Cognitive changes in menopause

随着年龄的增长，整个大脑皮质的结构和功能都会丧失，尤其是在额叶和前额叶皮质。大脑的这一区域负责认知执行功能，如工作记忆、切换和专注于多项任务的能力，以及忽略分心的能力。关于衰老大脑的变化已经有了大量的研究，然而，对中年后期发生的变化的关注较少，这一点对女性来说尤其如此。虽然一些研究已经解决了雌激素变化与认知功能的相互作用，但结果喜忧参半。这很可能是因为使用的测试范围有限，女性的经历也存在很大差异。众所周知，与年轻人相比，老年人在表现上的差异更大，其中一些人使用“补偿”策略或大脑通路，这一点很可能适用于中年后期的女性。此外，更年期伴随着其他生活压力因素(例如，改变照顾责任和工作角色)和睡眠减少。这些也会暂时损害认知能力。关键是要制定一种认识更年期的方法，这种方法承认结果和经验的多样性，并将更年期的直接影响和间接影响(例如，因缺乏睡眠而产生的影响)分开。我们调查了不同的技能和能力是如何结合在一起的，并比较了各种执行和感知功能的发展和衰落。例如，我们发现，控制和引导注意力的能力的发展可能会与忽视分心的能力相权衡。在我们的任务中，参与者被要求在一组非目标项目(非倾斜线)中找到特定的目标项目(倾斜线)。在一些试验中，他们得到了目标物品背景颜色的预先提示。在一些试验中，还出现了一个无关的形状。因此，在我们的范式中，我们可以研究这两种能力是如何发展的。例如，在它们完全发育之前，使用线索的能力实际上会降低忽略不相关形状的能力。在这个博士学位中，学生将使用我们的范例(以及其他技术)来调查所报道的更年期对女性的影响是直接的还是间接的。从长远来看，这将有助于在工作场所或其他地方设计正确的支持和干预措施。在短期内，更好地理解和承认这些影响可以直接支持妇女。在项目开始时，学生将使用现有的行为任务和工具，并将其扩展到这一人群。他们还将对相关证据进行系统审查。然后，该项目可以调查症状严重程度、更年期和认知效果之间的关系。还有更多的选择来观察特定的条件如何与更年期相互作用。一个例子可能是年龄或更年期(后来的变化可能与年龄相关下降的早期阶段相互作用)，或者诸如注意力缺陷多动障碍(注意力和执行功能存在差异)之类的情况。

As we age there are losses of structure and function across the cortex, but particularly in the frontal and prefrontal cortex. This area of the brain is responsible for cognitive executive functions such as working memory, the ability to switch and focus on multiple tasks and the ability to ignore distractions. There has been significant work on how the ageing brain changes, however, there is less focus on the changes that occur in late middle age and this particularly true for women. Although some research has addressed the interaction of estrogen changes with cognitive function, the results have been mixed. This is likely to be because of the limited range of tests used and the wide variation of experience of women. It is known that older people vary in performance more than younger people, with some using 'compensatory' strategies or brain pathways and this is likely to be true for women in late middle age. Furthermore, menopause is accompanied by other life stressors (e.g. changing caring responsibilities and job roles) and reduced sleep. These can also temporarily impair cognitive performance. It is critical to develop an approach to cognition in the menopause which acknowledges the diversity of outcomes and experiences and that separates the direct effects of the menopause and the indirect effects (e.g. effects mediated by lack of sleep). We have investigated how different skills and abilities combine and compared the development, and decline, of various executive and perceptual functions. For instance we found that development of the ability to control and direct attention can trade off against the ability to ignore distraction. In our task, participants were asked to find a specific target item (tilted line) in an array of non-target items (non-tilted lines). On some trials they were given a pre-cue of the background colour of the target item. On some trials an irrelevant shape also appeared. In our paradigm we can thus investigate how the two abilities develop. For example, before they are fully developed, the ability to use the cue actually reduces the ability to ignore the irrelevant shape. In this PhD, the student will use our paradigm (among other techniques) to investigate whether reported effects of the menopause for women are direct or indirect. In the longer term this will help design the correct support and interventions in the workplace or otherwise. In the shorter term, better understanding and acknowledgment of the effects can directly support women. At the start of the project the student will use existing behavioural tasks and tools and extend them to this population. They will also conduct a systematic review of the relevant evidence. The project can then investigate the relationship between symptom severity, menopause stage and cognitive effects. There are further options to look at how specific conditions interact with the menopause. An example might be age or menopause (where later change might interact with the early stages of age-related decline) or conditions such as Attention Deficit Hyperactivity Disorder (where there are differences in attention and executive function).