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J Gerontol A Biol Sci Med Sci. 2018 Apr 24. doi: 10.1093/gerona/gly092. [Epub ahead of print]

Frailty is inversely related to age at menopause and elevated in women who have had a hysterectomy: an analysis of the Canadian Longitudinal Study on Aging.

Author information

1
Department of Health Research Methods, Evidence and Impact, McMaster University, Canada.
2
School of Kinesiology and Health Science, York University, Canada.

Abstract

Background:

Frailty is a complex pathophysiological phenomenon that will impact a significant proportion of adults over the age of 65 and contributes to the risk of several adverse health outcomes. Although women have a disproportionately higher risk of frailty, the sex-specific factors related to this syndrome are not well-described. Hence, we sought to examine the relationship of age at menopause, hysterectomy status and hormone replacement therapy (HRT) use with prevalent frailty in older women.

Methods:

We performed a cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA) Baseline Comprehensive cohort (n=30 097, 45-85 years old). Frailty was operationalized using both the deficit accumulation (frailty index) and frailty phenotype (Fried) models. Post-menopausal women were categorized as: premature (30-39 years old), early (40-45 yrs), normal (46-54 yrs) and late (55+) menopause, or hysterectomy. Associations were determined using multivariate analysis, adjusting for sociodemographics, lifestyle factors, social support and HRT use.

Results:

Age at menopause was inversely related to frailty in older Canadian women. The frailty index decreased 1.2% of the mean (p<0.001) with every year of menopause onset, and was significantly higher for women in the premature (24%; p<0.001) and early (8%; p<0.01) menopause and hysterectomy (21%; p<0.001) groups, compared to the normal menopause group. The odds for being classified as frail using Fried's criteria was higher for the premature menopause (OR=1.45, 95%CI=0.75-2.81) and hysterectomy (OR=1.48, 95%CI=1.11-1.99) groups.

Conclusions:

Our study supports a role for age at menopause and hysterectomy in the risk of frailty in older women, and warrants further investigation.

PMID:
29688443
DOI:
10.1093/gerona/gly092

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