Aging Clinical and Experimental Research

, Volume 14, Issue 3, pp 170–177 | Cite as

Understanding the physiological and functional consequences of menopause: The PROSALMEN study

  • Stefania Bandinelli
  • Fulvio Lauretani
  • Enrico Benvenuti
  • Annamaria Corsi
  • Maria Francesca De Marco
  • Benedetta Bartali
  • Giacomo Ruotolo
  • Benedetta Miniati
  • Claudio Macchi
  • Cosimo R. Russo
  • Jack M. Guralnik
  • Luigi Ferrucci
Original Articles


Background and aims: Women live longer and are more often affected by disability and poor health than men. The mechanism underlying this sex-related “mortality-morbidity” paradox is still unclear but it has been suggested that the physiological and functional changes occurring during the menopausal transition play an important role. The aim of PROSALMEN (PROgetto SALute MENopausa: Health in Menopause Project) is to study in great detail how these changes affect the integrity and function of the physiologic subsystems that are relevant to the maintenance of an active and healthy life-style during the aging process. Methods: PROSALMEN is a cross-sectional comparison of age-matched pre- and post-menopausal women. Thirty post-m enopausal women, aged 48–58 years, were enrolled in the study together with 30 age-matched pre-menopausal controls. A number of clinical, biological and functional parameters were collected assessing the integrity and level of function of the physiological subsystems that are important for mobility. Furthermore, we collected information on risk factors, medical conditions and symptoms that frequently develop or become clinically evident after menopause, including the most important elements of the classical post-m enopausal syndrome. Conclusions: This rich dataset will be used to start dissecting the causal pathway leading from menopause to damages in the musculoskeletal system and, in turn, to reduced physical function. The final goal is to understand how and to what extent changes in health behavior and pharmacological treatments in addition to hormone replacement therapy (HRT) may counteract these processes.


