Early Menopause and Brain Health

Latest research published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association shows early menopause (before age 40) can exacerbate cognitive decline.

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How does early menopause impact cognitive function & depression?

The study found women experiencing menopause before age 40 show worse cognitive function (e.g., delayed recall, verbal fluency) and depressive symptoms compared to those in menopause at age 50+.

What to take away from this research

• A team of researchers from Tohoku University and Tokyo Metropolitan Science Institute used data from a nationally representative aging cohort in England (4,726 women and 4,286 men) via the English Longitudinal Study of Ageing (ELSA).

• Key takeaway 1: Age matters. Women who experience early menopause (before age 40) is considered a high-risk group for dementia compared to those in menopause after age 50. Reducing dementia risks includes changing lifestyle factors such as smoking, alcohol use, and physical inactivity.

• Key takeaway 2: Gender difference matters. Men show fewer depressive symptoms but worse cognitive function compared to women experiencing menopause at age 50 or older. This suggests the differences in the role of depressive symptoms in dementia risk between men and women.

• Key takeaway 3: HRT’s effect on cognitive decline is up in the air. The effectiveness of using Hormone Replacement Therapy for cognitive decline is inconclusive in this study. Some studies suggest HRT is a benefit for cognition, but it depends on context and timing. 

• The authors concluded: “Dementia risk-reduction strategies should consider women who experience early menopause as a sex-specific high-risk group. Further research is warranted to elucidate the underlying mechanisms.”

• Interested to learn more? Check out their published article in April 2025 of Alzheimer’s & Dementia.

On a related note from Harvard Medical School on prevention & treatment

• HRT timing: “Research shows that timing matters. Initiation of hormone replacement (HR) in perimenopause (roughly four to eight years before menopause) or early menopause may have positive effects on brain activity and memory function, although systematic HR trials have not been conducted during perimenopause.”

• Lifestyle changes: “There are three major pillars for maintaining intact memory: effortful physical activity, effortful cognitive activity, and social contact.” In short, exercising, learning new things, playing board games, etc. in addition to a healthy diet such as Mediterranean diet and adequate sleep all have benefits on cognitive function.

• Interested to learn more? Check out their article on Menopause and memory: Know the facts.

Why it matters especially for younger women

Dementia disproportionately affects women and early menopause can increase the risk of cognitive decline. Lifestyle changes like physical, cognitive, and social activities can potentially reduce these risks.