Association of reproductive lifespan and age at menopause with depression: Data from NHANES 2005-2018

Background: The association between reproductive lifespan and depression in older women is unclear. We conducted this analysis to explore whether a shorter reproductive lifespan is associated with higher odds of depression, while also considering the age at menarche and age at menopause. Methods: This observational study used data from the National Health and Nutrition Examination Survey (NHANES), which was conducted between 2005 and 2018. Reproductive lifespan was defined as years from age at menarche to age at menopause. Depression was assessed using the Patient Health Questionnaire -9 (PHQ-9). Multivariable logistic regression models were used to explore the relationship between the association of reproductive life span, age at menarche and age at menopause with the incidence of depression. Results: Totally, 2947 patients aged 60 and above were enrolled in the trial, with 241 individuals (8.18 %) diagnosed with depression. Higher odds of depression were found to be significantly correlated with a shorter reproductive lifespan [Odds Ratio (OR) = 0.95, 95 % Confidence interval (CI) = 0.92 -0.98] or an earlier ager at menopause (OR = 0.95, 95 % CI = 0.92 -0.99), according to the results of multivariable logistic regression analysis after full adjustment. Subgroup analysis and interaction tests indicated a similar association. Limitations: The cross-sectional study could not yield any conclusions regarding causality. Conclusion: In this large cross-sectional study, our result suggested that populations with a shorter reproductive lifespan or an earlier age at menopause were significantly more likely to have depressive symptoms in older U.S. women. Further large-scale prospective studies are warranted for a comprehensive analysis of the role of the reproductive lifespan and age at menopause in depression.