title: A longitudinal study of cognition change during early menopausal transition in a rural community.
abstract: OBJECTIVE
  To characterize changes in cognition that occur during the hormonal transitions of menopause.
  
  
  METHODS
  We conducted a longitudinal population-based study in Kinmen, Taiwan, recruiting all women age 40-54 years who were premenopausal and without a history of hormone replacement therapy (HRT) or hysterectomy. The cognitive measures used to assess function included the Auditory-Verbal Learning Test, visual memory, verbal fluency, Trail Making Test and digit span.
  
  
  RESULTS
  A total of 694 eligible women participated in the baseline study, and 573 women (83%) completed follow-up 18 months later. After excluding 78 women who received hysterectomy or HRT, the final sample was composed of 495 subjects, of whom 114 (23%) progressed to perimenopause during follow-up. Women who remained premenopausal were younger than those who became perimenopausal (44.7 +/- 2.3 years versus 47.1 +/- 3.0 years, p < 0.01). All follow-up cognitive scores in women who entered perimenopause were slightly better than baseline measures except for Rey Auditory-Verbal Learning Test, which decreased by 0.23 (S.D. = 2.9, p = 0.3). At follow-up, cognitive function except for verbal fluency did not differ significantly between women who stayed premenopausal and those became perimenopausal after controlling for age, education, and baseline cognitive scores. Women who entered perimenopause have an average of 1.3 items (S.D. = 0.4) less in verbal fluency measures as compared with their premenopausal peers at the follow-up period.
  
  
  CONCLUSIONS
  The menopausal transition might not accompany significant cognitive decline except for verbal fluency.
authors.affiliation: Neurological Institute, Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan. jlfuh@vghtpe.gov.tw
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
authors.forename: Shin-Jung
authors.initials: SJ
authors.lastname: Lee
authors.forename: Shiang-Ru
authors.initials: SR
authors.lastname: Lu
authors.forename: Kai-Dih
authors.initials: KD
authors.lastname: Juang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009483:Neuropsychological Tests; D047648:Perimenopause / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*; D012424:Rural Population; D013624:Taiwan / Q000208:ethnology