Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, Delhi, 110067, India.
BMC Psychol. 2023 Aug 9;11(1):228. doi: 10.1186/s40359-023-01267-3.
Menopause occurring before the age of 40 is premature and between 40 and 44 years age is early, since the natural age of menopause lies between 45 and 50. The endocrine changes that come with menopause include an erratic decline in estrogen levels which affects the brain. Thus, leading to changes in cognitive function in the longer term due to the menopausal transition. The study aims to explore the effect of premature and early menopause on cognitive health, and psychosocial well-being. The moderated multiple mediation hypothesis of the study is that the effect of premature or early menopause is mediated by depression and insomnia, while all the pathways are moderated by smoking habits.
The study utilized Longitudinal Aging Study in India (LASI), 2017-2018, Wave 1 data. The sample of 31,435 women were aged 45 and above and did not undergo hysterectomy. A moderated multiple mediation model was used to understand the association between premature or early menopause (X), insomnia (M1), depression (M2), moderator (W), and cognitive health (Y), while controlling for possible confounders.
Premature menopause was negatively associated with cognition (β:-0.33; SE:0.12; p < 0.05), whereas positively associated with insomnia (β:0.18; SE:0.03; p < 0.001) and depression (β:0.25; SE:0.04; p < 0.001). There is a moderating effect of smoking or tobacco consumption has a significant moderating effect on the pathways among premature menopause, depression, insomnia and cognition. When the same model was carried out for early menopause (40-44 years), the results were not significant.
The findings emphasize the fact that smoking is associated with premature menopause, depression and insomnia. Women who experienced premature menopause has lower cognitive scores, depressive symptoms and insomnia symptoms, which were higher among those who consumed tobacco. The study, strongly recommends the dissemination of information on the negative effects of tobacco consumption and making more informed choices to maintain a healthy life. More research into various methods and therapy is needed to determine the relationship between the age of early menopause and their psychosocial well-being.
40 岁之前绝经属于提前绝经，40-44 岁之间绝经属于早期绝经，因为自然绝经年龄在 45-50 岁之间。绝经带来的内分泌变化包括雌激素水平的不稳定下降，这会影响大脑。因此，由于绝经过渡，认知功能会在长期内发生变化。本研究旨在探讨提前绝经和早期绝经对认知健康和社会心理幸福感的影响。研究的有调节的多重中介假设是，提前绝经或早期绝经的影响通过抑郁和失眠来介导，而所有途径都受到吸烟习惯的调节。
本研究利用了 2017-2018 年印度纵向老龄化研究（LASI）的第一波数据。样本为 31435 名年龄在 45 岁及以上且未接受子宫切除术的女性。使用有调节的多重中介模型来理解提前绝经或早期绝经（X）、失眠（M1）、抑郁（M2）、调节变量（W）和认知健康（Y）之间的关联，同时控制可能的混杂因素。
提前绝经与认知能力呈负相关（β：-0.33；SE：0.12；p<0.05），而与失眠（β：0.18；SE：0.03；p<0.001）和抑郁（β：0.25；SE：0.04；p<0.001）呈正相关。吸烟或烟草消费有显著的调节作用，对提前绝经、抑郁、失眠与认知之间的途径有调节作用。当对早期绝经（40-44 岁）进行相同的模型时，结果不显著。
研究结果强调了这样一个事实，即吸烟与提前绝经、抑郁和失眠有关。经历提前绝经的女性认知分数较低，抑郁症状和失眠症状较高，而那些吸烟的女性则更高。该研究强烈建议传播关于烟草消费负面影响的信息，并做出更明智的选择，以维持健康的生活。需要进一步研究各种方法和疗法，以确定早期绝经年龄与社会心理幸福感之间的关系。
