Longer reproductive span linked with slower rates of cognitive decline

New large-scale study documented a significant association between endogenous estrogen-exposure history and better cognitive function in older women, but a longer duration of hormone therapy did not contribute to positive outcomes

The Menopause Society

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CLEVELAND, Ohio (April 15, 2026)—Cognitive decline not only affects a woman’s quality of life but also her ability to lead an independent lifestyle later in life. A new large-scale study suggests that a longer reproductive lifespan, resulting in greater exposure to endogenous estrogen, is associated with better cognitive health. Results of the study are published online today in Menopause, the journal of The Menopause Society.

Cognitive decline can be considered a preclinical marker of dementia. Women experience faster cognitive decline than men, and it is hypothesized that sex hormones may contribute to this disparity. Reproductive span, defined as the time between age at menarche and age at menopause, represents an important aspect of natural estrogen exposure, although previous studies found inconsistent results between reproductive span and cognition. Studies on the effects of hormone therapy on cognition have also yielded conflicting results.

Given these inconsistencies in prior research regarding reproductive span and timing of hormone therapy initiation on cognitive decline, this new study used more than 30 years of prospectively collected data from more than 14,000 women to evaluate reproductive span, age at menarche, age at menopause, and surgical menopause and their associations with cognition. The results confirmed that a longer reproductive span is associated with better cognitive maintenance. However, hormone therapy use within 10 years of menopause showed no cognitive benefits.

Survey results are published in the article “Prospective study of reproductive span and menopausal hormone therapy and cognitive decline over 8 years in the Nurses’ Health Study.”

“This large observational study showed an association of longer reproductive span with better cognitive trajectories. However, longer duration of hormone therapy use, either within or outside 10 years of menopause, was not associated with better global cognitive performance. Although the results of this well-designed study may still be affected by residual confounding, they support current guidelines that recommend against the use of hormone therapy for prevention of dementia,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

For more information about menopause and healthy aging, visit www.menopause.org.

The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.

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Journal

Menopause

DOI

10.1097/GME.0000000000000002782 

Method of Research

Survey

Subject of Research

People

Article Title

Prospective study of reproductive span and menopausal hormone therapy and cognitive decline over 8 years in the Nurses' Health Study

Article Publication Date

15-Apr-2026

Having more kids associated with reduced risk of stroke and brain damage, research co-led by UT Health San Antonio shows

Number of live births could be an important predictive factor

The University of Texas at San Antonio Health Science Center

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SAN ANTONIO, April 20, 2026 – While some say having lots of kids can make you lose your faculties, a new study suggests otherwise.

Research co-led by UT Health San Antonio, the academic health center of The University of Texas at San Antonio, associates a greater number of live births with a reduced risk of stroke or brain damage for mothers. As more women than men have strokes, the finding is seen as significant in helping determine risk.

The study, titled, “Number of Live Births as a Protective Factor Against Clinical and Covert Brain Infarcts: The Framingham Heart Study,” was published on April 7 in the Journal of the American Heart Association, and on behalf of the association.

“Our findings would suggest that reproductive factors – for example, number of live births – may be an additional factor to consider when assessing stroke risk in women,” said Sudha Seshadri, MD, a behavioral neurologist, professor and founding director of the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio.

She is joint senior author of the study with Emer R. McGrath, PhD, with the School of Medicine at the University of Galway in Ireland. “Inclusion of this risk factor in female-specific clinical prediction rules for stroke may enhance risk prediction in women,” Seshadri said.

Reproductive factors in stroke

The study notes that stroke is a major cause of morbidity and death and disproportionately affects women, who account for 57% of all strokes in the United States.

Reproductive factors – for example, age at first menstrual period, age at menopause, circulating estrogen levels, number of pregnancies and use of hormone replacement therapy – affect overall lifetime exposure to estrogen, and therefore have been implicated as important predictors of future stroke risk in women.

Generally, greater exposure for a longer period or to higher levels of the body’s own estrogen has recently been associated with a lower burden of cerebral small-vessel disease in women. However, evidence for some factors, such as live births, has been conflicting.

