Investigating links between white matter hyperintensities and menopausal status using robust age-correction methods...

Area of Science:

• Neurology
• Radiology
• Gerontology

Background:

• White matter hyperintensities (WMHs) are linked to cognitive decline and show sex differences, with women having a higher burden.
• The menopausal transition is hypothesized to influence WMH accumulation, a dementia risk factor.

Purpose of the Study:

• To investigate the relationship between menopausal status and white matter hyperintensity (WMH) volumes in women.
• To differentiate the effects of aging and menopause on WMH burden.

Main Methods:

• Utilized UK Biobank data from 9560 women, employing strict age-matching to compare WMH volumes across premenopausal and postmenopausal groups.
• Analyzed associations with age at menopause, hormone therapy, and cardiometabolic factors (smoking, blood pressure).

Main Results:

• Premenopausal women exhibited higher WMH volumes than postmenopausal women in some analyses, particularly when postmenopausal women had a longer time since menopause.
• Menopausal characteristics like age at menopause or hormone therapy did not show significant associations with WMH volumes.
• Cardiometabolic factors (smoking, blood pressure) predicted WMH volumes, with effects largely consistent across menopausal status, except for blood pressure medication use.

Conclusions:

• Findings contradict the hypothesis that menopause increases WMH burden; premenopausal women showed higher volumes in this cohort.
• Cardiometabolic and lifestyle factor effects on brain health (WMH) appear consistent before and after menopause.
• Factors beyond menopausal status may explain sex differences in WMH burden in older adults.