This AHA and NIH funded study will investigate the menopause as an accelerant of cerebrovascular and brain aging in middle-aged women.
Health agencies and organizations such as the American Heart Association recognize the importance of the menopause transition for cardiovascular disease risk in women. Cardiovascular health in midlife and later-life brain health are strongly linked. Thus, the menopause transition may be a critical midlife period influencing later-life brain health in women, however this is underexplored. Our data suggest women may have less inherent protection against damaging blood flow patterns and that the menopause transition may accelerate increases in cerebral blood flow pulsatility (a measure of 'discontinuous' blood flow) which is associated with cerebrovascular disease risk and brain health. Thus, going through menopause may speed up brain aging and play a part in women's disproportionate risk of cerebrovascular disease and Alzheimer's disease and related dementia.
Dr. Wes Lefferts has received funding from both the American Heart Association, and NIH National Institute on Aging to examine how cerebral blood flow, and specifically blood flow pulsatility within the brain, differs across stages of the menopause transition in middle-aged women and its cross-sectional and longitudinal relations to measures of brain health (blood biomarkers and cognitive function).
This study will enroll nearly 370 women across the stages of the menopause transition over the next 3 years. This study is recruiting pre- (regular menstrual cycle), peri- (irregular menstrual cycle), and early post-menopausal women (within 5 years of their final menstrual cycle) between the ages 40-64 years with specific health characteristics (assessed through online screening surveys and an in-person screening visit). Women who do not experience a menstrual cycle because their uterus has been removed are also eligible.
The study involves 1 online eligibility questionnaire, 1 set of online questionnaires, 2 in-person visits (1 screening visit [~40 min-1.5 hr], 1 assessment visit [~1.9 hr]), and 8 days of at-home ovulation tracking (for menstruating pre- and peri-menopausal women only). Participants will complete a comprehensive cardiovascular health assessment (heart, artery, and brain blood flow assessments), in addition to muscular strength, aerobic fitness, physical activity, diet, sex hormone, cardiovascular disease risk, cognitive function, and blood biomarker assessments. Participants will receive complimentary comprehensive health reports, monetary compensation for participating, and have the option to return annually for repeated annual assessments for 5 years. 
Expected impact of this critical and foundational study.
The importance of characterizing changes in cerebrovascular mechanisms of brain health across the menopause transition is as self-evident as it is currently underappreciated. Women are historically understudied and have worse cerebrovascular disease outcomes, and greater Alzheimer's disease and dementia risk, than men, and we are not sure why. If we find that brain blood flow patterns are impaired across the stages of menopause it will give us a target for drug and behavioral interventions to improve brain blood flow patterns during this critical aging window. This will help us find ways to improve brain blood flow in women during menopause and reduce later life disease risk. This study will be a key starting point for targeted preventive research for women's brain health.
Interested in learning more?
Watch some videos created by the BRAVA team that provide an overview of the study!
Have additional questions? You can email brava@iastate.edu or Dr. Wes Lefferts (study PI) at wleffert@iastate.edu if you wish to learn more about the study.
Interested in participating?
Fill out the short (5-10 min) eligibility survey here to find out if you are eligible to get involved! Or, copy and paste 'https://redcap.link/ISUBRAVAeligibilitysurvey' into your internet browser.