Lifelong Endocrine Fluctuations and Related Cognitive Disorders

Ancelin, Marie-Laure; Ritchie, Karen

doi:10.2174/138161205774913228

Cited by 50 publications

(43 citation statements)

References 187 publications

(261 reference statements)

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“…While observational studies provided some evidence that HT could be beneficial, 53 results of the largest clinical trial showed that HT given to older postmenopausal women could have a detrimental effect on cognitive function and dementia risk. [54][55][56] However, it is possible that there is a 'critical window' whereby estrogen treatment needs to be administered shortly after menopause to have the greatest neuroprotective effects.…”

Section: Discussionmentioning

confidence: 99%

Impact of a premature menopause on cognitive function in later life

Ryan

Scali

Carrière

et al. 2014

BJOG

162

107

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Objective To determine whether premature menopause (≤40 years) can have long-lasting effects on later-life cognition and investigate whether this association varies depending on the type of menopause and use of hormone treatment (HT).Design Population-based cohort study.Setting The French Three-City Study.Population Four thousand eight hundred and sixty-eight women aged at least 65 years.Methods Multivariable-adjusted logistic regression models were used to determine the association between age at menopause, type of menopause (surgical, natural), and the use of menopausal HT and later-life cognitive function.Main outcome measures Performance on a cognitive test battery (at baseline and over 7 years) and clinical dementia diagnosis.Results Menopause at or before the age of 40 years, both premature bilateral ovariectomy and premature ovarian failure (non-surgical loss of ovarian function), was associated with worse verbal fluency (OR 1.56, 95%CI 1.12-1.87, P = 0.004) and visual memory (OR 1.39, 95%CI 1.09-1.77, P = 0.007) in later life. HT at the time of premature menopause appeared beneficial for later-life visual memory but increased the risk of poor verbal fluency. Type of menopause was not significantly associated with cognitive function. Premature menopause was associated with a 30% increased risk of decline in psychomotor speed and global cognitive function over 7 years.Conclusion Both premature surgical menopause and premature ovarian failure were associated with long-term negative effects on cognitive function, which are not entirely offset by menopausal HT. In terms of surgical menopause, these results suggest that the potential long-term effects on cognitive function should form part of the risk/benefit ratio when considering ovariectomy in younger women.

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Section: Discussionmentioning

confidence: 99%

Impact of a premature menopause on cognitive function in later life

Ryan

Scali

Carrière

et al. 2014

BJOG

162

107

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“…abnormal TG or HDL-C levels) and with different sex-specific effects regarding key enzymes involved in lipid transport and metabolism (Aulchenko et al, 2009). Steroid hormones and steroid-related genes have also been associated with gender-specific effects on lipid metabolism, neurotransmitter turnover and cognitive dysfunction and dementia (Ancelin and Ritchie, 2005;Sowers et al, 2006;Sundermann et al, 2010). Hence, differences in both lipid and hormonal levels could lead to differential expression of the underlying genetic networks, with gene(s) by cellular environment interactions resulting in differential effects of the same variation in men and women.…”

Section: Discussionmentioning

confidence: 99%

Gender-specific associations between lipids and cognitive decline in the elderly

Ancelin

Ripoche

Dupuy

et al. 2014

European Neuropsychopharmacology

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The aim of this study was to examine the associations between serum lipid levels and cognitive function in a community-based sample of non-demented subjects aged 65 years and over.Participants were 2737 men and 4118 women from a population-based cohort recruited from three French cities. Visual memory, verbal fluency, psychomotor speed, and executive abilities were evaluated at baseline, and after 2, 4, and 7 years of follow-up. Lipid levels were evaluated at baseline. Multiadjusted Cox models stratified by gender were adjusted for sociodemographic and lifestyle characteristics, mental and physical health, and genetic vulnerability to dyslipidemia (apolipoprotein E and A, and cholesteryl ester transfer protein) and taking into account baseline vascular pathologies. In men, a hypercholesterolemic pattern in late-life (high total cholesterol (T-C), low HDL-C, high LDL-C levels) was associated with a 25 to 50% increased risk of decline over 7 years in psychomotor speed, executive abilities, and verbal fluency. Specific associations with low T-C and low LDL-C levels were also observed which may depend on genetic vulnerability to dyslipidemia (related to apolipoprotein A5 and cholesteryl exchange transfer protein). In contrast, in women, a 30% higher rate of decline was found in psychomotor speed with high HDL-C levels and in executive abilities with low levels of LDL-C and triglycerides, in interaction with hormonal treatment. For men and women, vascular pathologies only slightly outweighed the risk related to lipids. This suggests a complex gender-specific pattern of cognitive decline involving genetic vulnerability in men and hormonal status in women.

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“…This methodology is now being applied in the area of cognitive ageing where it has been suggested that no individual marker is as potent as a combined index for prediction of cognitive dysfunction, indicating that the effects of steroids on brain may be more apparent when the cumulative effects of exposure are evaluated (see for review [149]). No such study has as yet applied such a cumulative model to psychiatric disorder, although life-long low exposure to steroid hormones has been reported to be associated with lifetime history of depression [54,64].…”

Section: Is It Possible To Identify Women At Risk Of Hormone-related mentioning

confidence: 99%

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

Ancelin¹,

Scali²,

Ritchie³

2007

Journal of Psychosomatic Research

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implications: that women vary in vulnerability to mood disorder when abrupt change in steroid levels occur, that these effects could be cumulative across the female lifespan, and that women do not arrive at menopause with equal risk of mood disorders, or equal susceptibility to the effects of hormonal replacement therapy as has been assumed by current clinical research and practice. Conclusion:While hormonal therapies could have positive effects in the treatment and prevention of depressive disorders, further research is required to differentiate hormone-responsive subgroups of women for whom specific hormonal treatments may be most beneficial. To this end we suggest that a multifactorial model of cumulative vulnerability, which takes into account hormonal exposure throughout life, genetic vulnerability and environmental factors, may provide better prediction of treatment response.

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Lifelong Endocrine Fluctuations and Related Cognitive Disorders

Cited by 50 publications

References 187 publications

Impact of a premature menopause on cognitive function in later life

Impact of a premature menopause on cognitive function in later life

Gender-specific associations between lipids and cognitive decline in the elderly

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

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