title: Early menopause and the risk of silent brain infarction in community-dwelling elderly subjects: the Sefuri brain MRI study.
abstract: Our previous study showed that the male predominance of silent brain infarction (SBI) was largely because of higher prevalence of alcohol habit and smoking in men than in women. In the present study, we further conducted an analysis of brain magnetic resonance imaging findings to examine whether early menopause contributes to SBI in community-dwelling subjects. Women were queried as to the age and cause of menopause, the total number of children, and the age at giving birth to her last child. Among 306 female subjects aged 60 years or older, univariate analysis showed that early menopause (total or natural) was significantly associated with SBI but age at natural menopause, number of children, and age at the last parity were not. In the total of 715 subjects (283 men and 432 women with a mean age of 67.2 years), the forward stepwise method of logistic analysis revealed that natural early menopause (odds ratio [OR] 4.28, 95% confidence interval [CI] 1.07-17.11), in addition to age, hypertension, alcohol intake, and smoking, was a significant factor concerning SBI. Also in the subgroup of female subjects aged 60 years or older, natural early menopause was a significant factor concerning SBI (OR 4.35, 95% CI 1.05-18.08) adjusted for covariates. Although the prevalence of natural early menopause was low (3.3% of 306 female subjects), natural menopause before the age of 40 years may be a risk for SBI or small-vessel disease of the brain.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Takashima
authors.affiliation: Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Uchino
authors.affiliation: Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Japan.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Yuzuriha
authors.affiliation: Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Japan. Electronic address: hyao@hizen2.hosp.go.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000453:epidemiology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D057187:Independent Living; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008594:Menopause, Premature; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors
keywords: Silent stroke; magnetic resonance imaging; menopause; parity; small-vessel disease