Skip Navigation LinksHome > September 2014 - Volume 21 - Issue 9 > Investigation of menopausal stage and symptoms on cognition...
doi: 10.1097/GME.0000000000000203
Original Articles

Investigation of menopausal stage and symptoms on cognition in human immunodeficiency virus–infected women

Rubin, Leah H. PhD1; Sundermann, Erin E. PhD1; Cook, Judith A. PhD1; Martin, Eileen M. PhD2; Golub, Elizabeth T. PhD, MPH3; Weber, Kathleen M. RN, BSN4; Cohen, Mardge H. MD4,5; Crystal, Howard MD6; Cederbaum, Julie A. PhD7; Anastos, Kathyrn MD8; Young, Mary MD9; Greenblatt, Ruth M. MD10; Maki, Pauline M. PhD1,11

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Objective: We evaluated the separate and interactive associations of menopausal stage, menopausal symptoms, and human immunodeficiency virus (HIV) infection with cognition. We hypothesized that HIV-infected perimenopausal women would show the greatest cognitive difficulties and that menopausal symptoms would be inversely associated with cognition.

Methods: This cross-sectional study included 708 HIV-infected and 278 HIV-uninfected premenopausal, perimenopausal, or postmenopausal women (64% African American; median age, 44 y) from the Women’s Interagency HIV Study. Participants completed tests of verbal learning and memory, attention/processing speed, and executive function. We administered a menopausal symptom questionnaire that assessed anxiety, vasomotor, and sleep symptoms and obtained measures of depressive symptoms.

Results: In multivariable regression analyses controlling for relevant covariates, HIV infection, but not menopausal stage, was associated with worse performance on all cognitive measures (P’s < 0.05). Depressive symptoms were associated with lower cognitive performance on measures of verbal learning and memory, attention, and executive function (P’s < 0.05); anxiety symptoms were associated with lower performance on measures of verbal learning and memory (P’s < 0.05). Vasomotor symptoms were associated with worse attention (P < 0.05). HIV and anxiety symptoms interacted to influence verbal learning (P’s < 0.05); elevated anxiety was associated with worse verbal learning in HIV-infected women only.

Conclusions: Vasomotor, depressive, and anxiety symptoms, but not menopausal stage, are associated with worse cognitive performance in both HIV-infected and HIV-uninfected women, although elevated anxiety symptoms are more associated with verbal learning deficits in HIV-infected women. Because cognitive problems can interfere with everyday functioning, including treatment adherence, it may be important to screen and treat anxiety in HIV-infected women.

© 2014 by The North American Menopause Society.


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