Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Los Angeles, CA 90095-1687, USA.
Obstet Gynecol Clin North Am. 2011 Sep;38(3):519-35. doi: 10.1016/j.ogc.2011.05.007.
The impact of perimenopause on cognition seems to be characterized by an absence of improved scores rather than a decline. In the SWAN, the perimenopausal decrement in cognitive performance was not accounted for; however, increases in anxiety and depressive symptoms had independent, unfavorable effects on performance. Estradiol has been found to protect against changes resulting from serotonin withdrawal and defend against changes from cholinergic depletion. There is support for the critical timing hypothesis--that estrogen benefits cognitive function when instituted early, but not later. The menopausal transition may affect cognitive function in older age owing to worsened cardiovascular risk factors.
围绝经期对认知的影响似乎表现为分数没有提高，而不是下降。在 SWAN 中，围绝经期认知表现的下降并未得到解释；然而，焦虑和抑郁症状的增加对表现有独立的不利影响。已发现雌二醇可防止因 5-羟色胺戒断引起的变化，并防止因胆碱能耗竭引起的变化。有证据支持关键时机假说——即雌激素早期而非晚期介入时有利于认知功能。由于心血管危险因素恶化，绝经过渡可能会影响老年的认知功能。
