Risk and Protective Factors for Cognitive Function in the Menopause Transition

Principal Investigator

Amber Watts, Associate Professor, Department of Psychology

Issue

Over 60% of women report cognitive symptoms during the menopause transition, but few effective treatments are available. These symptoms are bothersome, impair work performance, and may indicate underlying risk for chronic health conditions. Findings will lead to more targeted mechanistic hypotheses of underlying disease risk and inform intervention strategies benefiting cognitive function in the menopause transition.

Response

The proposed project will specifically study the interrelationships between protective and risk factors for cognitive symptoms during the menopause transition.

Project Details

Aim 1: Quantify the relative contributions of risk factors associated with cognitive symptoms in peri- and recently post-menopausal women with at least one cardiometabolic risk factor.

Women with cardiometabolic risk factors including diabetes, high blood pressure, high cholesterol, obesity, and history of smoking are potentially more likely to experience cognitive symptoms during the menopause transition. Common cognitive complaints include difficulty concentrating, forgetting things, and slower thinking speed. We will conduct detailed cognitive testing to evaluate participants’ function on learning and memory, attention, processing speed, executive function, and working memory in visual and verbal domains.

We will investigate the proportion of variance in cognitive performance accounted for by cardiometabolic risk factors, vasomotor symptoms (hot flashes and night sweats), sleep disruptions, and psychological factors (depression, adverse childhood events). We will use electronic health records to identify and recruit a diverse sample of women. We will obtain

high quality measures of cardiometabolic risk, vasomotor symptoms, sleep, physical activity, and psychological symptoms along with a detailed battery of cognitive assessments. Establishing the relative strength of these contributing factors will lead to more targeted mechanistic hypotheses and inform intervention strategies benefiting cognitive function. Intervention strategies might include treatment of underlying cardiometabolic risk factors, treatment for vasomotor symptoms of menopause, and treatment for depression and insomnia.

Aim 2: Investigate habitual physical activity as a potential protective factor for cognitive performance via its effects on sleep and vasomotor symptoms in peri- and recently post-menopausal women.

Exercise interventions improve vasomotor symptoms, sleep, depression, and cognition. Less well established is whether habitual physical activity is a protective factor for cognition in perimenopause. Objective measurement of vasomotor symptoms, physical activity, and sleep are needed because self-report is less strongly associated with cognition than self-report. We hypothesize that higher levels of habitual moderate to vigorous physical activity will be associated with less severe vasomotor symptoms, fewer nighttime awakenings, fewer depressive symptoms, and better cognitive performance. Further, we hypothesize that fewer awakenings will mediate the relationship between nighttime vasomotor symptoms and cognitive performance. Findings will inform future non-pharmacological strategies for maintaining cognition in the menopause transition, such as increased exercise and sleep interventions. Our proposal is innovative in its simultaneous use of objective, physiological measures of physical activity and sleep and quantification of potential risk and protective factors for cognition during the menopause transition. It will use bioinformatic tools to identify and recruit a diverse set of participants. These aims align with calls from organizations like The Menopause Society and the NIH Office of Research on Women’s Health and support the goals of the CoBRE: Leveraging Big Data to Improve Women's Health.