Identifying and characterizing cognitive profiles in midlife women: a latent profile analysis

INTRODUCTION: Due to sex differences in cognitive aging and dementia burden, there is increased focus on the role of the menopause transition on cognitive functioning across midlife. This study aimed to characterize cognitive profiles among midlife women and to examine the demographic, social, and health factors associated with profile membership. METHOD: = 202; Age 40-60 years) from the Human Connectome Project - Aging completed NIH Toolbox cognitive and emotion measures. Latent profile analysis was used to identify cognitive profiles utilizing nine performance-based measures. Emergent profiles were then characterized in terms of demographic, cardiovascular and metabolic health indicators, and medication use (e.g. hormone therapy). Multinomial regression was then used to determine whether sleep, physical activity, depressive symptoms, and psychological stress varied by cognitive profile. RESULTS: Four distinct cognitive profiles were identified, the most common reflecting strength in verbal learning and memory (43% of women) and the next most common reflecting weaknesses in those same domains (39%). Black race and elevated depressive and anxiety symptoms were associated with the latter profile. A third profile (12%) reflected weakness in executive function (e.g. divided attention, picture vocabulary, working memory, task switching). The fourth (6%) was a mixed group showing strengths in pattern recognition and picture vocabulary but weaknesses in verbal memory and inhibitory control. CONCLUSION: Midlife women show heterogeneity in cognitive performance, with nearly half showing a profile of strength in verbal memory. However, two menopause-relevant profiles emerged that were characterized by subtle weaknesses. One was in the domain of verbal memory and, consistent with earlier work, related to sadness and anxiety. The second was in executive function. Though less common, that vulnerability is notable given reports of attention-deficit hyperactivity disorder (ADHD)-like symptoms at menopause. Longitudinal studies are underway to determine the stability and predictors of cognitive profiles among midlife women.