Researchers are exploring a theory linking severe menopause symptoms to dementia

A University of Calgary study examines whether severe menopause symptoms can act as early warning signs of dementia.

Dr. Zahinoor Ismail, professor of psychiatry, neurology, epidemiology and pathology at the Hotchkiss Brain Institute, said the CAN-PROTECT project began in March and involves ongoing research into the brain and aging.

The large-scale study will involve 2,400 people across Canada and will ask a series of questions about cognition, behavior, function, health, wellness, lifestyle, diet, exercise, vitamin supplements, medications, medical and psychiatric conditions, and quality of life. .

Ismail's research on the effects of menopause on the brain included health data from 800 of them, all women with an average age of 64.

According to Ismail, his first interest in the effects of menopause arose in his medical practice several years ago.

“I remember a case in early 2001 where a woman came to the emergency room with a lot of cognitive and psychiatric brain symptoms, and she was just in early menopause,” Ismail said.

“So instead of treating her for neurological and psychiatric conditions, we normalized her estrogen and her symptoms went away.

“That was the genesis of this study.”

A key paper on the data was presented at the Canadian Dementia Conference in Toronto in November, which Ismail chaired. The results are updated every year.

The study, “Menopausal Symptom Burden as a Predictor of Cognitive Functioning and Mild Behavioral Impairment in Midlife and Later Life,” remains in its early stages and is currently under review.

Ismail said he hopes the results will be released this spring. They have not been released yet.

“Women who experience more menopausal symptoms in midlife tend to report poorer cognition and milder behavioral impairment severity in mid-to-late life,” the study's summary says.

“These findings suggest that the burden of untreated menopausal symptoms may extend beyond menopause and act as an early marker of susceptibility to cognitive and behavioral decline.

Ismail said the study included postmenopausal symptoms, “from hot flashes that people talk about, to neuropsychiatric symptoms like irritability, mood swings, anxiety, and then neurocognitive symptoms like inattention and poor memory.”

“What we found was that the more menopausal symptoms they had, the worse they got and the more symptoms they had.”

Postmenopausal women who received estrogen-based treatments during menopause had fewer neuropsychiatric symptoms than those who did not, she said.

Dr. Iris Gorfinkel, founder and principal investigator of PrimeHealth Clinical Research in Toronto, said the study makes sense because many of the symptoms of menopause are directly related to what's happening in the brain.

But 800 participants is a small number and may not be representative of a larger population, he said.

“Just because you have two items that are both true, that doesn't mean they're related to, or have symptoms of, natural, predictable symptoms of menopause that predict later dementia.”

Gorfinkel said there are a number of causes of dementia, including Alzheimer's disease, diabetes and smoking.

“It's unknown how many will go through difficult life transitions. I think it's an interesting initiative and research that needs to be done in a wider population, mostly women. It will endure,” she said.

Menopausal hormone therapy has been a controversial issue since the 1990s, when a large study linked it to higher rates of breast cancer and stroke.

But many experts say the study overestimates the risks, which mostly apply to women over 60 — the risk of these conditions rises with age anyway.

Gorfinkel said estrogen may be especially helpful in helping women struggling with some of the symptoms of menopause, such as hot flashes and night sweats. But that's a discussion between the woman and her doctor, he said.

An article published last year in the Journal of the Canadian Medical Association found that women suffering from the debilitating symptoms of menopause should be offered an option of hormone therapy.

The paper's lead author, Dr. Iliana Lega, an endocrinologist at Women's College Hospital in Toronto, said women in their 40s and 50s may be at the peak of their careers while raising children and trying to live with severe symptoms.

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This report by The Canadian Press was first published on February 12, 2024.