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. 2023 Jul;130(8):968-977.
doi: 10.1111/1471-0528.17415. Epub 2023 Feb 19.

Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study

Lara Terra  1 , Philippe R Lee Meeuw Kjoe  1 , Joost A Agelink van Rentergem  1 , Maarten J Beekman  1 , Bernadette A M Heemskerk-Gerritsen  2 , Marc van Beurden  3 , Jeanine E Roeters van Lennep  4 , Helena C van Doorn  5 , Joanna A de Hullu  6 , Marian J E Mourits  7 , Eleonora B L van Dorst  8 , Constantijne H Mom  9 , Brigitte F M Slangen  10   11 , Katja N Gaarenstroom  12 , Lizet E van der Kolk  13 , J Margriet Collée  14 , Marijke R Wevers  15 , Margreet G E M Ausems  16 , Klaartje van Engelen  17 , Irma van de Beek  18 , Lieke P V Berger  19 , Christi J van Asperen  20 , Encarna B Gomez Garcia  21 , Angela H E M Maas  22 , Maartje J Hooning  2 , Elsken van der Wall  23 , Flora E van Leeuwen  1 , Sanne B Schagen  1
Affiliations

Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study

Lara Terra et al. BJOG. 2023 Jul.

Abstract

Objective: To examine the effect of a premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer on objective and subjective cognition at least 10 years after RRSO.

Design: A cross-sectional study with prospective follow-up, nested in a nationwide cohort.

Setting: Multicentre in the Netherlands.

Population or sample: 641 women (66% BRCA1/2 pathogenic variant carriers) who underwent either a premenopausal RRSO ≤ age 45 (n = 436) or a postmenopausal RRSO ≥ age 54 (n = 205). All participants were older than 55 years at recruitment.

Methods: Participants completed an online cognitive test battery and a questionnaire on subjective cognition. We used multivariable regression analyses, adjusting for age, education, breast cancer, hormone replacement therapy, cardiovascular risk factors and depression.

Main outcome measures: The influence of RRSO on objective and subjective cognition of women with a premenopausal RRSO compared with women with a postmenopausal RRSO.

Results: After adjustment, women with a premenopausal RRSO (mean time since RRSO 18.2 years) performed similarly on objective cognitive tests compared with women with a postmenopausal RRSO (mean time since RRSO 11.9 years). However, they more frequently reported problems with reasoning (odds ratio [OR] 1.8, 95% confidence interval [95% CI] 1.1-3.1) and multitasking (OR 1.9, 95% CI 1.1-3.4) than women with a postmenopausal RRSO. This difference between groups disappeared in an analysis restricted to women of comparable ages (60-70 years).

Conclusions: Reassuringly, approximately 18 years after RRSO, we found no association between premenopausal RRSO and objective cognition.

Keywords: BRCA1/2 pathogenic variant carriers; cognitive functioning; premature menopause; risk-reducing salpingo-oophorectomy.

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References

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