Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA.
Climacteric. 2021 Aug;24(4):401-407. doi: 10.1080/13697137.2021.1892626. Epub 2021 Mar 24.
Perimenopause is associated with declines in attention, working memory and verbal memory; however, there are significant individual differences. Further, the contributions of hormones and menopausal symptoms to domain-specific cognitive functions remain unknown. This longitudinal study aimed to determine whether there were distinct cognitive profiles in perimenopause and to identify factors associated with each profile.
In a sample of 85 women evaluated over 400 bi-annual visits, we administered a comprehensive neuropsychological battery, assessed menopausal symptoms and measured 17β-estradiol and follicle stimulating hormone. Multilevel latent profile analysis was used to identify cognitive profiles. Regressions were conducted to determine differences in hormones and symptoms by profile after adjusting for Stages of Reproductive Aging Workshop + 10 (STRAW + 10) stage and demographic factors.
Perimenopausal cognitive profiles consisted of cognitively normal (Profile 1; = 162), weaknesses in verbal learning and memory (Profile 2; = 94), strengths in verbal learning and memory (Profile 3; = 98) and strengths in attention and executive function (Profile 4; = 61). Profile 2 was differentiated by less hormonal variability and more sleep disturbance than Profile 1 ( < 0.05).
There is significant heterogeneity in cognition during perimenopause. While most women do not develop impairments, a significant minority experience weaknesses in verbal learning and memory. Profile analysis may identify at-risk populations and inform interventions.
围绝经期与注意力、工作记忆和言语记忆下降有关，但存在显著的个体差异。此外，激素和绝经症状对特定领域认知功能的贡献仍不清楚。本纵向研究旨在确定围绝经期是否存在不同的认知特征，并确定与每种特征相关的因素。
在 85 名女性的样本中，我们在 400 多次双年度访视中进行了全面的神经心理学测试，评估了绝经症状，并测量了 17β-雌二醇和卵泡刺激素。采用多层次潜在剖面分析来识别认知特征。在调整了生殖衰老工作坊 + 10 期（STRAW + 10）和人口统计学因素后，回归分析用于确定不同特征之间的激素和症状差异。
围绝经期认知特征包括认知正常（特征 1；=162）、言语学习和记忆能力下降（特征 2；=94）、言语学习和记忆能力增强（特征 3；=98）和注意力及执行功能增强（特征 4；=61）。特征 2 与特征 1 相比，激素变异性较小，睡眠障碍较多（<0.05）。
围绝经期认知存在显著异质性。虽然大多数女性没有出现认知障碍，但仍有相当一部分女性出现言语学习和记忆能力下降。特征分析可能确定高危人群并为干预措施提供信息。
