Cohort profile: the Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) in Olmsted County, Minnesota (USA)

Abstract

PurposeThis cohort study was established to investigate the effects of unilateral and bilateral oophorectomy on the ageing processes in women.ParticipantsWe used the records-linkage system of the Rochester Epidemiology Project (REP, http://www.rochesterproject.org) to identify 570 women who underwent unilateral oophorectomy and 1653 women who underwent bilateral oophorectomy in Olmsted County, Minnesota from 1988 through 2007 (20 years). Each woman was matched by age (±1 year) to a population-based referent woman who had not undergone any oophorectomy (570 referent women) or bilateral oophorectomy (1653 referent women). These four cohorts are being followed to assess morbidity and mortality and to study imaging and biological markers related to ageing.Findings to dateAn extensive medical record abstraction using the REP has been completed for each woman to obtain demographic, reproductive and adult life characteristics and extensive clinical information about the surgical procedure and subsequent oestrogen replacement therapy (or other sex steroid therapy). The cohorts have been used to date to study the accumulation of multiple chronic conditions following bilateral oophorectomy in women with or without chronic conditions at the time of the oophorectomy (or index date). From the cohorts, we have also derived a sample of 128 pairs of women for a case–control study linking adverse childhood or adult experiences to the risk of bilateral oophorectomy.Future plansWe hypothesise that the abrupt hormonal changes caused by bilateral oophorectomy in younger women have a major effect on the ageing processes across the full body. Therefore, we plan to investigate the risk of a wide range of chronic conditions following bilateral oophorectomy. Specific studies are underway for kidney diseases, psychiatric diseases and neurological diseases. In addition, we plan to invite a subsample of women from the bilateral oophorectomy cohort to participate in an in-person study involving brain imaging and the collection of biomarkers.

Hysterectomy and Oophorectomy in Reproductive Age: A Cross-Sectional Study from a Tertiary Care Hospital

“…Uterine prolapse is uncommon at a young age; however, in our study, uterine prolapse was the clinical indication in 29 (18.47%) women and was reported in 38 (24.20%) women, all of whom were older than 25 years. This frequency of prolapse is comparable to a study from Pakistan, which reported prolapse in 24% of hysterectomies, as compared to 37.5% in patients from India and 20% from the United States [23,25,27].…”

“…An international cohort study on women undergoing simultaneous hysterectomy and oophorectomy for uterine pathologies has reported that ovarian cancer was reported in only 1.5% of bilateral and 1.9% of unilateral oophorectomies removed with the hysterectomy specimen and that benign conditions or normal histology was present in the majority of these oophorectomies [26]. Literature has verified that ovarian conservation for women undergoing hysterectomy for benign causes has long-term survival benefits; for many years post-menopause, the ovaries continue to synthesize testosterone and androstenedione, which is converted to estrogen [27]. Removal of hormonally active ovaries is associated with increased risk of coronary artery disease, hypertension, osteoporosis, fractures, and psychological problems such as depression, Parkinson's disease, schizophrenia, and dementia, as demonstrated in large-cohort studies [28][29].…”

Association of Bilateral Salpingo-Oophorectomy Before Menopause Onset With Medial Temporal Lobe Neurodegeneration

“…The Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) is a population-based cohort study that includes women who underwent BSO before age 50 years and before reaching natural menopause from 1988 through 2007 and an age-matched control group who had not undergone bilateral oophorectomy before age 50 years. 5 The Mayo Clinic Study of Aging (MCSA) is another population-based cohort study, which includes participants with normal cognitive aging, mild cognitive impairment, and dementia. 6 All MCSA participants are invited to undergo MRI and Pittsburgh compound B (PiB) positron emission tomography (PET).…”

CKD in Patients with Bilateral Oophorectomy

“…Women were identified as part of the Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) as described extensively elsewhere (15)(16)(17). All of the data used for this study were derived from the medical records linkage system of the Rochester Epidemiology Project, which has been described elsewhere (18)(19)(20)(21).…”

“…Medical comorbidities present at the index date were electronically abstracted using selected International Classification of Diseases (ICD) diagnosis codes (ICD-8 or ICD-9) (22). Women needed to have at least two diagnostic codes in a given category separated by .30 days to avoid false positive diagnoses (17). Medical records were manually reviewed, and oophorectomy status was confirmed by trained study personnel (primarily L.G.R.).…”