title: Age at menopause and mortality in Japan: the Jichi Medical School Cohort Study.
abstract: BACKGROUND
  Although several studies have reported increased mortality risk with early menopause, there were no studies examining the relationship between age at menopause and mortality in Japan. The goal of this analysis is to investigate the relationship between age at menopause and all-cause mortality among the Japanese.
  
  
  METHODS
  Study subjects were 4,683 postmenopausal females in the Jichi Medical School Cohort Study, a population-based prospective study. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995 in 12 rural areas in Japan. Main outcome measures were all-cause mortality derived from death certificates up to December 31, 2002. Cox's proportional hazard models were used to analyze the association of age at menopause with mortality.
  
  
  RESULTS
  A total of 215 deaths were observed during the average of 9.2 year follow-up period. After adjusting for age, systolic blood pressure, serum total cholesterol level, serum high density lipoprotein cholesterol level, history of diabetes mellitus, body mass index, smoking habits, alcohol drinking habits, marital status, study area, and types of menopause, the hazard ratios (95% confidence intervals) of all-cause mortality were 2.10 (1.07-4.11), 0.68 (0.36-1.26), 0.94 (0.68-1.30), and 1.17 (0.63-2.20) for females with a menopause at ages younger than 40 years, 40-44, 50-54, and 55 or older, respectively, relative to those with menopause at age 45-49 years.
  
  
  CONCLUSIONS
  Our data suggest that menopause aged younger than 40 years increases the risk of death from all causes among the Japanese.
authors.affiliation: Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Japan. y.amagai@jichi.ac.jp
authors.forename: Yoko
authors.initials: Y
authors.lastname: Amagai
authors.forename: Shizukiyo
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Tadao
authors.initials: T
authors.lastname: Gotoh
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kayaba
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajii
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires