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Factors associated with motivation for dementia-preventive lifestyle change in women with surgical menopause

This cross-sectional study of 75 women with surgical menopause in Türkiye found that greater motivation for dementia-preventive lifestyle changes was significantly associated with a lower perceived dementia risk and a younger age at menopause, but not with dementia knowledge.

Original authors: Selcan Zeynep ERGÖZ AKSOY, Ecem ÖZGÜL, Dilek BİLGİÇ, Burcu AKPINAR SÖYLEMEZ, Nuri YILDIRIM, Birgit TEICHMANN

Published 2026-07-15

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CC BY 4.0

Original authors: Selcan Zeynep ERGÖZ AKSOY, Ecem ÖZGÜL, Dilek BİLGİÇ, Burcu AKPINAR SÖYLEMEZ, Nuri YILDIRIM, Birgit TEICHMANN

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine your brain is a high-tech car engine. For most women, the transition to menopause is like a slow, gentle tune-up where the fuel (estrogen) gradually runs out. But for Women with Surgical Menopause (WSM), it's like someone suddenly yanking the fuel line out of the car while it's still driving. This happens when they have surgery to remove their ovaries, causing an abrupt, total drop in estrogen.

Because this "fuel" is crucial for keeping the brain's gears turning smoothly, these women face a higher risk of the engine sputtering later in life—a condition called dementia. The big question the researchers asked was: What makes these women want to change their lifestyle to protect their brains? Do they need to know a lot about dementia? Do they need to be scared of the risk? Or does something else drive them?

The team gathered 75 women who had undergone this surgery, mostly around the age of 49, and gave them a series of quizzes and surveys. They measured three main things:

How much they knew about dementia (the "Dementia Knowledge" score).
How high their risk was based on their lifestyle and history (the "Risk Index").
How much they wanted to change their habits to stay healthy (the "Motivation" score).

Here is what the data actually showed, without the fluff:

The "Knowledge" Myth is Busted
You might think that if you know more about a danger, you'd be more motivated to fix it. It's like knowing your car is about to explode would make you want to buy a fire extinguisher. But in this study, knowing more about dementia did not make women more motivated. The researchers found no clear link between how much a woman knew about the disease and her desire to change her lifestyle. The paper explicitly rules out the idea that "education alone" is the magic switch for motivation in this group.

The "Risk" Paradox
Here is a twist that feels a bit counter-intuitive. The study found that women with lower estimated dementia risk scores were actually more motivated to change their lifestyle.
Think of it like this: If you think your car is already broken beyond repair (high risk), you might feel hopeless and just give up. But if you think, "Hey, my engine is still in good shape, but I need to keep it that way" (lower risk), you feel capable and eager to put in the work. The paper suggests that feeling like you have control over your future health might be a bigger driver than feeling terrified of a high risk score.

The "Younger" Advantage
The study also found that women who had their surgery at a younger age (around 45 or earlier) were more motivated to make changes than those who had it later. It's as if younger women see a longer road ahead and feel more urgency to keep their "car" running smoothly for the long haul. The paper notes this connection is real but suggests we need more research to understand exactly why age at surgery changes the mindset.

The "Symptom" Whisper
The women who were suffering the most from menopausal symptoms (like hot flashes, mood swings, or sleep trouble) showed a trend toward being more motivated. It's like a driver with a really noisy, rattling engine might be more desperate to fix it than someone with a quiet one. However, the paper is careful to say this didn't quite reach the level of "statistical proof." It's a strong hint, a whisper saying, "Hey, maybe pain helps push people to act," but the authors can't shout it as a fact yet.

The Bottom Line
The study, which included 75 women and analyzed their data using complex math (multiple linear regression), concludes that motivation isn't just about reading a pamphlet or knowing the facts. It's a mix of how young they were when the surgery happened and how their current risk profile makes them feel.

The authors are careful to say this is a "snapshot" in time, not a movie of the future. They can't prove that one thing caused the other, only that they happened together in this group. They suggest that doctors shouldn't just hand out fact sheets to these women; instead, they should focus on how the women feel about their health and their future. If a woman feels capable and sees a long road ahead, she's more likely to hit the gas on a healthy lifestyle.

In short: Knowing the facts doesn't drive the car; feeling like you can steer it does. And for women who had surgery young, that steering wheel feels very important.

