Changes in women’s physical function in mid-life by reproductive age and hormones:  a longitudinal study

Fanny C Kilpi; Ana Luiza  Goncalves Soares; Gemma L Clayton; Abigail Fraser; Paul Welsh; Naveed A. Sattar; Scott M Nelson; Kate M Tilling; Debbie A Lawlor

doi:10.1186/s12905-022-02070-9

Changes in women’s physical function in mid-life by reproductive age and hormones: a longitudinal study

Fanny C Kilpi^*, Ana Luiza Goncalves Soares, Gemma L Clayton, Abigail Fraser, Paul Welsh, Naveed A. Sattar, Scott M Nelson, Kate M Tilling, Debbie A Lawlor

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

4 Citations (Scopus)

39 Downloads (Pure)

Abstract

Background
Whether women’s physical function in mid-life is related to their reproductive age is not known. The objectives of this study were to examine and compare changes in physical function in women by reproductive age, measured as time since final menstrual period (FMP), and chronological age, and to explore associations with repeatedly assessed levels of reproductive hormones.

Methods
We used data from 2319 UK women with up to three repeated measurements of physical function (median length of follow up: 2 years), focusing on changes occurring in women experiencing a natural menopausal transition. The main outcome was a composite physical function score that incorporated assessments of strength (grip strength), balance (one-leg stand) and cardiorespiratory fitness (timed chair rises). Associations with time since FMP, age, and time-updated measures of anti-Müllerian hormone, follicle-stimulating hormone and luteinizing hormone were assessed by multilevel models and generalised estimating equations models adjusted for the underlying effects of chronological age and confounding by education, age at first birth and smoking.

Results
The results showed that, adjusted for these confounders, time since FMP (− 0.21 SD per 10 years, 95% CI − 0.37, − 0.06) and chronological age (− 0.31 SD per 10 years, 95% CI − 0.46, − 0.15) were inversely associated with the physical function composite score. Grip strength seemed to be the main contributor to the decline in the composite score by time since FMP. There was no strong evidence of associations between any of the three reproductive hormones and the composite score.

Conclusions
Physical function in women in mid-life declined with both chronological and reproductive age. The decline with reproductive age was independent of chronological age but did not seem to be driven by changes in reproductive hormones.

Original language	English
Article number	473
Number of pages	10
Journal	BMC Women's Health
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12905-022-02070-9
Publication status	Published - 24 Nov 2022

Bibliographical note

Funding Information:
The UK Medical Research Council and Wellcome (Grant Ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC, with additional support from a wide range of national and international funders (a comprehensive list of Grant funding is available on the ALSPAC website; http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). This research was specifically funded by the British Heart Foundation (Grant Ref: SP/07/008/24066), Wellcome Trust (Grant Ref: WT092830/Z/10/Z) and UK Medical Research Council (Grant Ref: G1001357). Roche Diagnostics provided support for the reproductive hormone measures that are used in this paper. FK, ALGS, AF, GLC, KT, and DAL work in or are affiliated to a Unit that is funded by the UK Medical Research Council (Grant Refs: MC_UU_00011/6 and MC_UU_00011/3) and University of Bristol, and DAL is a National Institute for Health Research Senior Investigator (NF-0616-10102). AF is funded by a UK MRC fellowship (MR/M009351/1). The European Union’s Horizon 2020 research and innovation programme under Grant agreement No 874739 (LongITools) funds AGS' salary. The publication is the work of the authors and FK and DAL will serve as the guarantors for the contents of this paper. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding Information:
AF and KT report funding from UK MRC, DAL reports receiving support from several national and international government and charity research funders, and Grants from Medtronic Ltd for work unrelated to that presented here. SMN reports personal fees from Access Fertility, personal fees from Merck, personal fees from Ferring, Grants and personal fees from Roche Diagnostics, personal fees from The Fertility Partnership and personal fees from Modern Fertility, outside the submitted work. Roche Diagnostics provided support in kind for the hormone assays used in this report, and have not contributed to the statistical analysis plan, analysis of data, interpretation of results or any part of the manuscript. PW declares Grant funding from Roche Diagnostics, Astrazeneca, and Boheringer Ingelheim. FK, ALGS, GLC, NS declare that they have no competing interests.

Publisher Copyright:
© 2022, The Author(s).

