A later menopausal age is associated with a lower prevalence of physical frailty in community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS)

Association between Menopausal Hormone Therapy and Frailty: Cross-Sectional Study Using National Survey Data in Korea

“…An association was also found with an MHT duration of 2 to 5 years, which is in alignment with current evidence, where an increased risk of venous thromboembolism was reported in the first 1–2 years of treatment, and an increased risk of breast and ovarian cancers with treatment periods longer than 5 years [ 35 , 37 , 38 ]. Additionally, older age, low socioeconomic status, baseline multimorbidity, younger age at menopause, and a higher number of pregnancies were all positively associated with frailty, which are all consistent with previous findings [ 6 , 7 , 8 , 9 , 13 ]. In the subgroup analysis, similar results were found as in the overall analysis.…”

“…In a previous cross-sectional study in Korea (KNHANES 2008–2011), compared with those never treated or those who had received treatment for <13 months, a longer duration of MHT (≥13 months) was significantly associated with lower odds of sarcopenia, a criterion for physical frailty [ 16 ]. In a cross-sectional analysis of an ongoing cohort study (the Korean Frailty and Aging Cohort Study), where women aged 70 to 84 years were enrolled, the prevalence of physical frailty was lower in women with a history of MHT, approximately one-third of what was observed in those with no history of MHT [ 8 ]. However, there is also evidence that contradicts these findings.…”

“…To control for confounding, the propensity score (PS) based inverse probability of treatment weighting (IPTW) was applied to estimate the average treatment effect (ATE) at a national level [ 25 , 26 ]. Stabilized IPTW weights were generated using prognostically or clinically important information such as socioeconomic, reproductive, and clinical characteristics [ 7 , 8 , 27 ]. Variables to be included in the PS model were selected from those significantly different between the treatment groups.…”

“…Frailty is of concern to society, as frail individuals become prone to deleterious health outcomes including falls, hospitalization, and death [ 1 , 4 , 5 ]. Well-known risk factors for frailty include age, multimorbidity, poor socioeconomic status, and a higher number of pregnancies in women [ 6 , 7 , 8 , 9 ]. Although the prevalence of frailty increases in both men and women with age, it is predominantly higher in women, by up to twofold in the oldest old [ 10 ].…”

“…Menopause, the permanent cessation of menstruation, is accompanied by a significant fall in blood estrogen [ 12 ]. Previous studies have reported a close link between age at menopause and frailty [ 8 , 9 , 13 ], which may partly be explained by the loss of the protective effects of estrogen on various physiological systems including lipid profiles, cognitive function, bone and muscle density, and inflammation [ 6 , 14 , 15 ]. In previous studies, MHT was associated with a lower prevalence of sarcopenia and increased grip strength, which are key criteria for physical frailty [ 16 , 17 ].…”