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Is Postmenopausal Estrogen Therapy Associated With Neuromuscular Function or Falling in Elderly Women?
Dana G. Seeley, PhD;
Jane A. Cauley, DrPH;
Deborah Grady, MD, MPH;
Warren S. Browner, MD, MPH;
Michael C. Nevitt, PhD;
Steven R. Cummings, MD;
Study of Osteoporotic Fractures Research Group;
Steven R. Cummings, MD;
Michael C. Nevitt, PhD;
Dana G. Seeley, PhD;
Dennis M. Black, PhD;
Harry K. Genant, MD;
Claude Arnaud, MD;
Warren S. Browner, MD, MPH;
Lisa Christianson;
Maurice Dockrell;
Cary Fox, MA;
Claus Glüer, PhD;
Sarah Harvey;
Stephen B. Hulley, MD, MPH;
Mario Jaime, PhD;
Michael Jergas, MD;
Lisa Palermo, MS;
Alice R. Pressman, MS;
Ria San Valentin, MD;
Katie Stone, MA;
Diana Tanaka;
Jean Scott, RN, DrPH;
Kathy Fox, PhD;
Roger Sherwin, MD;
Jane Lewis, RN;
Gail Greenberg, MSN;
Mary Bahr;
Linda Finazzo;
Bert Hohman, RN;
Eileen Oliner;
Tiffany Page;
Sharlene Trusty;
Kristine Ensrud, MD, MPH;
Richard Grimm, Jr, MD, PhD;
Cathy Bell, MBA;
Eileen Mitson;
Mary Baumhover;
Isabelle Chavier;
Susan Estill;
Sandra Fillhouer;
Arlene Gillet;
Jerry Hansen;
Kristi Jacobson;
Diane Michel;
Carmen Shoberg;
Jane Cauley, DrPH;
Lew Kuller, MD, DrPH;
Loretta Harper;
Mary Nasim, RN;
Carol Bashada;
Linda Buck, RN;
Arlene Githens;
Alexis McCune;
Debbie Medve;
Steve Rudovsky;
Nora Watson;
Thomas M. Vogt, MD, MPH;
William M. Vollmer, PhD;
Eric Orwoll, MD;
Jan Blank;
Fran Heinith;
Rose Bright;
Joyce Downing;
Kathy Harding;
Gail Morgan;
Betsy Packer;
Cheryl Ray;
Sabina Smith;
Carrie Souvanlasy
Arch Intern Med. 1995;155(3):293-299.
Abstract
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Background
Muscle strength declines with advancing age; the causes of this are uncertain. In women, strength begins to decline around the time of menopause, suggesting that hormonal changes might influence strength. To determine the effect of postmenopausal estrogen use on muscle strength, neuromuscular function, and the risk of falling, we examined 9704 participants aged 65 years or more enrolled in the Study of Osteoporotic Fractures.
Methods
We measured hip abductor, triceps extensor, and hand-grip muscle strength, balance, gait speed, and self-reported functional disability. Falls during the first year of follow-up were determined from postcards that participants mailed every 4 months indicating whether they had fallen in the previous 4 months (>99% complete follow-up).
Results
After adjusting for age, medications, medical history, and personal habits, current estrogen users did not differ in a clinically meaningful way from those who had never used estrogen on tests of hip abductor strength (mean difference, 0.15 kg; 95% confidence interval, —0.05 to 0.34 kg), triceps extensor strength (0.005 kg; —0.17 to 0.18 kg), or grip strength (0.30 kg; 0.00 to 0.59 kg). Gait speed, time to stand five times from a chair, balance, self-reported disability, and incidence of falls (odds ratio, 1.12; 95% confidence interval, 0.87 to 1.44) also did not differ between current users and never users. In addition, current users were similar to past users on all measures.
Conclusion
We found no evidence that postmenopausal estrogen use has beneficial effects on muscle strength or neuromuscular function or that it reduces the risk of falling.
(Arch Intern Med. 1995;155:293-299)
Author Affiliations
University of California, San Francisco (Coordinating Center); University of Maryland, Baltimore; University of Minnesota, Minneapolis; University of Pittsburgh (Pa); Kaiser Permanente Center for Health Research, Portland, Ore
From the Division of Clinical Epidemiology, Department of Epidemiology and Biostatistics (Drs Seeley, Grady, Browner, Nevitt, and Cummings), and Division of General Internal Medicine (Dr Cummings), University of California—San Francisco; Department of Epidemiology, University of Pittsburgh (Pa) (Dr Cauley); and General Internal Medicine Section, Department of Veterans Affairs Medical Center, San Francisco (Drs Grady and Browner). Members of the Study of Osteoporotic Fractures Research Group are listed at the end of the article.
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