Cognitive changes in menopause

As we age there are losses of structure and function across the cortex, but particularly in the frontal and prefrontal cortex. This area of the brain is responsible for cognitive executive functions such as working memory, the ability to switch and focus on multiple tasks and the ability to ignore distractions. There has been significant work on how the ageing brain changes, however, there is less focus on the changes that occur in late middle age and this particularly true for women.

Although some research has addressed the interaction of estrogen changes with cognitive function, the results have been mixed. This is likely to be because of the limited range of tests used and the wide variation of experience of women. It is known that older people vary in performance more than younger people, with some using 'compensatory' strategies or brain pathways and this is likely to be true for women in late middle age. Furthermore, menopause is accompanied by other life stressors (e.g. changing caring responsibilities and job roles) and reduced sleep. These can also temporarily impair cognitive performance. It is critical to develop an approach to cognition in the menopause which acknowledges the diversity of outcomes and experiences and that separates the direct effects of the menopause and the indirect effects (e.g. effects mediated by lack of sleep).

We have investigated how different skills and abilities combine and compared the development, and decline, of various executive and perceptual functions. For instance we found that development of the ability to control and direct attention can trade off against the ability to ignore distraction. In our task, participants were asked to find a specific target item (tilted line) in an array of non-target items (non-tilted lines). On some trials they were given a pre-cue of the background colour of the target item. On some trials an irrelevant shape also appeared. In our paradigm we can thus investigate how the two abilities develop. For example, before they are fully developed, the ability to use the cue actually reduces the ability to ignore the irrelevant shape.

In this PhD, the student will use our paradigm (among other techniques) to investigate whether reported effects of the menopause for women are direct or indirect. In the longer term this will help design the correct support and interventions in the workplace or otherwise. In the shorter term, better understanding and acknowledgment of the effects can directly support women. At the start of the project the student will use existing behavioural tasks and tools and extend them to this population. They will also conduct a systematic review of the relevant evidence. The project can then investigate the relationship between symptom severity, menopause stage and cognitive effects. There are further options to look at how specific conditions interact with the menopause. An example might be age or menopause (where later change might interact with the early stages of age-related decline) or conditions such as Attention Deficit Hyperactivity Disorder (where there are differences in attention and executive function).