Prospective study of reproductive span and menopausal hormone therapy and cognitive decline over 8 years in the Nurses' Health Study.

IF 3.9 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Menopause: The Journal of The North American Menopause Society Pub Date : 2026-10-01 DOI:10.1097/GME.0000000000002782

Namuunaa Juramt, Jae H Kang, Dong D Wang, Chirag M Vyas, Cheng Peng, Sharon Curhan, Erica T Warner, Oana A Zeleznik, Bernard A Rosner, Molin Wang, Meir J Stampfer, Francine Grodstein, Olivia I Okereke, Audrey Heather Eliassen

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Abstract

Objectives: Higher endogenous estrogen may be associated with better cognition, but associations with menopausal hormone therapy (MHT) have been inconsistent, possibly due to differences in the timing of use. This prospective cohort study aimed to evaluate the associations between reproductive span, as a proxy for endogenous estrogen history, MHT use, and cognitive function.

Methods: We assessed cognitive change (1995-2008) with four telephone interviews (primary outcome: global composite score average of six test z -scores) in 14,217 Nurses' Health Study participants (mean age 74.3 y) and examined associations with reproductive span ([age at menopause]-[age at menarche]), and MHT use duration, separately by 0-10 years, and 11+ years after menopause.

Results: A longer reproductive span was associated with better cognitive trajectories (mean annual rate of change difference [95% CI] 41-46 vs. ≤33 y =0.008 [0.00005, 0.015]; P -trend=0.02). MHT use 0-10 years postmenopause was associated with faster decline (mean difference 8-10 vs. 0 y =-0.007 [-0.016, 0.002]; P -trend=0.02); use during 11+ years postmenopause was not associated.

Conclusions: Although MHT use was not inversely associated, a longer reproductive span was associated with better cognitive trajectories.

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在护士健康研究中，生殖期和绝经期激素治疗与认知能力下降的8年前瞻性研究。

目的：较高的内源性雌激素可能与更好的认知有关，但与绝经期激素治疗（MHT）的关系不一致，可能是由于使用时间的差异。这项前瞻性队列研究旨在评估生殖周期之间的关系，作为内源性雌激素史、MHT使用和认知功能的代理。方法：我们通过四次电话访谈评估了14,217名护士健康研究参与者（平均年龄74.3岁）的认知变化（1995-2008）（主要结果：六个测试z分数的全球综合得分平均值），并分别在绝经后0-10年和11年以上检查了生殖跨度（[绝经年龄]-[初月经年龄]）和MHT使用时间的关系。结果：较长的生育年限与较好的认知轨迹相关（平均年变化率差[95% CI]41-46 vs.≤33 y=0.008 [0.00005, 0.015]； p趋势=0.02）。绝经后0-10年使用MHT与下降较快相关（平均差异8-10 vs. 0 y=-0.007 [-0.016, 0.002]； p趋势=0.02）；绝经后11年以上使用无相关性。结论：尽管MHT的使用与认知轨迹无负相关，但较长的生育跨度与较好的认知轨迹相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Menopause: The Journal of The North American Menopause Society 医学-妇产科学

CiteScore

5.40

自引率

7.40%

发文量

330

审稿时长

3-8 weeks

期刊介绍： Menopause, published monthly, provides a forum for new research, applied basic science, and clinical guidelines on all aspects of menopause. The scope and usefulness of the journal extend beyond gynecology, encompassing many varied biomedical areas, including internal medicine, family practice, medical subspecialties such as cardiology and geriatrics, epidemiology, pathology, sociology, psychology, anthropology, and pharmacology. This forum is essential to help integrate these areas, highlight needs for future research, and enhance health care.