Adverse childhood experiences interact with inflammation and menopause transition stage to predict verbal memory in women

Objective Women with more adverse childhood experiences (ACEs) may face a triple threat of risk factors for cognitive concerns during the menopause transition: reduced estradiol, increased inflammation, and early life stress sequelae. Our objective was to determine the extent to which ACEs and peripheral basal inflammatory markers associate with verbal memory across the menopause transition. Methods Penn Ovarian Aging cohort participants (n ​= ​167) were assessed for ACEs (low (0–1) or high (≥2)) and had remaining stored blood samples at study end assayed for interleukin (IL)-6, IL-1-beta (IL-1β), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α). Annual assessment included a verbal memory test (the Buschke Selective Reminding Test) and menopause stage determination. To estimate the effects of menopause stage, ACEs, and cytokines on verbal memory, repeated cognitive outcome measures were modeled in generalized estimating equations. Covariates included body mass index, smoking, race, education, age at baseline, and baseline verbal memory performance. Cytokine levels were log-transformed. Results Advancing menopause stage was associated with worse performance on immediate verbal recall and delayed verbal recall (ps ​
Highlights • Controlling for age, advancing menopause stage was associated with decrements in verbal memory. • In perimenopause, high TNF-α was associated with decreased verbal memory in high ACE women. • Inflammation may be a mechanism by which menopausal high ACE women are prone to cognitive deficits.