More menopausal symptoms linked to poorer brain function in later life

Experiencing more menopausal symptoms is linked to poorer brain function and warnings signs associated with dementia in later life, according to a new study involving the University of Exeter.

The research, part of the CAN-PROTECT study and published in PLOS ONE, found the more symptoms women reported experiencing during menopause the more likely they were to show signs of cognitive decline and neuropsychiatric issues as they age, based on repeat test results.

The authors call for more research to investigate this link and whether they could form part of an early alert for dementia, as well as whether hormone replacement therapy could help to mitigate any risk. This study, led by Dr Zahinoor Ismail at the University of Calgary, adds to a growing body of evidence suggesting that menopausal health may be a key factor in brain aging.

CAN-PROTECT is the Canadian arm of the larger PROTECT study, which is run by the University of Exeter in partnership with the NHS and aims to understand how healthy brains age and why people develop dementia, including Alzheimer’s disease.

Professor Anne Corbett, from the University of Exeter, is the PROTECT study lead and said: “Changes in cognitive function are part of the normal aging process and are often nothing to worry about. However, we know that Alzheimer’s disease starts long before diagnosis and identifying the earliest factors influencing its progression is crucial to helping people access the best treatment and support. This study suggests that the menopausal phase could be an important period for assessing dementia risk.

“However, it’s important to note that dementia risk involves many different factors. It’s difficult to know at this stage how much of an effect menopausal symptoms really have, and more research is needed before we can say for certain whether menopause severity should be considered a major risk factor. What we do know is the best way to reduce our risk of dementia is to stay physically active, maintain a healthy weight, and to manage other medical conditions.”

According to the World Health Organization, the number of people living with Alzheimer’s and related dementias is expected to rise to 152 million globally by 2050. Women, who are three times more likely to develop Alzheimer’s disease than men, have long been known to face this higher risk due to their longer life expectancy. However, this new research suggests that menopausal symptoms could be linked to this increased vulnerability.

The study, which involved 896 postmenopausal women from CAN-PROTECT, found a link between the number of menopausal symptoms experienced – such as poor sleep, depression, and memory problems – and poorer cognitive function later in life. Cognitive function was measured using the Everyday Cognition (ECog-II) Scale, which assesses changes in memory, language, visual-spatial and perceptual abilities, planning, organisation, and executive function. In addition, neuropsychiatric symptoms were evaluated using the Mild Behavioral Impairment Checklist (MBI-C), which focuses on neuropsychiatric symptoms (emotional and behavioural changes).

The results showed that women with more menopausal symptoms reported worse cognitive function and more neuropsychiatric symptoms as they aged. Hormone replacement therapy, which is often used to manage menopause symptoms, was found to be associated with fewer neuropsychiatric symptoms in later life, though it did not seem to have the same effect on cognitive function.

While further research is needed to fully explore these findings, the study raises important questions about how menopausal symptoms may influence brain health. Future research could help identify whether the age at which menopause begins has a lasting impact on cognitive and behavioural changes in later life.

The paper titled ‘Menopausal symptom burden as a predictor of mid- to late-life cognitive function and mild behavioral impairment symptoms: A CAN-PROTECT study’ is published in PLOS ONE and was supported by the UK National Institute for Health and Care Research Exeter Biomedical Research Centre.

The PROTECT study continues to recruit participants over the age of 40. To learn more about how you can get involved and help researchers understand brain aging, visit the PROTECT Study Website.