Author ORCID Identifier

https://orcid.org/0000-0001-7509-2761

Date of Award

8-2025

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Vonetta M. Dotson

Second Advisor

Sarah J. Barber

Third Advisor

Sierra E. Carter

Fourth Advisor

Whitney Wharton

Abstract

The menopausal transition is known to bring considerable changes to the physical and mental health of many women. The hormonal cascade during menopause is associated with cognitive and mood disturbances and can amplify preexisting vulnerabilities for cognitive decline. However, there is variability in the literature about the extent to which menopause is linked to cognition in women. Biopsychosocial factors related to the menopausal transition and cognitive decline may account for this variability. Additionally, racial disparities in the experience of menopausal and its related symptoms, many of which impact cognitive health, suggest the relationships among biopsychosocial factors, menopausal status, and cognition may differ for women from different ethnoracial backgrounds; however, there is a dearth of research about these relationships in diverse samples. Using a multiple-group structural equation modeling approach, the present study investigated how changes in biopsychosocial functioning that are prominent for women in midlife interact with menopausal status to influence cognitive performance in a sample of 1,221 women. Additionally, this study examined differences in the relationships among biopsychosocial factors, menopausal status, and cognition between Black and White women. Results revealed that menopausal status was related to cognition, but the effect was no longer significant when models accounted for demographic variables including age. Higher depressive symptoms and worse sexual functioning were significantly associated with worse cognition, but these factors did not significantly interact with menopausal status. For premenopausal women, greater vascular burden was associated with better cognition, with an effect in the opposite direction for early perimenopausal women. Furthermore, for Black postmenopausal women, greater vascular burden was associated with better cognition. This contrasts with a significantly negative relationship between vascular health and cognition for Black early perimenopausal women and White women in the early peri- and postmenopausal groups. Overall, biopsychosocial factors tended to have stronger relationships with cognition for Black women. Future studies should more rigorously study these relationships with objective measures, more comprehensive cognitive testing, and in more diverse populations over time.

DOI

https://doi.org/10.57709/37452992

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