Luetters Crystal, Huang Mei-Hua, Seeman Teresa, Buckwalter Galen, Meyer Peter M, Avis Nancy E, Sternfeld Barbara, Johnston Janet M, Greendale Gail A
David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
J Womens Health (Larchmt). 2007 Apr;16(3):331-44. doi: 10.1089/jwh.2006.0057.
By one estimate, 60% of women experiencing the menopause transition perceive that they have memory problems, but most studies that have used cognitive function tests have not substantiated a relation between menopause stage and cognitive performance. We sought to describe the cross-sectional relation between menopause status, estradiol (E(2)), follicle-stimulating hormone (FSH), and measured cognitive function.
Cross sectional analysis of a community-based cohort of midlife women was used. Cognitive tests were the East Boston Memory Test, Symbol Digit Modalities, and Digits Span Backward. Menopause categories (premenopausal, early perimenopausal, late perimenopausal, and postmenopausal) were defined based on menstrual patterns. One set of general linear models assessed the relations between each cognitive test and menopause transition category, initially adjusted for age, race/ethnicity, education, symptoms, self-rated general health, and body mass index (BMI); next, these were additionally adjusted for FSH and E(2). A second set of models, stratified by menopause status, examined the possible relations between each cognitive test and either E(2) or FSH, adjusted for age, race/ethnicity, education, symptoms, self-related general health, and BMI.
The mean age of the analytical sample (n = 1657) was 49.7 years. Only 5% of the sample had less than a high school education, 16% graduated from high school, and the rest had at least some college. The percent of women in each menopause category was premenopausal (9.0%), early perimenopausal (57.0%), late perimenopausal (13.4%), postmenopausal (20.6%). Although clinical-site adjusted models showed moderate differences between menopause transition groups and cognitive performance, no association was found between each of the measured cognitive performance tests and menopause transition status when adjusting for covariates. Similarly, no association between each cognitive test and E(2) or FSH was found.
This study does not support a cross-sectional relation between cognitive test performance and menopause stage, FSH, or E(2).
据一项估计，60%处于绝经过渡期的女性认为自己存在记忆问题，但大多数使用认知功能测试的研究并未证实绝经阶段与认知表现之间存在关联。我们试图描述绝经状态、雌二醇（E₂）、促卵泡激素（FSH）与所测量的认知功能之间的横断面关系。
采用基于社区的中年女性队列进行横断面分析。认知测试包括东波士顿记忆测试、符号数字模式测试和数字倒背测试。根据月经模式定义绝经类别（绝经前、围绝经期早期、围绝经期晚期和绝经后）。一组一般线性模型评估每项认知测试与绝经过渡类别之间的关系，最初对年龄、种族/族裔、教育程度、症状、自我评定的总体健康状况和体重指数（BMI）进行调整；接下来，再对FSH和E₂进行额外调整。另一组模型按绝经状态分层，研究每项认知测试与E₂或FSH之间的可能关系，并对年龄、种族/族裔、教育程度、症状、自我相关的总体健康状况和BMI进行调整。
分析样本（n = 1657）的平均年龄为49.7岁。样本中只有5%的人受教育程度低于高中，16%的人高中毕业，其余至少上过一些大学。每个绝经类别的女性百分比分别为绝经前（9.0%）、围绝经期早期（57.0%）、围绝经期晚期（13.4%）、绝经后（20.6%）。尽管临床站点调整模型显示绝经过渡组与认知表现之间存在适度差异，但在调整协变量后，所测量的每项认知表现测试与绝经过渡状态之间均未发现关联。同样，每项认知测试与E₂或FSH之间也未发现关联。
本研究不支持认知测试表现与绝经阶段、FSH或E₂之间存在横断面关系。
