Social isolation and loneliness raise cognitive decline risk in perimenopausal women

The relationship between social connections and cognitive abilities is a complex one, particularly during the perimenopausal period when women transition from the reproductive period to menopause. A new study suggests that loneliness and social isolation are not only independently associated with subjective cognitive decline during perimenopause but also exhibit a joint relationship. Results of the study are published online today in Menopause, the journal of The Menopause Society.

Perimenopause, which typically occurs between the ages of 45 and 55 years, is a time of numerous changes because of a gradual ovarian decline and fluctuating estrogen levels. Common physical symptoms include hot flashes and sleep disturbances. Significant emotional and cognitive changes also occur, affecting a woman's memory, attention, and processing speed.

Identifying women at high risk for subjective cognitive decline is of great public health significance for the early implementation of interventions to mitigate cognitive deterioration. In a new study involving more than 900 perimenopausal women, researchers sought to clarify the independent and joint associations of loneliness and social isolation with subjective cognitive decline in perimenopausal women. They defined loneliness as a subjective social experience reflecting a person's dissatisfaction with existing social relationships and the perceived lack of emotional connection, while they described social isolation as an objective state characterized by a limited social network, infrequent social interactions, and reduced social participation.

Previous studies have demonstrated that both loneliness and social isolation are significant risk factors for a range of adverse health outcomes, including cognitive decline, cardiovascular disease, and all-cause mortality, but their roles in perimenopausal women were not clear. Perimenopausal women already face a number of additional stressors on top of fluctuating hormone levels, including major life changes, such as children moving off to college, increased caretaker roles for aging parents, and possibly, changing occupational roles.

This new study specifically aimed to identify high-risk groups of subjective cognitive decline in perimenopausal women based on latent class analysis and further investigate the independent and joint associations of loneliness and social isolation with subjective cognitive decline. Doing so would promote healthy aging through early identification and intervention of cognitive deterioration.

Study results are published in the article "Independent and joint associations of loneliness and social isolation with subjective cognitive decline in perimenopausal women."

The findings of this study highlight the importance of psychosocial factors in cognitive health during the menopause transition and may inform the development of multidimensional psychosocial interventions targeting persons at risk for subjective cognitive decline during this time."

Dr. Stephanie Faubion, medical director, The Menopause Society