Higher Dementia Risk Linked to Menopause Symptoms in Women

Women experiencing menopause symptoms may face a higher risk of developing dementia later in life, according to research published in the journal PLOS One. The study, conducted by the University of Calgary, highlights the connection between menopause-related health issues and cognitive decline.

Researchers analyzed data from 896 postmenopausal women who participated in the CAN-PROTECT study, a Canadian initiative focused on aging and health. The participants reported their perimenopausal symptoms, while their cognitive function was assessed using the Everyday Cognition Scale and the Mild Behavioral Impairment Checklist. Higher scores on these tests indicated more severe cognitive decline.

Dr. Zahinoor Ismail, lead study author and professor at the University of Calgary, noted a particularly striking link between the burden of menopause symptoms and mild behavioral impairment (MBI)—a syndrome increasingly recognized as an early indicator of dementia risk. "These findings underscore the importance of considering mood, social interaction, and personality changes that emerge and persist after menopause," Ismail said.

Interestingly, while hormone therapy wasn't directly associated with cognitive function, women who reported using estrogen-based hormone therapy during perimenopause showed significantly fewer MBI symptoms. This opens the door for more research into hormone therapy's role in long-term brain health.

Alexa Fiffick, a board-certified family medicine physician specializing in menopause, explained that previous studies have shown a connection between higher menopause symptom burdens and decreased cognitive function or dementia. Even symptoms like hot flashes, whether perceived or not, were linked to worsened cognitive function.

"Vasomotor symptoms appear to correlate with the development of white matter hyperintensities in the brain, resembling vascular dementia on imaging," Fiffick said. However, she emphasized the need for more data to confirm whether treating these symptoms could prevent cognitive decline.

The study does come with limitations. Being cross-sectional, it provides a snapshot rather than tracking changes over time. This means it can only identify associations rather than causation. Additionally, the researchers did not assess the severity of menopause symptoms or differentiate between types of hormone therapy.

Dr. Ismail suggested that future research should include long-term participant tracking, hormone level analysis, and exploration of brain-related biomarkers. "We are actively working on studies that address these gaps," he added.

New York menopause expert Tamsen Fadal, author of the upcoming book How to Menopause, said the findings align with existing research. "Brain scans of menopausal women reveal real structural and metabolic changes," she noted. "This study reinforces that menopause isn’t just hormonal—it’s a neurological shift."

For many women, symptoms like brain fog, memory lapses, and mood changes have been dismissed as 'normal aging.' Fadal emphasized that this research validates the need for deeper understanding of menopause’s impact on brain health.