Women who enter menopause before their 50s and who also have heart disease risk factors may be at especially high risk for thinking declines and later dementia, new research shows.

“While cardiovascular risk factors are known to increase a person’s risk for dementia, what is lesser known is why women have a greater risk for Alzheimer’s disease than men,” said study lead author Jennifer Rabin, of the University of Toronto. “We examined if the hormonal change of menopause, specifically the timing of menopause, may play a role in this increased risk.”

Rabin’s team found that it did.

“We found that going through this hormonal change earlier in life while also having cardiovascular risk factors is linked to greater cognitive problems when compared to men of the same age,” she explained in a news release from the American Neurological Association.

Maintaining good blood flow to and within the brain is a known factor in neurological health. High blood pressure, smoking and diabetes can all impair brain blood flow.

In the new study, Rabin’s team tracked the cognitive health of 16,720 people, averaging 65 years of age, evenly divided as to gender.

They further divided the female participants into three subgroups: Those who experienced earlier menopause between the ages of 35 and 48; those who entered menopause between ages 49 and 52 (which is typical); and those who had a later menopause, between the ages of 53 and 65.

For all participants, they also tracked heart risk factors such as high LDL (“bad”) cholesterol, diabetes, obesity, smoking, high blood pressure, as well as prescriptions for blood pressure meds.

Everyone was also given a battery of cognitive tests at the beginning and end of the three-year study.

The result: Two factors together — early menopause and higher heart risk — seemed linked to a drop in test scores for women over the three years of the study.

No such trend was seen among women from the average or late menopause groups.

The study was published April 3 in the journal Neurology.

“Our findings highlight that age at menopause, as well as cardiovascular risk, should be considered when developing prevention strategies for cognitive decline” in women, Rabin said.

More information

Find out more about menopause and the brain at Harvard Health.

SOURCE: American Neurological Association, news release, April 3, 2024