Abstract：
OBJECTIVE: Among other risk factors, the decline in estrogen concentrations during menopause may compromise cognitive function. Whether early menopause (EM) is associated with an increased risk of dementia remains unclear. The purpose of this study was to systematically review and meta-analyze current evidence regarding the association between EM or premature ovarian insufficiency (POI) and the risk of dementia of any type.
METHODS: A comprehensive literature search was conducted through the PubMed, Scopus and CENTRAL databases up to August 2022. Study quality was assessed using the Newcastle-Ottawa scale. Associations were calculated as odds ratio (OR) with 95 % confidence interval (CI). The I2 index was employed for heterogeneity.
RESULTS: Eleven studies (nine assessed as of good and two as of fair quality) were included in the meta-analysis (n = 4,716,862). Women with EM demonstrated a greater risk of dementia of any type than women of normal age at menopause (OR 1.37, 95 % CI 1.22-1.54; I2 93%). However, after excluding a large retrospective cohort study, the results were altered (OR 1.07, 95 % CI 0.78-1.48; I2 94%). Increased risk of dementia was also found in women with POI (OR 1.18, 95 % CI 1.15-1.21; I2 0%). Subgroup analysis showed that this risk was mostly evident in cohort studies, and those which included women with natural menopause.
CONCLUSIONS: Women with EM or POI may be at increased risk of dementia compared with women of normal age at menopause, but further research investigating that hypothesis is warranted.
METHODS: A comprehensive literature search was conducted through the PubMed, Scopus and CENTRAL databases up to August 2022. Study quality was assessed using the Newcastle-Ottawa scale. Associations were calculated as odds ratio (OR) with 95 % confidence interval (CI). The I2 index was employed for heterogeneity.
RESULTS: Eleven studies (nine assessed as of good and two as of fair quality) were included in the meta-analysis (n = 4,716,862). Women with EM demonstrated a greater risk of dementia of any type than women of normal age at menopause (OR 1.37, 95 % CI 1.22-1.54; I2 93%). However, after excluding a large retrospective cohort study, the results were altered (OR 1.07, 95 % CI 0.78-1.48; I2 94%). Increased risk of dementia was also found in women with POI (OR 1.18, 95 % CI 1.15-1.21; I2 0%). Subgroup analysis showed that this risk was mostly evident in cohort studies, and those which included women with natural menopause.
CONCLUSIONS: Women with EM or POI may be at increased risk of dementia compared with women of normal age at menopause, but further research investigating that hypothesis is warranted.
摘要：
目标：在其他危险因素中，绝经期间雌激素浓度的下降可能会损害认知功能。早期绝经（EM）是否与痴呆症风险增加有关尚不清楚。这项研究的目的是系统回顾和荟萃分析有关EM或卵巢早衰（POI）与任何类型痴呆风险之间关联的现有证据。
方法：通过PubMed进行了全面的文献检索，截至2022年8月的Scopus和CENTRAL数据库。使用纽卡斯尔-渥太华量表评估研究质量。关联计算为比值比（OR），95%置信区间（CI）。I2指数用于异质性。
结果：11项研究（9项评估为良好，2项评估为一般质量）纳入荟萃分析（n=4,716,862）。与绝经时正常年龄的女性相比，患有EM的女性患痴呆的风险更高（OR1.37，95％CI1.22-1.54；I293％）。然而,排除大型回顾性队列研究后，结果改变(OR1.07,95%CI0.78-1.48;I294%)。患有POI的女性患痴呆的风险也增加(OR1.18,95%CI1.15-1.21;I20%)。亚组分析显示，这种风险在队列研究中最为明显，包括自然更年期女性。
结论：患有EM或POI的女性在绝经时与正常年龄的女性相比，患痴呆的风险增加，但进一步的研究调查这一假设是有必要的。
方法：通过PubMed进行了全面的文献检索，截至2022年8月的Scopus和CENTRAL数据库。使用纽卡斯尔-渥太华量表评估研究质量。关联计算为比值比（OR），95%置信区间（CI）。I2指数用于异质性。
结果：11项研究（9项评估为良好，2项评估为一般质量）纳入荟萃分析（n=4,716,862）。与绝经时正常年龄的女性相比，患有EM的女性患痴呆的风险更高（OR1.37，95％CI1.22-1.54；I293％）。然而,排除大型回顾性队列研究后，结果改变(OR1.07,95%CI0.78-1.48;I294%)。患有POI的女性患痴呆的风险也增加(OR1.18,95%CI1.15-1.21;I20%)。亚组分析显示，这种风险在队列研究中最为明显，包括自然更年期女性。
结论：患有EM或POI的女性在绝经时与正常年龄的女性相比，患痴呆的风险增加，但进一步的研究调查这一假设是有必要的。
