MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Population Health Sciences, Bristol Medical School, Bristol, UK.
BMC Womens Health. 2020 Aug 14;20(1):177. doi: 10.1186/s12905-020-01040-3.
There may be changes in cognitive function in women going through the menopause. The current evidence remains unclear, however, whether these changes occur over and above those of general ageing. We aimed to evaluate the potential impact of the menopause (assessed by reproductive age and hormone levels) on cognitive function in women in mid-life accounting for the underlying effects of ageing.
The study was based on the follow up of women originally enrolled in pregnancy in a birth cohort when resident in the South West of England, UK between 1991 and 1992. Using up to three repeated measurements in 2411 women (mean age 51 at first assessment), we modelled changes in six cognitive function domains: immediate and delayed verbal episodic memory, working memory, processing speed, verbal intelligence and verbal fluency. The exposures of interest were reproductive age measured as years relative to the final menstrual period (FMP), chronological age and reproductive hormones (follicle-stimulating hormone (FSH), luteinizing hormone (LH) and anti-Müllerian hormone (AMH)).
Processing speed (- 0.21 (95% CI - 0.36 to - 0.06) standard deviation (SD) difference per 10 years since FMP), immediate verbal episodic memory (- 0.15 (95% CI - 0.35 to 0.06)) and delayed verbal episodic memory (- 0.17 (95% CI - 0.37 to 0.03)) declined with reproductive age. Reproductive hormones were not robustly associated with processing speed, but FSH and LH were both negatively associated with immediate (- 0.08 (95% CI - 0.13 to - 0.02) SD difference per SD difference in hormone level) and delayed verbal episodic memory (- 0.08 (95% CI - 0.13 to - 0.03)). There was little consistent evidence of cognitive function declining with menopause in other cognitive domains.
Of the cognitive domains tested only verbal episodic memory declined both in relation to age since the menopause and in conjunction with the reproductive hormones that reflect the menopause. This decline was independent of normal ageing and suggests that the menopause is associated with a mild impact on this specific domain of cognitive function.
女性在经历更年期时，认知功能可能会发生变化。然而，目前尚不清楚这些变化是否超过了一般衰老的影响。我们旨在评估更年期（通过生育年龄和激素水平来评估）对英国西南部生育队列中参加妊娠的女性中年认知功能的潜在影响，同时考虑到衰老的潜在影响。
该研究基于对英国西南部 1991 年至 1992 年间参加妊娠的女性的后续研究，这些女性最初在妊娠队列中注册。在 2411 名女性（第一次评估时平均年龄为 51 岁）中使用多达三次重复测量，我们对六个认知功能领域的变化进行了建模：即时和延迟口头情景记忆、工作记忆、处理速度、言语智力和言语流畅性。感兴趣的暴露因素是生育年龄，以相对于最后一次月经周期（FMP）的年限来衡量（FMP）、实际年龄和生殖激素（卵泡刺激素（FSH）、促黄体生成素（LH）和抗缪勒管激素（AMH））。
处理速度（每 10 年 FMP 后下降 0.21（95%CI -0.36 至 -0.06）标准差（SD）差异）、即时口头情景记忆（下降 0.15（95%CI -0.35 至 0.06））和延迟口头情景记忆（下降 0.17（95%CI -0.37 至 0.03））随着生育年龄的增加而下降。生殖激素与处理速度没有明显的相关性，但 FSH 和 LH 均与即时（每增加一个激素水平的 SD 差异，下降 0.08（95%CI -0.13 至 -0.02）SD 差异）和延迟口头情景记忆（每增加一个激素水平的 SD 差异，下降 0.08（95%CI -0.13 至 -0.03））呈负相关。在其他认知领域，几乎没有证据表明更年期与认知功能下降有关。
在所测试的认知领域中，只有口头情景记忆既与更年期后年龄有关，也与反映更年期的生殖激素有关，这两个领域都呈下降趋势。这种下降与正常衰老无关，表明更年期与这种特定认知功能领域的轻度影响有关。
