Polycystic ovary syndrome (PCOS) is a common reproductive disorder that affects up to 10% of women. It is characterized by irregular menstruation and elevated levels of a hormone called androgen. Other symptoms may include excess hair growth, acne, infertility and poor metabolic health. PCOS has been linked to metabolic diseases like obesity and diabetes that can lead to heart problems, but less is known about how this condition affects brain health.
A new study, published in the journal Neurology, suggests that women with PCOS may be more likely to have memory and thinking problems in middle age, as well as subtle brain changes that could indicate early brain aging. The study followed 907 women for 30 years, from age 18 to 30 at the start of the study to their late 40s or older at the end of the study. The researchers compared the cognitive test results and brain scans of 66 women who likely had PCOS based on their reported symptoms or hormone levels, to those of women without PCOS.
Memory and Attention Deficits
The study found that women with PCOS scored lower on three of the five cognitive tests administered, specifically in areas of memory, attention and verbal abilities, compared to those without PCOS. For example, in an attention test, participants were shown a list of words in various colors and asked to identify the color of the ink rather than reading the word itself. For this test, women with PCOS had an average score that was about 11% lower than women without PCOS.
The researchers also found that women with PCOS had lower scores on tests that measured their ability to recall 15 unrelated words or to name as many animals as possible in one minute. These tests are commonly used to assess memory function and verbal fluency.
Brain Changes
The study also used magnetic resonance imaging (MRI) to examine the brain structure of the participants. The researchers focused on the white matter of the brain, which consists of nerve fibers that connect different regions of the brain and enable communication between them. White matter integrity is important for cognitive performance and declines with age.
The study found that women with PCOS had lower white matter integrity in several regions of the brain, compared to women without PCOS. These regions included the corpus callosum, which connects the left and right hemispheres of the brain; the cingulum bundle, which is involved in emotion regulation and memory; and the superior longitudinal fasciculus, which is involved in language processing and attention.
The researchers noted that these brain changes could be a sign of early brain aging in women with PCOS, and could potentially increase their risk of developing dementia or Alzheimer’s disease later in life.
Implications and Recommendations
The study did not prove that PCOS causes cognitive decline or brain changes, but rather found consistent associations between them. The researchers also acknowledged some limitations of the study, such as the lack of a confirmed diagnosis of PCOS for the women in the PCOS group, and the possibility of other factors influencing the results, such as medication use, lifestyle habits or genetic factors.
However, the study highlights the need for more research on how PCOS affects brain health, as well as the potential benefits of early diagnosis and treatment of PCOS for preventing or delaying cognitive impairment and dementia. The researchers also suggested that women with PCOS may benefit from making lifestyle changes that can improve their metabolic health and cardiovascular health, such as exercising regularly, eating a balanced diet, managing stress and getting enough sleep.
“Making changes like incorporating more cardiovascular exercise and improving mental health may serve to also improve brain aging for this population,” said Heather G. Huddleston, MD, of the University of California, San Francisco, and lead author of the study.