MDNews - Greater Boston

Tracing the link between Menopause and Cognition she can't find her Keys. she struggles to calculate a tip at a restaurant. doing her taXes is out of the Question. as many as two-thirds of menopausal women report forgetfulness, lacK of focus and other cognitiVe difficulties, according to a uniVersity of rochester medical center report. R eSeArcherS Are eXAMining the negative changes in cognitive functioning following surgical and natural menopause, and two recent studies found that frustrations women experience during "the change" are not frivolous or just a natural part of aging — but a real physiological response to the reproductive transition. In March 2012, Miriam Weber, Ph.D., assistant professor of neurology at the University of Rochester Medical Center, published results of a study of cognitive function in 75 women who were approaching or beginning menopause. Her research found subtle declines in verbal learning, verbal memory and fine motor skills, specifically in the first year after the final menstrual period, compared with women in other stages of menopause. "Our understanding of what happens across the menopause transition is evolving, and we're just beginning to understand what happens with cognition," says Dr. Weber. "It's long been known that women report memory problems, but there have only been a few studies of objective cognition. We found there's something to women's complaints, and I think it's helpful to normalize the experience for them." When the trouble hits Dr. Weber's research team put women through a battery of cognitive tests that assessed their abilities to learn and retain new information, to manipulate information, and to sustain their attention over a 14 | Greater Boston MD News ■ MdneWS.coM period of time. In the cross-sectional study, women in the first year of postmenopause, defined as the year after a woman has had her last menstrual period, performed significantly worse than women in the late menopausal transition. Dr. Weber says learning, retaining and applying new information are associated with the hippocampus and prefrontal cortex, parts of the brain that are flooded with estrogen receptors. "We know estrogen is related to cognitive function," Dr. Weber says. "We know women perform differently across different stages of their menstrual cycles — that they perform differently in high-estrogen phases versus low-estrogen phases. We know it's something above and beyond just menopause symptoms, such as depression and sleep disturbances, but we tend to not find a linear relationship between cognitive performance and estrogen levels. There is some thought it may be due more to the tremendous hormonal fluctuations during the transition." the estrogen Question Further study is ongoing at the University of Vermont College of Medicine, where Julie Dumas, Ph.D., associate professor of psychiatry, has examined the neurobiology underlying age-related cognitive dysfunction — specifically the interaction of estrogen and the cholinergic system, which is thought to be critical for attention, learning, memory and psychomotor performance.

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