For this study, researchers determined the association between number of live births and other female-specific reproductive factors and subsequent risk of stroke and magnetic resonance imaging markers of vascular brain injury in a community-based cohort. That cohort was the Framingham Heart Study, a long-term and ongoing community-based observational study of residents in Framingham, Massachusetts, dating to 1948. Seshadri serves as senior investigator.

Live births and decreased risk

The scientists followed 1,882 women over time, and who were stroke-free at a baseline examination during 1998 to 2001 and at a mean age of 61. They considered reproductive factors including the women’s number of live births given, age at menopause, postmenopausal hormone replacement therapy use, and serum estradiol and estrone levels.

During a median 18-year follow-up, they assessed the same participants for number of strokes from all causes, and secondarily for “covert brain infarcts” – like brain lesions representing vascular damage from restricted or reduced blood blow – and white matter hyperintensity volume, detected by MRI.
 

Over that period, 126 women had strokes. The researchers used statistical analyses known as multivariable Cox proportional hazards models adjusting for major vascular risk factors, and determined that three or more live births were associated with a reduced risk of stroke. Similarly, they found that three or more live births were associated with decreased risk of vascular brain injury.

“This may be an important factor to include in female-specific clinical prediction rules for stroke, but will require further study,” Seshadri said.

The researchers found no significant association between other reproductive factors and stroke or MRI markers of vascular brain injury.

Other authors of the study are with Boston University; Mass General Brigham, Boston; and University of California-Davis.


Number of Live Births as a Protective Factor Against Clinical and Covert Brain Infarcts: The Framingham Heart Study

Senan Maher, Matthew R. Scott, Rachel F. Buckley, Charles S. DeCarli, Hugo J. Aparicio, Jose Rafael Romero, Ramachandran S. Vasan, Joanne M. Murabito, Shalender Bhasin, Alexa S. Beiser, Sudha Seshadri, Emer R. McGrath

Published April 7, 2026, by Journal of the American Heart Association

Link to full study: https://www.ahajournals.org/doi/10.1161/JAHA.125.044037


UT Health San Antonio is the academic health center of The University of Texas at San Antonio (UT San Antonio), offering a comprehensive network of inpatient and outpatient care facilities staffed by medical, dental, nursing and allied health professionals who conduct more than 2.5 million patient visits each year. It is the region’s only academic health center and one of the nation’s leading health sciences institutions, supported by the schools of medicine, nursing, dentistry, health professions, graduate biomedical sciences and public health that are leading change and advancing fields throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

Stay connected with UT Health San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases at UT Health San Antonio is dedicated to providing comprehensive dementia care while advancing treatment through clinical trials and research. The Biggs Institute is a National Institute on Aging (NIA)-designated Alzheimer’s Disease Research Center (ADRC). UT Health San Antonio is the academic health center of The University of Texas at San Antonio (UT San Antonio). In addition to providing patient care and conducting research, the Biggs Institute partners with the School of Nursing at UT San Antonio to offer the Caring for the Caregiver program. 

 

 

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Journal

Journal of the American Heart Association

DOI

10.1161/JAHA.125.0440 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Number of Live Births as a Protective Factor Against Clinical and Covert Brain Infarcts: The Framingham Heart Study

Article Publication Date

17-Apr-2026

 

New BSC study reveals, for the first time, that the female immune system changes much more than that of men with age

As they age, women have a greater tendency to suffer from autoimmune diseases, while in men, changes are more discreet but related to the risk of suffering from certain blood cancers.

Barcelona Supercomputing Center

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image: 

BSC researchers Aida Ripoll-Cladelles (left), Marta Melé (center) and Maria Sopena-Rios (right) in front of MareNostrum 5 supercomputer.

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Credit: Mario Ejarque / BSC-CNS

Barcelona, April 10, 2026 – Statistics show clear differences in the population's immune system according to sex: men are more susceptible to infections and cancers, while women have stronger immune responses, which translate, for example, into better responses to vaccines. Even so, with a more reactive immune system, the probability of the body attacking itself also increases, causing 80% of autoimmune disease development to occur in women.

