Cognitive impairment in Postmenopausal women

Abstract

Background: Plasma level of sex hormones is expected to affect different aspects of cognition in postmenopausal females and increase risk of dementia in women than in men. Objective: To assess the relation between estrogen and progesterone levels and cognition in postmenopausal females. Methods: Seventy subjects (30 postmenopausal females, and 40 premenopausal females) were subjected to the following: thorough history, medical and neurological examination, full routine laboratory investigations, serum estrogen and progesterone level, a battery of neuropsychological tests including MMSE, Beck's questionnaire for depression, Digit span forward and backward of Wechsler, Benton visual retention test, picture completion and picture arrangement from Wechsler, paired associate learning test, word recognition test, verbal fluency test. Results: Mean estrogen and progesterone levels in post-menopausal females were 14.58±10.12 pg/ml and 0.72±0.21 ng/ml respectively. Whereas their levels in premenopausal females were 190.7±91.18 pg/ml and 6.25±5.21 ng/ml respectively. There is a significant decrease in results of paired associate-learning test measuring verbal memory in postmenopausal females with no significant difference between them and premenopausal females in other cognitive domains studied. Positive significant correlation between estrogen level and verbal memory in postmenopausal females. Progesterone level showed non significant correlation with all neuropsychological tests in postmenopausal females. Significant correlation between age of onset of menopause, duration of menopause and verbal memory. Conclusion: Postmenopausal females had worse performance in different domains of cognition, so early and repeated assessment of cognition in this period is recommended. Also the use of hormonal replacement in postmenopausal period should be investigated.