Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
권호 표지

Menopause and Cognitive Function : Hospitalized Female Patients with Depression

여성 우울증 입원 환자에서 폐경 여부에 따른 인지기능의 차이

  • You, Ji-Young (Department of Psychiatry, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Min, Jung-Ah (Department of Psychiatry, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeon, Yang-Whan (Department of Psychiatry, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Han, Sang-Ick (Department of Psychiatry, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, E-Jin (Department of Psychiatry, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 유지영 (가톨릭대학교 의과대학 인천성모병원 정신과학교실) ;
  • 민정아 (가톨릭대학교 의과대학 인천성모병원 정신과학교실) ;
  • 전양환 (가톨릭대학교 의과대학 인천성모병원 정신과학교실) ;
  • 한상익 (가톨릭대학교 의과대학 인천성모병원 정신과학교실) ;
  • 박이진 (가톨릭대학교 의과대학 인천성모병원 정신과학교실)
  • Received : 2016.09.01
  • Accepted : 2016.10.17
  • Published : 2016.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives Although forgetfulness is a common complaint among menopausal depressed women, there is still a debate about the relationship between memory impairment and menopause. The aim of this study is to examine whether menopause is related to cognitive decline among women with depressive disorders. We hypothesized that postmenopausal depressed women show generally poorer performance than premenopausal depressed women on various cognitive function tests. Methods With a retrospective chart review, we identified a total of 87 female patients (45 premenopausal patients and 42 postmenopausal patients) who were hospitalized with depressive disorders from 2000 to 2016. Demographic and clinical variables and cognitive test results were compared between two groups. Results Education year is longer in premenopausal group than postmenopausal group whereas clinical characteristics (illness duration, recurrence, and symptom severity) and mean Intelligence Quotient (IQ) were similar between two groups. The postmenopausal group took longer time for Bender-Gestalt Test (BGT) recall, Trail Making Test (TMT)-A, and TMT-B than the premenopausal group. After controlling for age and education, significant difference was remained for BGT recall (p = 0.029). Conclusions Postmenopausal state may be related with decline of visuospatial memory function, in particular, among depressed female patients. Other areas of cognitive function including complex attention, verbal memory, auditory memory, and working memory might be interpreted while considering age and education level.