In this context, understanding the aging of the immune system is key since, with age, the composition of immune cells changes and their protective functions deteriorate, causing a greater susceptibility to diseases. However, understanding how sex influences this profound transformation was not possible until now.

A new study by the Barcelona Supercomputing Center – Centro Nacional de Supercomputación (BSC-CNS) published today in Nature Aging demonstrated, for the first time, that immunological aging follows different dynamics between men and women, identifying the cells and genes responsible for the process, and providing a molecular explanation for the differences that previously were only observed globally in the population.

Thus, the results reveal that women present more pronounced changes in the immune system with age, with an increase in inflammatory immune cells. This finding could help explain why autoimmune diseases are mainly developed by women, especially at advanced ages, as well as the worsening of certain inflammatory pathologies after menopause.

On the other hand, the changes associated with immune system aging observed in men are globally less extensive, but an increase in certain blood cells presenting pre-leukemia alterations was observed, a fact that could explain why some blood cancers are more frequent in older men.

Finding these patterns was possible thanks to the analysis of blood samples from nearly 1,000 people of different ages covering the entire adult life, combined with a technology capable of analyzing each cell individually, called single-cell RNA sequencing. In total, the researchers analyzed the activity of 20,000 genes in more than one million blood cells, which allowed them to identify how the immune system changes over the years and detect clear differences between sexes.

“Until now, most studies analyzed the immune system based on the average of many cells at once, which makes it difficult to capture the progressive effects of aging. With cell-by-cell analysis and a much larger sample, we were able to detect these patterns and compare them robustly between biological sexes,” explained Maria Sopena-Rios, researcher at BSC and first co-author of the study.

To manage, process, and analyze a volume of data of this magnitude, the scientific team required the use of advanced computational methods that had never been applied to such complex data sets, with the MareNostrum 5 supercomputer as a key piece to make possible a study that would not have been viable without high-performance computing infrastructure.

 

Aging with a sex perspective

Although evidence existed that the immune system ages differently according to sex, women have been traditionally underrepresented in studies, the authors comment. This is the first time that large quantities of samples were analyzed with a balance between men and women, a fact that was decisive in obtaining these results.

“Many studies still do not take sex into account in their analyses, or directly only use data from men, so they leave key questions unanswered. Our research was born precisely from this need and combines a scientific outlook with a sex perspective, inclusive data, and great computational power,” highlighted Marta Melé, leader of the Transcriptomics and Functional Genomics group at BSC and director of the study.

With these discoveries, the study establishes the bases for incorporating biological sex as a key variable in precision medicine for aging. The identification of sex-specific aging cells and biomarkers opens the door to the development of preventive, diagnostic, and therapeutic strategies better adapted to women and men, contributing to more individualized and equitable healthcare in an increasingly aging population.

“The immune system plays a fundamental role throughout the organism; therefore, the differences we observed have a very important generalized impact on the entire body. Better understanding the aging of the immune system can help us understand processes that go beyond the blood and affect multiple tissues,” noted Aida Ripoll-Cladellas, researcher at BSC and first co-author of the study.

Treating aging as a homogeneous process in the entire population hides key biological differences, and understanding how it varies between women and men, the authors conclude, will be essential to improve immune health and promote healthy aging within everyone's reach.

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Journal

Nature Aging

DOI

10.1038/s43587-026-01099-x 

Method of Research

Data/statistical analysis

Subject of Research

Cells

Article Title

Single-cell analysis of the human immune system reveals sex-specific dynamics of immunosenescence

Article Publication Date

10-Apr-2026

From Recent Spillovers To ‘Biology’ Of War And Its Consequences: The Bio-Geopolitical Conundrum Of China, Russia, And Middle East Crisis (Part III) – Analysis

March 31, 2026 

By Jumel Gabilan Estrañero


A conflict that is not resolved in small scale will be a full-blown asymmetric disaster and in time, a warfare that will be exploited by different actors (state and non-state). In just a span of one month, short-term increases in oil income linked to the Iran conflict have eased fiscal pressures, but ongoing inflation, higher import expenses, and deep structural issues still weaken Russia’s economic outlook. Across the country, failing infrastructure and recurring heating disruptions are fueling public frustration. At the same time, tighter digital restrictions are sparking localized protests and increasing social strain.

