Premature menopause associated with risk of lower cognitive function

Early menopause-whether natural or surgical-may be associated with negative effects on cognitive function that are not entirely offset by postmenopausal hormone therapy (HT), according to a new study in BJOG.

French researchers at Hospital La Colombiere assessed 4868 women aged aged 65 and older. A multivariable-adjusted logistic regression model was used to determine the association between age at menopause, the type of menopause (surgical or natural), and the use of HT and later-life cognitive function. Main outcome measures were a clinical dementia diagnosis and performance on a cognitive test battery, which was performed at baseline and over 7 years.

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Menopause at or before age 40, whether from premature bilateral ovariectomy or premature ovarian failure, was associated with worse verbal fluency (odds ratio [OR] 1.56, 95% confidence interval [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. Although at onset of premature menopause, HT appeared to be beneficial for later-life visual memory, it appeared to increase the risk of poor verbal fluency. The type of menopause had no significant association with cognitive function. Women who experienced premature menopause had a 30% higher risk of decline in psychomotor speed and global cognitive function over 7 years.

Given the association between premature menopause and cognitive decline irrespective of HT, the researchers concluded that potential effects on cognitive function should be included in the risk/benefit ratio for ovariectomies in younger patients.

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