A study from the University of Calgary suggests that severe menopause symptoms could be early signs of dementia.
Dr. Zahinoor Ismail, a professor in psychiatry, neurology, epidemiology, and pathology at the Hotchkiss Brain Institute, said the finding comes from an ongoing cross-sectional study on brain and aging among Canadians as part of CAN-PROTECT.
Dr. Ismail shared that his initial interest in menopause effects dates back several years in his medical practice.
"I remember a case in early 2001 where a woman came to the ER with a range of brain symptoms, both cognitive and psychiatric. It turned out she was just starting menopause," he explained to The Canadian Press.
"So, instead of treating her for these neurological and psychiatric issues, we normalized her estrogen levels, and her symptoms disappeared. That's how this study began," Dr. Ismail recalled.
The overall study involves 2,400 individuals across Canada, who are asked various questions about their cognition, behavior, function, health, well-being, lifestyle, diet, exercise, vitamin supplements, medications, medical and psychiatric issues, and quality of life.
Data from 800 of these subjects are used to study the effects of menopause on the brain. A baseline paper on these data was presented at the Canadian Dementia Conference in Toronto in November. The results are to be updated annually.
"We took menopausal women and recorded the number of symptoms they had during menopause [...] So, everything from those hot flashes people talk about, to neuropsychiatric symptoms like irritability, mood changes, anxiety, and also neurocognitive symptoms like inattention and poor memory," Dr. Ismail mentioned.
"I focused on neuropsychiatric and cognitive symptoms. Because when these appear and persist in midlife and beyond, they are risk factors for dementia.
"What we found is that the more menopause symptoms they had, the more affected they were, and the more symptoms they had," he added.
Dr. Ismail also asserted that it became evident that menopausal women who underwent estrogen therapy during menopause had fewer neuropsychiatric symptoms compared to those who didn't.
Previous studies showing that hormone replacement therapy increased the risk of stroke by about one-third — which was somewhat overestimated later on — resulted in an entire generation of women being deprived of its benefits, he noted.
"There was a sort of rebellion for menopausal women to be offered hormone replacement therapy again.
"There's clearly a renewed wave of interest, and that has certainly been reflected in my clinical experience and in the data from our study," Dr. Ismail affirmed.