Menopause Symptoms and Perceived Cognitive Decline in Menopausal Women: The Mediating Effect of Health Promotion Behavior

Ji Hyun Kim; Pok Ja Oh

doi:10.7475/kjan.2017.29.2.200

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Kim and Oh: Menopause Symptoms and Perceived Cognitive Decline in Menopausal Women: The Mediating Effect of Health Promotion Behavior

Original Article

Korean J Adult Nurs 2017;29(2):200-210.

Published online: 9 April 2017

DOI: https://doi.org/10.7475/kjan.2017.29.2.200

Menopause Symptoms and Perceived Cognitive Decline in Menopausal Women: The Mediating Effect of Health Promotion Behavior

Ji Hyun Kim, MSN, RN¹, Pok Ja Oh, Ph.D., RN^2,

¹Assistant Professor, Department of Nursing, Sahmyook University, Seoul, Korea

²Professor, Department of Nursing, Sahmyook University, Seoul, Korea

Corresponding author: Oh, Pok Ja Department of Nursing, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 01795, Korea. Tel: +82-2-3399-1589, Fax: +82-2-3399-1594, E-mail: ohpj@syu.ac.kr

- This research was supported by the Health Sciences for Specialization Project Fund of the Sahmyook University in 2016.

Received 2 March 20175 April 2017 Accepted 25 April 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to assess the relationship between menopausal symptoms and decline in cognitive functioning of menopausal women with mediating effects of health promoting behavior.

Methods

Using a convenience sampling, 140 menopausal women were recruited for the cross-sectional survey. Data were collected by using the Menopause Rating Scale, Health Promoting Lifestyle Profile, Everyday Cognition, and Korean Mini-Mental State Examination.

Results

The mean scores for menopausal symptoms, health promotion behavior, and subjective cognitive decline were 14.40, 153.79, and 67.40 respectively. Health promotion behavior was directly affected by menopausal symptom (R²=8%). Cognitive decline was directly affected by menopausal symptom (R²=11%). Menopausal symptom (β=.33, p<.001) and health promotion behavior (β=-.21, p=.014) were found to be predictive factors in subjective cognitive decline and explained 14%. Health promotion behavior had a partial mediating effect in the relationship between menopausal symptom and perceived cognitive decline (Sobel test: Z=2.05, p=.040).

Conclusion

Based on the findings of this study, developing nursing intervention programs focusing on decreasing menopausal symptoms and encouraging health promotion behavior are recommended to improve cognitive decline in menopausal women.

Keywords: Menopause, Cognitive function, Health promotion

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Figure 1.

Mediating effect of health promotion behavior in the relationship between menopause symptom and perceived cognitive decline.

Table 1.

Menopause Symptom, Health Promotion Behavior and Cognitive Function according to General Characteristics of Participants (N=140)

Variables	Categories	n (%)	Menopause symptom		Health promotion behavior		Perceived cognitive decline		Objective cognitive function
Variables	Categories	n (%)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)
Age (year)	＜50	14 (10.0)	16.43±11.13	0.49	153.36±23.46	0.01	66.93±17.56	1.18	26.71±2.37	0.87
	50~59	105 (75.0)	14.28±7.85	(.615)	153.79±19.80	(.995)	68.83±21.11	(.320)	25.91±3.04	(.420)
	60~65	21 (15.0)	13.67±9.73		154.10±22.86		60.57±18.23		25.33±3.34
Martial status	Yes	128 (91.4)	14.64±8.67	-1.58	155.16±20.31	-2.62	67.59±20.39	-0.35	25.93±2.98	-0.29
Martial status	No	12 (8.6)	11.83±5.57	(.038)	139.25±17.09	(.504)	65.42±22.08	(.638)	25.67±3.63	(.333)
Education	≤ High school	61 (43.6)	12.44±7.76	-2.36	153.73±19.64	-0.09	66.29±20.66	-0.62	25.00±3.31	-3.21
Education	≥ College	79 (56.4)	15.86±8.83	(.019)	154.06±21.20	(.925)	68.49±20.48	(.535)	26.66±2.53	(.002)
Monthly income (10,000 won)	＜200	13 (9.6)	12.00±6.65	0.90	141.38±17.94	1.84	61.00±19.79	1.18	25.92±1.75	0.97
	200~399	54 (39.7)	13.91±8.04	(.446)	155.09±19.67	(.144)	68.83±21.38	(.320)	26.02±2.87	(.408)
	400~599	25 (18.4)	16.24±8.56		156.36±23.74		72.88±22.98		25.12±4.09
	≥600	44 (32.3)	15.16±9.46		154.55±19.76		65.75±18.00		26.39±2.62
Cohabitation family	Yes	135 (96.4)	14.41±8.57	0.11	154.12±20.22	0.98	67.33±20.21	-0.22	25.91±3.01	0.08
Cohabitation family	No	5 (3.6)	14.00±5.70	(.117)	145.00±28.40	(.623)	69.40±29.42	(.112)	25.80±3.83	(.428)
Age of menopause (year)	＜40	3 (2.2)	7.00±6.25	1.36	159.00±14.00	0.12	65.67±30.55	1.14	26.67±2.08	0.10
	41~50	64 (45.7)	15.03±7.85	(.260)	154.11±20.66	(.884)	70.23±20.44	(.325)	25.88±3.55	(.908)
	＞51	73 (52.1)	14.15±9.00		153.30±20.75		64.99±20.10		25.90±2.56
Hormone therapy	Yes	9 (6.4)	15.44±9.41	0.39	163.78±15.04	1.49	63.67±21.53	-0.55	25.33±3.00	-0.59
Hormone therapy	No	131 (93.6)	14.29±8.46	(.878)	153.32±20.63	(.236)	67.58±20.51	(.858)	25.95±3.05	(.861)
Comorbidity	Yes	59 (42.1)	15.98±8.15	1.90	154.73±20.94	0.46	67.20±19.32	-0.10	25.83±3.55	-0.24
Comorbidity	No	81 (57.9)	13.25±8.57	(.749)	153.11±20.27	(.841)	67.54±21.38	(.414)	25.96±2.61	(.030)