Keywords

References

  1. Ballard KD, Kuh DJ, Wadsworth MEJ. The role of the menopause in women's experiences of the "change of life." Sociol Health Illn 2001;23:397-424. https://doi.org/10.1111/1467-9566.00258
  2. Oppermann K, Fuchs SC, Donato G, Bastos CA, Spritzer PM. Physical, psychological, and menopause-related symptoms and minor psychiatric disorders in a community-based sample of Brazilian premenopausal, perimenopausal, and postmenopausal women. Menopause 2012;19:355-360. https://doi.org/10.1097/gme.0b013e31822ba026
  3. Gold EB, Sternfeld B, Kelsey JL, Brown C, Mouton C, Reame N, et al. Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age. Am J Epidemiol 2000;152:463-473. https://doi.org/10.1093/aje/152.5.463
  4. Paganini-Hill A, Henderson VW. Estrogen deficiency and risk of Alzheimer's disease in women. Am J Epidemiol 1994;140:256-261. https://doi.org/10.1093/oxfordjournals.aje.a117244
  5. Laws KR, Irvine K, Gale TM. Sex differences in cognitive impairment in Alzheimer's disease. World J Psychiatry 2016;6:54-65. https://doi.org/10.5498/wjp.v6.i1.54
  6. Henderson VW, Guthrie JR, Dudley EC, Burger HG, Dennerstein L. Estrogen exposures and memory at midlife: a population-based study of women. Neurology 2003;60:1369-1371. https://doi.org/10.1212/01.WNL.0000059413.75888.BE
  7. Woods NF, Mitchell ES, Adams C. Memory functioning among midlife women: observations from the Seattle Midlife Women's Health Study. Menopause 2000;7:257-265. https://doi.org/10.1097/00042192-200007040-00008
  8. Sullivan Mitchell E, Fugate Woods N. Midlife women's attributions about perceived memory changes: observations from the Seattle Midlife Women's Health Study. J Womens Health Gend Based Med 2001;10:351-362. https://doi.org/10.1089/152460901750269670
  9. Greendale GA, Derby CA, Maki PM. Perimenopause and cognition. Obstet Gynecol Clin North Am 2011;38:519-535. https://doi.org/10.1016/j.ogc.2011.05.007
  10. Bhalla RK, Butters MA, Mulsant BH, Begley AE, Zmuda MD, Schoderbek B, et al. Persistence of neuropsychologic deficits in the remitted state of late-life depression. Am J Geriatr Psychiatry 2006;14:419-427. https://doi.org/10.1097/01.JGP.0000203130.45421.69
  11. Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL. Risk for new onset of depression during the menopausal transition: the Harvard study of moods and cycles. Arch Gen Psychiatry 2006;63:385-390. https://doi.org/10.1001/archpsyc.63.4.385
  12. Freeman EW, Sammel MD, Lin H, Nelson DB. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry 2006;63:375-382. https://doi.org/10.1001/archpsyc.63.4.375
  13. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
  14. Lee YH, Song JY. A study of the reliability and the validity of the BDI, SDS, and MMPI-D Scales. Korean J Clin Psychol 1991;10:98-113.
  15. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory (Self Evaluation Questionaire) Palo Alto, CA: Consulting Psychologist Press;1970.
  16. Han DW, Lee CH, Tak JK. A standardization study of Spielberger State-Trait Anxiety Inventory (STAI); Korean Psychol annual convention; 1993 Oct 21-23; Seoul. Korean Psychological Association; 1993.
  17. Yeom TH, Park YS, Oh KJ, Kim JK, Lee YH. A manual for K-WAIS. Seoul: Korean Guidance;1992.
  18. Wechsler D. WAIS-R Manual: Wechsler Adult Intelligence Scalerevised. New York: Psychological Corporation;1981.
  19. Hwang ST, Kim JH, Park KB, Chey JY, Hong SH. Korean-Wechsler Adult Intelligence Scale-IV (K-WAIS-IV). Seoul: Korea Psychology Co;2011.
  20. Bender L. A visual-motor Gestalt test and its clinical use. American Orthopsychiatric Association Monograph Series, Number 3. New York: American Orthopsychiatric Association;1938.
  21. Reitan RM. Trail Making Test: manual for administration and scoring. South Tucson, AZ: Reitan Neuropsychology Laboratory;1992.
  22. Army Individual Test Battery. Manual of directions and scoring. Washington, DC: War Department Adjutant General's Office;1944.
  23. Arbuthnott K, Frank J. Trail making test, part B as a measure of executive control: validation using a set-switching paradigm. J Clin Exp Neuropsychol 2000;22:518-528. https://doi.org/10.1076/1380-3395(200008)22:4;1-0;FT518
  24. Wechsler D. Wechsler Memory Scale UK (WMS-IVUK). 4th ed. London: Pearson Education;2009.
  25. Pascal GR, Suttell BJ. The Bender-Gestalt Test: Quantification and Validity for Adults. New York: Grune & Stratton;1951.
