Seminar Recap: Cognition in the Menopausal Transition

Labeled “The Seven Dwarves of Menopause,” they grinned out at the audience from the projector screen in Helen Wood Hall Auditorium: Itchy, Bitchy, Sweaty, Sleepy, Bloated, Forgetful, and Psycho.

“So, I’m interested in numbers 2, 6, 7, and a little bit of 4,” quipped Miriam Weber, Ph.D., assistant professor of neurology and obstetrics and gynecology, at URMC.

Miriam Weber, Ph.D.

Miriam Weber, Ph.D.

For the past decade, Weber has been studying cognition in women in the menopausal transition. While the symptoms embodied by the Seven Dwarves have long been accepted as common experiences for women in the menopausal transition, there hasn’t been a particularly robust array of science to support the cognitive symptoms until recently.

On Sept. 23 at the CTSI Seminar Series, Weber shared her past work in the field and discussed how her current study is expanding on her previous findings.

What we know

In creating her original study, Weber had a little background from two prior studies. The first, published in 2000 (SWMHS-Mitchell), found that 62 percent of middle-aged women reported an undesirable change in memory. Meanwhile, the longitudinal SWAN study had also found that 40 percent of peri- and post-menopausal women listed “forgetfulness” among a self-reported inventory of their symptoms.

With this data as a backdrop, Weber launched her Rochester Investigation of Cognition Across Menopause (RICAM) study, hoping to expand on the findings. The first study took place in 2005-2006, and a second took place from 2007-2009. Weber is now in the midst of her most comprehensive study yet, which began in 2010 and runs through 2015.

“Memory complaints really do reflect objective performance, maybe not in retentive memory, but in working memory,” said Weber.

Since publishing her initial results, other groups have reported similar findings — other researchers found that memory complaints were associated with loss of verbal memory and attention, that subjectively recorded memory problems were associated with objective measures, and that the brains of post-menopausal women with cognitive complaints were working harder in order to perform to previous levels.

“These are high-functioning women, and they’re not impaired, but they’re noticing subtle differences,” said Weber.

Weber’s study also looked which women were struggling the most with memory symptoms, and found that women in early post-menopause — the first year after the post-menstrual period — were performing worse with verbal learning, verbal memory, and fine motor and dexterity, than women in the late-reproductive stage.

Future directions

In confirming that women are indeed good at self-reporting their memory symptoms during the menopausal transition, Weber offered a few directions for future studies.

Among other suggestions, Weber said that researchers need better measures of symptoms known to impact cognition.

“With that in mind, we just received funding to add to RICAM objective measures of hot flashes and sleep monitors,” said Weber. “That way, we can get subjectively reported symptoms as well as objective measures.”

She’s also hoping to expand the study to multiple sites and make it more representative, which may allow for more parsing of the data.

“Ideally, we need to identify who is at risk for cognitive declines. Clearly, some women are doing better and some who are taking a more significant hit,” said Weber. “So I’m interested in describing in general what the experience is during this time period for all women, but also whether there are certain factors that put some women at increased risk.”

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