title: Menopause effects on verbal memory: findings from a longitudinal community cohort.
abstract: BACKGROUND
  Although cognitive complaints are common among menopausal women, it is debatable whether there is an objective decline in cognition with menopause that exceeds what is expected with normal aging.
  
  
  OBJECTIVE
  The objective of the study was to determine whether reproductive senescence is associated with an age-independent decline in verbal memory.
  
  
  METHODS
  The study was a 14-year, longitudinal, population-based cohort study of women who underwent yearly endocrine, behavioral, and cognitive assessments from pre- to postmenopause.
  
  
  METHODS
  Caucasian and African American premenopausal women (n = 403), who were enrolled in the Penn Ovarian Aging Study, participated in the study.
  
  
  METHODS
  Buschke Selective Reminding Test (immediate and delayed verbal recall), the digit symbol substitution task, and the symbol copy task were used to measure outcomes.
  
  
  RESULTS
  A total of 3958 assessments were conducted in this sample of 403 women. In models that were adjusted for age and important cofactors, immediate (P = .03) and delayed (P = .03) recall on the Buschke Selective Reminding Test declined from the pre- to postmenopausal stages. Further evaluation identified a significant decline (P < .002) in delayed recall early in the transition and immediate recall (P = .04) late in the transition. Race was a significant factor in performance on all tasks (all P < .0001) except the delayed verbal recall task (P = .06) in adjusted models. Endocrine measures were significantly associated with cognitive performance in unadjusted models.
  
  
  CONCLUSIONS
  Certain cognitive domains are sensitive to the physiological changes of reproductive senescence independent of age. The differences in cognitive performance between African American and Caucasian women were not explained by factors examined in this study but are of important public health concern that warrants further investigation.
authors.affiliation: Department of Psychiatry, Penn Center for Women's Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. cepp@mail.med.upenn.edu
authors.forename: C Neill
authors.initials: CN
authors.lastname: Epperson
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
mesh_terms: D000328:Adult; D001741:Black or African American; D000375:Aging / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008568:Memory / Q000502:physiology*; D008593:Menopause / Q000502:physiology / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D044465:White People