Public Health.

Area of Science:

• Neuroscience
• Gerontology
• Reproductive Endocrinology

Background:

• A longer reproductive period (RP), characterized by a later onset of menopause, is associated with improved cognitive function and a reduced risk of age-related brain atrophy.
• Understanding the impact of RP on cognitive abilities and brain structure in post-menopausal women is crucial for public health strategies.

Purpose of the Study:

• To investigate cognitive performance and brain volume differences in post-menopausal women based on their reproductive period duration.
• To compare cognitive functions and neuroimaging markers between women with short and long reproductive periods in an urban Indian population.

Main Methods:

• Recruited 583 post-menopausal women (age ≥45) from the Tata Longitudinal Study of Aging.
• Assessed participants through clinical, cognitive, biochemical, and 3T MRI neuroimaging.
• Calculated RP (age at menopause minus age at menarche) and categorized women into short (≤35 years) and long (>35 years) RP groups.

Main Results:

• The short RP group exhibited significantly lower education, earlier age at first childbirth, and lower folic acid levels.
• Adjusted analyses revealed that women with a short RP had poorer attention function (β = -0.417, p = 0.023).
• The short RP group also showed significantly reduced total grey matter (β = -6464.403, p = 0.026), cortical volume (β = -4827.836, p = 0.044), and right hemisphere cortical volume (β = -2971.033, p = 0.018).

Conclusions:

• A longer reproductive period is associated with enhanced attention, preserved grey matter, and larger cortical volumes in post-menopausal women.
• These findings suggest potential neuroprotective effects of prolonged estrogen exposure, possibly mitigating age-related brain atrophy.
• Further research is warranted to elucidate the underlying mechanisms and public health implications of these associations.