Highlights
- •Compared with premenopausal women, perimenopausal and surgical postmenopausal women experience more perceived executive dysfunction.
- •Problems with perceived executive dysfunction were significantly higher in natural postmenopausal than in premenopausal women without controlling for difficulty sleeping, anxiety, and depression, but not when adjusting for these variables.
- •Menopause type (natural vs. surgical) and psychological symptoms (sleep, anxiety, and depression) are important confounders of the relationship between menopause and perceived executive function.
Abstract
Objective
The menopause transition is associated with difficulties in executive function. However,
it is unclear whether these difficulties persist past perimenopause. This study investigated
whether potential confounders, including natural vs. surgical postmenopause and menopause-related
psychological symptoms, influence whether executive dysfunction persists into postmenopause.
Study design
A cross-sectional sample of women aged 35–65 years (N = 1971) in one of four groups,
premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were
surveyed. Participants self-reported executive functioning with the Brown Attention
Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety
Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for
Epidemiologic Studies Depression Scale (CES D).
Main outcome measures
We analyzed the association between group and BADDS scores using linear regression
models – first, by controlling for age, education, and self-reported attention deficit
hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling
for current difficulty sleeping, anxiety, and depression (Model #2).
Results
In both models, BADDS scores were significantly elevated (indicating more difficulties
in executive function) among women in the perimenopausal and surgical postmenopausal
groups compared with those in the premenopausal group. Likewise, the perimenopausal
and surgical postmenopausal groups had the highest proportions of participants who
reported difficulty sleeping and clinical levels of anxiety and depression. BADDS
scores were significantly higher in natural postmenopausal vs. premenopausal women
without controlling for difficulty sleeping, anxiety, and depression (Model #1), but
not when adjusting for these variables (Model #2).
Conclusions
The type of menopause and psychological symptoms are important confounders of the
relationship between the menopause transition and executive dysfunction, and help
explain whether executive dysfunction persists or recovers in postmenopause.
Keywords
Abbreviations:
BADDS (Brown Attention Deficit Disorder Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 06, 2023
Accepted:
January 6,
2023
Received in revised form:
November 23,
2022
Received:
August 19,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
