目的:评估绝经类型(自发性或手术性)与轻度认知障碍(MCI)之间的关系。
方法:这项研究是一项横断面研究,观察,以及在九个拉丁美洲国家/地区的妇科咨询中进行的次分析调查。
方法:我们评估了社会人口统计学,临床,和人体测量数据,痴呆家族史,以及使用蒙特利尔认知评估(MoCA)工具的MCI的存在。
结果:该研究涉及1185名绝经后妇女,平均年龄为55.3岁,体重指数为26.4kg/m2。他们平均受教育13.3年,37%是家庭主妇。三百九十九人在40岁之前经历了更年期,其中136人患有手术更年期(双侧卵巢切除术)。在经历了40年或更长时间更年期的786名妇女中,110这样做是由于双侧卵巢切除术。在40岁之前或之后经历更年期的女性中,MoCA评分没有差异。然而,手术绝经妇女的MoCA评分低于自发绝经妇女(23.8±4.9vs.25.0±4.3分,分别,p<0.001)。我们的Logistic回归模型与国家内的患者聚集发现MCI和手术绝经之间存在显着关联(OR1.47,95%CI:1.01-2.16),使用(曾经)更年期激素治疗(OR0.33,95%CI:0.21-0.50),且受教育年限>12年(OR0.21,95%CI:0.14-0.30)。
结论:将40岁以上自然绝经的女性与该年龄之前自然绝经的女性进行比较时,没有观察到发生MCI的风险增加,而那些手术绝经的人,独立于年龄,更容易出现认知能力下降。曾经使用过更年期激素治疗的女性MCI风险较低。需要进一步的研究来深入研究这个主题。
OBJECTIVE: To evaluate the association between type of menopause (spontaneous or surgical) and mild cognitive impairment (MCI).
METHODS: This study was a cross-sectional, observational, and sub-analytical investigation conducted within gynecological consultations across nine Latin American countries.
METHODS: We assessed sociodemographic, clinical, and anthropometric data, family history of dementia, and the presence of MCI using the Montreal Cognitive Assessment (MoCA) tool.
RESULTS: The study involved 1185 postmenopausal women with a mean age of 55.3 years and a body mass index of 26.4 kg/m2. They had an average of 13.3 years of education, and 37 % were homemakers. Three hundred ninety-nine experienced menopause before 40, including 136 with surgical menopause (bilateral oophorectomy). Out of the 786 women who experienced menopause at 40 or more years, 110 did so due to bilateral oophorectomy. There were no differences in MoCA scores among women who experienced menopause before or after the age of 40. However, lower MoCA scores were observed in women with surgical menopause than in those with spontaneous menopause (23.8 ± 4.9 vs. 25.0 ± 4.3 points, respectively, p < 0.001). Our logistic regression model with clustering of patients within countries found a significant association between MCI and surgical menopause (OR 1.47, 95 % CI: 1.01-2.16), use (ever) of menopausal hormone therapy (OR 0.33, 95 % CI: 0.21-0.50), and having >12 years of education (OR 0.21, 95 % CI: 0.14-0.30).
CONCLUSIONS: When comparing women who experience spontaneous menopause over the age of 40 with those who undergo it before this age, there was no observed increased risk of developing MCI, while those with surgical menopause, independent of age, are more prone to cognitive decline. Women who have ever used menopausal hormone therapy have a lower MCI risk. Further research is warranted to delve deeper into this topic.