Premature Ovarian Insufficiency, Early Menopause and Mild Cognitive Impairment: A Cohort Study
Bibliographic record
Abstract
Background: Natural menopause (NP) typically occurs around the age of 50. In contrast, premature ovarian insufficiency (POI) and early menopause (EM) refer to the loss of normal ovarian function before the ages of 40 and 45, respectively. Surgical menopause, resulting from bilateral oophorectomy, leads to an abrupt hormonal decline. Emerging evidence suggests that early loss of ovarian function, whether natural or surgical, may impact cognitive performance. Objective: This study aimed to clarify the effect of different types of menopauses, POI and EM (spontaneous or surgical) on the risk of mild cognitive impairment (MCI). Study Design: This was an observational, cross-sectional, analytical study conducted in women’s health outpatient clinics at two university centers in Brazil. Methods: Socio-demographic factors, clinical histories, anthropometric measurements, and family histories were studied in a large population of postmenopausal women. MCI and postmenopausal symptoms were assessed using the Montreal Cognitive Assessment (MoCA) test and the Menopause Rating Scale (MRS), respectively. Data were analyzed according to the type of menopause (spontaneous or surgical) and age at menopause (POI, EM and NM) using logistic regression models. Results: A total of 519 women were studied. No significant differences were observed between the groups in the different domains and the total score, but a cognitive deficit above 85% was found in the three groups. A higher risk of MCI was observed in women with bilateral oophorectomy [adjusted odds ratio (aOR) 3.21, 95% confidence interval (CI) 1.57 to 7.19, P=0.03], use of sleep inducers (aOR 3.31, 95% CI 1.86 to 5.92, P< 0.0001), and higher body mass index (aOR 1.05, 95% CI 1.01 to 1.10, P=0.031). In contrast, more years of education were associated with a lower risk of cognitive impairment (aOR 0.93, 95% CI 0.86 to 0.99, P=0.028). Current or previous use of hormone therapy, parity, smoking, comorbidities, and use of anxiolytics or antidepressants were not significantly associated with MoCA scores. Conclusion: POI and EM are not associated with higher MCI risk. Bilateral oophorectomy, use of sleep inducers, and higher BMI are associated with an increased risk of MCI in postmenopausal women, independently of age or time since menopause. Conversely, higher educational attainment appears to be a protective factor. These results highlight the importance of identifying women at greater risk of cognitive decline based on menopausal type and modifiable factors. Longitudinal studies are needed to clarify causality and guide personalized management strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".