Technical Summary: Factors Associated with Motivation for Dementia-Preventive Lifestyle Change in Women with Surgical Menopause

Problem Statement
Women with surgical menopause (WSM), resulting from bilateral salpingo-oophorectomy (BSO), face an abrupt and permanent decline in estrogen levels. This physiological shift is associated with severe menopausal symptoms and an elevated risk of cognitive decline and dementia later in life. While lifestyle interventions are recognized as a primary strategy for dementia prevention (potentially preventing up to 40% of cases), the specific factors influencing the motivation of WSM to adopt these preventive behaviors remain poorly understood. Existing literature has not sufficiently clarified how dementia knowledge, perceived dementia risk, and menopausal symptom burden interact to drive lifestyle change motivation in this specific high-risk population.

Methodology
This cross-sectional study was conducted between May and August 2025 at a university hospital in Western Türkiye. The sample consisted of 75 women who had undergone surgical menopause at least six months prior, were aged 40 or older, and possessed no diagnosis of dementia.

Data collection utilized four validated instruments:

Menopause Rating Scale (MRS): To assess the burden of menopausal symptoms (somatic, psychological, and urogenital).
Dementia Knowledge Assessment Scale (DKAS): To evaluate knowledge regarding dementia causes, characteristics, and risk factors.
Australian National University Alzheimer's Disease Risk Index–Short Form (ANU-ADRI): To calculate a composite score representing dementia risk based on 11 risk and 4 protective factors.
Motivation to Change Lifestyle for Dementia Risk Reduction Scale (MOCHAD-10): To measure the motivation to adopt dementia-preventive lifestyle behaviors.

Statistical analysis involved multiple linear regression to identify factors associated with MOCHAD-10 scores. The model adjusted for sociodemographic covariates, including age, education, employment, residence, marital status, income, smoking, age at menarche, age at surgical menopause, and hormone therapy use.

Key Results
The study population had a mean age of 49.14 years and a mean age at surgical menopause of 45.10 years. The regression analysis (Adjusted $R^2$ = 0.16) revealed the following significant associations with motivation for lifestyle change:

Dementia Risk: Higher ANU-ADRI scores (indicating greater dementia risk) were significantly associated with lower motivation for lifestyle change ( $\beta = -0.32, p = 0.048$ ).
Age at Surgical Menopause: A younger age at the time of surgical menopause was significantly associated with greater motivation for lifestyle change ( $\beta = -0.32, p = 0.043$ ).
Dementia Knowledge: DKAS scores were not significantly associated with motivation ( $\beta = 0.16, p = 0.210$ ).
Menopausal Symptom Burden: MRS scores showed a positive trend toward association with motivation ( $\beta = 0.25, p = 0.052$ ), though this did not reach statistical significance.

Key Contributions
This study provides the first empirical examination of the determinants of motivation for dementia prevention specifically within the WSM population. It challenges the assumption that increased knowledge of dementia risk alone drives behavioral motivation in this group. Instead, the findings highlight that motivation is more strongly linked to the perceived severity of current health status (symptom burden) and the timing of the hormonal transition (age at menopause) than to cognitive awareness of dementia.

Significance and Claims
The authors claim that motivation for dementia-preventive behaviors in WSM is influenced by a complex interplay of health-related factors rather than knowledge alone. The finding that women with lower calculated dementia risk and those who experienced menopause at a younger age exhibited higher motivation suggests that these groups may feel a greater sense of agency or perceive a longer window for effective intervention.

The study concludes that while dementia knowledge is a component of prevention frameworks, it is not an independent predictor of motivation in this context. Consequently, the authors suggest that clinical interventions for WSM should not rely solely on educational strategies. Instead, healthcare providers in gynecology and menopause clinics should consider integrating dementia risk reduction counseling with the management of menopausal symptoms, potentially leveraging the motivation to alleviate current distress as a pathway to long-term cognitive health.

Limitations
The authors explicitly note that the single-center design, small sample size ( $n=75$ ), and cross-sectional nature of the study limit causal inference and generalizability. The modest explained variance ( $16\%$ ) indicates that other unmeasured factors likely influence motivation. The authors call for larger, multicenter, longitudinal studies to confirm these associations and clarify underlying mechanisms.

Technical Summary: Factors Associated with Motivation for Dementia-Preventive Lifestyle Change in Women with Surgical Menopause

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