Cognitive symptoms during the menopausal transition and early postmenopause

To describe changes in levels of cognitive symptoms (forgetting and difficulty concentrating) during the menopausal transition (MT) stages and early postmenopause, including effects of age, MT-related factors(MT stages, estrone, follicle stimulating hormone (FSH), testosterone), symptoms (hot flush, sleep, mood), health-related factors (alcohol use, smoking, exercise, perceived health), stress-related factors (perceived stress, history of sexual abuse, cortisol, catecholamines) and social factors (partner and parenting status, education, employment).

A subset was studied of Seattle Midlife Women's Health Study participants who provided data during the late reproductive, early and late MT stages or postmenopause (n=292) including menstrual calendars for staging the MT, annual health questionnaires for social factors, morning urine samples assayed for estrone glucuronide (E1G), testosterone, FSH, cortisol and catecholamines and health diaries for rating symptoms several times each year. Multilevel modeling (R program) was used to test patterns of cognitive symptoms related to age, MT-related factors, symptoms, health-related, stress-related and social factors with as many as 6811 observations.

As individual covariates and in the multivariate model, age, anxiety, depressed mood, night-time awakening, perceived stress, perceived health, and employment were each significantly related to difficulty concentrating. Hot flushes, amount of exercise and history of sexual abuse had a significant effect as individual covariates but not in the final multivariate model. The best predictors of forgetfulness when analyzed as individual covariates and in the multivariate model were age, hot flushes, anxiety, depressed mood, perceived stress, perceived health and history of sexual abuse. Awakening during the night, although significant as an individual covariate, had no significant effect on forgetfulness in the final multivariate model.

Menopausal transition-related factors were not significantly associated with difficulty concentrating or forgetfulness. Consideration of women's ages and the context in which they experience the menopausal transition may be helpful in understanding women's experiences of cognitive symptoms.