Link Between PCOS and Cognitive Function in Middle-Aged Women

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Polycystic ovarian syndrome (PCOS) is a disorder of the female reproductive system that affects between 8% and 15% of women. It can cause many complications such as insulin resistance, infertility, and irregular periods. New research also shows that there are also associations between PCOS and brain health in middle age.

A research team led by Heather G. Huddleston, M.D., a reproductive oncologist at the University of California, San Francisco, reported the results in Neurology on Wednesday.

Researchers used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study that began in 1985. It was originally designed to investigate ovarian physiology and cardiovascular health. It consisted of 1,163 women ages 18-30 who were followed for 30 years.

Follow-up exams were completed at two, five, seven, 10, 15, 20, 25, and 30. At year 30, 907 of the 1,163 participants completed cognitive tests that measured verbal learning, memory, processing speed, and executive function. Sixty-five (7.1%) met the criteria for PCOS and participants with PCOS performed worse on these tests.

A subset of 291 also completed MRIs at years 25 and 30 to measure white matter integrity and 25 (8.5%) women who had PCOS demonstrated less but not abnormal white matter.

Researchers are unsure of the specific PCOS symptom that decreases cognition but believe PCOS broadly causes inflammation and early vascular changes from insulin signaling.

“Given that both hormonal and metabolic factors affect the brain, it is surprising that only a handful of studies to date have examined cognition in PCOS, and no study has yet reported on cognition in midlife women,” the authors write. “Additional research is needed to confirm these findings and to determine potential mechanistic pathways including potential modifiable factors.”