Shadyab Aladdin H, Macera Caroline A, Shaffer Richard A, Jain Sonia, Gallo Linda C, Gass Margery L S, Waring Molly E, Stefanick Marcia L, LaCroix Andrea Z
1San Diego State University/University of California San Diego Joint-Doctoral Program in Public Health (Epidemiology), San Diego, CA 2Division of Epidemiology, Graduate School of Public Health, San Diego State University, San Diego, CA 3Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA 4Department of Psychology, San Diego State University, San Diego, CA 5The North American Menopause Society, Emeritus, Cleveland, OH 6Departments of Quantitative Health Sciences and Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA 7Department of Medicine, Stanford Center for Prevention Research, Stanford University School of Medicine, Stanford, CA 8Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA.
Menopause. 2017 Jan;24(1):35-44. doi: 10.1097/GME.0000000000000710.
The aim of the present study was to investigate associations between reproductive factors and survival to age 90 years.
This was a prospective study of postmenopausal women from the Women's Health Initiative recruited from 1993 to 1998 and followed until the last outcomes evaluation on August 29, 2014. Participants included 16,251 women born on or before August 29, 1924 for whom survival to age 90 during follow-up was ascertained. Women were classified as having survived to age 90 (exceptional longevity) or died before age 90. Multivariable logistic regression models were used to evaluate associations of ages at menarche and menopause (natural or surgical) and reproductive lifespan with longevity, adjusting for demographic, lifestyle, and reproductive characteristics.
Participants were on average aged 74.7 years (range, 69-81 y) at baseline. Of 16,251 women, 8,892 (55%) survived to age 90. Women aged at least 12 years at menarche had modestly increased odds of longevity (odds ratio [OR], 1.09; 95% CI, 1.00-1.19). There was a significant trend toward increased longevity for later age at menopause (natural or surgical; Ptrend = 0.01), with ORs (95% CIs) of 1.19 (1.04-1.36) and 1.18 (1.02-1.36) for 50 to 54 and at least 55 compared with less than 40 years, respectively. Later age at natural menopause as a separate exposure was also significantly associated with increased longevity (Ptrend = 0.02). Longer reproductive lifespan was significantly associated with increased longevity (Ptrend = 0.008). The odds of longevity were 13% (OR 1.13; 95% CI, 1.03-1.25) higher in women with more than 40 compared with less than 33 reproductive years.
Reproductive characteristics were associated with late-age survival in older women.
本研究旨在调查生殖因素与活到90岁之间的关联。
这是一项对1993年至1998年从妇女健康倡议组织招募的绝经后妇女进行的前瞻性研究，随访至2014年8月29日的最后一次结局评估。参与者包括16251名出生于1924年8月29日或之前的女性，已确定她们在随访期间活到90岁。女性被分为活到90岁（超长寿命）或在90岁之前死亡。使用多变量逻辑回归模型评估初潮年龄和绝经年龄（自然绝经或手术绝经）以及生殖寿命与长寿之间的关联，并对人口统计学、生活方式和生殖特征进行了调整。
参与者在基线时的平均年龄为74.7岁（范围为69 - 81岁）。在16251名女性中，8892名（55%）活到了90岁。初潮年龄至少为12岁的女性长寿几率略有增加（优势比[OR]，1.09；95%置信区间[CI]，1.00 - 1.19）。绝经年龄较晚（自然绝经或手术绝经；P趋势 = 0.01）有显著的长寿增加趋势，与小于40岁相比，50至54岁和至少55岁的OR（95% CI）分别为1.19（1.04 - 1.36）和1.18（1.02 - 1.36）。自然绝经年龄较晚作为一个单独的暴露因素也与长寿增加显著相关（P趋势 = 0.02）。更长的生殖寿命与长寿增加显著相关（P趋势 = 0.008）。与生殖年限少于33年的女性相比，生殖年限超过40年的女性长寿几率高13%（OR 1.13；95% CI，1.03 - 1.25）。
生殖特征与老年女性的晚年生存有关。
