Midlife Women Outperform Men on Memory Tasks Until Menopause

Bridget M. Kuehn

November 09, 2016

In midlife, women consistently outperform men on memory tasks until menopause, when they lose their edge as their estrogen levels dip, according to a study published online November 9 in Menopause.

As many as three quarters of older adults experience memory-related deficits, and women frequently report increased forgetfulness during menopause, according to lead author Dorene M. Rentz, PsyD, codirector of the Center for Alzheimer Research and Treatment at Brigham and Women's Hospital in Boston, Massachusetts, and colleagues. However, few studies have examined how age-related declines in memory vary by sex.

To examine sex-related differences in memory, Dr Rentz and colleagues recruited 212 men and women between the ages of 45 and 55 years who have been followed since their mothers' pregnancies as part of the New England Family Study. All participants completed a battery of cognitive tests. Women participants also underwent hormonal assessment to determine their menopausal status.

Overall, women performed better than men on all memory measures, including the Face-Name Associative Memory Exam (FNAME; β = −0.30; P < .0001) and the Selective Reminding Test (SRT; β = −0.29; P < .0001).

When women's cognitive performance was compared on the basis of menopausal status, Dr Rentz and colleagues found that premenopausal and perimenopausal women performed better than postmenopausal women on FNAME (initial learning, β = 0.32; P = .01) and SRT (recall, β = 2.39; P = .02). Higher estrogen levels in women were also associated with significantly better performance on SRT (recall, β = 1.96; P = .01). (The authors excluded eight women who reported current use of hormonal therapy from this subset analysis.)

Postmenopausal women had difficulty with initial learning and retrieval of information, but not consolidating or storing memories, the authors note. Moreover, postmenopausal women's performance on memory tasks was comparable to men's, except on tests of delayed recall (7.5 vs 6.1; β = 0.80; P = .004) and overall SRT (0.07 vs −0.3; β = −0.19; P = .04).

The findings suggest that declining estrogen levels may be linked to problems with initial learning and retrieving memories in postmenopausal women, Dr Rentz and colleagues write. This may explain some of the symptoms like "brain fog" that women frequently report during this transition.

"We showed that loss of ovarian estradiol during menopause plays a significant role in shaping memory function," the authors write. "In the future, we hope to understand which memory changes experienced by women in early midlife are associated with healthy aging, and which memory deficits may be early indicators of preclinical Alzheimer disease and eventual memory decline in early life."

In the meantime, clinicians should be aware that changing estrogen levels may dampen women's memory postmenopause.

"Brain fog and complaints of memory issues should be taken seriously," said JoAnn V. Pinkerton, MD, the executive director of the North American Menopause society, which publishes Menopause, in a society news release. "This study and others have shown that these complaints are associated with memory deficits."

The study was funded by a grant from the National Institute of Mental Health. Dr Rentz has served as a consultant for Eli Lilly, Janssen Pharmaceuticals, and Biogen. She is also a paid member of the Neurotrack Scientific Advisory Board. Other coauthors have disclosed no relevant financial relationships.

Menopause. Published online November 9, 2016. Abstract

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