A recent study published in PLOS One on March 5, 2025, sheds light on the potential connection between menopausal symptoms and cognitive decline, as well as mild behavioral impairments. The research, led by Zahinoor Ismail from the University of Calgary and colleagues, suggests that women who experience a higher burden of menopausal symptoms may be at greater risk of developing cognitive and behavioral difficulties later in life, markers commonly associated with dementia.
Menopause and Increased Dementia Risk in Women
Women have a three-fold higher risk of developing Alzheimer’s disease and related dementias compared to men. As the global dementia burden increases, women will disproportionately bear the brunt of this public health challenge. One factor that may contribute to the increased vulnerability of women is the hormonal changes associated with menopause, particularly the loss of estradiol, a form of estrogen.
The new study, which used data from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT) study, provides valuable insights into this connection. The research focused on 896 postmenopausal women with an average age of 64.2 years and an average age of menopause onset at 49.4 years.
Assessing Menopausal Symptoms and Cognitive Function
The researchers assessed menopausal symptom burden by tallying the number of perimenopausal symptoms reported by participants. These symptoms included irregular periods, hot flashes, chills, vaginal dryness, weight gain, slowed metabolism, night sweats, sleep problems, mood swings, inattention, and forgetfulness. The study found a clear correlation between a higher number of reported menopausal symptoms and greater cognitive impairment, as indicated by higher ECog-II total scores.
In addition to cognitive impairments, women with more severe menopausal symptoms also reported higher scores on the MBI-C (Mild Behavioral Impairment Checklist), suggesting that they experienced more behavioral symptoms as they moved into mid- to late life. Specifically, the study observed that for every additional menopausal symptom reported, women had an increased likelihood of exhibiting mild behavioral impairments.
Hormone Therapy and Its Impact
Interestingly, the study found that hormone therapy, often prescribed to mitigate menopausal symptoms, was not significantly associated with improvements in cognitive function. However, hormone therapy did appear to be linked to fewer behavioral symptoms, suggesting that while it may not directly address cognitive decline, it could have a role in alleviating some of the behavioral challenges faced by postmenopausal women.
Implications and Future Research Directions
The findings of this study suggest that women who experience a higher burden of menopausal symptoms may be more susceptible to cognitive and behavioral changes in later life. While these results are compelling, the study’s authors note that further investigation is needed to confirm these findings in a larger dataset and, ideally, with a longitudinal design. This would allow researchers to better understand the cause-and-effect relationship between menopausal symptoms and dementia-related outcomes.
Additionally, future studies would benefit from examining more specific subgroups, taking into account confounding factors such as the age at menopause onset, surgical menopause, and other potential influences on cognitive and behavioral health.
Conclusion
This study highlights the potential long-term cognitive and behavioral risks associated with higher menopausal symptom burdens, offering new insights into women’s health and aging. It underscores the need for further research to establish definitive links between menopause, cognitive decline, and dementia risk, as well as the potential role of hormone therapy in mitigating these risks. Understanding these connections could be crucial for developing preventive measures and therapeutic interventions for women as they age.
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