Impact of a premature menopause on cognitive function in later life. (7th May 2014)

• Record Type: Journal Article
• Authors: Ryan, J; Scali, J; Carrière, I; Amieva, H; Rouaud, O; Berr, C; Ritchie, K; Ancelin, M‐L
• Is Part Of: BJOG. Volume 121:Number 13(2014)
• Page Start: 1729
• Page End: 1739
• Publication Date: 2014-05-07
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12828
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12828-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12828-sec-0001" sec-type="section"> <title>Objective</title> <p>To determine whether premature menopause (≤40 years) can have long‐lasting effects on later‐life cognition and investigate whether this association varies depending on the type of menopause and use of hormone treatment (HT).</p> </sec> <sec id="bjo12828-sec-0002" sec-type="section"> <title>Design</title> <p>Population‐based cohort study.</p> </sec> <sec id="bjo12828-sec-0003" sec-type="section"> <title>Setting</title> <p>The French Three‐City Study.</p> </sec> <sec id="bjo12828-sec-0004" sec-type="section"> <title>Population</title> <p>Four thousand eight hundred and sixty‐eight women aged at least 65 years.</p> </sec> <sec id="bjo12828-sec-0005" sec-type="section"> <title>Methods</title> <p>Multivariable‐adjusted logistic regression models were used to determine the association between age at menopause, type of menopause (surgical, natural), and the use of menopausal HT and later‐life cognitive function.</p> </sec> <sec id="bjo12828-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Performance on a cognitive test battery (at baseline and over 7 years) and clinical dementia diagnosis.</p> </sec> <sec id="bjo12828-sec-0007" sec-type="section"> <title>Results</title> <p>Menopause at or before the age of 40 years, both premature bilateral ovariectomy and premature ovarian failure (non‐surgical loss of ovarian function), was associated with worse verbal fluency (OR 1.56, 95%CI 1.12–1.87, <italic>P </italic>= 0.004) and visual memory (OR 1.39, 95%CI 1.09–1.77, <italic>P </italic>= 0.007) in later life. HT at the time of premature menopause appeared beneficial for later‐life visual memory but increased the risk of poor verbal fluency. Type of menopause was not significantly associated with cognitive function. Premature menopause was associated with a 30% increased risk of decline in psychomotor speed and global cognitive function over 7 years.</p> </sec> <sec id="bjo12828-sec-0008" sec-type="section"> <title>Conclusion</title> <p>Both premature surgical menopause and premature ovarian failure were associated with long‐term negative effects on cognitive function, which are not entirely offset by menopausal HT. In terms of surgical menopause, these results suggest that the potential long‐term effects on cognitive function should form part of the risk/benefit ratio when considering ovariectomy in younger women.</p> </sec> </abstract>