Grace Huang1, Andrea Coviello2, Michael P LaValley3, Kristine E Ensrud4,5, Jane A Cauley6, Peggy M Cawthon7,8, Lisa Fredman9. 1. Section of Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Brookline, Massachusetts. 2. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, School of Medicine, Duke University, Durham, North Carolina. 3. Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts. 4. Division of Epidemiology and Community Health, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. 5. Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, Minnesota. 6. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 7. Research Institute, California Pacific Medical Center, San Francisco, California. 8. Department of Epidemiology, University of California, San Francisco, San Francisco, California. 9. Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts.
Abstract
OBJECTIVES: To determine whether women with surgical menopause have a higher risk of frailty than naturally menopausal women. DESIGN: Prospective cohort study with up to 18 years of follow-up. SETTING: Four U.S clinical centers. PARTICIPANTS: Community-dwelling white women aged 65 and older (mean 71.2±5.2) enrolled in the Study of Osteoporotic Fractures (N=7,699). MEASUREMENTS: Surgical menopause was based on participant self-report of having undergone bilateral oophorectomy before menopause. The outcome was incident frailty, classified as robust, prefrail, frail, or death at 4 follow-up interviews, conducted 6 to 18 years after baseline. Information on baseline serum total testosterone concentrations was available for 541 participants. RESULTS: At baseline, 12.6% reported surgical menopause. Over the follow-up period, 22.0% died, and 10.1% were classified as frail, 39.7% as prefrail, and 28.3% as robust. Surgically menopausal women had significantly lower total serum testosterone levels (13.2 ± 7.8 ng/dL) than naturally menopausal women (21.7 ± 14.8 ng/dL) (p=0.000), although they were not at greater risk of frailty (adjusted odds ratio (aOR)=0.94, 95% confidence interval (CI)=0.72-1.22), prefrailty (aOR=0.96, 95% CI=0.80-1.10), or death (aOR=1.17, 95% CI=0.97-1.42) after adjusting for age, body mass index, and number of instrumental activity of daily living impairments. There was no evidence that oral estrogen use modified these associations. CONCLUSION: In postmenopausal women, surgical menopause was not associated with greater risk for frailty than natural menopause, even in the absence of estrogen therapy. Future prospective studies are needed to investigate hormonal mechanisms involved in development of frailty in older postmenopausal women. J Am Geriatr Soc 66:2172-2177, 2018.
OBJECTIVES: To determine whether women with surgical menopause have a higher risk of frailty than naturally menopausal women. DESIGN: Prospective cohort study with up to 18 years of follow-up. SETTING: Four U.S clinical centers. PARTICIPANTS: Community-dwelling white women aged 65 and older (mean 71.2±5.2) enrolled in the Study of Osteoporotic Fractures (N=7,699). MEASUREMENTS: Surgical menopause was based on participant self-report of having undergone bilateral oophorectomy before menopause. The outcome was incident frailty, classified as robust, prefrail, frail, or death at 4 follow-up interviews, conducted 6 to 18 years after baseline. Information on baseline serum total testosterone concentrations was available for 541 participants. RESULTS: At baseline, 12.6% reported surgical menopause. Over the follow-up period, 22.0% died, and 10.1% were classified as frail, 39.7% as prefrail, and 28.3% as robust. Surgically menopausal women had significantly lower total serum testosterone levels (13.2 ± 7.8 ng/dL) than naturally menopausal women (21.7 ± 14.8 ng/dL) (p=0.000), although they were not at greater risk of frailty (adjusted odds ratio (aOR)=0.94, 95% confidence interval (CI)=0.72-1.22), prefrailty (aOR=0.96, 95% CI=0.80-1.10), or death (aOR=1.17, 95% CI=0.97-1.42) after adjusting for age, body mass index, and number of instrumental activity of daily living impairments. There was no evidence that oral estrogen use modified these associations. CONCLUSION: In postmenopausal women, surgical menopause was not associated with greater risk for frailty than natural menopause, even in the absence of estrogen therapy. Future prospective studies are needed to investigate hormonal mechanisms involved in development of frailty in older postmenopausal women. J Am Geriatr Soc 66:2172-2177, 2018.
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053