RESUMO
BACKGROUND: Many women experience various symptoms during the period of menopausal transition, including complaints of reduced cognitive functioning. However, these complaints are not necessarily recognized as core menopausal symptoms. In this study, we sought to characterize subjective complaints of reduced cognitive functioning by analyzing cross-sectional data from the Japan Nurses' Health Study (JNHS). METHODS: The JNHS 4-year follow-up questionnaire containing a 21-item climacteric symptom checklist, which included a question about "poor memory or forgetfulness", was mailed between 2005 and 2011 to all JNHS participants, regardless of their age at the time of the survey. We estimated the prevalence of slight and severe complaints in 5-year age-groups. We used principal component analysis to explore the underlying factors among the 21 symptoms during the menopausal transition period in women aged 45-54 years at the time of the survey. We also examined risk factors for complaints using multivariable modified Poisson regression analysis. RESULTS: In total, 12,507 women responded to the 4-year survey. The mean age at the time of the 4-year survey was 46.5 years (range 27-82). "Poor memory or forgetfulness" showed a peak prevalence of 81.7% (severe 27.9%; slight 53.8%) at 50-54 years, and gradually decreased after 55 years. Principal component analysis indicated that "poor memory or forgetfulness" belonged to somatic symptoms and was close to psychological symptoms in women aged 45-54 years. In women aged 45-54 years, the complaint was also significantly associated with hot flashes and sweats. Multivariable modified Poisson regression analysis showed that menopausal status (uncertain and postmenopausal), less sleep (sleep of < 5 h and sleep of 5- < 6 h), night-shift work, and severe vasomotor symptoms (VMS) were significantly associated with the prevalence of severe complaints of reduced cognitive functioning in women aged 45-54 years. CONCLUSIONS: We found that prevalence of "poor memory or forgetfulness" was highest during the menopausal transition period and among perimenopausal women. This subjective complaint was associated with somatic, psychological complaints and VMS. It may be useful for women with cognitive problems in the transition period to consider management of comorbid menopausal symptoms.
RESUMO
Este artigo discute sobre o uso de cartas como fontes de pesquisa e sua articulação com os conceitos de memória e esquecimento, no âmbito da história da loucura. Os autores partem do encontro ao acaso com algumas correspondências escritas no início do século XX, por pacientes do antigo Hospício São Pedro, localizado em Porto Alegre (Rio Grande do Sul/Brasil), as quais ficaram guardadas nos seus prontuários e que, aparentemente, não foram enviadas aos seus destinatários. Os procedimentos de exclusão e a regulação dos discursos daqueles que eram tidos como loucos operou um silenciamento desses sujeitos, tomando seus escritos, exclusivamente, como referentes da sua suposta loucura; entende-se que a dinâmica das relações de poder é capaz de produzir "vidas memoráveis" e "vidas pouco dignas de serem lembradas". Destaca-se o compromisso ético-político de uma perspectiva histórica que se compromete com a "memória dos oprimidos". Este estudo examina alguns "rastros do passado", entendendo-os como possibilidade de insurgência daqueles que foram relegados ao esquecimento, neste caso, lembrar do passado é intervir no presente.(AU)
This article discusses the use of letters as source of research and their articulation with the concepts of memory and forgetfulness, within the history madness. The authors start from the encounter by chance with some correspondences written, in the beginning of the 20th century, by patients of the former Hospício São Pedro, located in Porto Alegre (Rio Grande do Sul/Brasil), which were kept in their medical records and, possibly, were not sent to their recipients. The procedures of exclusion and the regulation of the discourses of those who were considered crazy operated a silencing of these subjects, taking their writings exclusively as referents of their supposed madness; it is understood that the dynamics of power relations is capable of producing "memorable lives" and "lives not worthy of being remembered". The ethical-political commitment of a historical perspective engaged with the "memory of the oppressed" is highlighted. This study examines some "traces of the past", understanding them as the possibility of insurgency of those who have been relegated to oblivion; in this case, remembering the past is intervening in the present.(AU)
Este artículo discute sobre el uso de cartas como fuentes de investigación y su articulación con los conceptos de memoria y olvido dentro de la historia de la locura. Los autores parten desde el encuentro por casualidad con algunas correspondencias escritas, a principios del siglo XX, por pacientes del antiguo Hospício São Pedro, ubicado en Porto Alegre (Rio Grande do Sul/Brasil), las cuales quedaron guardadas en sus expedientes clínicos y que, posiblemente, no fueron enviadas a los suyos destinatarios. Los procedimientos de exclusión y la regulación delos discursos de aquellos que eran tenidos como locos opero un silenciamiento de esos sujetos, tomando sus escritos, exclusivamente, como referentes de su supuesta locura; se entiende que la dinámica de las relaciones de poder es capaz de producir "vidas memorables" y "vidas poco dignas de ser recordadas". Se destaca el compromiso ético-político desde una perspectiva histórica que se compromete con la "memoria de los oprimidos". Este estudio examina algunos rastros del pasado, entendiéndolos como posibilidad de insurgencia de aquellos que fueron relegados al olvido; en este caso, recordar el pasado es intervenir en el presente.(AU)
