Cognitive profiles in perimenopause: hormonal and menopausal symptom correlates

Abstract

Objective

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.

Design

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.

Results

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).

Conclusions

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.

摘要

目的：围绝经期与注意力、工作记忆和言语记忆下降有关。然而存在显著的个体差异。此外, 激素和更年期症状对特定领域认知功能的影响仍不清楚。这项纵向研究目的是确定围绝经期是否有不同的认知特征, 并确定与每个认知特征相关的因素。

设计：在 85 名女性中评估了 400 多个两年一次的访问, 我们对其进行了全面的神经心理学检查以评估更年期症状, 并测定了17β-雌二醇和卵泡刺激素。多级潜在剖面分析用于识别认知特征。在调整生殖衰老分期研讨会+10（STRAW + 10）和人口统计学因素后, 进行回归分析以确定激素和症状的差异。

结果：围绝经期认知特征包括认知正常（特征1, n=162）、言语学习和记忆的缺陷（特征2, n=94）、语言学习和记忆的优势（特征3, n=98）以及注意力和执行功能的优势（特征4, n=61）。与特征1相比, 特征2的区别在于激素变异性较小, 睡眠障碍较多（p<0.05）。

结论：围绝经期的认知存在明显的异质性。虽然大多数女性不会出现障碍, 但有相当一部分女性在言语学习和记忆方面薄弱。特征分析可以识别高危人群, 并为干预措施提供信息。

Keywords:

• Perimenopause
• cognition
• menopausal symptoms
• estrogen

Acknowledgements

The authors wish to thank Raha Dastgheyb, PhD for her assistance with creating Figure 1. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Potential conflict of interest

P. M. Maki has received honoraria from Belcham, Abbvie and Pfizer.

Additional information

Funding

This study was supported in part by National Institute on Aging (NIA) [grant K23AGO34256], [grant R03AG027844], [grant R03AG045612] (to M.T.W.); National Center for Research Resources [grant M01 RR00044] (to University of Rochester Medical Center); National Science Foundation Graduate Research Fellowship Program [grant 184239] (to R.S.).