Gonadal Hormones and Cognitive Aging: A Midlife Perspective

摘要

Gonadal steroids affect a variety of brain processes. Cognitive consequences of hormonal changes associated with menopause are of scientific interest and of public heath relevance. Natural menopause is a normal physiological process that can be directly studied only through observational research. Similarly, surgical menopause in humans is rarely directly amenable to experimental research. Causality with respect to cognitive outcomes is therefore difficult to infer. Cross-sectional and longitudinal findings from the Melbourne Women’s Midlife Health Project, the Study of Women’s health Across the Nation, and other midlife cohorts suggest that cognitive consequences of the natural menopausal transition are probably small, at least during midlife and at least for episodic memory, a key cognitive domain for which data are the most robust. Midlife episodic memory performance is similar shortly after natural menopause compared to shortly before, and serum estradiol concentration in midlife is unassociated episodic memory performance. Effects of natural menopause on other cognitive domains, cognitive consequences of surgical menopause, and late-life cognitive consequences of midlife hormonal exposures are less well understood and merit continued study.