Beyond brain fog: Urgent need to address the unmet cognitive needs of women going through menopause

Cognitive issues, such as difficulty concentrating, poor memory and ‘brain fog’ are among the most commonly-reported symptoms during menopause. Despite this, surprisingly little is known about these challenges in non-clinical populations, due to the lack of adequate measures.

This systematic review, published in Menopause identified 28 studies investigating the subjective cognition of people transitioning through menopause. These studies tested those at different stages of menopause: premenopausal, perimenopausal and postmenopausal (including surgical and/or treatment-induced), through a total of 15 subjective cognitive measures.

Out of the 15 cognitive measures, the majority (ten) measured one cognitive domain such as attention or memory, with the remaining five looking at multiple domains. Seven measures were developed for clinical samples, for example for people with head injuries.

Analysing the psychometric properties of the cognitive tests, the researchers found that the overall performance was moderate to poor. Nearly half the measures were developed for clinical samples, they found a lack of sensitivity to accurately detect subtle cognitive changes in nonclinical samples at menopause transition. This could hinder our understanding menopausal experiences.

They did observe good content validity, internal consistency and construct validity in the existing measures, suggesting that the items in the measures worked well together and accurately measured the intended cognitive domain.

Lead author, Lexi He, UCL Division of Psychology and Language Sciences said: “Brain fog is by far one of the most reported symptoms of menopause, yet our understanding of women’s cognitive health has been constrained by the lack of a validated self-reported cognitive measures designed specifically for them.

“This systematic review highlights the urgent need to address the unmet cognitive needs of women. It is our hope that this review will motivate development of reliable cognitive measures of people going through menopause, such as the one we are developing in the UCL Menopause Mind Lab. This tool will raise awareness of the cognitive problems in women undergoing menopause, and allow researchers and clinicians to identify unfulfilled cognitive needs and facilitate the development of specific support.”

Related:

• Read the systematic review in Menopause
• UCL Division of Psychology and Language Sceinces
• UCL Menopause Mind Lab