This study explored the relationship between menopausal symptoms and cognitive decline in postmenopausal women through a sub-analysis of a larger observational study. 

The study, which included data from nine Latin American countries, included 1,287 women who had recorded visits to a gynaecology facility. The participants had a mean age of 55.5 years and a mean body mass index of 26.3 kg/m², with 50.3% leading sedentary lifestyles and 29.5% smoking. Of the cohort, only 36.7% had received hormone replacement therapy.

Symptoms were assessed using a general questionnaire and the Menopause Rating Scale (MRS), while the cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA). Scores below 21 indicate mild cognitive impairment (MCI).

The following findings were recorded:

• Women with MCI experienced significantly more intense menopausal symptoms compared to those without, affecting 15.3% of the study group

• The average MRS score was notably higher in women with MCI (15.24) compared to those without (10.53, P < 0.001)

• Severe menopausal symptoms (MRS ≥14) were linked to increased odds of MCI (OR 1.74)

• Conversely, factors associated with lower odds of MCI included lower BMI (OR 0.96), sexual activity (OR 0.70), physical exercise (OR 0.55), menopausal hormone therapy (OR 0.36), and higher education levels (OR 0.31)

These findings suggest a clear association between severe menopausal symptoms and cognitive impairment in postmenopausal women. However, several limitations require a cautious interpretation of the results.

Notably, the study could not establish causation or prevention of mild cognitive impairment by any specific risk factor investigated. Additionally, the focus on Latin American women with access to private healthcare raises concerns of selection bias. The study also relied on self-reported data and excluded women over the age of 70, of whom fewer than 60% had experienced natural menopause.

These concerns highlight the interplay between hormonal changes, lifestyle, and cognitive health.
Additional studies are required to replicate the findings in larger, more diverse samples and to extend the role of underlying mechanisms such as hormones, sleep quality and others that occur during menopause.