Department of Research, Dr. AGA Clinic, Tokyo, Japan.
Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan.
J Am Geriatr Soc. 2022 Sep;70(9):2602-2609. doi: 10.1111/jgs.17838. Epub 2022 May 12.
Although it is well known that women have higher risk of frailty, mechanisms are not clear. Reproductive history may be related to the sex difference in frailty.
A total of 1249 community-dwelling women aged ≥60 in England were examined for associations between age at menopause and risk of developing frailty. Frailty defined by the frailty phenotype was measured at baseline and 4 years later. Age at menopause was used as a continuous variable and categorical groups: premature/early (10-45 years), normal (46-55 years), and late (56 years or older). Men with comparable conditions from the same cohort were also used as a comparison.
Earlier age at menopause was significantly associated with higher risk of incident frailty. One year later menopause age was associated with a 3% decrease in incident frailty risk (Odds ratio [OR] = 0.97, 95%CI = 0.95-1.00, p = 0.02). Women with premature or early menopause had a significantly higher risk of developing frailty compared with those with normal menopause (OR = 1.90, 95%CI = 1.28-2.81, p = 0.001), while those with late menopause did not. In a supplementary analysis with older men, older women with premature or early menopause were more likely to develop frailty compared with older men (OR = 2.29, 95%CI = 151-3.48, p < 0.001), however, there was no significant difference between women with normal or late menopause.
Earlier menopause was significantly associated with higher risk of developing frailty. Our findings suggest that menopause or its related factors, such as decline in estrogen after menopause, potentially play an important role in the sex difference in frailty.
虽然众所周知女性发生衰弱的风险更高，但机制尚不清楚。生育史可能与衰弱的性别差异有关。
共纳入英格兰 1249 名年龄≥60 岁的社区居住女性，以探讨绝经年龄与衰弱发生风险之间的相关性。采用衰弱表型定义衰弱，在基线和 4 年后进行评估。绝经年龄作为连续变量和分类变量：早绝经（10-45 岁）、正常绝经（46-55 岁）和晚绝经（56 岁及以上）。同时还纳入了具有相同条件的男性作为对照。
绝经年龄越早，发生衰弱的风险越高。绝经后 1 年，绝经年龄每提前 1 岁，发生衰弱的风险降低 3%（比值比 [OR] = 0.97，95%CI = 0.95-1.00，p = 0.02）。早绝经或绝经提前的女性发生衰弱的风险显著高于正常绝经的女性（OR = 1.90，95%CI = 1.28-2.81，p = 0.001），而晚绝经的女性则没有。在纳入老年男性的补充分析中，早绝经或绝经提前的老年女性发生衰弱的风险高于老年男性（OR = 2.29，95%CI = 151-3.48，p<0.001），但正常绝经或晚绝经的女性之间没有显著差异。
绝经年龄越早，发生衰弱的风险越高。我们的研究结果表明，绝经或其相关因素（如绝经后雌激素水平下降）可能在衰弱的性别差异中发挥重要作用。
