A study of 2,603 older women followed for up to 18 years found that earlier menopause was associated with faster declines in global cognition and episodic memory, and an earlier clinical Alzheimer’s diagnosis. The findings do not show menopause causes dementia.
Among 774 women with repeated MRI scans, earlier spontaneous menopause was associated with faster accumulation of white-matter hyperintensities. The study estimated that menopause five years earlier was linked to about 15% greater volume over a decade; this is an imaging measure, not a 15% increase in dementia risk.
Analysis of more than 1,200 autopsies found no significant association between menopause timing and Alzheimer’s neuropathologic changes after statistical correction. Exploratory analyses found no significant evidence that hormone therapy changed brain-volume trajectories; the subgroup was small, and the study does not show that therapy prevents the measured changes. More than 92% of participants were White and non-Hispanic, and the group was relatively highly educated.
