Finding: Intimate Partner Violence Tied to Declines in Working Memory
Declines in working memory after menopause are more pronounced in women who had been victims of intimate partner violence earlier in life, according to a large, longitudinal study. Women with ADHD face a significantly heightened risk for intimate partner violence.
September 27, 2024
Women who reported physical intimate partner violence (IPV) before menopause experienced a significantly greater decline in working memory after menopause as compared to women who had not reported violence, according to new research.
Comprising a subgroup analysis of the Study of Women’s Health Across the Nation (SWAN), this research revealed that women who reported physical intimate personal violence showed an annual decline of 0.17 points in working memory performance post-menopause, compared to women who had not reported IPV. Declines in other areas of cognition, including processing speed and verbal memory, were not observed.
SWAN is a multisite, longitudinal cohort study that began in 1996. It seeks to investigate physical, psychological, and social changes that occur during midlife. Baseline information was collected at the start of the study from participants, women aged 42 to 55, and follow-up visits continue to be conducted annually. The subgroup analysis focused on IPV was led by Jillian Baker, MPH, of the University of Michigan in Ann Arbor, and presented at the annual meeting of the Menopause Society this month.
Baker’s subgroup analysis measured the cognitive performance over time of women who reported physical IPV in the year prior to the SWAN baseline. That subgroup comprised 3.1% of all participants.
The cumulative effect of working-memory decline can dramatically impact quality of life. “Over the course of several years, a decline like this would equate to a drop of nearly two points. and a ten-year change of nearly two points is objectively a loss of nearly a quarter of the average baseline score,” Baker explains. “We think of working memory as the ability to follow directions you just heard or to remember the steps of a task you need to do. If this function is impaired, it can feel pretty debilitating.”
Connecting IPV to Working Memory Impairments
Much remains unknown about how physical IPV contributes to working memory decline. Baker explains that many survivors of IPV have experienced brain injury, often repeatedly, which is linked to changes in cognitive performance. In addition, IPV survivors often struggle with mental health conditions including anxiety, depression, or post-traumatic stress disorder. They may also experience poor sleep and chronic hypervigilance, which may have a deleterious impact on working memory.
“We need more research into these potential mechanisms,” urges Baker. “As they may indicate points of intervention to prevent declines in working memory.”
Another question that remains: Why was physical IPV associated with working memory decline but not with declines in other areas of cognition? These unknowns underline the necessity of additional research, says Baker: “This work sends a strong signal that the association between intimate partner violence and change in cognitive performance is worth studying further.”
Implications for Women with ADHD
Research has proven that women with ADHD are at a particularly high risk for physical IPV due to low self-esteem, high rejection sensitive dysphoria (RSD), and social skill deficits. A study published in the Journal of Abnormal Child Psychology found that:1
- Girls with ADHD were five times more likely to be victims of physical intimate partner violence than non-ADHD girls (30% vs. 6%)
- Greater ADHD symptom severity in childhood was associated with increased risk for physical victimization
While the sub-analysis did not include data on ADHD, Baker notes that, “it is both an interesting and important research question to understand how ADHD may play a role in this association,” especially given that women with ADHD often struggle with pre-existing challenges in working memory.
According to the WHO, one-third of women worldwide will experience some form of intimate partner violence during their lifetime, making this research critical to a broad audience of women. “Millions of women are at risk for health effects of partner violence,” says Baker. “We hope this research contributes to the call to invest in violence prevention and support for survivors.”
