Protective and Risk Factors for Cognitive Function in the Menopause Transition

Over 60% of women report cognitive symptoms during the menopause transition, but few effective treatments are available. These symptoms are bothersome and impair work performance. In the long term, they may indicate underlying risk for chronic health conditions. We propose to study the interrelationships between protective and risk factors for cognitive symptoms during the menopause

transition. In Aim 1 we will quantify the relative contributions of risk factors associated with cognitive symptoms in peri- and recently post-menopausal women with at least one cardiometabolic risk factor. We will investigate the proportion of variance in cognitive performance accounted for by cardiometabolic risk factors, vasomotor symptoms, sleep disruptions, and psychological factors.

We will use electronic health records to identify and recruit a diverse sample of women. We will obtain high quality measures of cardiometabolic risk, vasomotor symptoms, sleep, physical activity, and psychological symptoms along with a battery of cognitive assessments in multiple domains. Establishing the relative strength of these contributing factors will lead to more

targeted mechanistic hypotheses and inform intervention strategies benefiting cognitive function. Aim 2: Investigate habitual physical activity as a potential protective factor for cognitive performance via its effects on sleep and vasomotor symptoms in peri- and recently post-menopausal women. Exercise interventions improve vasomotor symptoms, sleep, and cognition. Less well

established is whether habitual physical activity is a protective factor for cognition in perimenopause. Objective measurement of vasomotor symptoms, physical activity, and sleep are needed because self-report is less strongly associated with cognition than self-report. We hypothesize that higher levels of habitual moderate to vigorous physical activity will be associated with less

severe vasomotor symptoms, fewer nighttime awakenings, and better cognitive performance. Further, we hypothesize that fewer awakenings will mediate the relationship between nighttime vasomotor symptoms and cognitive performance. Findings will inform future non-pharmacological strategies for maintaining cognition in the menopause transition. Our proposal

is innovative in its simultaneous use of objective, physiological measures of physical activity, sleep, and vasomotor symptoms and quantification of potential risk and protective factors for cognition during the menopause transition. It will use bioinformatic tools to identify and recruit a diverse set of participants. These aims align with calls from organizations like The Menopause

Society and the NIH Office of Research on Women's Health and support the goals of the CoBRE: Leveraging Big Data to Improve Women's Health.