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Abstract Details

Early Surgical Menopause Is Associated with a Spectrum of Cognitive Decline
Aging and Dementia
S24 - (-)
003
The decrease in estrogen associated with menopause has been implicated in cognitive decline. However, studies have been conflicting and the utility of hormone replacement therapy (HRT) remains unclear.
Female subjects from two longitudinal studies of cognitive decline: Religious Orders Study (ROS), and Memory and Aging Project (MAP) with data on reproductive histories at baseline were included. Three types of cognition-related outcomes were assessed: (1) longitudinal measure of 5 cognitive domains and global cognition using a linear mixed effects model, (2) neuropathologic measures from brain samples obtained at death using a linear regression model and (3) clinical diagnosis of Alzheimer's Disease (AD) according to NINCDS-ARDA criteria modeled using Cox proportional hazards regression. We examined the association between age at menarche and menopause, number of cycling years, and ever use and duration of HRT. All models were adjusted for age, education, smoking and study and stratified by surgical vs. natural menopause.
A total of 1837 women were included. For women with surgically induced menopause (33% of cohort), early age at menopause was associated with faster decline in semantic memory (p=0.002), episodic memory and global cognition (ps<0.001). A significant association was also seen with age at menopause and neuropathologic measures, primarily neuritic plaques (p=0.01) and global pathology score (p=0.04). No significant association was seen with incident AD (p=0.093). The number of cycling years showed similar associations. Duration of HRT was associated with slower decline in global cognition (p=0.037). These associations were not seen in women who had natural menopause.
Early age at surgical menopause was associated with longitudinal cognitive decline and neuropathologic outcomes in women with surgical menopause but not natural. Ongoing evaluation of the neuroprotective effects of HRT after early surgical menopause is warranted.
Authors/Disclosures
Riley Bove, MD, FAAN (University of California, San Francisco)
PRESENTER 		Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme-Sanofi. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD-Serono. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cadenza. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Eli Lilly. The institution of Dr. Bove has received research support from Novartis. The institution of Dr. Bove has received research support from Roche Genentech.
No disclosure on file
Lori Chibnik No disclosure on file
Lisa L. Barnes (Rush University Medical Center) Lisa L. Barnes has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Alzheimer's & Dementia. The institution of Lisa L. Barnes has received research support from NIH. Lisa L. Barnes has received personal compensation in the range of $500-$4,999 for serving as a Council member with NACMHD.
Julie A. Schneider, MD, MS (Rush Alzheimer'S Disease Center) Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Schneider has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for alnylam. Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for apellis. Dr. Schneider has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for National Hockey League. The institution of Dr. Schneider has received research support from NIH. Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving as a scientific advisor with Fondation Alzheimer, France.
David A. Bennett, MD (Rush University Medical Center) Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Annovis. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for New Amsterdam. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie.
Philip De Jager, MD, PhD (Columbia University Irving Medical Center) Dr. De Jager has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Puretech. Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for roche. Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. The institution of Dr. De Jager has received research support from roche. The institution of Dr. De Jager has received research support from puretech.
Anne H. Cross, MD, FAAN (Washington University School of Medicine) Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech / F. Hoffman la Roche. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb . Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave. Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Cross has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as an officer or member of the Board of Directors for Consortium of MS Centers. Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. The institution of Dr. Cross has received research support from Genentech. Dr. Cross has received intellectual property interests from a discovery or technology relating to health care.