kingdom.

The study involved 1,315 women from the Medical Research Council National Survey of Health and Development in Great Britain who had been followed since birth in March 1946. All of the women had tests of their verbal memory skills and their cognitive processing speed at ages 43, 53, between 60 and 64, and at age 69. The researchers collected information on age at menopause, either natural or due to removal of the ovaries, whether they took hormone replacement therapy, and other factors that could affect thinking and memory skills, such as childhood cognitive ability, amount of education, smoking and type of occupation.

Menopause, which is defined as the age at last menstrual cycle, started on average for the women with natural menopause at age 51 and a half.

For the verbal memory test, participants were asked to recall a 15-item list three times, with a maximum score of 45. At age 43, participants recalled an average of 25.8 words. By age 69, they recalled an average of 23.3 words. The study found that among 846 women who experienced menopause naturally, women who had later menopause had higher verbal memory scores, remembering 0.17 additional words per year. After researchers adjusted for other factors that could affect memory, the difference was 0.09 additional words per year.

"The difference in verbal memory scores for a 10-year difference in the start of menopause was small--recalling only one additional word, but it's possible that this benefit could translate to a reduced risk of dementia years later," Kuh said. "More research and follow-up are needed to determine whether that is the case."

Kuh noted that the relationship between the age at menopause and memory scores was not affected by use of hormone therapy.

For 313 women who experienced menopause due to surgery, the relationship between age at the time of surgery and memory scores was no longer present after researchers adjusted for other factors that could affect memory.

On the test of how fast the women could process information, there was no relationship between the age at menopause and test scores.

"This difference may be due to the estrogen receptor role, which regulates the gene that codes brain-derived neurotrophic factor, which helps to solidify memory formation and storage," Kuh said.

Limitations of the study were that the tests of memory and processing speed were taken relatively far apart in time and that information was not available on the dose for women taking hormone therapy.


Age at menopause and lifetime cognition - Findings from a British birth cohort study

Abstract

Objective We investigated whether cognitive performance between ages 43 and 69 years was associated with timing of menopause, controlling for hormone replacement therapy, childhood cognitive ability, and sociobehavioral factors.

Methods We used data from 1,315 women participating in the Medical Research Council National Survey of Health and Development (a British birth cohort study) with known age at period cessation and up to 4 assessments of verbal memory (word-learning task) and processing speed (letter-cancellation task) at ages 43, 53, 60–64, and 69. We fitted multilevel models with linear and quadratic age terms, stratified by natural or surgical menopause, and adjusted for hormone replacement therapy, body mass index, smoking, occupational class, education, and childhood cognitive ability.

Results Verbal memory increased with later age at natural menopause (0.17 words per year, 95% confidence interval [CI]: 0.07–0.27, p = 0.001); an association remained, albeit attenuated, after full adjustment (0.09, 95% CI: 0.02–0.17, p = 0.013). Verbal memory also increased with later age at surgical menopause (0.16, 95% CI: 0.06–0.27, p = 0.002), but this association was fully attenuated after adjustment. Search speed was not associated with age at menopause.

Conclusion Our findings suggest lifelong hormonal processes, not just short-term fluctuations during the menopause transition, may be associated with verbal memory, consistent with evidence from a variety of neurobiological studies; mechanisms are likely to involve estrogen receptor β function. Further follow-up is required to assess fully the clinical significance of these associations.

Reference

Diana Kuh, Rachel Cooper, Adam Moore, Marcus Richards, Rebecca Hardy. Age at menopause and lifetime cognition. Neurology Apr 2018, 10.1212/WNL.0000000000005486; DOI: 10.1212/WNL.0000000000005486

Content created April 2018 

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