Severe menopause symptoms linked to mild cognitive impairment

• Dementia is becoming more common and does not have a cure.
• Researchers are interested in what factors contribute to increased risk for cognitive impairment and what factors may be protective.
• One study found that more severe menopausal symptoms were associated with an increased risk for mild cognitive impairment.
• In contrast, other factors, like the use of menopausal hormone therapy, were associated with a decreased risk.

Dementia is a condition of significant concern, affecting over 55 million people all over the world. Research is ongoing about how to address dementia and what risk factors should be the focus of prevention.

A study recently published in the journal Menopause has now found that more severe menopause symptoms were associated with mild cognitive impairment in an analysis of 1,287 postmenopausal Latin American women.

The results point to the need for further research into how menopause affects dementia risk and what protective action might be most effective.

Menopause symptoms and cognitive impairment

Menopause occurs when menstruation has stopped for one full year. The transition into menopause often happens over several years and can include unpleasant symptoms like hot flashes.

The researchers who conducted the current study wanted to look at the relationship between menopause symptoms and mild cognitive impairment , which increases a person’s risk of developing dementia.

They noted that some menopause symptoms include sleep problems, muscle and bone pain, cognitive difficulties, mood swings, night sweats, and hot flashes. They further note that these symptoms are “related to estrogen deficiency .”

This research was a subanalysis of an observational, cross-sectional study that included women from nine Latin American countries. Researchers used surveys to collect data on menopause symptoms and cognitive function.

Researchers included 1,287 women in their analysis. All participants were 70 years old or younger and postmenopausal. They included women who had experienced natural and surgical menopause.

They excluded participants who had a dementia diagnosis that stopped them from understanding the questionnaires, and they also excluded women who had previously received radiation or chemotherapy.

Higher risk of cognitive problems linked to severe menopause symptoms

Researchers collected data on many factors, including body mass index, number of children, sexual activity, physical activity levels, and comorbidities like high blood pressure and diabetes .

They also noted the age of menopause onset, history of ovary removal, and use of menopausal hormone therapy . They used the Menopause Rating Scale to gather data on the severity of menopausal symptoms.

A score of 14 points or higher designates severe menopause symptoms. They then evaluated mild cognitive impairment.

The study found that 15.3% of participants had mild cognitive impairment, and that women with mild cognitive impairment were more likely to report more severe menopause symptoms.

The researchers also noted that having more children was also associated with cognitive impairment. In contrast, lower body mass index, sexual activity, active lifestyle, ever using menopausal hormone therapy, and higher education were associated with a decreased risk for mild cognitive impairment.

Study author Juan E. Blumel, MD, PhD , from the Faculty of Medicine at the University of Chile in Santiago de Chile, explained to Medical News Today that:

“As the study is exploratory, the results are likely to provide initial insights that call for further investigation. However, identifying a possible association between severe menopausal symptoms and cognitive decline could pave the way for new research and potential treatments. If severe menopausal symptoms do indeed contribute to cognitive decline, it could lead to a more comprehensive approach to treating women during menopause, addressing not only the physical symptoms but also the cognitive and emotional aspects.”

Do severe menopause symptoms cause cognitive impairment?

This research has limitations, including some related to the nature of the study. First of all, the study cannot prove that these risk factors cause or prevent mild cognitive impairment.

Furthermore, the research focused on women in Latin American countries who had access to private healthcare, so the results may not apply to other populations.

Also, the researchers included women from gynecological care settings, such as those experiencing early menopause, which does not reflect the general population. The researchers acknowledge a risk of selection bias because of limited access to preventive health screenings in Latin America.

Moreover, the research did not include women over 70, which could be an additional demographic to explore. The data relied on participant reporting, which cannot always ensure accuracy. Exclusion criteria, such as excluding deaf and blind participants, could also have impacted the study’s results.

There was a slight difference between the Portuguese and Spanish assessments for mild cognitive impairment, and the assessment for mild cognitive impairment was only measured once.

In addition, the reasons for menopause occurring differed, with fewer than 60% of participants experiencing natural menopause, while others experienced surgical ovary removal.

Researchers also appear to have included primary ovarian insufficiency as a menopause category, which is a slightly different condition. Further research could focus on other subcategories to see how they might impact the results.

It could also focus on the identified factors that may protect against cognitive impairment, particularly hormone replacement therapy, and on collecting more long-term data.

“Further studies should seek to replicate these findings in larger and more diverse samples and explore the underlying mechanisms that might explain this relationship. This could involve research into the role of hormones, sleep quality, stress, and other factors that fluctuate during menopause,” Blumel told us.

Does menopause increase dementia risk?

This study offers more evidence and details about potential risk and protective factors related to mild cognitive impairment. While more research is required, the data highlight a possible need to examine certain components like menopausal symptoms more closely and how they relate to the risk for dementia.

Karen Miller, PhD , a neuropsychologist and geropsychologist, and senior director of the Brain Wellness and Lifestyle Programs at Pacific Neuroscience Institute in Santa Monica, CA, who was not involved in this research, made the following comments about women’s particular risk for dementia:

“The rates of dementia are slightly higher in women. This is thought to be related to possibly one or more reason. First, women live longer, and the greatest risk factor for having dementia is age […] Second, there is some controversy around this concept, but menopause can increase the risk for dementia as there is a dramatic decline in estrogen for women after menopause, and there is abundance of estrogen receptors in the hippocampus (the memory center). With less estrogen, there may be an increase the risk for dementia in women as they age. Finally, for all people a history of depression can also be considered a risk factor for increased dementia in later life, and a larger number of women experience/diagnosed with depression than men.”

People who are concerned about their risk for dementia should work with their doctors to address risk factors and examine what preventive strategies could be most helpful, such as seeking treatment for depression, quitting smoking, and increasing physical activity.