Access to Document

10.1186/s12905-022-02070-9Licence: CC BY

Full-text PDF (final published version)
This is the final published version of the article (version of record). It first appeared online via Springer Nature at https://doi.org/10.1186/s12905-022-02070-9. Please refer to any applicable terms of use of the publisher.
Final published version, 948 KBLicence: CC BY

Handle.net

Persistent link

Cite this

@article{07db0a7c2df849e5a7c89c8faf438c8a,

title = "Changes in women{\textquoteright}s physical function in mid-life by reproductive age and hormones: a longitudinal study",

abstract = "Background Whether women{\textquoteright}s physical function in mid-life is related to their reproductive age is not known. The objectives of this study were to examine and compare changes in physical function in women by reproductive age, measured as time since final menstrual period (FMP), and chronological age, and to explore associations with repeatedly assessed levels of reproductive hormones. Methods We used data from 2319 UK women with up to three repeated measurements of physical function (median length of follow up: 2 years), focusing on changes occurring in women experiencing a natural menopausal transition. The main outcome was a composite physical function score that incorporated assessments of strength (grip strength), balance (one-leg stand) and cardiorespiratory fitness (timed chair rises). Associations with time since FMP, age, and time-updated measures of anti-M{\"u}llerian hormone, follicle-stimulating hormone and luteinizing hormone were assessed by multilevel models and generalised estimating equations models adjusted for the underlying effects of chronological age and confounding by education, age at first birth and smoking. Results The results showed that, adjusted for these confounders, time since FMP (− 0.21 SD per 10 years, 95\% CI − 0.37, − 0.06) and chronological age (− 0.31 SD per 10 years, 95\% CI − 0.46, − 0.15) were inversely associated with the physical function composite score. Grip strength seemed to be the main contributor to the decline in the composite score by time since FMP. There was no strong evidence of associations between any of the three reproductive hormones and the composite score. Conclusions Physical function in women in mid-life declined with both chronological and reproductive age. The decline with reproductive age was independent of chronological age but did not seem to be driven by changes in reproductive hormones.",

author = "Kilpi, \{Fanny C\} and \{Goncalves Soares\}, \{Ana Luiza\} and Clayton, \{Gemma L\} and Abigail Fraser and Paul Welsh and Sattar, \{Naveed A.\} and Nelson, \{Scott M\} and Tilling, \{Kate M\} and Lawlor, \{Debbie A\}",

note = "Funding Information: The UK Medical Research Council and Wellcome (Grant Ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC, with additional support from a wide range of national and international funders (a comprehensive list of Grant funding is available on the ALSPAC website; http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). This research was specifically funded by the British Heart Foundation (Grant Ref: SP/07/008/24066), Wellcome Trust (Grant Ref: WT092830/Z/10/Z) and UK Medical Research Council (Grant Ref: G1001357). Roche Diagnostics provided support for the reproductive hormone measures that are used in this paper. FK, ALGS, AF, GLC, KT, and DAL work in or are affiliated to a Unit that is funded by the UK Medical Research Council (Grant Refs: MC\_UU\_00011/6 and MC\_UU\_00011/3) and University of Bristol, and DAL is a National Institute for Health Research Senior Investigator (NF-0616-10102). AF is funded by a UK MRC fellowship (MR/M009351/1). The European Union{\textquoteright}s Horizon 2020 research and innovation programme under Grant agreement No 874739 (LongITools) funds AGS' salary. The publication is the work of the authors and FK and DAL will serve as the guarantors for the contents of this paper. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: AF and KT report funding from UK MRC, DAL reports receiving support from several national and international government and charity research funders, and Grants from Medtronic Ltd for work unrelated to that presented here. SMN reports personal fees from Access Fertility, personal fees from Merck, personal fees from Ferring, Grants and personal fees from Roche Diagnostics, personal fees from The Fertility Partnership and personal fees from Modern Fertility, outside the submitted work. Roche Diagnostics provided support in kind for the hormone assays used in this report, and have not contributed to the statistical analysis plan, analysis of data, interpretation of results or any part of the manuscript. PW declares Grant funding from Roche Diagnostics, Astrazeneca, and Boheringer Ingelheim. FK, ALGS, GLC, NS declare that they have no competing interests. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = nov,

day = "24",

doi = "10.1186/s12905-022-02070-9",

language = "English",

volume = "22",

journal = "BMC Women's Health",

issn = "1472-6874",

publisher = "BioMed Central Ltd",

number = "1",

}

TY - JOUR

T1 - Changes in women’s physical function in mid-life by reproductive age and hormones

T2 - a longitudinal study

AU - Kilpi, Fanny C

AU - Goncalves Soares, Ana Luiza

AU - Clayton, Gemma L

AU - Fraser, Abigail

AU - Welsh, Paul

AU - Sattar, Naveed A.

