Key Takeaways & Executive Findings
- ā¢ā¢ Annual publications on postmenopausal cognitive impairment have shown a fluctuating upward trend over the past two decades, indicating growing research interest. ā¢ The United States leads in research output, with top institutions including Stanford University, University of Pittsburgh, Harvard Medical School, and University of Illinois. ā¢ Hormonal interventions, particularly estrogen therapy and its long-term safety, remain the central focus, as evidenced by high-frequency and burst keywords. ā¢ Research themes have expanded from single topics like MRI and hormones to broader health issues (psychological, tumor risk, cardiovascular, metabolic, physical activity), with a shift toward non-hormonal intervention strategies.
Abstract
BACKGROUND: At present, there are few longitudinal studies on postmenopausal cognitive impairment, and there is no systematic bibliometric analysis of its development context and hot trends. OBJECTIVE: To systematically integrate the related research on postmenopausal cognitive impairment with the help of bibliometric tools, identify the research trends and hot trends in this field, and promote interdisciplinary cooperation and clinical transformation. METHODS: The Web of Science Core Collection database was retrieved for literature related to postmenopausal cognitive impairment published from January 1, 2005 to March 24, 2025. Visualization analysis was conducted using software such as VOSviewer, the R package āBibliometrix,ā and CiteSpace. RESULTS AND CONCLUSION: A total of 1 452 articles were included, involving 71 countries, 1 830 institutions, 510 journals, and 6 909 authors. The annual publication volume showed a fluctuating upward trend. The United States dominated the field, with Stanford University, University of Pittsburgh, Harvard Medical School, and University of Illinois leading. Menopause-The Journal of the North American Menopause Society published the most articles (78), and JAMA-J Am Med Assoc had the highest co-citation count (3 791). Espeland, Mark A. ranked first with 55 publications, and Shumaker, Sally A. was the most co-cited author (859 times). High-frequency keyword āestrogenā (211 times) and burst keywords āplus progestinā (strength=15.77) and āestrogen replacement therapyā (strength=15.57) indicated that the long-term effects and safety of hormonal interventions remained the core research focus. Keyword clustering revealed four research directions. Future research could focus on constructing a ācross-life cycle-multidimensionalā framework, which would help comprehensively understand the mechanisms of hormones on cognitive function and neuropsychiatric status at different life stages. The shift in hot topics from single issues (e.g., magnetic resonance imaging, hormones and cognition) to multiple health issues (psychological, tumor risk, cardiovascular, metabolic diseases, physical activity, etc.) and the non-hormonal turn in intervention strategies reflected the development trend of the discipline.
1. Introduction
Postmenopausal cognitive impairment refers to cognitive decline in women after natural or surgical menopause (e.g., bilateral oophorectomy), primarily due to a sharp decrease in endogenous estrogen levels, compounded by aging and other factors. A US Chinese study showed that the prevalence (77.06%) and incidence (75.20%) of cognitive impairment in women aged 60 and above are higher than in men (22.94% and 24.80%, respectively). Postmenopausal women face an increased risk of cognitive disorders, including subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease. A study involving Latina women indicated that menstrual cycle and reproductive history significantly affect cognitive levels, further emphasizing the importance of cognitive health in postmenopausal women.
However, longitudinal studies on postmenopausal cognitive impairment are scarce, and no systematic integration of its developmental context and hot trends exists. Hormone replacement therapy (HRT), a key treatment, remains controversial regarding its efficacy and safety, particularly concerning long-term risks such as thrombosis and malignancy. Therefore, it is necessary to map the research landscape over the past 20 years to provide insights for researchers and reduce the risk of dementia in postmenopausal women.
Bibliometrics is a quantitative method for analyzing scientific literature, assessing impact, and identifying trends. This study focuses on postmenopausal cognitive impairment, systematically analyzing core output characteristics (countries, institutions, journals, authors, keywords) using VOSviewer, R package 'Bibliometrix', and CiteSpace. This approach provides a comprehensive, visualized overview of the field, identifies research hotspots and frontiers, and offers a foundation for future research.
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Chen Xiaoxia, Zhao Lihua, Li Taowen, Qin Yimei, Liang Jinyu (2026). Postmenopausal cognitive impairment: a bibliometric analysis of developmental context and hot trends. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21608
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Frequently Asked Questions
What is postmenopausal cognitive impairment?
Postmenopausal cognitive impairment refers to cognitive decline in women after natural or surgical menopause, primarily due to a sharp decrease in endogenous estrogen levels, compounded by aging and other factors. It includes symptoms like memory loss and attention deficits, and increases the risk of mild cognitive impairment and Alzheimer's disease.
What are the main findings of this bibliometric analysis?
The analysis included 1,452 articles from 2005 to 2025. The United States leads in research output, with top institutions like Stanford and Harvard. Hormonal interventions, especially estrogen therapy, remain the core focus. Research themes have expanded to include psychological, cardiovascular, and metabolic health, with a shift toward non-hormonal interventions.
Which journals and authors are most influential in this field?
The journal 'Menopause-The Journal of the North American Menopause Society' published the most articles (78), while 'JAMA-J Am Med Assoc' had the highest co-citation count (3,791). Espeland, Mark A. was the most prolific author (55 publications), and Shumaker, Sally A. was the most co-cited author (859 times).
What are the current research hotspots and trends?
Current hotspots include the long-term effects and safety of hormone therapy, as well as non-hormonal interventions such as physical activity and psychological approaches. Research themes are expanding from single topics like MRI and hormones to broader health issues, reflecting a multidisciplinary trend.
What are the future research directions suggested by this study?
Future research should focus on constructing a 'cross-life cycle-multidimensional' framework to understand the mechanisms of hormones on cognition across different life stages. Additionally, there is a need to validate the efficacy of non-hormonal interventions and accelerate the translation of clinical intervention protocols.
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