Severe obesity and menopause symptoms are associated with cognitive impairment in postmenopausal women from Latin America

Objective This study aimed to evaluate the association between obesity and cognitive impairment.Methods This study is a sub-analysis of an observational, cross-sectional study in nine Latin American counties. Sociodemographic, clinical and anthropometric data were collected, and cognition was assessed using the Montreal Cognitive Assessment (MoCA) tool in 722 postmenopausal women.Results The mean age, body mass index (BMI) and years of education of the cohort were 56.9 years, 26.8 kg/m2 and 13.6 years, respectively. Women with cognitive impairment, compared to those without, had a higher BMI (27.8 ± 5.9 vs. 26.6 ± 4.9 kg/m2, p = 0.037), had more children (3.1 ± 2.4 vs. 2.5 ± 1.7, p = 0.023), experienced more severe menopausal symptoms (56.3% vs. 31.9%, p < 0.001) and presented more comorbidities (60.0% vs. 43.8%, p = 0.006). They also had fewer years of study (10.8 ± 5.1 vs. 13.9 ± 4.9 years, p = 0.001), were less physically active (35.0% vs. 49.1%, p = 0.018) and were less likely to use menopausal hormone therapy (MHT) (11.3% vs. 28.8%, p = 0.001). In binary logistic regression analysis, BMI ≥ 35.0 kg/m2 (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.08–4.76) and severe menopausal symptoms (OR 2.10, 95% CI 1.29–3.43) were associated with cognitive impairment. In the model, factors related to lower risk were ever use of MHT (OR 0.44, 95% CI 0.21–0.92) and having more years of education (OR 0.38, 95% CI 0.20–0.64).Conclusion Severe obesity and severe menopausal symptoms increased the risk of cognitive impairment in postmenopausal women, while higher education and ever use of MHT were protective factors.