21 Neurocognitive Differences Between Lifestyle Profiles of Women Across the Menopausal Transition
Authors: Hagy Hannah , Bohnert Amy 
Published: December 2023

Objective:

Women are at greater risk of developing Alzheimer’s disease (AD) than men. The menopausal transition, which involves a neuroendocrine shift, is a potential contributor to this sex difference. Multiple estrogen-regulated systems (i.e., circadian rhythms) are disrupted during this transition which affects cognitive functioning (Barha & Liu-Ambrose, 2020), most notably verbal learning and memory. Little is known about how lifestyle factors (i.e., sleep, physical activity (PA), stress) may promote neurocognitive functioning across this transition (Maki & Weber, 2021). Utilizing data from the Human Connectome Aging project (HCP-A), the current study will examine whether distinct lifestyle profiles including sleep, PA, and stress relate to multiple domains of cognitive performance among a sample of perimenopausal/menopausal women.

Participants and Methods:

Perimenopausal/menopausal women (ages 45 to 65) from the HCP-A were included (n =150, M age = 54.6, SD = 5.5). Demographic information, menopausal status, sleep problems (Pittsburgh Sleep Quality Index), PA (International Physical Activity Questionnaire), stress (Distress subscale of the Perceived Stress Scale) were assessed with surveys, and participants completed several lab-based tasks including: dimensional change card sort (DCCS), flanker, pattern recognition processing speed (PS), working memory (WM), picture sequencing, oral reading, Trails Making Test A and B (TMT), and Rey Auditory Verbal Learning (RAVLT) tasks. Using latent profile analysis (LPA), lifestyle profiles were identified via sleep problems, PA, and stress levels. A MANOVA compared cognitive performance between these lifestyle profiles, above and beyond age and education status.

Results:

Fit indices indicated that a three-class solution fit the sample best: high PA, low stress and sleep problems (Class 1, n=38), high PA, stress, and sleep problems (Class 2, n= 17), and low PA, high stress and sleep problems (Class 3, n= 95) which were not significantly different based on age or menopausal status (p>0.05). A significant multivariate effect of age and education on cognitive performance (p<.001) emerged. There was a significant multivariate effect of lifestyle profile on cognitive performance, F (18, 260) = 1.73, p=.034, eta squared = .11, after controlling for age and education. Univariate analyses determined that certain lifestyle profiles were associated with better performance on all cognitive tasks except verbal memory. Contrary to expectation, Class 3 performed better on TMT A & B, DCCS, flanker, WM, and PS tasks as compared to Class 1. Class 3 performed better on reading and picture sequencing tasks than Class 2. There was no difference in performance between Class 1 and 2.

Conclusions:

Results suggest three distinct lifestyle profiles exist in this analytic sample. After controlling for age and education, cognitive performance on all tasks except for verbal memory significantly differed between lifestyle profiles. The profile characterized by low PA and high stress and sleep problems demonstrated superior performance as compared to other classes. These findings provide preliminary evidence that women who have high levels of stress and sleep problems with low PA are performing better on cognitive tasks, but replication of these findings utilizing longitudinal designs are needed.