Case in point in Russia, with legislative elections approaching, it is adjusting expectations for voter turnout and revising its political approach, signaling concern over participation levels and overall regime stability. What complicated more is the detention of former Deputy Defense Minister Ruslan Tsalikov highlighting the widening divisions within Russia’s elite, revealing growing insecurity even among senior leadership. At the backdrop of this, although Russia may gain from periods of global instability, mounting economic pressures, governance issues, and internal elite conflicts could drive meaningful systemic change in the near term.

On the other hand, the US is contending this week that the war will end in two to four weeks, we must look at the end of the tunnel; or at least the middle of the tunnel how the war has already affected the biology of life in the ground. The Middle East is one of the most biologically stressed regions on Earth.

When it comes to biological stress as a driver of conflict, water scarcity, desertification, and population pressures are not just environmental issues, they are geopolitical triggers. Water scarcity affects major river systems like the Tigris River and Euphrates River, creating tensions among Turkey, Syria, and Iraq. Its direct effect is declining agricultural productivity leads to food insecurity, which historically contributed to unrest (e.g., pre-conflict rural collapse in Syria). Its biological takeaway stems out from resource scarcity rooted in ecology translates directly into political instability and conflict escalation.

Next, the vacuum of strategic power and climate science. Climate science plays a central role in reshaping regional alliances and vulnerabilities. One of which is the rising temperatures and droughts intensify migration flows across Middle East and into Europe followed by countries with advanced desalination and agricultural biotech—like Israel—gain strategic resilience and influence. And of course, climate stress amplifies dependence on external powers for food and water security. So how this scientifically implicates? Technological adaptation to biological limits becomes a new axis of geopolitical power.


Further, we have the third risk – the biosecurity and warfare. Modern conflict increasingly includes biological dimensions such as risks of disease outbreaks in war zones (e.g., cholera, COVID-like disruptions) destabilize already fragile states like Yemen; weak healthcare systems increase vulnerability to pandemics, making biology a national security issue; and concerns over biological weapons, while regulated under the Biological Weapons Convention, remain part of strategic calculations. Note that in the bio-security parlance, biology is no longer just health, it is embedded in military and national defense frameworks.

Meanwhile, there will always be an intersection of leverage among energy, science, and economy. The Middle East crisis intersects with global energy systems, where science and biology indirectly shape outcomes. Fossil fuels (biological in origin) remain central to economies in Iran and Saudi Arabia. Conflict disruptions affect global oil prices, benefiting actors like Russia as reflected in your key takeaway on temporary revenue gains. Scientific advances in renewable energy threaten long-term fossil fuel dominance, reshaping geopolitical influence. In other words, the control over biologically-derived energy resources remains a core geopolitical lever—but is increasingly challenged by scientific innovation.


What about the demographic implication of war? The human biology is centrally affected by the protracted wars across the region of Middle East. Population dynamics rooted in biology are central to ‘political outcomes’. This connoted that youth-heavy populations in countries like Iraq and Egypt create pressure for jobs, governance reform, and stability. There is urban overcrowding and health stress increase susceptibility to unrest and migration patterns reshape regional and global political landscapes. Now, human biology progression can also be paralyzed (population growth reproduction, age structure, assisted health and medical / surgical technology if disrupted) directly influences state regime stability, conflict risk , and health risk of the affected populace that may also look into migration in a safer space nation (Switzerland, New Zealand, and other extremely peaceful state), as expressed by Dr. Krista Marie

