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He L, Jaff NG, Kontaris E, Spector A. The psychometric properties and applicability of subjective cognitive measures used in menopause research: a systematic review. Menopause 2025; 32:361-379. [PMID: 40067760 DOI: 10.1097/gme.0000000000002494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2025]
Abstract
IMPORTANCE Many midlife women report cognitive issues when they transition through menopause. These cognitive complaints affect women's mental health and quality of life. However, the current understanding of women's cognitive experiences during the menopause transition has been limited by the lack of validated self-reported cognitive measures. OBJECTIVE This systematic review aimed to identify existing self-reported, or subjective, cognitive measures used in menopause research and evaluate their psychometric properties and applicability. EVIDENCE REVIEW Three databases, Medline, Embase, and PsycINFO, were searched in March 2024 with no restriction on publication year. Studies investigating women transitioning into postmenopause and with cognitive experiences measured using validated subjective cognitive measures were selected. The assessment of psychometric properties and applicability of included measures was conducted based on their development process and their performance in the menopause studies selected. FINDING Twenty-eight menopause studies involving 15 measures were included. Included measures showed adequate content validity, internal consistency, and construct validity when they were developed, yet other psychometric properties were either poor or not reported. Hence, the overall performance of included measures was generally moderate to poor. Information relating to psychometric properties of included measures in menopause studies was also lacking, indicating doubtful applicability. CONCLUSIONS AND RELEVANCE Poor psychometric properties or the lack of psychometric assessment of existing subjective cognitive measures may indicate doubt or uncertainty regarding their applicability in women transitioning through menopause. This review recommends the use of subjective cognitive measures that assess more than one cognitive domain, as well as further assessment of the psychometric properties of these measures before their use in menopause research or clinical settings, particularly those measures initially developed for clinical practice. It also highlights the need for future development of a subjective cognitive measure for women transitioning through menopause to improve the current understanding of their cognitive challenges.
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Affiliation(s)
- Lexi He
- From the Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
| | | | - Emily Kontaris
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Aimee Spector
- From the Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
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Zhu C, Arunogiri S, Thomas EHX, Li Q, Kulkarni J, Gurvich C. The development and evaluation of a fact sheet resource for women managing menopausal-related cognitive complaints. Menopause 2024; 31:987-995. [PMID: 39255423 DOI: 10.1097/gme.0000000000002434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
OBJECTIVES Cognitive symptoms are frequently reported by women during the menopause transition years. The aim of this research was to codesign and evaluate a fact sheet resource to help women understand and manage cognitive symptoms that may occur during menopause. METHODS This study adopted a codesign approach involving women during the menopause transition years as well as professionals to develop and evaluate a fact sheet, with a focus on acceptability and safety. Four phases (discover, define, develop, deliver) were conducted to develop, refine, and evaluate the fact sheet using a mixed-methods approach of focus groups, interviews, and surveys. RESULTS The discover phase identified a need for online educational resources for women in premenopause, perimenopause, and postmenopause to learn about menopause-related topics. The define and develop phases, relying on focus group sessions with perimenopausal and postmenopausal women, revealed common themes related to the experience of cognitive symptoms and a desire for management tips to optimize cognitive functioning. Structured interviews with professionals highlighted a desire for more concrete examples of cognitive symptoms. The results of the deliver phase found strong acceptability for the fact sheet, alongside requests for additional information on menopausal hormone therapy from premenopausal, perimenopausal, and postmenopausal women. CONCLUSIONS The study reported a wide range of cognitive symptoms among women during the menopause transition years. This study showed broad agreement on the fact sheet's acceptability and safety in addressing menopausal cognitive symptoms. Feedback on menopausal hormone therapy and management tips underscores the demand for more research on effective interventions.
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Affiliation(s)
- Chen Zhu
- From the HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Shalini Arunogiri
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Turning Point, Melbourne, Australia
| | - Elizabeth H X Thomas
- From the HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Qi Li
- From the HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Jayashri Kulkarni
- From the HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Caroline Gurvich
- From the HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
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Zhu C, Arunogiri S, Li Q, Thomas EHX, Gurvich C. Cognitive Training During Midlife: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2024:10.1007/s11065-024-09649-z. [PMID: 39235660 DOI: 10.1007/s11065-024-09649-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 08/16/2024] [Indexed: 09/06/2024]
Abstract
Midlife has been suggested to be a crucial time to introduce interventions for improving cognitive functions. The effects of cognitive training (CT) in healthy middle-aged populations and more specifically during the menopausal transition have not been systematically investigated. To investigate the effects of CT on cognition in healthy middle-aged adults and specifically in females during the menopause transition, literature was searched inception to July 2023 and studies were included that examined the effects of CT on a defined cognitive outcome. The improvement on cognitive performance following CT was the main outcome measured as mean difference (from baseline to immediate post) estimates with corresponding 95% confidence intervals (CI) in meta-analysis and was discussed with the support of subgroup analysis based on outcome type (i.e., far or near-transfer) and cluster tabulations. Nineteen articles were included in the qualitative synthesis with a total of 7765 individuals, and eight articles were included in the meta-analyses. CT was categorized into six type clusters: Game-based CT, General CT, Speed of Processing Training, Working Memory Training, Strategy-based CT, and Cognitive Remediation. Cognitive outcome was divided into six clusters: working memory, verbal memory, language, executive function, attention/processing speed, and visual memory. Meta-analysis reported significant improvement in the domain of executive function (0.48, 95% CI 0.08-0.87), verbal memory (0.22, 95% CI 0.11-0.33), and working memory (0.16, 95% CI 0.05-0.26). CT confers benefits on various cognitive domains, suggesting a potential role of CT to promote optimal cognitive functioning in the midlife and specifically in women during the menopause transition.
