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Cognitive aging has become an important issue because of increased life expectancy in women. Cognitive complaints are common during midlife, as part of the climacteric syndrome. By using data from a longitudinal observational study in 2124 participants from the Study of Women’s Health Across the Nation, Karlamangla and colleagues [1] attempted to demonstrate that cognitive aging is present in midlife women, irrespective of menopausal transition and its associated symptoms. Moreover, their study design tried to avoid the so-called practice effects deriving from the ability to learn from repeat testing in younger women. Average age at baseline (third cognition testing visit) was 54 years and the majority of the women were postmenopausal, with half the cohort being 2 or more years beyond the final menstrual period. There were 7185 cognition assessments (processing speed, verbal episodic memory [immediate and delayed], and working memory) with median follow-up time of 6.5 years. By adjusting for practice effects, retention, menopause symptoms (depressive, anxiety, vasomotor, and sleep disturbance), and covariates, they found a mean decline in cognitive speed of 0.28 per year (95% confidence interval, CI 0.20–0.36) or of 4.9% in 10 years, and a mean decline in verbal episodic memory (delayed testing) of 0.02 per year (95% CI 0.00–0.03) or of 2% in 10 years.


  • Rossella E. Nappi
    Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy


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