Menopause effects on verbal memory: findings from a longitudinal community cohort.

CONTEXT: 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. DESIGN AND
SETTING: 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. PARTICIPANTS: Caucasian and African American premenopausal women (n = 403), who were enrolled in the Penn Ovarian Aging Study, participated in the study. MAIN OUTCOME MEASURES: 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.