AU - Nelson, Scott M

AU - Tilling, Kate M

AU - Lawlor, Debbie A

N1 - Funding Information: The UK Medical Research Council and Wellcome (Grant Ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC, with additional support from a wide range of national and international funders (a comprehensive list of Grant funding is available on the ALSPAC website; http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). This research was specifically funded by the British Heart Foundation (Grant Ref: SP/07/008/24066), Wellcome Trust (Grant Ref: WT092830/Z/10/Z) and UK Medical Research Council (Grant Ref: G1001357). Roche Diagnostics provided support for the reproductive hormone measures that are used in this paper. FK, ALGS, AF, GLC, KT, and DAL work in or are affiliated to a Unit that is funded by the UK Medical Research Council (Grant Refs: MC_UU_00011/6 and MC_UU_00011/3) and University of Bristol, and DAL is a National Institute for Health Research Senior Investigator (NF-0616-10102). AF is funded by a UK MRC fellowship (MR/M009351/1). The European Union’s Horizon 2020 research and innovation programme under Grant agreement No 874739 (LongITools) funds AGS' salary. The publication is the work of the authors and FK and DAL will serve as the guarantors for the contents of this paper. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: AF and KT report funding from UK MRC, DAL reports receiving support from several national and international government and charity research funders, and Grants from Medtronic Ltd for work unrelated to that presented here. SMN reports personal fees from Access Fertility, personal fees from Merck, personal fees from Ferring, Grants and personal fees from Roche Diagnostics, personal fees from The Fertility Partnership and personal fees from Modern Fertility, outside the submitted work. Roche Diagnostics provided support in kind for the hormone assays used in this report, and have not contributed to the statistical analysis plan, analysis of data, interpretation of results or any part of the manuscript. PW declares Grant funding from Roche Diagnostics, Astrazeneca, and Boheringer Ingelheim. FK, ALGS, GLC, NS declare that they have no competing interests. Publisher Copyright: © 2022, The Author(s).

PY - 2022/11/24

Y1 - 2022/11/24

N2 - Background Whether women’s physical function in mid-life is related to their reproductive age is not known. The objectives of this study were to examine and compare changes in physical function in women by reproductive age, measured as time since final menstrual period (FMP), and chronological age, and to explore associations with repeatedly assessed levels of reproductive hormones. Methods We used data from 2319 UK women with up to three repeated measurements of physical function (median length of follow up: 2 years), focusing on changes occurring in women experiencing a natural menopausal transition. The main outcome was a composite physical function score that incorporated assessments of strength (grip strength), balance (one-leg stand) and cardiorespiratory fitness (timed chair rises). Associations with time since FMP, age, and time-updated measures of anti-Müllerian hormone, follicle-stimulating hormone and luteinizing hormone were assessed by multilevel models and generalised estimating equations models adjusted for the underlying effects of chronological age and confounding by education, age at first birth and smoking. Results The results showed that, adjusted for these confounders, time since FMP (− 0.21 SD per 10 years, 95% CI − 0.37, − 0.06) and chronological age (− 0.31 SD per 10 years, 95% CI − 0.46, − 0.15) were inversely associated with the physical function composite score. Grip strength seemed to be the main contributor to the decline in the composite score by time since FMP. There was no strong evidence of associations between any of the three reproductive hormones and the composite score. Conclusions Physical function in women in mid-life declined with both chronological and reproductive age. The decline with reproductive age was independent of chronological age but did not seem to be driven by changes in reproductive hormones.

AB - Background Whether women’s physical function in mid-life is related to their reproductive age is not known. The objectives of this study were to examine and compare changes in physical function in women by reproductive age, measured as time since final menstrual period (FMP), and chronological age, and to explore associations with repeatedly assessed levels of reproductive hormones. Methods We used data from 2319 UK women with up to three repeated measurements of physical function (median length of follow up: 2 years), focusing on changes occurring in women experiencing a natural menopausal transition. The main outcome was a composite physical function score that incorporated assessments of strength (grip strength), balance (one-leg stand) and cardiorespiratory fitness (timed chair rises). Associations with time since FMP, age, and time-updated measures of anti-Müllerian hormone, follicle-stimulating hormone and luteinizing hormone were assessed by multilevel models and generalised estimating equations models adjusted for the underlying effects of chronological age and confounding by education, age at first birth and smoking. Results The results showed that, adjusted for these confounders, time since FMP (− 0.21 SD per 10 years, 95% CI − 0.37, − 0.06) and chronological age (− 0.31 SD per 10 years, 95% CI − 0.46, − 0.15) were inversely associated with the physical function composite score. Grip strength seemed to be the main contributor to the decline in the composite score by time since FMP. There was no strong evidence of associations between any of the three reproductive hormones and the composite score. Conclusions Physical function in women in mid-life declined with both chronological and reproductive age. The decline with reproductive age was independent of chronological age but did not seem to be driven by changes in reproductive hormones.

U2 - 10.1186/s12905-022-02070-9

DO - 10.1186/s12905-022-02070-9

M3 - Article (Academic Journal)

C2 - 36434722

SN - 1472-6874

VL - 22

JO - BMC Women's Health

JF - BMC Women's Health

IS - 1

M1 - 473

ER -