Cognitive Changes with Reproductive Aging, Perimenopause, and Menopause - 29/10/18

Doi : 10.1016/j.ogc.2018.07.011

Kelly N. Morgan, PsyD ^a,^⁎ , Carol A. Derby, PhD ^b,^c,^{^{1
Present address: 1225 Morris Park Avenue, Van Etten Room 3C5D, Bronx, NY 10461.}}, Carey E. Gleason, PhD, MS ^d
^a Division of Neuropsychology, The Institute of Living/Hartford Hospital, 200 Retreat Avenue, Research Building 6th Floor, Hartford, CT 06106, USA
^b Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1410 Pelham Parkway South, Bronx, NY 10461, USA
^c Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA
^d Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison Geriatric Research Education and Clinical Center (GRECC) (11G), Wm S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53706, USA

^∗Corresponding author.

Résumé

This article reviews the role of endogenous estrogen in neural and cognitive processing, followed by an examination of longitudinal cognitive data captured in various stages of the menopausal transition. The remaining text reviews the contradictory results from major hormone therapy trials to date, evidence for the “timing hypothesis,” and closes with recommendations for future research and for practicing clinicians.

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Keywords : Estrogens, Cognition, Menopause, Study of women across the nation, Hormone therapy, Women’s Health Initiative, Kronos early estrogen prevention study, Early versus late intervention trial with estradiol

Plan

Key points

Introduction

Mechanisms linking estrogen with neural and cognitive processes

Estrogen and Brain Metabolism

Estrogenic Neuroprotection

Longitudinal data regarding the effect of menopausal hormone changes on cognitive function

Hormone therapy trials and emerging support for the critical window hypothesis

Women’s Health Initiative Hormone and Cognition Therapy Trials

Emerging Support for the Critical Window Hypothesis

Addressing gaps in understanding after the Women’s Health Initiative trials

Summary: implications for clinical practice

	Disclosure Statement: No disclosures.
	Funding: KEEPS Continuation Grant number: NIH-NIA 1RF1AG057547; GRECC article number: 002 to 2018 (C. Gleason). The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women's Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495) (C. Derby).
	The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH.