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Nulliparity and Late Menopause Are Associated With Decreased Cognitive Decline

Received February 1, 2001; revised January 28, 2002; accepted February 6, 2002. From the Department of Psychiatry, Naval Medical Center San Diego, San Diego (R.N.M.), Departments of Psychiatry and Psychology, University of Illinois at Chicago (P.M.M.), and the Neuropsychiatry Service, Johns Hopkins University School of Medicine, Baltimore (C.G.L.). Address correspondence to Dr. Lyketsos, Johns Hopkins University School of Medicine, Neuropsychiatry Service, 320 Osler Building, 600 North Wolfe Street, Baltimore, MD 21287-5371.

Changes in Mini-Mental State Examination (MMSE) scores were examined over a median of 12.8 years in a population of 361 community-dwelling postmenopausal women who had never received estrogen replacement therapy. In a linear regression model that took into account age, education, race, surgical versus natural menopause, use of birth control pills, and MMSE score at baseline, it was found that nulliparous women and women who went through menopause later in life had significantly less cognitive decline. These results suggest that greater lifetime exposure to endogenous estrogen may be associated with less age-related cognitive decline.

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