Women who show more menopausal symptoms are more likely to have a poorer cognitive function and mild behavioral disorders later – both markers of dementia. That is the conclusion of a study of 896 postmenopausal women published on March 5, 2025, in the Open-Access Journal Plos One By Zahinoor Ismail from the University of Calgary, Canada and colleagues.
Women are known to have a triple greater risk of developing Alzheimer’s disease and related dementies and will be disproportionately influenced by the increasing global dementia-burden. A proposed factor that can give a special risk to women is the loss of estradiol in the menopause.
In the new study, researchers used data from the current Canadian platform for research online to investigate the health, quality of life, cognition, behavior, function and care provision in aging (can-protect) study. Data for 896 respondents who completed demographic, cognitive and behavioral assessments and reported that they were post-menopausal were recorded. Participants had an average age of 64.2 years and an average age at the start of the menopause of 49.4 years.
Menopausal symptom tax was assessed by the total number of recalled perimenopausal symptoms, including irregular periods, hot flashes, cold shivers, vaginal dryness, weight gain, delayed metabolism, night sweat, sleeping problems or other voting symptoms. The study showed that women who reported more perimenopausal symptoms had a greater cognitive impairment, with higher ECOG-II total scores (B [95% confidence interval (CI)] = 5.37 [2.85, 7.97]). They also had more mild symptoms of behavioral disorders halfway through late life, with higher MBI-C Total Scores (B [95% CI] = 6.09 [2.50, 9.80]). Hormone therapy was not significantly associated with cognitive function, but was linked to fewer behavioral symptoms.
The authors conclude that a higher symptom tax of menopause can indicate the sensitivity to cognitive and behavioral changes later in life. The study recognizes the need for further research to attach these findings in a larger dataset, ideally with a longitudinal design to determine causality. Further segregation of the participants to take into account confusing risk factors, including age of the beginning of the menopausal or surgical menopause, would also benefit future studies.
The authors add: “Larger symptom tax of menopause can be associated with a larger cognitive and behavioral decrease in later life, both risk markers of dementia. Estrogen -based hormone therapy can contribute to reducing clinical symptoms, in particular behavioral symptoms. “
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Journal Reference:
Crockford, JFE, et al .. (2025) Menopausal symptom tax as a predictor of the cognitive function from the middle to late life and mild behavioral disorders Symptoms: a can-protect examination. Plos One. doi.org/10.1371/journal.pone.0301165.