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P4–385: Cognitive changes following oophorectomy
Author(s) -
Au April,
Schwartz Deborah,
Finch Amy,
Tierney Mary,
Hampson Elizabeth,
Narod Steven,
Einstein Gillian
Publication year - 2013
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2013.08.218
Subject(s) - oophorectomy , medicine , estrogen , cognitive decline , menopause , gynecology , psychology , hysterectomy , disease , surgery , dementia
Background: Epidemiological evidence indicating oophorectomy prior to natural menopause is associated with an increased risk of Alzheimer’s Disease (Rocca et al., 2007) and parkinsonism (Rocca et al., 2008) suggests that estrogen deprivation is implicated in cognitive decline. However, the trajectory of cognitive changes following oophorectomy is poorly understood beyond six months post-surgically (Sherwin, 1988). The purpose of this study was to determine the long-term effects of estrogen deprivation induced by oophorectomy on cognitive functioning, up to ten years post-surgically. Methods: The experimental group comprised of female carriers of the BRCA1/2 mutation who had undergone a bilateral salpingo-oophorectomy (BSO; removal of fallopian tubes and ovaries) between one to seven years ago as prophylaxis against the risk of gynaecological cancers. An agematched control group of healthy women and a BRCA control group comprised of women with a BRCA mutation prior to oophorectomy were also recruited. All women were tested once a year, for three years using a battery of neuropsychological tests assessing spatial and verbal memory, working memory, as well as executive functioning. Urine and saliva samples were taken respectively to determine estrogen levels at the time of testing and apolipoprotein E (APOE) genotype. It was hypothesized that women who have undergone BSO would score lower on measures of verbal memory. Carriers of the APOE E4 allele who had undergone BSO were hypothesized to perform the worst as the E4 allele is associated with an increased vulnerability to Alzheimer’s disease. Results: Results indicate that women with BSO performed significantly worse than age-matched controls on the immediate and delayed recall of the Logical Memory task of the Wechsler Memory Scale. Years since oophorectomy was also negatively correlated to the score on the delayed recall of the RAVLTafter controlling for age. Conclusions: Preliminary results suggest that premature estrogen deprivation is associated with a decrement in verbal memory compared to women matched in age and education. Importantly, time since BSO appears to exacerbate the decline of verbal memory independent of age. Results corroborate previous research showing cognitive decline post-BSO, but also suggests that verbal memory declines as a function of time since estrogen deprivation.