 I. Pacifico[1], MD, FPOGS, FPSRM.

In the context of Russia and the war-torn area where spillover is prominent, our observations about Russia connect strongly to this biological-scientific framework. We have to take note that oil revenue gains is tied to ‘biologically derived fossil fuels and Middle East instability’. To simply put: Inflation & import costs → exacerbated by climate-driven supply chain disruptions (food, energy)
Infrastructure failures → worsened by environmental stress (extreme cold, resource strain)
Political anxiety & elite fractures → intensified by economic volatility rooted in global scientific/biological systems

This shows a critical point in assessing the effects across biospheres of politics and life sciences while the war is still not contained; far from over at this point. Middle East crises are not regionally contained, they trigger systemic effects across global biological, economic, and political networks. Biology and science are not peripheral; they are foundational to modern geopolitics in the Middle East but in what sense?
Biology (water, food, population) → drives internal instability
Science (climate tech, energy, healthcare) → determines resilience and power
Conflict feedback loops → amplify global economic and political consequences

The Middle East crisis should be understood as a bio-geopolitical system, where ecological limits, scientific capability, and political power interact. States that can manage biological stress through scientific innovation will shape the next phase of regional and global order while those that cannot risk collapse or prolonged instability. Meanwhile, strategies are moving from wide-array of spheres while the world is busy looking at the Middle East.

In fact, China and Russia adopt fundamentally different strategies in some regions like in Africa (power institutionalization) and ASEAN (oil allocation); reflecting contrasting views on how power should be projected. China focuses on embedding its influence through institutions, emphasizing stability, governance partnerships, infrastructure expansion, professional military engagement, and long-term information investments that outlast leadership changes or short-term crises. In contrast, Russia prioritizes immediate outcomes over system-building, relying on regime support, security services, political disruption, and information campaigns to secure rapid influence, though often without creating lasting institutional ties.

These divergent approaches reveal two competing geopolitical models. China’s strategy is structural and future-oriented, aiming to reshape political and economic ecosystems in ways that ensure enduring alignment. Its investments in infrastructure and governance capacity are designed to anchor influence within the state itself, making it more resilient over time. Russia’s approach, however, is tactical and opportunistic, thriving in unstable environments where quick intervention often through security or political means can yield immediate strategic gains without requiring deep institutional integration.

The implications are significant. States with relatively stable governance structures are more likely to align with China’s long-term development model, while politically fragile states may gravitate toward Russia’s security-driven engagements. This creates a dual-track geopolitical landscape across the continent, where influence is divided not just by geography, but by levels of internal stability.

Ultimately, the competition between China and Russia in power bio-genesis reflects a broader global contest between institutional power and transactional influence. The durability of China’s model versus the immediacy of Russia’s approach will shape not only one region’s political trajectory (i.e. Baltic, Balkan, East Asia, and Southeast Asia) but also the evolving architecture of global power in the coming decades.

*Ideas and/or views expressed here are entirely independent and not in any form represent author’s organization and affiliation.

Endnotes:Filipino physician working in the Department of Obstetrics and Gynecology of various hospitals (St. Luke’s, VMC-DOH, JC Delgado MH, etc.). She specializes in OB-GYN Reproductive Endocrinology and Infertility which focuses on endocrine and reproductive health disorders such as polycystic ovary syndrome (PCOS), menopause, endometriosis, adenomyosis, In-Vitro Fertilization (IVF), social egg freezing, and other sexual problems. The subspecialty also focuses on diagnosing and treating infertility and providing options for fertility preservation.



