Cognitive markers of dementia risk in middle-aged women with bilateral salpingo-oophorectomy prior to menopause

Oophorectomy prior to menopause is associated with elevated dementia risk and accelerated cognitive decline. This cognitive decline may start within six months after oophorectomy in middle-aged women, suggested by lower verbal and working memory performance. Unknown is whether such changes persist beyond 6 months, and whether they are reversed by estradiol-based hormone therapy (E2). Short-term benefits of E2 on verbal memory following oophorectomy were observed in one study, but longer-term effects remain unknown. In the present study, middle-aged BRCA1/2 mutation carriers with early oophorectomy at least one year prior to study onset were tested on verbal and working memory with results stratified by 1) current E2 use (n=22) or 2) no history of E2 use (n=24), and compared to age-matched premenopausal controls (n=25). Both forms of memory were adversely affected by oophorectomy, but only working memory was maintained by E2 use. Estrogen metabolite levels correlated with working memory, suggesting a role for E2 in preserving this ability. Memory decline appears to persist after early oophorectomy, particularly for women who do not take E2.