Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents
Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents
BACKGROUND: Age at natural menopause (ANM) is considered a marker of biological ageing and is increasingly recognized as a sentinel for chronic disease risk in later life. Socioeconomic position (SEP) and lifestyle factors are thought to be associated with ANM.
METHODS: We performed a systematic review and meta-analyses to determine the overall mean ANM, and the effect of SEP and lifestyle factors on ANM by calculating the weighted mean difference (WMD) and pooling adjusted hazard ratios. We explored heterogeneity using meta-regression and also included unpublished findings from the Australian Longitudinal Study on Women's Health.
RESULTS: We identified 46 studies across 24 countries. Mean ANM was 48.8 years [95% confidence interval (CI): 48.3, 49.2], with between-study heterogeneity partly explained by geographical region. ANM was lowest among African, Latin American, Asian and Middle Eastern countries and highest in Europe and Australia, followed by the USA. Education was associated with later ANM (WMD middle vs low education 0.30, 95% CI: 0.10, 0.51; high vs low education 0.64, 95% CI 0.26, 1.02). A similar dose-response relationship was also observed for occupation. Smoking was associated with a 1-year reduction of ANM (WMD: -0.91, 95% CI: -1.34, -0.48). Being overweight and moderate/high physical activity were modestly associated with later ANM, but findings were less conclusive.
CONCLUSIONS: ANM varies across populations, partly due to differences across geographical regions. SEP and some lifestyle factors are associated with ANM, but further research is needed to examine the impact of the associations between risk factors and ANM on future health outcomes.
Age Factors, Body Mass Index, Female, Humans, Life Style, Menopause, Risk Factors, Smoking/adverse effects, Socioeconomic Factors, Women's Health
1542-1562
Schoenaker, Danielle A.J.M.
84b96b87-4070-45a5-9777-5a1e4e45e818
Jackson, Caroline A.
8466283f-8904-426f-99fc-9178268de1a5
Rowlands, Jemma V.
2e9ad6a6-7980-41cf-ade1-249be9f5bc64
Mishra, Gita D.
02143b82-e536-4915-9b30-3c86cbe1a1fe
October 2014
Schoenaker, Danielle A.J.M.
84b96b87-4070-45a5-9777-5a1e4e45e818
Jackson, Caroline A.
8466283f-8904-426f-99fc-9178268de1a5
Rowlands, Jemma V.
2e9ad6a6-7980-41cf-ade1-249be9f5bc64
Mishra, Gita D.
02143b82-e536-4915-9b30-3c86cbe1a1fe
Schoenaker, Danielle A.J.M., Jackson, Caroline A., Rowlands, Jemma V. and Mishra, Gita D.
(2014)
Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents.
International Journal of Epidemiology, 43 (5), .
(doi:10.1093/ije/dyu094).
Abstract
BACKGROUND: Age at natural menopause (ANM) is considered a marker of biological ageing and is increasingly recognized as a sentinel for chronic disease risk in later life. Socioeconomic position (SEP) and lifestyle factors are thought to be associated with ANM.
METHODS: We performed a systematic review and meta-analyses to determine the overall mean ANM, and the effect of SEP and lifestyle factors on ANM by calculating the weighted mean difference (WMD) and pooling adjusted hazard ratios. We explored heterogeneity using meta-regression and also included unpublished findings from the Australian Longitudinal Study on Women's Health.
RESULTS: We identified 46 studies across 24 countries. Mean ANM was 48.8 years [95% confidence interval (CI): 48.3, 49.2], with between-study heterogeneity partly explained by geographical region. ANM was lowest among African, Latin American, Asian and Middle Eastern countries and highest in Europe and Australia, followed by the USA. Education was associated with later ANM (WMD middle vs low education 0.30, 95% CI: 0.10, 0.51; high vs low education 0.64, 95% CI 0.26, 1.02). A similar dose-response relationship was also observed for occupation. Smoking was associated with a 1-year reduction of ANM (WMD: -0.91, 95% CI: -1.34, -0.48). Being overweight and moderate/high physical activity were modestly associated with later ANM, but findings were less conclusive.
CONCLUSIONS: ANM varies across populations, partly due to differences across geographical regions. SEP and some lifestyle factors are associated with ANM, but further research is needed to examine the impact of the associations between risk factors and ANM on future health outcomes.
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Accepted/In Press date: 26 March 2014
e-pub ahead of print date: 26 April 2014
Published date: October 2014
Keywords:
Age Factors, Body Mass Index, Female, Humans, Life Style, Menopause, Risk Factors, Smoking/adverse effects, Socioeconomic Factors, Women's Health
Identifiers
Local EPrints ID: 442212
URI: http://eprints.soton.ac.uk/id/eprint/442212
ISSN: 0300-5771
PURE UUID: 346bb804-d473-423d-a51d-e12457a184ff
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Date deposited: 09 Jul 2020 16:30
Last modified: 17 Mar 2024 04:01
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Contributors
Author:
Caroline A. Jackson
Author:
Jemma V. Rowlands
Author:
Gita D. Mishra
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