Date of Conferral

10-23-2025

Degree

Ph.D.

School

Public Health

Advisor

Harrison Ndetan

Abstract

Mold exposure and menopausal transition have been independently linked to cognitive decline, yet their interaction among socioeconomically disadvantaged populations has not been well examined. This quantitative study is an exploration of how menopausal transition influences the relationship between mold exposure and cognitive health outcomes among women aged 40 to 60 living in low-income housing in the United States. Bronfenbrenner’s ecological systems theory was used to guide the cross-sectional design using secondary data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES; N = 149). Weighted logistic regression and Hayes’ PROCESS (Models 2 and 4) were used to test associations and the potential moderating and mediating roles of menopausal transition (Weighted N ≈ 7,135,536). The analysis showed that mold exposure remained a significant predictor of cognitive difficulty after adjusting for education, poverty-to-income ratio, and menopausal transition (OR = 1.768, 95% CI [1.761, 1.775], p < .001). Women in the postmenopausal stage were twice as likely to report cognitive difficulty as those in perimenopause (OR = 2.072, 95% CI [2.061, 2.083], p < .001). However, no significant moderating or mediating effects of menopausal transition were observed. The findings may inform public health strategies, guide housing and environmental health policies, and promote early cognitive and indoor air quality screenings and intervention efforts, particularly for women in underserved communities.

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