Polycystic ovary syndrome may lead to greater cognitive decline later in life
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ANAHEIM, Calif. — Women with polycystic ovary syndrome may be more likely to have cognitive decline and reductions in white brain matter integrity than those without PCOS, according to a presenter.
In findings from a cohort of 910 participants who enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study in 1985 at age 18 to 30 years, those with PCOS had worse performances on several cognitive tests at a 30-year follow-up compared with people without PCOS.
“This is a relatively small study, and I would like to see this work replicated,” Heather Huddleston, MD, professor of obstetrics, gynecology and reproductive sciences at University of California, San Francisco, told Healio. “However, our work with this cohort appears to show that people with PCOS during their reproductive years demonstrate evidence of diminished brain health with aging compared to those without PCOS.”
Among CARDIA participants, researchers collected data from those who completed cognitive testing. People were defined as having PCOS if they had elevated androgen levels at year 2 and symptoms of oligomenorrhea and hirsutism at year 16 during CARDIA Women’s Study. At year 30, participants completed the Rey Auditory Verbal Learning Test to measure verbal learning and memory, the Digit Symbol Substitution Test to measure processing speed and executive function, the Visual Stroop test to measure attention and cognitive control, and category and letter fluency tests to measure semantics and attention. Of the cohort, 291 participants also underwent brain MRIs to measure matter volume and integrity.
Of the study cohort, 7.1% had PCOS. At year 30, those with PCOS had lower scores on the Rey Auditory Verbal Learning Test (beta = –0.14; 95% CI, –0.45 to 0.17; P = .043), the Stroop test (beta = –4; 95% CI, –0.69 to –7.37; P = .018) and category fluency (beta = –1.3; 95% CI, –2.6 to –0.003; P = .049) compared with those without PCOS. No significant differences were observed with the Digit Symbol Substitution Test and the letter fluency test.
Of participants who underwent an MRI, 8.5% had PCOS. No difference in gray or white brain matter volume was observed between people with PCOS and those without PCOS. Those with PCOS had a lower amount of total white matter fractional anisotropy, a measure of white brain matter integrity, compared with people without PCOS (beta = –0.14; 95% CI, –0.21 to –0.05; P = .003).
Huddleston said the study sample was small, and similar studies are needed with larger cohorts.
“Providers should be aware that patients with PCOS may face an adverse trajectory for their brain health as they age,” Huddleston said. “More research is needed to determine specific mediators of our observations; however, it is possible that some mediators may be modifiable and would be an important therapeutic target for this population.”
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Huddleston HG, et al. OST-03. Presented at: ASRM Scientific Congress & Expo; Oct. 22-26, 2022; Anaheim, California.
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