Early Menopause Spares the Brain

A new study reported at today's American Neurological Association annual meeting in Toronto asserts that women do not begin to show cognitive decline as a condition of menopause, according to the ANA and Newswise.

Contrary to popular belief, women do not suddenly start to lose their memory when menopause begins, according to a study presented October 4, 2004, at the 129th annual meeting of the American Neurological Association in Toronto. Researchers in Taiwan studied women around the menopausal shift and found scant evidence for memory deficits in women during the early part of menopause.

A number of factors have contributed to the common belief that memory loss is an inevitable part of menopause, not the least of which is the perception by women themselves that they become more forgetful during or after menopause. In addition, some, but not all, studies of the effects of hormonal replacement therapy (HRT) have indicated that women who use HRT have less cognitive decline following menopause and lower rates of Alzheimer's disease. This research has been supported by a large body of experimental evidence that estrogen helps to keep brain cells healthy.

In this atmosphere, memory preservation has been viewed as a possible advantage of HRT, and many women use herbal supplements containing plant estrogens, touted as memory protective.

However, a well-publicized study released last year by researchers at Rush University in Chicago contradicted the idea of memory loss during menopause. In the present study, Jong-Ling Fuh, MD, of Taipei Veterans General Hospital in Taiwan and colleagues reveal findings that support this conclusion.

Fuh and colleagues took advantage of an ongoing study of women who live in a rural archipelago of islands called Kinmen (or Quemoy), located between Taiwan and the Chinese mainland. Until the mid 1990s, access to the island was restricted by the Taiwanese government, which maintained many military bases in Kinmen. Thus, the population remains relatively homogenous, making it attractive for epidemiological studies.

The researchers recruited 694 premenopausal women, aged 40 to 54, into their study and assessed their memory at baseline and 18 months later. At the follow-up, Fuh and colleagues found that 23 percent of the 495 remaining eligible women (no hysterectomy or HRT during the intervening 18 months) had entered menopause.

With the exception of one test, these women scored similarly on various memory tests to the women who had not yet entered menopause. The exception was a test of verbal memory, which involved the sequential presentation of 70 nonsensical figures, several of which were repeated during the test. The subjects were asked whether the figures had been seen before or not.

On the verbal memory test, the women who had entered menopause scored slightly lower than those who had not.

"Since menopause is apparently not accompanied by a significant decline in most cognitive abilities, it might not be helpful for women to use estrogen or progesterone in order to improve their memory during this period," said Fuh.

The researchers note, however, that the follow-up period was just 18 months in this study, and their conclusions are limited to the early menopausal transition.

"A longer follow-up period is warranted to evaluate the impact of menopause on cognitive change," said Fuh.

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