Table 2.

Descriptive Statistics of Menopause Symptom, Health Promotion Behavior, Perceived Cognitive Decline and Objective Cognitive Function (N=140)

Variables	n (%)	Possible range	Actual range	M± SD	Mean of item± SD
Menopause symptom		0~44	0~36	14.40±8.47	1.32±0.78
0~4	17 (12.1)
5~7	19 (13.6)
8~15	42 (30.0)
＞16	62 (44.3)
Somato-vegetative		0~16	0~13	5.24±3.36	1.31±0.84
Psychological		0~16	0~15	5.26±3.66	1.33±0.92
Urogenital		0~12	0~11	3.91±2.69	1.32±0.91
Health promotion behavior		0~215	97~203	153.79±20.50	3.60±0.47
Self-actualization		0~45	14~45	34.45±5.81	3.85±0.64
Health responsibility		0~65	20~65	45.70±8.65	3.54±0.66
Exercise		0~25	5~25	15.21±3.84	3.08±0.77
Nutrition		0~30	14~30	21.93±3.86	3.66±0.65
Interpersonal support		0~25	9~25	19.44±3.21	3.91±0.64
Stress management		0~25	10~25	17.07±3.05	3.43±0.62
Perceived cognitive decline		0~156	38~126	67.40±20.46	1.74±0.52
Everyday memory	70 (50.0)	0~32	4~26	15.41±4.53	1.94±0.56
Language	44 (31.4)	0~36	7~32	15.30±5.43	1.71±0.60
Executive function: planning	37 (26.4)	0~20	2~20	7.61±3.14	1.52±0.63
Executive function: organization	41 (29.3)	0~24	2~20	10.05±3.99	1.68±0.67
Executive function: divided attention	64 (45.7)	0~16	1~16	7.39±3.08	1.86±0.77
Visuospatial abilities	40 (28.6)	0~28	5~28	11.64±5.19	1.67±0.74
Objective cognitive function		0~30	14~30	25.91±3.03	-
＜23	16 (11.4)
≥23	124 (88.6)

Table 3.

Mediating Effect of Health Promotion Behavior in the Relationship between Menopause Symptom and Perceived Cognitive Decline (N=140)

Variables	B	β	t	p	Adj. R²	F	p
Step 1. Menopause symptom → Health promotion behavior	-.71	-.29	-3.60	＜.001	.08	12.95	＜.001
Step 2. Menopause symptom → Perceived cognitive decline	.81	.33	4.16	＜.001	.11	17.30	＜.001
Step 3. Menopause symptom, Health promotion behavior → Perceived cognitive decline					.14	12.07	＜.001
1) Menopause symptom → Perceived cognitive decline	.66	.27	3.32	.001
2) Health promotion behavior → Perceived cognitive decline	-.21	-.21	-2.49	.014
	Sobel test: Z=2.05, p=.040

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