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Age at natural menopause and life expectancy with and without type 2 diabetes
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EMAS2017 / Maturitas 100 (2017) 93–202
management and mechanisms to ensure that consent to treatment is informed. http://dx.doi.org/10.1016/j.maturitas.2017.03.301 O24 Age at period cessation and verbal memory across adult life: Findings from the MRC National Survey of Health and Development Diana Kuh ∗ , Rachel Cooper, Adam Moore, Marcus Richards, Rebecca Hardy University College London, MRC Unit for Lifelong Health and Ageing, London, United Kingdom Whether earlier menopause is associated with earlier or faster cognitive decline and risk of dementia has long been of interest. We used data from the British 1946 birth cohort to investigate whether verbal memory assessed between 43 and 69 years was associated with timing of natural or surgical menopause; and whether associations were explained by hormone therapy (HT), childhood cognition and sociobehavioural covariates. Verbal memory (word learning) was assessed at 43, 53, 60–64 and 69 years. Age at period cessation was derived from 11 questionnaires between 43 and 64 years. We fitted multi-level models based on 3631 observations on 1153 women with linear and quadratic age terms, stratified by natural or surgical menopause, and adjusting for: HT use, body mass index, and smoking at each cognitive assessment; and adult occupational class, educational qualifications, and childhood cognition. Later age at natural menopause was consistently associated with higher verbal memory from 43 to 60–69 years (0.18 words per year, 95% CI 0.08,0.27, p-value < .001). An association remained after adjustment for covariates (0.10 words per year, 95%CI: 0.03,0.18, p-value = .007); HT use was not associated with verbal memory. Verbal memory increased with later age at surgical menopause (0.16, 95% CI 0.08,0.27, p value < .001) but no association remained after adjustment. Lifelong oestrogen exposure rather than short-term menopausal fluctuations may be the underlying mechanism. http://dx.doi.org/10.1016/j.maturitas.2017.03.302
O25 Age at natural menopause and life expectancy with and without type 2 diabetes Eralda Asllanaj 1,∗ , Arjola Bano 1 , Loes Jaspers 1 , Eric J. Sijbrands 2 , M. Afran Ikram 1,3 , Joop S.E. 5,6 , Taulant Muka 1 , Oscar ˝ Laven 4 , Henry Volzke H. Franco 1 1 Erasmus University Medical Center, Department of Epidemiology, Rotterdam, Netherlands 2 Erasmus University Medical Center, Department of Internal Medicine, Section Pharmacology Vascular and Metabolic Diseases, Rotterdam, Netherlands 3 Erasmus University Medical Center, Department of Neurology, Rotterdam, Netherlands 4 Erasmus University Medical Center, Department of Obstetrics and Gynaecology, Rotterdam, Netherlands 5 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany 6 DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
Background: Early onset of menopause is associated with increased risk of type 2 diabetes (T2D) and all-cause mortality. However, little is known about the effects of early age at natural menopause (ANM) on years lived with and without T2D. Objective: We aimed to examine the association of ANM with the number of years lived with and without T2D. Methods: We included 3.623 postmenopausal women aged 45+ years from the Rotterdam Study, a prospective population-based cohort study. Multistate life tables were built to calculate total life expectancy (LE) and LE with and without T2D among women who experienced early (≤44 years), normal (45 to 55 years), and late menopause (>55 years, reference). For life table calculations, we used prevalence, incidence rates and hazard ratios (HR) for 3 transitions (free of T2D to T2D, free of T2D to death and T2D to death) stratifying by ANM and adjusting for confounders. Results: During a median follow-up of 12 years, we identified 306 incident cases of T2D. Early (HR 1.8, 95% CI 1.17; 2.76), but not normal ANM (HR 1.1, 95% CI 0. 77; 1.64), was associated with increased risk of T2D. Also, early ANM was associated with mortality in women without T2D (HR 1.4, 95% CI 1.02; 1.96), but not in women with T2D (HR 1.5, 95% CI 0.83; 2.54), whereas no association was found between normal ANM and mortality in either groups. Compared with those who experienced late menopause, women who experienced early and normal onset of menopause lived 3.2 (95% CI: −5.8; −1.0) and 0.9 (95% CI −2.6; 0.8) years fewer overall of which 5.0 (95% CI −9.5; −1.2) and 1.4 (95% CI −4.1; 0.9) years fewer without T2D, respectively. In addition, although not significant, women who experienced early menopause lived 1.8 (95% CI −1.4; 5.8) years longer with T2D than women who experienced late menopause. Conclusions: The increase in the risk of T2D and mortality from early onset of menopause represents an important decrease in total LE and LE free of T2D. http://dx.doi.org/10.1016/j.maturitas.2017.03.303
