Women's Health Info
Navigating Cognitive Decline for Women in Midlife
Overview: cognitive changes in women during the menopause transition years
- Cognition is the umbrella term for the array of mental processes of acquiring and understanding knowledge, including perception, recall, problem-solving, decision-making, and reasoning. These cognitive abilities appear to peak around age 30 and, on average, decline subtly with age.
- The long-term SWAN study of women’s health uses various measures to test cognitive function and changes therein over the middle years (the fifth through the seventh decades of life).
- This area of research is particularly important as women tend to live longer than men, and therefore are more likely to develop dementia (or significant impairment in cognition) in their later years.
- Researchers found that the biggest factors in cognitive declines were financial hardship and hypertension (often linked to stress).
- Fortunately, this suggests that boosting positive aspects of quality of life may have a noteworthy impact on modifying potential declines.
Understanding cognition, memory & the mind
Cognition is the overall term for how the mind works. Consider it the brain’s operating system, orchestrating processes from seeing and thinking to solving problems. Memory, on the other hand, is one specific aspect of cognition. It’s what helps us remember things, like where we put our belongings or what we’ve learned before. It involves the processes of acquiring, retaining, and recalling past experiences, knowledge, or skills.
Others aspects of cognition include perception, attention span, language, judgement, decision making, and problem solving. It is important to note that aging does not have to lead to cognitive impairment. Cognitive abilities, such as vocabulary, verbal reasoning, and reading skills, can be improved in middle and later years.
SWAN is a long-term, multi-racial and ethnic, and multicenter research project that aims to understand the physical, biological, and psychosocial changes that occur in women during the menopause transition. Researchers are examining various aspects, including hormone levels, sleep patterns, cardiovascular health, bone density, and psychological well-being. By studying a diverse population of women over time, SWAN aims to provide comprehensive insights into the menopause transition and its impact on women's health.
Cognitive impairment differences in women and men
There is increasing worry surrounding cognitive function and aging, stemming from a couple of key factors. Firstly, women generally have a longer life expectancy, making them more likely to reach the age of 85 compared to men. This means women have a longer period in which they will need to manage cognitive impairment. Secondly, even when considering this longevity difference, women appear to face a slightly higher risk than men of developing dementia, which is an advanced stage of cognitive impairment that generally involves more than one aspect of cognition and interferes with one’s ability to conduct daily activities.
The exact reasons for this variation remain unclear, prompting SWAN research to embark on a mission to better understand these complexities. As of now, we’re still in the process of uncovering these insights, but the hope is that SWAN’s ongoing endeavors will shed light on the factors contributing to age-related declines and potential interventions.
Impact of midlife on cognitive impairment
SWAN’s extensive research, spanning about 15-20 years, has identified general patterns in cognitive decline. Notably, changes in cognitive processing speed (the time it takes to process information and respond) become more demonstrable in the 50s. Although there are transient memory deficits experienced during the menopause transition, these appear to be reversible, and persistent declines only become apparent in well after menopause. Understanding these patterns is crucial for anticipating and managing cognitive changes.
Research reveals age-related declines in memory starting around age 58, processing speed in the early fifties, and working memory around age 61. However, not everyone declines at the same rate. For example, those in financial hardship consistently emerged with accelerated rates of cognitive decline.
From a physiological perspective, diabetes, elevated fasting glucose, central obesity, hypertension, and poor heart health were associated with rate of decline in processing speed during midlife.
Encouragingly, physical activity, even in small amounts, exhibits potential benefits as women age, though its impact on cognition specifically remains under exploration.
How menopausal women can prevent cognitive impairment & memory loss
The findings suggest that maintaining financial well-being and managing cardiovascular health are crucial factors influencing cognitive decline during the menopausal transition.
Certainly, financial hardship is often something that cannot be avoided. However, understanding heightened risks can enable women to have important discussions with their doctors and stay vigilant for signs of concerns. There are also a number of lifestyle changes women can practice to help maintain or improve cognition as they age. Recommended lifestyle changes include:
- Exercising regularly. While research is ongoing, the best way women can increase their odds of living a long and healthy life is to start exercising, right now, even a little bit.
- Stress management. Chronic stress can cause hypertension, negatively impacting cognitive function. Adopting stress management techniques, such as mindfulness, meditation, or relaxation exercises, may contribute to maintaining cognitive well-being.
- Adopting a healthy diet. This has the added benefit of boosting heart health and emotional well-being.
- Seeing a doctor if memory changes suddenly.
Latest cognitive function news
PLOS (Public Library of Science) article features SWAN recent findings on Cognitive Decline
Congratulations to SWAN authors Arun S. Karlamangla (pictured), WeiJuan Han, Mei-Hua Huang, and Gail A. Greendale!
We are still learning from our cognition studies during menopause
SWAN and other researchers continue to explore the complex interplay between cognitive function, physical function, hormonal changes, and quality of life. Looking ahead, ongoing studies and emerging interventions provide hope for effectively managing cognitive decline, contributing to a more vibrant and independent aging experience for women.
Reviewed by:
Arun S. Karlamangla, MD, PhD, Professor, David Geffen School of Medicine, University of California, Los Angeles