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Affiliation(s)
- Chen Zhu
- HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Shalini Arunogiri
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Turning Point, Melbourne, Australia
| | - Qi Li
- HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Elizabeth H X Thomas
- HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Caroline Gurvich
- HER Centre Australia, Department of Psychiatry, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
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Zhu C, Thomas N, Arunogiri S, Gurvich C. Systematic review and narrative synthesis of cognition in perimenopause: The role of risk factors and menopausal symptoms. Maturitas 2022; 164:76-86. [DOI: 10.1016/j.maturitas.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 04/14/2022] [Accepted: 06/18/2022] [Indexed: 11/27/2022]
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Abstract
Objective: Recent evidence suggests that early or induced menopause increases the risk for cognitive impairment and dementia. Given the potential for different cognitive outcomes due to menopause types, it is important that present research on menopause and cognition distinguishes between types. The aim of this project was to determine to what extent research looking at cognition in postmenopausal women published in one year, 2016, accounted for menopausal type. Methods: We searched MEDLINE, EMBASE, and PsychINFO using keywords and MeSH terms for menopause and cognition. We included any research paper reporting a cognitive outcome measure in a menopausal human population. Differentiation between the types of menopause was defined by four categories: undifferentiated, demographic differentiation (menopause type reported but not analyzed), partial differentiation (some but not all types analyzed), and full differentiation (menopause types factored into analysis, or recruitment of only one type). Results: Fifty research articles were found and analyzed. Differentiation was distributed as follows: undifferentiated, 38% (19 articles); demographic differentiation, 16% (8); partial differentiation, 28% (14); and full differentiation, 18% (9). Conclusions: This review revealed that although some clinical studies differentiated between the many menopauses, most did not. This may limit their relevance to clinical practice. We found that when menopause types are distinguished, the differing cognitive outcomes of each type are clarified, yielding the strongest evidence, which in turn will be able to inform best clinical practice for treating all women.
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Troyer AK, Leach L, Vandermorris S, Rich JB. The measurement of participant-reported memory across diverse populations and settings: a systematic review and meta-analysis of the Multifactorial Memory Questionnaire. Memory 2019; 27:931-942. [PMID: 31020904 DOI: 10.1080/09658211.2019.1608255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Multifactorial Memory Questionnaire (MMQ) is a participant-reported measure of memory satisfaction, ability, and strategy use. Initially validated with healthy older adults, it has since been used in many different populations and settings for a variety of purposes. We conducted a systematic review and meta-analysis of the measurement properties of the MMQ across multiple, diverse studies. METHODS The study was designed using the Consensus-Based Standards for the Selection of Health Measurement Instruments and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We calculated aggregate statistics and evaluated the methodological quality of 29 studies retrieved from PsycINFO, MEDLINE, EMBASE, and Web of Science. RESULTS Analyses revealed high-quality evidence for internal consistency, stability, measurement error, convergent validity, and known-groups validity of the three MMQ scales. There was moderate-quality evidence for responsiveness and structural validity, with some studies identifying separate factors for internal and external memory strategy use. Measurement properties were similar across languages, participant samples, and study designs. CONCLUSIONS The MMQ is a valid, reliable, and responsive measure across diverse settings and populations. Future research is needed to determine whether more detailed information can be obtained from the scales, specifically, internal versus external strategy use.
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Affiliation(s)
- Angela K Troyer
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada.,b Department of Psychology , University of Toronto , Toronto , Canada
| | - Larry Leach
- c Department of Psychology , Glendon College, York University , Toronto , Canada
| | - Susan Vandermorris
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada
| | - Jill B Rich
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada.,d Department of Psychology , York University , Toronto , Canada
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Jafari M, Seifi B, Heidari M. Risk Assessment: Factors Contributing to Discomfort for Menopausal Women in Workplace. J Menopausal Med 2017; 23:85-90. [PMID: 28951855 PMCID: PMC5606914 DOI: 10.6118/jmm.2017.23.2.85] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 05/26/2017] [Accepted: 06/09/2017] [Indexed: 01/03/2023] Open
Abstract
The purpose of this study was to review the Factors contributing to discomfort for menopausal women in workplace and the perceived effects of working conditions on menopausal symptoms, and to produce recommendations for managers and women. This study was a review article. We searched PubMed and Science Direct for articles related to menopause and workplace. Keywords included: menopause AND workplace OR occupational health or menopausal women AND managers. Because we aimed to update the literature following the 2011 review of menopause and workplace, only English-language articles published between 2011 and 2017 were included. This review showed that how managers could be help and awareness and what should be done for menopausal women in workplace by risk assessment. Many risk factors are contributing to discomfort for menopausal women in workplace and managers should be assessed them. Managers should be aware that menopausal transition causes difficulty for some women at work, then occupational health and safety and health promotion policies will be increasingly important. It may help inform the development of tailored occupational health policies and programs that cater for the needs of women as they transition through menopause in the workplace.
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Affiliation(s)
- Mehdi Jafari
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahar Seifi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health in Emergency and Disaster, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Heidari
- Department of Medical and Surgical, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
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