Early menopause combined with a high risk of cardiovascular disease are associated with an increased risk of later thinking and memory problems, according to a study published in the online issue of the American Academy of Neurology’s medical journal Neurology.

As a person ages, blood vessels, including those in the brain, can be damaged by cardiovascular risk factors such as high blood pressure, diabetes and smoking. These risk factors also increase the risk of dementia.

Researchers from the University of Toronto in Canada looked at whether the timing of menopause may play a role in this increased risk and found that women who go through this hormonal change earlier in life, before the age of 49, and at the same time have cardiovascular risk factors are at risk of greater cognitive problems compared to men of the same age.

The study involved 8,360 women and an equal number of men from the Canadian Longitudinal Study of Aging. Female participants had an average age of menopause of 50 years. All participants had an average age of 65 at the start of the study and were followed for three years.

The women were divided into three groups: those who experienced early menopause between ages 35-48 years oldthose who had menopause close to the average 49-52 years old and those who had later menopause 53-65 years old. They also looked at whether they had taken estrogen-containing hormone therapy, cardiovascular risk factors (high LDL cholesterol, diabetes, obesity, smoking, high blood pressure) and whether they had received prescriptions for blood pressure-lowering drugs.

In addition, participants were given a series of thinking and memory tests at the beginning and end of the study.

It found that female participants with early menopause and higher cardiovascular risk had lower cognitive scores three years later compared to men in the same age group. In contrast, there was no difference for participants with middle or later menopause, and hormone therapy did not affect the results.

However, the researchers point out that more years of follow-up are needed. In addition, no information was available on whether participants had undergone oophorectomy and those who reported hysterectomy were also excluded, as the age at surgery was not available.