Review synthesizes observational data linking earlier menopause to accelerated aging and dementia risk in postmenopausal women.

This narrative review synthesizes findings from two large observational cohorts: the UK Biobank, which included 15,012 participants, and the Women's Health Initiative Long Life Study, which included 1,210 participants. The scope focuses on how earlier menopause correlates with biological aging markers in postmenopausal women. The authors note that this association was robustly replicated in the Women's Health Initiative Long Life Study.

Key synthesized findings indicate that earlier menopause is associated with the upregulation of pro-inflammatory and extracellular matrix degradation pathways. Furthermore, the data suggest accelerated aging of organs and cells. Elevated GDF15 was identified as the top protein correlate of earlier menopause. Concordant associations were observed between earlier menopause and incident dementia risk, brain atrophy, cerebral small vessel disease burden, and reduced white matter microstructural integrity.

The authors highlight that these results provide a framework to inform interventions aimed at reducing dementia risk. However, because the source is an observational study, the authors explicitly caution against inferring causation. The review does not report specific adverse events, tolerability, or discontinuation rates. Practice relevance is framed around using these biological markers to understand risk rather than establishing direct clinical outcomes.