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Women who go through menopause very early, before the age of 40, are more likely to develop dementia of any type later in life compared to those who start menopause at the average age of menopause onset, 50 to 51 years .
“Our study concluded that women who go through menopause very early had a higher risk of developing dementia later in life,” says Wenting Hao of the
Shandong University in Jinan(China).
Dementia involves serious changes in the brain that affect a person’s ability to remember, make decisions, and use language.
Alzheimer’s disease is the most common type of dementia, while the second most common is vascular dementia, which is the result of disruptions in blood flow to brain cells caused by strokes or plaque buildup in the arteries that supply blood to the brain.
Both types are more common with age. Diseases that affect specific parts of the brain can also cause dementia, and a person may have dementia due to more than one disease process.
In the current study, the researchers looked at the possible relationship between the age of onset of menopause and the diagnosis of dementia from any cause. Health data on 153,291 women who had an average age of 60 years when they entered the UK Biobank (between 2006 and 2010).
The researchers identified diagnoses of all types of dementia, including Alzheimer’s disease, vascular dementia, and dementias of other causes.
They calculated the odds risk in terms of the age at which women reported entering menopause, compared with women who began menopause at the average age of menopause onset, which is 50 to 51 years (51 years is the average age of onset of menopause among women in the United States).
Results were adjusted for factors such as age at last exam, race, education level, cigarette and alcohol use, body mass indexcardiovascular diseases, diabetes, income, and physical and leisure activities.
• Women who entered menopause before the age of 40 had a 35% more likely to have been diagnosed with dementia
• Those who started before the age of 45 were 1.3 times more likely to have been diagnosed with dementia before age 65 (called presenile or early onset dementia).
• Those who entered menopause at age 52 or older had rates of dementia similar to women who entered menopause at the average age of menopause onset, which is the age of 50 to 51 years.
Although postmenopausal women are at higher risk of stroke than premenopausal women, and stroke can disrupt blood flow to the brain and lead to vascular dementia, in this study the researchers found no association between age at menopause and risk of vascular dementia.
“Dementia can be prevented, and there are several ways that women experiencing early menopause can reduce their risk of dementia. This includes regular exercise, participation in leisure and educational activities, not smoking or drinking alcohol, maintaining a healthy weight, getting enough vitamin D and, if recommended by your doctor, possibly take calcium supplements», Hao points out.
The researchers suggest that low estrogen levels may be a factor in the possible connection between early menopause and dementia. “We know that long-term lack of estrogen increases oxidative stress, which can increase brain aging and lead to cognitive decline,” he said. Hao.
Physicians caring for women should know the woman’s age at the onset of menopause and closely monitor cognitive decline in those who reached menopause before age 45.
“More research is needed to assess the added value of including the timing of menopause as a predictor in existing dementia models» adds Hao. “This may provide clinicians with a more accurate way to assess a woman’s risk of dementia.”
The study has several limitations. The researchers relied on self-reported information from women regarding their age at the onset of menopause. Furthermore, the researchers did not look at rates of dementia in women who had an early natural menopause separately from women with menopause induced by surgery to remove the ovaries, which might affect the results. The data used for this study mainly included white women living in the UK and may not be generalized to other populations.