  26. Rogers DL, Swenson WM. Bender-Gestalt recall as a measure of memory versus distractibility. Percept Mot Skills 1975;40:919-922. https://doi.org/10.2466/pms.1975.40.3.919
  27. McEwen BS, Alves SE. Estrogen actions in the central nervous system. Endocr Rev 1999;20:279-307.
  28. Bean LA, Ianov L, Foster TC. Estrogen receptors, the hippocampus, and memory. Neuroscientist 2014;20:534-545. https://doi.org/10.1177/1073858413519865
  29. Shughrue PJ, Lane MV, Merchenthaler I. Comparative distribution of estrogen receptor-alpha and -beta mRNA in the rat central nervous system. J Comp Neurol 1997;388:507-525. https://doi.org/10.1002/(SICI)1096-9861(19971201)388:4<507::AID-CNE1>3.0.CO;2-6
  30. Shilling V, Jenkins V, Fallowfield L, Howell A. The effects of oestrogens and anti-oestrogens on cognition. Breast 2001;10:484-491. https://doi.org/10.1054/brst.2001.0311
  31. Sherwin BB. Estrogenic effects on memory in women. Ann N Y Acad Sci 1994;743:213-230; discussion 230-231. https://doi.org/10.1111/j.1749-6632.1994.tb55794.x
  32. Prigatano GP. Wechsler Memory Scale: a selective review of the literature. J Clin Psychol 1978;34:816-832. https://doi.org/10.1002/1097-4679(197810)34:4<816::AID-JCLP2270340402>3.0.CO;2-Q
  33. Resnick SM, Metter EJ, Zonderman AB. Estrogen replacement therapy and longitudinal decline in visual memory. A possible protective effect? Neurology 1997;49:1491-1497. https://doi.org/10.1212/WNL.49.6.1491
  34. Kampen DL, Sherwin BB. Estradiol is related to visual memory in healthy young men. Behav Neurosci 1996;110:613-617. https://doi.org/10.1037/0735-7044.110.3.613
  35. Luine VN, Jacome LF, Maclusky NJ. Rapid enhancement of visual and place memory by estrogens in rats. Endocrinology 2003;144:2836-2844. https://doi.org/10.1210/en.2003-0004
  36. Maki PM, Drogos LL, Rubin LH, Banuvar S, Shulman LP, Geller SE. Objective hot flashes are negatively related to verbal memory performance in midlife women. Menopause 2008;15:848-856. https://doi.org/10.1097/gme.0b013e31816d815e
  37. Epperson CN, Sammel MD, Freeman EW. Menopause effects on verbal memory: findings from a longitudinal community cohort. J Clin Endocrinol Metab 2013;98:3829-3838. https://doi.org/10.1210/jc.2013-1808
  38. Weber MT, Maki PM, McDermott MP. Cognition and mood in perimenopause: a systematic review and meta-analysis. J Steroid Biochem Mol Biol 2014;142:90-98. https://doi.org/10.1016/j.jsbmb.2013.06.001
  39. Glisky EL. Changes in Cognitive Function in Human Aging. In: Riddle DR, editor. SourceBrain Aging: Models, Methods, and Mechanisms. Boca Raton, FL: CRC Press/Taylor & Francis;2007. p.3-20.
  40. Salthouse TA. Influence of processing speed on adult age differences in working memory. Acta Psychol (Amst) 1992;79:155-170. https://doi.org/10.1016/0001-6918(92)90030-H
  41. Farmer ME, Kittner SJ, Rae DS, Bartko JJ, Regier DA. Education and change in cognitive function. The Epidemiologic Catchment Area Study. Ann Epidemiol 1995;5:1-7.
  42. Kim MK, Hyun MH, Han SI. The performance of trail making B test of the organic patients and alcoholics. Korean J Clin Psychol2003;22:463-473.
  43. Mortimer J. Do psychosocial risk factors contribute to. Alzheimer's disease? In: Henderson AS, Henderson JH, editors. Etiology of dementia of Alzheimer's type. New York: John Wiley & Sons;1988. p.39-52.
  44. Katzman R. Education and the prevalence of dementia and Alzheimer's disease. Neurology 1993;43:13-20. https://doi.org/10.1212/WNL.43.1_Part_1.13
  45. Stern Y. What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc 2002;8:448-460. https://doi.org/10.1017/S1355617702813248
  46. Sharp ES, Gatz M. Relationship between education and dementia: an updated systematic review. Alzheimer Dis Assoc Disord 2011;25:289-304. https://doi.org/10.1097/WAD.0b013e318211c83c
  47. Rapp SR, Espeland MA, Manson JE, Resnick SM, Bryan NR, Smoller S, et al. Educational attainment, MRI changes, and cognitive function in older postmenopausal women from the Women's Health Initiative Memory Study. Int J Psychiatry Med 2013;46:121-143. https://doi.org/10.2190/PM.46.2.a
  48. Zakzanis KK, Leach L, Kaplan E. On the nature and pattern of neurocognitive function in major depressive disorder. Neuropsychiatry Neuropsychol Behav Neurol 1998;11:111-119.
  49. Herrmann LL, Goodwin GM, Ebmeier KP. The cognitive neuropsychology of depression in the elderly. Psychol Med 2007;37:1693-1702.