Key result
Post-menopausal status is linked to lower MoCA scores and increased parasympathetic HRV versus reproductive-age women.
Why the study?
The interplay between cognitive function and autonomic regulation remains underexplored in Indian women undergoing menopausal transition.
Does post-menopausal status affect cognitive performance and heart rate variability compared to reproductive-age women?
Does post-menopausal status affect cognitive performance and heart rate variability compared to reproductive-age women?
Post-menopausal women exhibit lower cognitive scores but preserved or enhanced parasympathetic modulation compared to reproductive-age women, suggesting HRV may serve as a biomarker for cognitive health during aging.
Post-menopausal cognitive deficits associate with higher parasympathetic HRV; cross-sectional data leave open causal links and biomarker utility.
Background: The menopausal transition is associated with hormonal, cognitive, and autonomic changes, yet the interplay between cognitive function and autonomic regulation—measured via heart rate variability (HRV) remains underexplored in Indian women. Aims: The study aimed to compare cognitive performance and HRV parameters between reproductive-age and post-menopausal women, and to assess the relationship between cognitive domains and HRV indices. Methods: A cross-sectional study was conducted at a tertiary care center of Northern India, enrolling 240 healthy women (120 reproductive-age, 20–40 years; 120 post-menopausal, 45–60 years). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while HRV was evaluated via 5-min resting ECG. Time-domain [standard deviation of NN interval (SDNN), root mean square of successive differences (RMSSD), proportion of NN50 (pNN50), mean RR] and frequency-domain [low-frequency (LF) and high-frequency (HF), LF/HF ratio] HRV metrics were analyzed. Results: Post-menopausal women showed significantly lower MoCA scores than reproductive-age women (22.35 ± 3.17 vs. 25.54 ± 2.34, P < 0.001), with pronounced deficits in executive function, memory, and abstraction. Interestingly, the language domain score was significantly higher in the post-menopausal group. HRV analysis revealed significantly longer RR intervals and higher parasympathetic indices (RMSSD, pNN50, HF power) in post-menopausal women, while LF-power was lower; however, LF/HF ratio remained unchanged between groups ( P = 0.96). Positive correlations were observed between MoCA scores and SDNN, mean RR; LF/HF ratio correlated negatively with cognitive scores in both groups. Conclusion: Post-menopausal women exhibited cognitive deficits—particularly in executive and memory domains—alongside distinct alterations in autonomic function. Contrary to expectations, HRV parameters indicated preserved or enhanced parasympathetic modulation in the older group. These findings underscore the relevance of autonomic-cognitive coupling in aging women and support HRV can be a potential biomarker of cognitive health.
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Haldar et al. (2026) studied this question. Post-menopausal women had lower MoCA scores (22.35 vs 25.54, P<0.001) with cognitive deficits and showed increased parasympathetic HRV indices compared to reproductive-age women.
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