Menopause Effects on Verbal Memory: Findings from a Longitudinal Community Cohort
C. Neill Epperson, MD, Mary D. Sammel, ScD, and Ellen W. Freeman, PhD
Context Although cognitive complaints are common among menopausal women, it is debatable whether there is an objective decline in cognition with menopause that exceeds what is expected with normal aging.
Objective To determine whether reproductive senescence is associated with an age-independent decline in verbal memory.
Design and Setting 15-year, longitudinal, population-based cohort study of women who underwent yearly endocrine, behavioral and cognitive assessments from pre- to postmenopause.
Participants Caucasian and African American (AA) premenopausal women (n=403), who were enrolled in the Penn Ovarian Aging Study.
Main Outcome Measures Buschke Selective Reminding Test (BSRT, Immediate and Delayed Verbal Recall), the Digit Symbol Substitution Task and the Symbol Copy Task.
Results A total of 3958 assessments were conducted in this sample of 403 women. In models which were adjusted for age and important cofactors, immediate (p=0.03) and delayed (p=0.03) recall on the BSRT declined from the pre to postmenopause stages. Further evaluation identified a significant decline (p<0.002) in delayed recall early in the transition. Race was a significant factor in performance on all tasks (all p<0.0001) except the delayed verbal recall task (p=0.06) in adjusted models. Endocrine measures were significantly associated with cognitive performance in unadjusted models.
Conclusions Certain cognitive domains are sensitive to the physiologic changes of reproductive senescence independent of age. The differences in cognitive performance between AA and Caucasian women were not explained by factors examined in this study, but are of important public health concern that warrants further investigation.
Posted to Members in the News & Publications on July 15, 2013