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更年期与认知主诉:卵巢激素与主观认知下降有关吗?

Menopause and cognitive complaints: are ovarian hormones linked with subjective cognitive decline?

机构信息

Department of Psychology, University of Toronto, Toronto, ON, Canada.

Tema Genus, Linköping University, Linköping, Sweden.

出版信息

Climacteric. 2021 Aug;24(4):321-332. doi: 10.1080/13697137.2021.1892627. Epub 2021 Mar 15.

Abstract

Subjective cognitive decline (SCD) and the loss of ovarian hormones after menopause have been independently linked to later-life Alzheimer's disease (AD). The objective of this review was to determine whether menopause and the loss of ovarian hormones contribute to cognitive complaints and SCD in women. This would suggest that SCD at the menopausal transition might be an important marker of eventual cognitive decline and AD. We conducted a literature search using PubMed, PsycINFO and Web of Science in July 2020. All English-language studies assessing SCD and cognitive complaints with respect to menopause and ovarian hormones were included. A total of 19 studies were included. Studies found that cognitive complaints increased across the menopause transition and were associated with reductions in attention, verbal and working memory, and medial temporal lobe volume. Women taking estrogen-decreasing treatments also had increased cognitive complaints and reduced working memory and executive function. The current literature provides impetus for further research on whether menopause and the loss of ovarian hormones are associated with cognitive complaints and SCD. Clinicians may take particular note of cognitive complaints after menopause or ovarian hormone loss, as they might presage future cognitive decline.

摘要

主观认知衰退 (SCD) 和绝经后卵巢激素的丧失与晚年阿尔茨海默病 (AD) 独立相关。本综述的目的是确定绝经和卵巢激素丧失是否会导致女性认知障碍和 SCD。这表明绝经过渡期的 SCD 可能是最终认知能力下降和 AD 的一个重要标志物。我们于 2020 年 7 月使用 PubMed、PsycINFO 和 Web of Science 进行了文献检索。所有评估绝经和卵巢激素与 SCD 和认知障碍关系的英文研究均被纳入。共纳入 19 项研究。研究发现,认知障碍在绝经过渡期间增加,并与注意力、言语和工作记忆以及内侧颞叶体积减少有关。服用雌激素减少治疗的女性也有更多的认知障碍和工作记忆及执行功能下降。目前的文献为进一步研究绝经和卵巢激素丧失是否与认知障碍和 SCD 相关提供了动力。临床医生可能会特别注意绝经后或卵巢激素丧失后的认知障碍,因为它们可能预示着未来的认知能力下降。

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