A condition that affects millions of American women has been associated with an increased risk of developing Alzheimer's disease. A new review has set out to understand what could be behind the potential connection. Researchers across the U.S. and Iran said that having polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), has been linked with an increased risk of cognitive vulnerability and dementia, and outlined possible mechanisms behind the connection.
However, they said that clinical evidence showing a link between PMOS and Alzheimer's disease remains "inconsistent" and focus should "remain on optimizing metabolic health" while further investigation is conducted. The experts conducted a thorough search of data through October 2025 to come to their conclusions. The review was published online in the Journal of the Endocrine Society on October 13.
"The findings align with our research linking metabolic alterations with cognitive function in PMOS," Marla Lujan, a professor of nutritional sciences at Cornell University, told Newsweek. "We need more mechanistic studies to fully capture how reproductive hormones might alter Alzheimer's disease development in PMOS." "This article presents food for thought," Shruthi Mahalingaiah, a professor of environmental reproductive and women's health at Harvard University, told Newsweek, adding it is "important to study the potential long-term effects of PMOS on cognition and neurological health." However, she added that "we should be careful not to present the current evidence reviewed in this article as demonstrating a clear, independent dementia risk," as available studies are "limited and inconsistent." She said, at the same time, the research could "offer an important opportunity for prevention." PMOS is a condition where cysts, which are small sacs of fluid, develop on the ovaries. This can lead to irregular menstruation and is a common cause of infertility.
The condition is believed to affect 10 to 15 percent of women worldwide. Other symptoms include acne, hair growth, darkening of the skin in body creases, weight gain and more. It is understood that imbalances in hormones could play a role in the symptoms.
It is known that PMOS can increase a woman's risk of developing a number of diseases including type 2 diabetes, gestational diabetes (which is diabetes during pregnancy), heart disease, high blood pressure, high cholesterol, sleep apnea and stroke, as well as depression and anxiety. Mina Amiri, the first author of the study and an assistant professor at Tehran University of Medical Sciences, told Newsweek that one of the studies reviewed was a retrospective Canadian cohort of more than 16,000 women with PMOS and almost 50,000 age-matched controls, where a higher dementia prevalence was found among those with PMOS, alongside a younger age at onset. Although, another study included was a prospective UK Biobank analysis of around 1,000 women with PMOS and around 5,000 age- and BMI-matched controls, which found no significant association with all-cause dementia.
"The differences between these studies likely reflect study design, diagnostic criteria and, most importantly, how well each adjusted for metabolic factors such as BMI and insulin resistance," she said. "Studies that account for these factors show a much weaker association or none at all." Therefore, they said that "direct evidence of Alzheimer’s-type changes in the brains of women with PMOS is lacking. The existing biomarker findings come from blood tests and are strongest in women with obesity or insulin resistance." "Research needs large, long-term studies following women across the reproductive lifespan, and randomized trials with cognitive outcomes, to clarify whether PMOS independently affects dementia risk," she said.
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