J Korean Med Sci.  2025 Mar;40(10):e15. 10.3346/jkms.2025.40.e15.

Association Between Serum Follicle-Stimulating Hormone Levels and Cognitive Function in Middle-Aged and Older Women

• Oh DJ
• Baek KH
• Kang DW
• Hong YJ
• Jeong C

• KMID: 2565804
• DOI: http://doi.org/10.3346/jkms.2025.40.e15

Abstract

Background
Researchers have proposed that there is a potential link between folliclestimulating hormone (FSH) and cognitive function, yet the evidence remains inconclusive. The current study aims to identify the association between serum FSH levels and cognitive performance, and to examine whether this association varies by cognitive diagnosis, serum estradiol (E2) levels, or cognitive domain.
Methods
This multicenter cross-sectional study used a clinical database comprising female visitors to memory clinics at three referral hospitals in Korea. Venous blood samples were collected to determine serum FSH and E2 concentrations via immunoradiometric assay. Cognitive performance was evaluated using either the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease or the Seoul Neuropsychological Screening Battery, while cognitive diagnoses were made via clinical diagnostic interviews.
Results
Among the 159 participants (normal cognition [NC], n = 70; mild cognitive impairment [MCI], n = 52; Alzheimer’s disease [AD] dementia, n = 37), there were no significant differences in serum FSH levels associated with cognitive diagnosis. In women with NC, serum FSH levels were found to be positively correlated with cognitive performance in global cognition, nonverbal memory, and executive function, even after adjusting for serum E2 level and its interaction with serum FSH level. However, no significant correlations were observed in women with MCI and AD dementia.
Conclusion
The association between circulating FSH and cognition may be independent from circulating E2, but it may depend on disease progression or cognitive domains. This suggests a potential role of gonadotropin in cognitive decline in elderly women.

Keyword

Follicle Stimulating Hormone; Cognition Disorders; Cognitive Dysfunction; Alzheimer Disease

Figure

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  Fig. 1 Box plots comparing serum follicle-stimulating hormone concentrations by cognitive diagnosis.NC = normal cognition, MCI = mild cognitive impairment, AD = Alzheimer’s disease.

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  Fig. 2 Scatter plots for the distribution of Z-scores for cognitive performance tests by serum FSH concentration in women with normal cognition. (A) MMSE, Z-score; (B) Verbal memory, Z-score; (C) Nonverbal memory, Z-score; (D) Language, Z-score; (E) Visuospatial function, Z-score; (F) Executive function, Z-score.FSH = follicle-stimulating hormone, MMSE = Mini-Mental State Examination.

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