Polycystic ovary syndrome can cause dementia-like symptoms for women in middle age, study suggests

Women with polycystic ovary syndrome may be vulnerable to cognitive issues later in life, a new study has found. 

Research published in the journal Neurology, the medical journal of the American Academy of Neurology, found that people who suffer from the hormonal condition may be more likely to have memory and thinking issues in middle age. 

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that affects between eight and 15 percent of women of childbearing age in the US. It causes the ovaries to produce excessive amounts of the male sex hormone androgen due to cysts that form along the outer edges of the organ.

This results in irregular menstrual cycles, ovarian cysts, and excess levels of male sex hormones, which can cause abnormal hair growth.

Researchers from California, Michigan, Tennessee and Maryland followed 907 women between 18 to 30 years old at the start of the study for 30 years. 

At the end of the 30 years, they completed tests to measure memory, verbal abilities, processing speed and attention. At the time of testing, 66 women had PCOS. 

Study author Dr Heather Huddleston of the University of California, San Francisco, said: ‘While [PCOS] has been linked to metabolic diseases like obesity and diabetes that can lead to heart problems, less is known about how this condition affects brain health. 

‘Our results suggest that people with this condition have lower memory and thinking skills and subtle brain changes at midlife. This could impact a person on many levels, including quality of life, career success and financial security.’

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that affects between eight and 15 percent of women of childbearing age in the US

The authors stressed their findings do no prove PCOS causes a cognitive decline, only that it shows an association.

To measure attention, participants completed a Stroop test, which had them look at a list of words in different colors and attempt to state the color of the word rather than read what the word said. 

Results showed that people with PCOS had an average score 11 percent lower compared to the women without the condition. 

Another test to measure processing speed, the digit symbol substitution test, tracked how fast participants could memorize a sequence of numbers that corresponded to symbols and recreate the sequence accurately. 

The Montreal Cognitive Assessment tested for cognitive decline by having participants complete a series of drawings. 

Verbal memory was tested using the Rey Auditory Verbal Learning Test, which measures the ability to memorize and retrieve words after 10 minutes. 

The fifth test measured verbal fluency using category and letter fluency tests, which asked women to name as many unique words as possible within a specified category or starting with a specific letter.  

After adjusting for age, race and education, people with PCOS had lower scores than women without on three of the five tests researchers administered, specifically on tests measuring memory, attention and verbal abilities. 

A smaller group of 300 women had brain scans at 25 and 30 years, of which 25 had PCOS. In the scans, researchers analyzed the makeup of white matter pathways in the brain by looking at how water molecules moved in brain tissue. 

Brain white matter is found in the deeper tissues of the brain and contains nerve fibers, which are extensions of neurons.

White matter plays a critical role in helping the body process information. It connects regions of the brain that send and receive signals, affecting the ability to focus and learn, solve problems, and stay balanced when walking. 

When examining the participants’ brain scans, researchers observed that the white matter in people with PCOS was not as healthy as the matter in people without the hormonal condition, which could indicate early evidence of brain aging. 

Huddleston said: ‘Additional research is needed to confirm these findings and to determine how this change occurs, including looking at changes that people can make to reduce their chances of thinking and memory problems.

‘Making changes like incorporating more cardiovascular exercise and improving mental health may serve to also improve brain aging for this population.’