Early menopause linked to worse cognitive function in later life

A team of researchers from the Tohoku University Graduate School of Medicine and Tokyo Metropolitan Institute of Medical Science showed that women who had participated in the menopause before the age of 40, had worse cognitive results than women who came to menopause after the age of 50. This finding can be useful for clinicians when assessing the risk of their patient.

These findings were published in Alzheimer & Dementia: The Journal of the Alzheimer’s Association on April 15, 2025.

The research team chose to investigate this link, because dementia finds women disproportionately worldwide, which suggests that dementia can have risk factors that are specific to women. Moreover, early menopause is associated with a higher risk of depression in later life, which is a well -known risk factor for dementia. Direct evidence with regard to the impact of earlier menopause on the age -related processes of depressive symptoms and the cognitive function is scarce.

The team used data from the English longitudinal study of aging, classifying age in menopause in three categories: <40, 40-49 and ≥50 years. The study included 4,726 women and 4,286 men who were assessed in measures of cognitive functioning such as orientation, immediate and delayed recall and verbal fluency. The team tested the association between gender and age during the menopause and cognitive functioning two years later after adjusting basic line -to -change risk factors for dementia.

When we are looking for associations, we want to exclude as many other changeable risk factors for dementia as possible. Since early menopause increases the risk of depression, which then increases the risk of dementia, we had to check the control for this factor to determine whether early menopause was a direct risk factor in itself. “

Miharu Nakanishi, main author, Tohoku University Graduate School of Medicine

After checking for outcome measures from Baseline and other Covariates (such as other changeable dementia risk factors), the menopause after <40 years, compared to ≥50 years, was significantly associated with poorer 2-year follow-up orientation, as well as immediate and immediate recall action. The cognitive function in women who participated in ≥50 years old was actually better than the comparison group of men. Hormone replacement therapy (HRT) (a treatment to minimize the symptoms of the menopause) was not associated with cognitive function.

The results imply that women who experience early menopause can form a sex -specific risk group for cognitive decline. Further investigation is justified to clarify the underlying mechanisms of the relationship between levels of female hormones and cognitive function.

“Insight into this relationship in -depth can help us to design treatments that delay the start of dementia in risk patients,” says Nakanishi.