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Article Abstract
Objectives: This study investigates the associations between surgical menopause, age at menopause, and frailty in older women. Furthermore, we examine whether age at menopause mediates the potential association between surgical menopause and frailty, and the extent of interaction or joint effects of surgical menopause and age at menopause on frailty.
Methods: The analysis included 7462 women aged ≥60 from the National Health and Nutrition Examination Survey 1999-2018. Frailty was measured using a 49-item frailty index and was diagnosed if the score on that index exceeded 0.21. Menopausal data were collected using a standardized reproductive health questionnaire. Survey-weighted logistic regression models were used to assess the association between surgical menopause, menopausal age, and frailty. We also conducted mediation analyses and interaction analyses on both the multiplicative and additive scales.
Results: Of the 7462 women, 2687 (32.4 %) had frailty. Women with a history of surgical menopause had an odds ratio (OR) of 1.44 (95 % CI: 1.25-1.66) for frailty compared to those with natural menopause. Age at menopause mediated 26.4 % of the total association between surgical menopause and frailty. No significant multiplicative or additive interactions were observed in the effects of type of menopause and age at menopause on frailty (Additive: Relative excess risk due to interaction = -0.01, 95 % CI: -0.32-0.31; Multiplicative, OR = 0.94, 95 % CI: 0.75-1.19). Joint ORs for individuals with both surgical and early menopause, compared with those with natural menopause and without early menopause, were 1.59 (95 % CI: 1.40-1.81) for frailty.
Conclusions: In postmenopausal women, surgical menopause was significantly associated with a higher likelihood of frailty than natural menopause. Age at menopause mediated more than 26 % of this association.
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| http://dx.doi.org/10.1016/j.maturitas.2025.108680 | DOI Listing |
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