Jumel Gabilan Estrañero

Jumel Gabilan Estrañero is a defense, security, & political analyst and a university lecturer in the Philippines. He has completed the Executive Course in National Security at the National Defense College of the Philippines and has participated in NADI Track II discussions in Singapore (an ASEAN-led security forum on terrorism). His articles have appeared in Global Security Review, Geopolitical Monitor, Global Village Space, Philippine Daily Inquirer, Philippine Star, Manila Times, Malaya Business Insights, Asia Maritime Review, The Nation (Thailand), Southeast Asian Times, and Global Politics and Social Science Research Network. He worked in the Armed Forces of the Philippines, Office of Civil Defense, National Security Council-Office of the President, and currently in the Department of the National Defense. He is currently teaching lectures in De La Salle University Philippines while in the government and formerly taught at Lyceum of the Philippines as part-time lecturer. He is the co-author of the books titled: Disruptive Innovations, Transnational Organized Crime and Terrorism: A Philippine Terrorism Handbook, and Global Security Studies Journal (Springer Link, United States). He is an alumnus of ASEAN Law Academy Advanced Program in Center for International Law, National University Singapore and Geneva Centre for Security Policy, Switzerland. He is also a Juris Doctor student.

#MeToo and the French farming sector

FRANCE24
27/03/2026 
12:24 min

In this edition, we meet French farmer Laura Chalendard, who reported a sexual assault in 2023 and when no charges followed, launched a #MeToo movement in the agricultural sector to empower women to speak out against sexual violence. Also how perimenopause and menopause in female employees are worsening Germany's labour shortage and prompting a number of companies to confront what has long been one of the last workplace taboos. Plus how a team of elderly women in eastern Uganda use cricket to ease stress and field loneliness while staying on the front foot against health challenges.

BY:

Annette Young

Stéphanie CHEVAL

Jennifer BEN BRAHIM

Sonia BARITELLO

 

Loneliness and social isolation can take a toll on women's cognitive abilities

New study highlights the importance of psychosocial factors in cognitive health, especially during the menopause transition

The Menopause Society

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CLEVELAND, Ohio (March 11, 2026)—The relationship between social connections and cognitive abilities is a complex one, particularly during the perimenopausal period when women transition from the reproductive period to menopause. A new study suggests that loneliness and social isolation are not only independently associated with subjective cognitive decline during perimenopause but also exhibit a joint relationship. Results of the study are published online today in Menopause, the journal of The Menopause Society.

Perimenopause, which typically occurs between the ages of 45 and 55 years, is a time of numerous changes because of a gradual ovarian decline and fluctuating estrogen levels. Common physical symptoms include hot flashes and sleep disturbances. Significant emotional and cognitive changes also occur, affecting a woman’s memory, attention, and processing speed.

Identifying women at high risk for subjective cognitive decline is of great public health significance for the early implementation of interventions to mitigate cognitive deterioration. In a new study involving more than 900 perimenopausal women, researchers sought to clarify the independent and joint associations of loneliness and social isolation with subjective cognitive decline in perimenopausal women. They defined loneliness as a subjective social experience reflecting a person’s dissatisfaction with existing social relationships and the perceived lack of emotional connection, while they described social isolation as an objective state characterized by a limited social network, infrequent social interactions, and reduced social participation.

Previous studies have demonstrated that both loneliness and social isolation are significant risk factors for a range of adverse health outcomes, including cognitive decline, cardiovascular disease, and all-cause mortality, but their roles in perimenopausal women were not clear. Perimenopausal women already face a number of additional stressors on top of fluctuating hormone levels, including major life changes, such as children moving off to college, increased caretaker roles for aging parents, and possibly, changing occupational roles.

This new study specifically aimed to identify high-risk groups of subjective cognitive decline in perimenopausal women based on latent class analysis and further investigate the independent and joint associations of loneliness and social isolation with subjective cognitive decline. Doing so would promote healthy aging through early identification and intervention of cognitive deterioration.

Study results are published in the article “Independent and joint associations of loneliness and social isolation with subjective cognitive decline in perimenopausal women.”

“The findings of this study highlight the importance of psychosocial factors in cognitive health during the menopause transition and may inform the development of multidimensional psychosocial interventions targeting persons at risk for subjective cognitive decline during this time,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

For more information about menopause and healthy aging, visit www.menopause.org.

The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.

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Journal

Menopause

DOI

10.1097/GME.0000000000000002763 

Method of Research

Survey

Article Title

Independent and joint associations of loneliness and social isolation with subjective cognitive decline in perimenopausal women

Article Publication Date

11-Mar-2026