Polycystic Ovary Syndrome Linked to Cognitive Decline in Midlife

Polycystic ovary syndrome (PCOS) is a condition that affects up to 10% of women. A new study published in the journal Neurology from the American Academy of Neurology has identified a link between the hormonal disorder and issues with memory in midlife.

PCOS and brain health

“Polycystic ovary syndrome is a common reproductive disorder,” said study lead author Dr. Heather G. Huddleston, MD, from the University of California, San Francisco. It is characterized by irregular menstruation patterns and heightened levels of the steroid hormone androgen. PCOS symptoms also include excess hair growth, acne, infertility and compromised metabolic health.

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“While it [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,” said Huddleston.

Previous research has highlighted links between PCOS and a decrease in specific areas of cognitive function, however these studies used small samples and focused on younger populations.

Reduction in memory and processing speeds

The study followed 907 female participants – who were between the age of 18-30 years old at the start of the study – for 30 years. The participants, including 66 individuals with PCOS, took part in several tests to measure their memory, verbal abilities, processing speed and attention.

For one activity, measuring attention ability, participants were asked to look at a list of words in different colors and recall the color of the ink, rather than read the word written on the card. Those with PCOS scored 11% lower on average compared to those without the condition.

Huddleston and team also found participants with PCOS scored lower on three out of five of the tests, specifically in those assessing memory, attention and verbal abilities – even after adjusting for age, race and education.

A smaller subsection of the participants also received brain scans at years 25 and 30 of the study. Out of the 291 participants selected, 25 had PCOS. When assessing white matter pathways in the brain, the researchers identified participants with PCOS had decreased white matter integrity, indicating early evidence of brain aging.

Reducing the risk of cognitive decline

Identifying the link between PCOS and memory and thinking problems in middle age could allow for early interventions to prevent cognitive decline in those with the condition.

 “Our work suggests that appropriate management of these aspects may serve to improve brain aging for this population,” the authors wrote:

“Making changes like incorporating more cardiovascular exercise and improving mental health,” said Huddleston, which could reduce the risk of memory and thinking problems. “Additional research is needed to confirm these findings and to determine how this change occurs,” Huddleston concluded.

A drawback of the research is that participants with PCOS were not diagnosed by a doctor; instead, the researchers relied on clinical androgen levels and self-reported symptoms.

Reference: Huddleston HG, Jaswa EG, Casaletto KB, et al. Associations of polycystic ovary syndrome with indicators of brain health at midlife in the cardia cohort. Neurology. 2024. doi: 10.1212/WNL.0000000000208104

This article is a rework of a press release issued by The American Academy of Neurology. Material has been edited for length and content.