About 75 percent of older adults have memory-related problems, and many women report forgetfulness and “brain fog” during menopause, as well. It’s been shown that women are twice as likely to develop Alzheimer’s disease as men, although not much is known about why that is or when they become more vulnerable.
“For years, the dominant thinking in the field was that women were at higher risk of Alzheimer’s disease simply because they tend to live longer,” senior author Jill Goldstein, PhD, director of research at the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital, said in a press release. “But that idea was perpetuated by research that looked late in life—not at middle age, when key hormonal transitions take place and when changes in memory begin to surface.”
In hopes of documenting some of these mid-life brain changes, Goldstein and her colleagues recruited 212 healthy men and women, ages 47 to 55. Because the participants weren’t yet showing signs of dementia or obvious problems, they used a series of tests designed to evaluate several different forms of learning and memory and detect early, otherwise unnoticeable cognitive defects.
When they compared their results, they found that differences in memory function corresponded to gender and menopausal stage, more so than chronological age.
Specifically, pre- and peri-menopausal women performed better than men of the same age in all categories of memory. After menopause, however, women’s scores for tests of initial learning and retrieval of information dropped, bringing them about equal with age-matched men.
Hormone measurements also showed that women with lower levels of estradiol estrogen (which go down after menopause) tended to do worse on memory tests.
The findings suggest that during or shortly after menopause, women experience changes in the frontal areas of their brains that play a role in short-term memory and advanced cognitive abilities, like organizing, structuring and evaluating information. They also highlight the importance of ovarian hormones in maintaining memory function, the authors say.
Goldstein is hopeful that one day, doctors will be able to identify in middle-age who is at highest risk of developing Alzheimer’s disease years down the road.
“This is critical because the treatments given after disease onset have been unsuccessful,” she says. “We hope findings from our cohort will ultimately provide clues early in mid-life with regard to who is at highest risk for the disease in later mid-life, and how this may differ for men and women.”
JoAnn Pinkerton, M.D., executive director of the North American Menopause Society, added that the study also brings attention to the common issue of cognitive problems during menopause.
"Brain fog and complaints of memory issues should be taken seriously," said Dr. Pinkerton, who was not involved in the study, in a press release. "This study and others have shown that these complaints are associated with memory deficits."
The new findings were published this week in the journal Menopause. Goldstein and her fellow researchers are also working on a clinical risk tool that can help pinpoint men and women who are at increased risk for Alzheimer’s disease based on genetic factors and other clinical characteristics.
“Alzheimer’s disease is one of the greatest public health challenges of our time,” said Goldstein. “Going forward, it is imperative that we understand how to retain memory function throughout life, and that we incorporate these sex differences into future research and therapeutic discovery strategies.”