Impact of a premature menopause on cognitive function in later life
Article first published online: 7 MAY 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
How to Cite
Impact of a premature menopause on cognitive function in later life. BJOG 2014; DOI:10.1111/1471-0528.12828., , , , , , , .
- Article first published online: 7 MAY 2014
- Manuscript Accepted: 16 MAR 2014
- Fondation Plan Alzheimer
- Agence Nationale de la Recherche. Grant Numbers: ANR 2007-LVIE-004, 06-PNRA-005
- Caisse Nationale Maladie des Travailleurs Salariés
- Direction Générale de la Santé
- MGEN, Institut de la Longévité
- Agence Française de Sécurité Sanitaire des Produits de Santé
- Regional Governments of Aquitaine
- Bourgogne and Languedoc-Roussillon
- Fondation de France
- Ministry of Research-Inserm Programme
- hormone treatment;
- premature menopause
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).
Population-based cohort study.
The French Three-City Study.
Four thousand eight hundred and sixty-eight women aged at least 65 years.
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.
Main outcome measures
Performance on a cognitive test battery (at baseline and over 7 years) and clinical dementia diagnosis.
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, P = 0.004) and visual memory (OR 1.39, 95%CI 1.09–1.77, P = 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.
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.