title: Impact of a premature menopause on cognitive function in later life.
abstract: OBJECTIVE
  To determine whether premature menopause (≤40 years) can have long-lasting effects on later-life cognition and investigate whether this association varies depending on the type of menopause and use of hormone treatment (HT).
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  The French Three-City Study.
  
  
  METHODS
  Four thousand eight hundred and sixty-eight women aged at least 65 years.
  
  
  METHODS
  Multivariable-adjusted logistic regression models were used to determine the association between age at menopause, type of menopause (surgical, natural), and the use of menopausal HT and later-life cognitive function.
  
  
  METHODS
  Performance on a cognitive test battery (at baseline and over 7 years) and clinical dementia diagnosis.
  
  
  RESULTS
  Menopause at or before the age of 40 years, both premature bilateral ovariectomy and premature ovarian failure (non-surgical loss of ovarian function), was associated with worse verbal fluency (OR 1.56, 95%CI 1.12-1.87, P=0.004) and visual memory (OR 1.39, 95%CI 1.09-1.77, P=0.007) in later life. HT at the time of premature menopause appeared beneficial for later-life visual memory but increased the risk of poor verbal fluency. Type of menopause was not significantly associated with cognitive function. Premature menopause was associated with a 30% increased risk of decline in psychomotor speed and global cognitive function over 7 years.
  
  
  CONCLUSIONS
  Both premature surgical menopause and premature ovarian failure were associated with long-term negative effects on cognitive function, which are not entirely offset by menopausal HT. In terms of surgical menopause, these results suggest that the potential long-term effects on cognitive function should form part of the risk/benefit ratio when considering ovariectomy in younger women.
authors.affiliation: Inserm, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; Université Montpellier 1, Montpellier, France; Cancer & Disease Epigenetics, Murdoch Children's Research Institute, Melbourne, Vic., Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia.
authors.forename: J
authors.initials: J
authors.lastname: Ryan
authors.forename: J
authors.initials: J
authors.lastname: Scali
authors.forename: I
authors.initials: I
authors.lastname: Carrière
authors.forename: H
authors.initials: H
authors.lastname: Amieva
authors.forename: O
authors.initials: O
authors.lastname: Rouaud
authors.forename: C
authors.initials: C
authors.lastname: Berr
authors.forename: K
authors.initials: K
authors.lastname: Ritchie
authors.forename: M-L
authors.initials: ML
authors.lastname: Ancelin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003704:Dementia / Q000453:epidemiology* / Q000523:psychology; D004958:Estradiol / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy / Q000523:psychology / Q000706:statistics & numerical data*; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008593:Menopause / Q000523:psychology; D008594:Menopause, Premature / Q000523:psychology*; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D010052:Ovariectomy / Q000523:psychology / Q000706:statistics & numerical data*; D016649:Primary Ovarian Insufficiency / Q000453:epidemiology* / Q000523:psychology; D011597:Psychomotor Performance; D012307:Risk Factors; D057968:Transdermal Patch
chemical_list: D004967:Estrogens; D004958:Estradiol
keywords: Cognition; dementia; hormone treatment; ovariectomy; premature menopause