Age at menopause and the progression of frailty among middle-aged and older women: A prospective cohort analysis from CHARLS.

Abstract

Objective: Menopause marks an important transition in women's health, with the age at menopause influencing a variety of later-life health risks. However, the impact of menopause timing on longitudinal progression of frailty among Chinese middle-aged and older women remains unclear.

Methods: We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study from 2011 to 2018. A total of 11,984 women aged 45 years and older who experienced natural menopause were included. Frailty index was calculated using 30 health deficits encompassing physical, cognitive, and psychological domains. Age at menopause was categorized as <40, 40-44, 45-49, 50-55, and > 55 years. Mixed-effects linear regression models were used to examine the association between age at menopause and frailty progression, adjusting for sociodemographic, lifestyle, and health-related confounders.

Results: Women who experienced menopause after age 55 exhibited the fastest frailty progression compared with those with menopause at age 50-55 (fully adjusted β = 0.43; 95 % confidence interval, 0.05 to 0.81; P = 0.027). Women who underwent menopause at ages 40-44 also had a significantly accelerated frailty progression (β = 0.35; 95 % confidence interval, 0.07 to 0.64; P = 0.016). In contrast, premature ovarian insufficiency (<40 years) was associated with lower baseline frailty index and a slower progression of frailty during follow-up.

Conclusions: Both early and late menopause are associated with accelerated frailty progression among Chinese middle-aged and older women. These findings highlight the need for early identification and targeted preventative interventions in women at risk of atypical menopause timing to promote healthy aging.