Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents

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, Advance Access 1-21. doi:10.1093/ije/dyu094

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Author Schoenaker, Danielle A. J. M.
Jackson, Caroline A.
Rowlands, Jemma V.
Mishra, Gita D.
Title Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents
Journal name International Journal of Epidemiology   Check publisher's open access policy
ISSN 0300-5771
1464-3685
Publication date 2014-04-26
Sub-type Article (original research)
DOI 10.1093/ije/dyu094
Volume Advance Access
Start page 1
End page 21
Total pages 21
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted 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 We explored heterogeneity using meta-regression and also included unpublished findings from the Australian Longitudinal Study on Women’s Health.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.
Keyword Menopause
Smoking
Body mass index
Physical activity
Socioeconomic factors
Systematic review
Meta-analysis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes First published online: April 26, 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 34 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 05 May 2014, 22:03:53 EST by Caroline Jackson on behalf of School of Public Health