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Surgical menopause in association with cognitive function and risk of dementia: A systematic review and meta-analysis
Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, 75M Asias Str, Athens 11745, Greece;Ludwig Maximilians Univ Munchen, Univ Hosp, Inst Stroke & Dementia Res ISD, Munich, Germany;Ludwig Maximilians Univ Munchen, Grad Sch System Neurosci GSN, Munich, Germany;LMU, Univ Hosp, Inst Stroke & Dementia Res, Feodor Lynen Str 17, D-81377 Munich, Germany.
Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, 75M Asias Str, Athens 11745, Greece.
Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, 75M Asias Str, Athens 11745, Greece.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.ORCID iD: 0000-0002-4935-7532
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2019 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 106, p. 9-19Article, review/survey (Refereed) Published
Abstract [en]

Introduction: Experimental and epidemiological studies suggest female sex hormones to have long-lasting neuroprotective and anti-ageing properties. Surgically-induced menopause leads to a premature cessation of exposure to female sex hormones and could thus impact late-life cognitive function. Yet, evidence remains controversial. Methods: We systematically reviewed literature for articles investigating the association of surgical menopause (defined as bilateral oophorectomy before the onset of menopause) with risk of dementia, cognitive performance, cognitive decline, and Alzheimer's disease neuropathological indices later in life. We evaluated study quality with the Newcastle-Ottawa scale and performed random-effects meta-analyses. Results: We identified 11 eligible studies (N = 18,867). Although surgical menopause at any age was not associated with risk of dementia (4 studies; HR: 1.16, 95%CI: 0.96-1.43), early surgical menopause (<= 45 years of age) was associated with a statistically significantly higher risk (2 studies; HR: 1.70, 95%CI: 1.07-2.69). Surgical menopause at any age was associated with faster decline in verbal memory, semantic memory, and processing speed, whereas early surgical menopause was further associated with faster global cognitive decline. No heterogeneity was noted. Among women undergoing surgical menopause, a younger age at surgery was associated with faster decline in global cognition, semantic and episodic memory, worse performance in verbal fluency and executive function, and accumulation of Alzheimer's neuropathology. Conclusions: Current evidence is limited, but suggests surgical menopause induced by bilateral oophorectomy at <= 45 years of age to be associated with higher risk of dementia and cognitive decline. Additional large-scale cohort studies are necessary to replicate these findings.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD , 2019. Vol. 106, p. 9-19
Keywords [en]
Oophorectomy, Hysterectomy, Menopause, Dementia, Cognitive impairment, Estrogen
National Category
Neurosciences
Identifiers
URN: urn:nbn:se:uu:diva-390417DOI: 10.1016/j.psyneuen.2019.03.013ISI: 000474678300002PubMedID: 30928686OAI: oai:DiVA.org:uu-390417DiVA, id: diva2:1342085
Available from: 2019-08-12 Created: 2019-08-12 Last updated: 2019-08-12Bibliographically approved

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Skalkidou, Alkistis

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