EMAS2017 / Maturitas 100 (2017) 93–202
management and mechanisms to ensure that consent to treatment is informed. http://dx.doi.org/10.1016/j.maturitas.2017.03.301 O24 Age at period cessation and verbal memory across adult life: Findings from the MRC National Survey of Health and Development Diana Kuh ∗ , Rachel Cooper, Adam Moore, Marcus Richards, Rebecca Hardy University College London, MRC Unit for Lifelong Health and Ageing, London, United Kingdom Whether earlier menopause is associated with earlier or faster cognitive decline and risk of dementia has long been of interest. We used data from the British 1946 birth cohort to investigate whether verbal memory assessed between 43 and 69 years was associated with timing of natural or surgical menopause; and whether associations were explained by hormone therapy (HT), childhood cognition and sociobehavioural covariates. Verbal memory (word learning) was assessed at 43, 53, 60–64 and 69 years. Age at period cessation was derived from 11 questionnaires between 43 and 64 years. We fitted multi-level models based on 3631 observations on 1153 women with linear and quadratic age terms, stratified by natural or surgical menopause, and adjusting for: HT use, body mass index, and smoking at each cognitive assessment; and adult occupational class, educational qualifications, and childhood cognition. Later age at natural menopause was consistently associated with higher verbal memory from 43 to 60–69 years (0.18 words per year, 95% CI 0.08,0.27, p-value < .001). An association remained after adjustment for covariates (0.10 words per year, 95%CI: 0.03,0.18, p-value = .007); HT use was not associated with verbal memory. Verbal memory increased with later age at surgical menopause (0.16, 95% CI 0.08,0.27, p value < .001) but no association remained after adjustment. Lifelong oestrogen exposure rather than short-term menopausal fluctuations may be the underlying mechanism. http://dx.doi.org/10.1016/j.maturitas.2017.03.302
O25 Age at natural menopause and life expectancy with and without type 2 diabetes Eralda Asllanaj 1,∗ , Arjola Bano 1 , Loes Jaspers 1 , Eric J. Sijbrands 2 , M. Afran Ikram 1,3 , Joop S.E. 5,6 , Taulant Muka 1 , Oscar ˝ Laven 4 , Henry Volzke H. Franco 1 1 Erasmus University Medical Center, Department of Epidemiology, Rotterdam, Netherlands 2 Erasmus University Medical Center, Department of Internal Medicine, Section Pharmacology Vascular and Metabolic Diseases, Rotterdam, Netherlands 3 Erasmus University Medical Center, Department of Neurology, Rotterdam, Netherlands 4 Erasmus University Medical Center, Department of Obstetrics and Gynaecology, Rotterdam, Netherlands 5 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany 6 DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
Background: Early onset of menopause is associated with increased risk of type 2 diabetes (T2D) and all-cause mortality. However, little is known about the effects of early age at natural menopause (ANM) on years lived with and without T2D. Objective: We aimed to examine the association of ANM with the number of years lived with and without T2D. Methods: We included 3.623 postmenopausal women aged 45+ years from the Rotterdam Study, a prospective population-based cohort study. Multistate life tables were built to calculate total life expectancy (LE) and LE with and without T2D among women who experienced early (≤44 years), normal (45 to 55 years), and late menopause (>55 years, reference). For life table calculations, we used prevalence, incidence rates and hazard ratios (HR) for 3 transitions (free of T2D to T2D, free of T2D to death and T2D to death) stratifying by ANM and adjusting for confounders. Results: During a median follow-up of 12 years, we identified 306 incident cases of T2D. Early (HR 1.8, 95% CI 1.17; 2.76), but not normal ANM (HR 1.1, 95% CI 0. 77; 1.64), was associated with increased risk of T2D. Also, early ANM was associated with mortality in women without T2D (HR 1.4, 95% CI 1.02; 1.96), but not in women with T2D (HR 1.5, 95% CI 0.83; 2.54), whereas no association was found between normal ANM and mortality in either groups. Compared with those who experienced late menopause, women who experienced early and normal onset of menopause lived 3.2 (95% CI: −5.8; −1.0) and 0.9 (95% CI −2.6; 0.8) years fewer overall of which 5.0 (95% CI −9.5; −1.2) and 1.4 (95% CI −4.1; 0.9) years fewer without T2D, respectively. In addition, although not significant, women who experienced early menopause lived 1.8 (95% CI −1.4; 5.8) years longer with T2D than women who experienced late menopause. Conclusions: The increase in the risk of T2D and mortality from early onset of menopause represents an important decrease in total LE and LE free of T2D. http://dx.doi.org/10.1016/j.maturitas.2017.03.303