For female adults, endocrine and vascular processes synergistically contribute to an increased risk for cognitive decline, according to a study published online April 3 in Neurology.
Madeline Wood Alexander, from the Sunnybrook Research Institute in Toronto, and colleagues examined whether age at menopause, vascular risk, and history of hormone therapy (HT) containing estrogens together influence cognition during a three-year follow-up period using data from 8,360 postmenopausal female participants and 8,360 age-matched male participants.
The researchers identified an interaction between age at menopause and vascular risk, with earlier menopause and higher vascular risk synergistically associated with lower cognitive scores at follow-up. Vascular risk was associated with lower cognitive scores in women with earlier menopause (menopausal ages, 35 to 48 years) but not average or later menopause (ages, 49 to 52 and 53 to 65 years, respectively) in stratified analyses. In female participants with earlier menopause, the negative association of vascular risk with cognition was stronger than the equivalent association in age-matched male participants. The synergistic association of age at menopause and vascular risk with follow-up cognition was not further modified by HT history.
“Considering that female individuals with earlier menopause and higher vascular risk may be at greater risk of dementia, both factors should be considered when developing sex-specific interventions to slow cognitive decline,” the authors write.
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