Doctor Explains '10-Year Rule' to Differentiate Menopause Brain Fog from Dementia
A UCLA neurology professor suggests women compare current cognitive function to their state a decade prior to assess memory lapses.
Women experiencing memory lapses and difficulty concentrating may not be showing early signs of Alzheimer's disease or dementia, but rather hormonal shifts associated with perimenopause and menopause, according to Dr. Rhonda Voskuhl, a neurology professor at UCLA.
Voskuhl, who also co-founded Cleopatra RX in Los Angeles, suggests that women experiencing these cognitive changes in midlife should compare their current mental state to their performance 10 years prior. This approach, referred to as the Voskuhl Brain Fog Menopause Assessment, is used at UCLA's Comprehensive Menopausal Program.
"The first question is, are you worse than you were 10 years ago?" Voskuhl stated, encouraging women to reflect on their cognitive abilities from a decade earlier. This self-assessment can help determine if cognitive changes are linked to menopause by establishing a baseline for tracking symptoms over time.
Standard memory tests may not always detect subtle shifts in everyday cognitive function, a phenomenon known as subjective cognitive decline. The Centers for Disease Control and Prevention reports that approximately one in nine adults experience subjective cognitive decline, yet less than half discuss these concerns with a healthcare professional.
Voskuhl likened the challenge of identifying menopausal brain fog to that of a professional athlete. If a high-performing athlete notes a decrease in strength, their subjective experience is significant even if standard physical tests do not reveal an obvious decline. Similarly, women can often recognize when their cognitive abilities have changed from their own personal baseline.
Menopausal brain fog typically manifests as temporary and inconsistent lapses, such as misplacing items or experiencing slower processing speeds, while maintaining overall reasoning skills and independence. These symptoms can fluctuate and may be exacerbated by stress or poor sleep. In contrast, early dementia is characterized by persistent and progressive memory loss that interferes with fundamental daily tasks, including managing finances or navigating familiar routes.
Experts recommend a thorough medical evaluation for cognitive concerns, which may include brain MRIs or vascular screenings to rule out underlying conditions like blood vessel disease or thyroid imbalances. Voskuhl also advised that women whose concerns are dismissed by their doctors should seek a second opinion from another physician.