Abstract and Introduction
Abstract
Objective: Menopause is a natural phenomenon among women during their midlife, which is accompanied by unfavorable physical, physiological, and psychological consequences. Therefore, the major aim of the present cross-sectional study was to examine whether the cognitive performance of women is sensitive to the severity of menopausal symptoms.
Methods: A total number of 404 rural women aged between 40 and 65 years were included in the present study. The menopausal symptoms and cognitive performance of the women were assessed using the Greene Climacteric Scale and Hindi Mini-Mental State Examination scale respectively.
Results: The results of the present study demonstrated that women experiencing severe menopausal symptoms (higher Total Greene climacteric score) presented significantly lower mean values for orientation (8.11 vs 8.90, P < 0.001), registration (2.77 vs 2.91, P < 0.001), attention (4.31 vs 4.48, P < 0.01), recall (2.26 vs 2.53, P < 0.05), and language/visuo-spatial skills (7.13 vs 7.91, P < 0.001) as compared with their counterparts with mild menopausal symptoms. The multivariate linear regression model (after adjustment for age, marital status, and educational status) recorded severe depression and greater sexual dysfunction as the factors significantly associated with lower Mini-Mental State Examination scores.
Conclusion: Hence, the findings of the present study indicated that the cognitive performance of women was sensitive to severe depression and sexual dysfunction.
Video Summary: http://links.lww.com/MENO/A864.
Introduction
Menopause is an inevitable physiological event associated with the emergence of the postreproductive phase after the complete cessation of the menstrual cycle. Though it is a universal biological process among midlife women, the menopausal symptoms experienced by them vary in frequency as well as severity from one woman to another and also across different cultures.[1] These climacteric symptoms subsequently affect women's general health, wellbeing, and quality of life. Past studies in this domain[2,3] emphasized that the memory complaints also referred to as "mental fog" or "slowness in thinking" are commonly reported among midlife women. Findings of Dow[4] described it as a type of ephemeral cognitive dysfunction marked with memory complaints, forgetfulness, difficulty in concentration, and focusing. Previous studies[5–8] have recorded a significant prevalence of menopause associated symptoms among midlife women, while other studies in this realm[9,10] have noticed a decrease in the cognitive performance with the successive menopausal transition. Hypothetically, one may argue that the occurrence and severity of climacteric symptoms can impact the cognitive functioning of women approaching menopause.
Findings of a longitudinal study (Study of Women's Health Across the Nation) performed by Greendale et al,[11] documented that the greater anxiety and depressive symptoms were significantly associated with poor Symbol Digit Modalities Test performance, after adjusting the model for the potential covariates. Similarly, findings of some prior studies[12,13] noticed an inverse association between the occurrence of vasomotor symptoms and memory functioning. The results of the multivariate linear regression analysis in the study conducted by Triantafyllou et al[14] highlighted that the intensity of psychological complaints and Total Greene climacteric score were the significant predictors of performance in the Mini-Mental State Examination scale. A recent study conducted by Jaff et al[15] also recorded a negative association of anxiety and hot flashes with processing speed, while acute mood changes were the significant predictors of decline in the incidental recall ability.
There are numerous cognitive tools available for the assessment of various functions of the human brain like memory, orientation, executive functions, attention, and language, etc. The Mini-Mental State Examination (MMSE) scale is one of the most widely acceptable[16] cognitive screening tools. However, its applicability in developing countries like India is limited due to diversity in language, culture, and educational status.[17] Therefore, the Hindi Mini-Mental State Examination[18] scale is a highly acceptable and relevant tool for assessing the global cognitive performance of the rural population with lower literacy levels.[19]
Limited studies have been conducted to investigate the impact of menopausal symptoms on the cognitive performance and have presented conflicting results. As some of the researchers reported lack of association,[20] while others[13,14,21–23] indicated a negative association between the occurrence of menopausal symptoms and cognitive abilities of the women. Given these ambiguities, it is imperative to explore whether the cognitive performance of women is sensitive to the severity of the menopausal symptoms, so that the cognitive health of the women experiencing menopausal transition can be improved. Hence, the major purpose of the present cross-sectional study was to examine the sensitivity of cognitive abilities of the rural women in various cognitive domains with respect to the severity of menopausal symptoms.
Menopause. 2022;29(2):170-177. © 2022 The North American Menopause Society
