A new clinical definition that recognises brain fog as a menopausal symptom and distinguishes it from other conditions like dementia has been proposed by Australian researchers.
The neuroscientists from Monash University, the University of Melbourne and University College London are also calling for clinical studies to understand the causes of brain fog in menopause and find effective treatments.
Brain fog encompasses a variety of symptoms including forgetfulness and difficulties with attention or concentration.
Clinicians don’t know exactly why it presents in women experiencing menopause and there are no specific treatments for it.
But the hormonal changes associated with menopause, as well as other menopause symptoms, are likely to be key contributors.
Subjective self-reported measure
In a new study published in The Lancet Obstetrics, Gynaecology, & Women’s Health, the researchers propose a new clinical definition that includes self-reported cognitive impairment that can be debilitating and impact quality of life but acknowledges the absence of a notable objective cognitive decline.
A clear definition is a good starting point, because it paves the way for it to be considered a primary symptom and for subjective measures of impairment to be used in clinical studies, said clinical neuropsychologist and lead researcher from Monash’s HER Centre Associate Professor Caroline Gurvich.
“The key symptom of brain fog is a subjective experience, so having a definition that acknowledges the key cognitive symptom is critical.”
There was significant pressure in clinical trials to rely on objective measures of cognitive decline, such as memory tests, he said.
“This is not without precedent – we already use subjective or self-report measures for depression, anxiety and other mental health conditions with great success.”
The proposed definition would also validate women’s individual experiences while empowering them through the reassurance that any objective decline in their cognitive ability is subtle.
“This is a decrease in cognitive or learning efficiency, not functionality or capacity,” said Associate Professor Gurvich.
“For many women, the perception they are losing capacity is what drives them to stop work or lose the confidence to live fulfilling lives during and after menopause.
“I hear all the time from women who have gone through menopause that validation would have made a significant difference to their resilience and the approach they took to living with menopause.”
The study fills much-needed gaps in understanding of brain fog, said Professor Martha Hickey, from the University of Melbourne and Royal Women’s Hospital.
“Our analysis of the best available research shows that many women experience some degree of cognitive symptoms, such as brain fog, during the menopause transition,” she said.
“But there’s a lack of long-term data, which means that there’s a gap in our knowledge about how the brain fog symptom develops and changes from peri-menopause to after menopause ends.”
Read the research paper here
