Predictors of cognitive performance in postmenopausal women: findings from the Canadian Longitudinal Study on Aging (CLSA)

INTRODUCTION: A range of demographic, reproductive, and health-related factors influence brain health in postmenopausal women, though their relative and combined contributions are not fully understood. Using data from the Canadian Longitudinal Study on Aging (CLSA), this study examined predictors of cognitive performance in postmenopausal women, including hormone therapy (HT) use, age at menopause, and relevant sociodemographic and health-related variables. METHOD: We included baseline and follow-up data from 10,978 CLSA participants. Multiple linear regressions were employed to examine the associations between predictors and cognitive test scores at a 3-year follow-up, adjusting for baseline scores. Cognitive performance was assessed using a neuropsychological battery, which included six tests probing verbal learning, episodic memory, executive function, and verbal and semantic fluency. RESULTS: Later age at menopause was predictive of better cognitive performance on specific cognitive tests, including verbal learning and delayed recall, as measured by the CLSA-modified REY I (β = .01, 95% CI [-.04, .02], p = .006) and REY II (β = .02, 95% CI [.01, .03], p < .001), as well as inhibitory control measured by Stroop test interference (β = -.01, 95% CI [-.01, -.02], p = .004). Sociodemographic factors, including education and income, were also consistent predictors of cognitive performance across domains. CONCLUSIONS: Overall, findings suggest that cognitive performance in postmenopausal women may reflect a combination of reproductive and sociodemographic influences. Future studies incorporating longer follow-up periods and more detailed reproductive and health measures are needed to better characterize the contribution of menopause-related factors to cognitive aging.