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Cognition in perimenopause: the effect of transition stage

Weber, Miriam T. PhD1; Rubin, Leah H. PhD2; Maki, Pauline M. PhD2,3

doi: 10.1097/gme.0b013e31827655e5
Original Articles

Objective The aims of this cross-sectional study were to determine if cognitive function differs across stages of reproductive aging and to evaluate whether hormones or menopausal symptoms predict cognition in perimenopause. We hypothesized that women in late menopausal transition and early postmenopause would perform more poorly than those in the late reproductive stage on attention and verbal memory tasks, and that estradiol, depressive symptoms, anxiety symptoms, hot flashes, and sleep disturbance would predict cognitive performance on those tasks.

Methods One hundred seventeen middle-aged women enrolled in the Rochester Investigation of Cognition Across Menopause were categorized into late reproductive stage (n = 34), early menopausal transition stage (n = 28), late menopausal transition stage (n = 41), or early postmenopause stage (n = 14) according to criteria from the Stages of Reproductive Aging Workshop +10. We administered a neuropsychological battery assessing six domains of cognition, assessed menopausal symptoms, and measured serum levels of estradiol and follicle-stimulating hormone. Multivariate regressions were conducted to determine the impact of menopausal stage and symptoms on cognition.

Results Women in the first year of postmenopause performed significantly worse than women in the late reproductive and late menopausal transition stages on measures of verbal learning, verbal memory, and motor function. They also performed significantly worse than women in the late menopausal transition stage on attention/working memory tasks.

Conclusions Cognitive function does not change linearly across perimenopause. Decreases in attention/working memory, verbal learning, verbal memory, and fine motor speed may be most evident in the first year after the final menstrual period.

From the 1Department of Neurology, University of Rochester, Rochester, NY; and Departments of 2Psychiatry and 3Psychology, University of Illinois at Chicago, Chicago, IL.

Received July 24, 2012; revised and accepted September 26, 2012.

The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Funding/support: This study was supported, in part, by grants K23-AG54385484 R03-AG027844 and T32-NS07338 (to M.T.W.) and 5 M01 RR-00044 (University of Rochester Medical Center General Clinical Research Center). L.H.R.’s effort was supported by grant K12HD055892 from the National Institute of Child Health and Human Development and the National Institutes of Health Office of Research on Women’s Health.

Financial disclosure/conflicts of interest: P.M.M. has received consultant fees from Noven Pharmaceuticals.

Address correspondence to: Miriam T. Weber, PhD, Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Avenue, Rochester, NY 14642. E-mail:

© 2013 by The North American Menopause Society.