The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study
Monica M Shieu,1 Tiffany J Braley,1 Jill Becker,2 Galit Levi Dunietz1 1Neurology, Medical School, University of Michigan, Ann Arbor, MI, USA; 2Psychology, Medical School, University of Michigan, Ann Arbor, MI, USACorrespondence: Monica M Shieu, Division of Sleep Medicine, Department of Neurology, Un...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-02-01
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| Series: | Nature and Science of Sleep |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-interplay-among-natural-menopause-insomnia-and-cognitive-health-a--peer-reviewed-fulltext-article-NSS |
| _version_ | 1811164200565735424 |
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| author | Shieu MM Braley TJ Becker J Dunietz GL |
| author_facet | Shieu MM Braley TJ Becker J Dunietz GL |
| author_sort | Shieu MM |
| collection | DOAJ |
| description | Monica M Shieu,1 Tiffany J Braley,1 Jill Becker,2 Galit Levi Dunietz1 1Neurology, Medical School, University of Michigan, Ann Arbor, MI, USA; 2Psychology, Medical School, University of Michigan, Ann Arbor, MI, USACorrespondence: Monica M Shieu, Division of Sleep Medicine, Department of Neurology, University of Michigan, Neurology, C728 Med Inn Building, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA, Tel +1 734-764-5415, Fax +1 734-232-9986, Email mshie@umich.eduPurpose: The interrelationships among age at menopause, sleep, and brain health have been insufficiently studied. This study sought to examine the influence of age at natural menopause and insomnia symptoms on long-term cognitive function among US women.Patients and Methods: Our study included a nationally representative cohort of US adults age 50+ from the Health and Retirement Study (2008– 2018). We restricted this cohort to 5880 women age 50+, from a diverse racial and ethnic groups. Age at menopause was retrieved from baseline (2008) for women having natural menopause. Five questions were used to identify women with insomnia symptoms (2010 and 2012): trouble falling asleep, nighttime awakenings, early morning awakenings, feelings of nonrestorative sleep, and use of sleep aids. A battery of four neuropsychological tests was conducted biennially (years) to evaluate cognitive function. Longitudinal associations between age at natural menopause and cognitive function were estimated with mixed effects models with a random intercept. Insomnia symptoms were examined as potential mediators or modifiers in the pathway between age at menopause and cognition.Results: One year earlier in age at menopause was associated with a 0.49 lower mean in composite cognitive score, in any given survey year (adjusted p = 0.002). Earlier age at menopause was associated with higher risk of developing insomnia symptoms (eg, trouble falling asleep OR = 0.97; 95% CI: 0.96, 0.99), and insomnia symptoms were associated with worse cognitive performance (eg, trouble falling asleep, beta = − 0.5, p-value = 0.02). Therefore, insomnia symptoms could potentially mediate the association between age at natural menopause and cognition.Conclusion: Earlier age at menopause is associated with a lower score in cognitive performance. This association may be mediated by insomnia symptoms. Our findings spotlight that among women who experience early menopause, there is the need for studies of sleep-based interventions to mitigate cognitive decline.Keywords: age at menopause, cognitive performance, mediation, effect modification, natural menopause, population-based study |
| first_indexed | 2024-04-10T15:17:36Z |
| format | Article |
| id | doaj.art-c6e5eedd67ce4855ae5662ab5fdaed88 |
| institution | Directory Open Access Journal |
| issn | 1179-1608 |
| language | English |
| last_indexed | 2024-04-10T15:17:36Z |
| publishDate | 2023-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Nature and Science of Sleep |
| spelling | doaj.art-c6e5eedd67ce4855ae5662ab5fdaed882023-02-14T18:00:38ZengDove Medical PressNature and Science of Sleep1179-16082023-02-01Volume 15394881637The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based StudyShieu MMBraley TJBecker JDunietz GLMonica M Shieu,1 Tiffany J Braley,1 Jill Becker,2 Galit Levi Dunietz1 1Neurology, Medical School, University of Michigan, Ann Arbor, MI, USA; 2Psychology, Medical School, University of Michigan, Ann Arbor, MI, USACorrespondence: Monica M Shieu, Division of Sleep Medicine, Department of Neurology, University of Michigan, Neurology, C728 Med Inn Building, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA, Tel +1 734-764-5415, Fax +1 734-232-9986, Email mshie@umich.eduPurpose: The interrelationships among age at menopause, sleep, and brain health have been insufficiently studied. This study sought to examine the influence of age at natural menopause and insomnia symptoms on long-term cognitive function among US women.Patients and Methods: Our study included a nationally representative cohort of US adults age 50+ from the Health and Retirement Study (2008– 2018). We restricted this cohort to 5880 women age 50+, from a diverse racial and ethnic groups. Age at menopause was retrieved from baseline (2008) for women having natural menopause. Five questions were used to identify women with insomnia symptoms (2010 and 2012): trouble falling asleep, nighttime awakenings, early morning awakenings, feelings of nonrestorative sleep, and use of sleep aids. A battery of four neuropsychological tests was conducted biennially (years) to evaluate cognitive function. Longitudinal associations between age at natural menopause and cognitive function were estimated with mixed effects models with a random intercept. Insomnia symptoms were examined as potential mediators or modifiers in the pathway between age at menopause and cognition.Results: One year earlier in age at menopause was associated with a 0.49 lower mean in composite cognitive score, in any given survey year (adjusted p = 0.002). Earlier age at menopause was associated with higher risk of developing insomnia symptoms (eg, trouble falling asleep OR = 0.97; 95% CI: 0.96, 0.99), and insomnia symptoms were associated with worse cognitive performance (eg, trouble falling asleep, beta = − 0.5, p-value = 0.02). Therefore, insomnia symptoms could potentially mediate the association between age at natural menopause and cognition.Conclusion: Earlier age at menopause is associated with a lower score in cognitive performance. This association may be mediated by insomnia symptoms. Our findings spotlight that among women who experience early menopause, there is the need for studies of sleep-based interventions to mitigate cognitive decline.Keywords: age at menopause, cognitive performance, mediation, effect modification, natural menopause, population-based studyhttps://www.dovepress.com/the-interplay-among-natural-menopause-insomnia-and-cognitive-health-a--peer-reviewed-fulltext-article-NSSage at menopausecognitive performancemediationeffect modificationnatural menopausepopulation-based study |
| spellingShingle | Shieu MM Braley TJ Becker J Dunietz GL The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study Nature and Science of Sleep age at menopause cognitive performance mediation effect modification natural menopause population-based study |
| title | The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study |
| title_full | The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study |
| title_fullStr | The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study |
| title_full_unstemmed | The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study |
| title_short | The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study |
| title_sort | interplay among natural menopause insomnia and cognitive health a population based study |
| topic | age at menopause cognitive performance mediation effect modification natural menopause population-based study |
| url | https://www.dovepress.com/the-interplay-among-natural-menopause-insomnia-and-cognitive-health-a--peer-reviewed-fulltext-article-NSS |
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