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A comprehensive assessment of age at menopause with well-characterized cognition at 70 years: A population-based British birth cohort

Needham, Louisa P; Lu, Kirsty; Nicholas, Jennifer M; Schott, Jonathan M; Richards, Marcus; James, Sarah-Naomi; (2023) A comprehensive assessment of age at menopause with well-characterized cognition at 70 years: A population-based British birth cohort. Maturitas , 170 pp. 31-38. 10.1016/j.maturitas.2023.01.009. Green open access

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Abstract

OBJECTIVES: Associations between age at menopause and cognition post-menopause are examined to determine whether relationships are stronger for certain cognitive domains. STUDY DESIGN: Women from the Medical Research Council National Survey of Health and Development and its neuroscience sub-study, Insight 46, were included if they had known age at menopause (self-reported via questionnaire) and complete cognitive outcome data at age 69 (n = 746) or at Insight 46 wave I (n = 197). Multivariable linear regression analyses adjusting for life course confounders were run; interactions with menopause type (natural/surgical) and APOE-ε4 status were examined; and the potential contribution of hormone therapy was assessed. MAIN OUTCOME MEASURES: Cognitive measures were standardized Addenbrooke's Cognitive Examination - third edition total and sub-domain scores at age 69 (whole cohort) and Preclinical Alzheimer's Cognitive Composite total and sub-test scores at age ~70 (Insight 46). RESULTS: Older age at menopause was associated with better performance across all outcomes, most strongly for the Addenbrooke's Cognitive Examination memory and visuospatial function sub-domains, and the Preclinical Alzheimer's Cognitive Composite digit-symbol substitution test and face-name associative memory examination sub-tests. Adjusting for early-life factors attenuated all effect estimates, driven by childhood cognition, and accounting for menopause type revealed negative confounding for some outcomes. No significant interactions with menopause type or APOE-ε4 status were detected. Further adjustment for hormone therapy did not meaningfully alter the estimated effects. CONCLUSIONS: Older age at menopause is associated with better later-life cognitive performance, particularly for visual processing and associative learning and memory domains. Childhood cognition was an important contributor.

Type: Article
Title: A comprehensive assessment of age at menopause with well-characterized cognition at 70 years: A population-based British birth cohort
Location: Ireland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.maturitas.2023.01.009
Publisher version: https://doi.org/10.1016/j.maturitas.2023.01.009
Language: English
Additional information: Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Keywords: Cognitive domains, Life course, Menopause
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10164903
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