Subjective versus objective cognition during menopause: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to review existing measures of subjective cognition during menopause and to estimate the correlation between subjective and objective cognition in perimenopausal and postmenopausal women.

Eligible studies reported scores for at least one subjective and objective measure of cognition for perimenopausal or postmenopausal women. EMBASE, Medline, and PsycINFO were searched for eligible studies on November 22^nd 2024. The risk of bias in individual studies was evaluated using a modified QUADAS-2 form. The results of the review were summarized in narrative form. Studies that reported correlations between subjective and objective cognition were synthesized using a multilevel meta-analysis.

The sample included 5629 participants over 24 studies, including 295 perimenopausal women, 5086 postmenopausal women, and 248 women across mixed peri- and post-menopausal samples. Twelve measures of subjective cognition were used across studies. Six studies were included in the meta-analysis. A small significant correlation was observed between subjective cognition and objective measures of learning efficiency (r = .12; CI = .02 to .23). Correlations across other cognitive domains were non-significant.

Our findings suggest subjective cognition may be associated with performance on measures of learning efficiency, offering a starting point for further research on menopausal brain fog. The present findings highlight the need for a reliable measure of subjective cognitive symptoms associated with menopause. Additionally, a better characterization of the neuropsychological profile of menopausal brain fog is needed to progress research in this field and ultimately improve clinical support for women experiencing these symptoms.