Aging menopause older women physical performance prevention PROSALMEN Study 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Guralnik JM, Balfour JL, Volpato S. The ratio of older women to men: historical perspectives and cross-national comparisons. Aging Clin Exp Res 2000; 12: 65–76.Google Scholar
  2. 2.
    Verbrugge LM. Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Mem Fund Q Health Soc 1984; 62: 475–519.PubMedCrossRefGoogle Scholar
  3. 3.
    Arber S, Ginn J. Gender and inequalities in health in later life. Soc Sci Med 1993; 36: 33–46.PubMedCrossRefGoogle Scholar
  4. 4.
    Ferrucci L, Benvenuti E, Bartali B, et al. Preventive health care for older women: life-style recommendations and new directions. Aging Clin Exp Res 2000; 12: 113–31.Google Scholar
  5. 5.
    Hazzard WH. The sex differential in longevity. In Hazzard WR, Bierman EL, Blass JP, Ettinger WH, Halter JB, eds. Principles of Geriatric Medicine and Gerontology. New York: McGraw-Hill, Inc. 1994: 37–47.Google Scholar
  6. 6.
    Verbrugge LM, Gates DM, Ike RW. Risk factors for disability among U.S. adults with arthritis. J Clin Epidemiol 1991; 44: 167–82.CrossRefGoogle Scholar
  7. 7.
    Giampaoli S. Epidemiology of major age-related diseases in women compared to men. Aging Clin Exp Res 2000; 12: 93–105.Google Scholar
  8. 8.
    Ferrucci L, Guralnik JM, Simonsick E, Salive ME, Corti C, Langlois J. Progressive versus catastrophic disability: a longitudinal view of the disablement process. J Gerontol 1996; 51: M123–M130.Google Scholar
  9. 9.
    Ahlborg HG, Johnell O, Nilsson BE, Jeppsson S, Rannevik G, Karlsson MK. Bone loss in relation to menopause: a prospective study during 16 years. Bone 2001; 28: 327–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Picard D, Imbach A, Couturier M, Lepage R, Ste Marie LG. Longitudinal study of bone density and its determinants in women. Calcif Tissue Int 2000; 67: 356–60.PubMedCrossRefGoogle Scholar
  11. 11.
    Felson DT, Zhang Y, Hannan MT, Kiel DP, Wilson PW, Anderson JJ. The effect of postmenopausal estrogen therapy on bone density in elderly women. N Engl J Med 1993; 329: 1141–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Ito M, Nakamura T, Tsurusaki K, Uetani M, Hayashi K. Effects of menopause on age-dependent bone loss in the axial and appendicular skeletons in healthy Japanese women. Osteoporos Int 1999; 10: 377–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Evans W. Symposium: Sarcopenia: Diagnosis and Mechanisms. Functional and Metabolic Consequences of Sarcopenia. J Nutr 1997; 127: 998S–1003S.Google Scholar
  14. 14.
    Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Eng J Med 1994; 330: 1769–75.CrossRefGoogle Scholar
  15. 15.
    Meschia M, Pansini F, Modena AB, et al. Determinants of age at menopause in Italy: results from a large cross-sectional study. ICARUS Study Group. Italian Climacteric Research Group Study. Maturitas 2000; 34: 119–25.Google Scholar
  16. 16.
    Schulze MB, Hoffmann K, Kroke A, Boeing H. Dietary patterns and their association with food and nutrient intake in the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study. Br J Nutr 2001; 85: 363–73.PubMedCrossRefGoogle Scholar
  17. 17.
    Bandinelli S, Benvenuti E, Del Lungo I, et al. Measuring muscular strength of the lower limbs by hand-held dynamometer: a standard protocol. Aging Clin Exp Res 1999; 11: 287–93.Google Scholar
  18. 18.
    Bassey EJ, Short AH. New method for measuring power output in a single leg extension: feasibility, reliability and validity. Eur J ApplPhysiol 1990; 60: 385–90.Google Scholar
  19. 19.
    Kannus P. Isokinetic evaluation of muscular performance: implications for muscle testing and rehabilitation. Int J Sports Med 1994; 15: S11–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Miller PJ. Assessment of Joint Motion. Measurement in physical therapy. New York: Churchill Livingstone, 1985: 103–36.Google Scholar
  21. 21.
    McLaughlin JE, King GA, Howley ET, Bassett DR, Jr., Ainsworth BE. Validation of the COSMED K4 b2 portable metabolic system. Int J Sports Med 2001; 22: 280–4.PubMedCrossRefGoogle Scholar
  22. 22.
    Ruotolo G, Zhang H, Bentsianov V, Le NA. Protocol for the study of the metabolism of retinylesters in plasma lipoproteins during postprandial lipemia. J Lipid Res 1992; 33: 1541–9.PubMedGoogle Scholar
  23. 23.
    Ruotolo G, Tettamanti C, Garancini MP, et al. Smaller, denser LDL particles are not a risk factor for cardiovascular disease in healthy nonagenarian women of the Cremona Population Study. Atherosclerosis 1998; 140: 65–70.PubMedCrossRefGoogle Scholar
  24. 24.
    Gatti D, Rossini M, Zamberlan N, Braga V, Fracassi E, Adami S. Effect of aging on trabecular and compact bone components of proximal and ultradistal radius. Osteoporos Int 1996; 6: 355–60.PubMedCrossRefGoogle Scholar
  25. 25.
    Parfitt AM. A structural approach to renal bone disease. J Bone Miner Res 1998; 13: 1213–20.PubMedCrossRefGoogle Scholar
  26. 26.
    Kehayias J, Heymsfield S. Symposium: Sarcopenia: Diagnosis and Mechanisms. Introduction. J Nutr 1997; 127: 989S–1015S.Google Scholar
  27. 27.
    Rogers A, Hannon RA, Eastell R. Biochemical markers as predictors of rates of bone loss after menopause. J Bone Miner Res 2000; 15: 1398–404.PubMedCrossRefGoogle Scholar
  28. 28.
    Wasserman JE, Hansen JE, Sue DY, Whipp BJ, Csaburi R. Principles of Exercise Testing and Interpretation, ed. 2. Philadelphia: Lea and Febiger, 1994.Google Scholar
  29. 29.
    Rittweger J, Beller G, Ehrig J, et al. Bone-muscle strength indices for the human lower leg. Bone 2000; 27: 319–26.PubMedCrossRefGoogle Scholar
  30. 30.
    Cheng S, Toivanen JA, Suominen H, Toivanen JT, Timonen J. Estimation of structural and geometrical properties of cortical bone by computerized tomography in 78-year-old women. J Bone Miner Res 1995; 10: 139–48.PubMedCrossRefGoogle Scholar
  31. 31.
    Ruff CB, Hayes WC. Subperiosteal expansion and cortical remodeling of the human femur and tibia with aging. Science 1982; 217: 945–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2002

Authors and Affiliations

  • Stefania Bandinelli
    • 1
  • Fulvio Lauretani
    • 2
  • Enrico Benvenuti
    • 1
  • Annamaria Corsi
    • 1
  • Maria Francesca De Marco
    • 1
  • Benedetta Bartali
    • 1
  • Giacomo Ruotolo
    • 3
  • Benedetta Miniati
    • 4
  • Claudio Macchi
    • 4
  • Cosimo R. Russo
    • 1
  • Jack M. Guralnik
    • 5
  • Luigi Ferrucci
    • 1
  1. 1.INRCA Geriatric DepartmentLaboratory of Clinical EpidemiologyFirenzeItaly
  2. 2.Unit of Gerontology and Geriatric MedicineUniversity of FirenzeItaly
  3. 3.Laboratory of Lipid Metabolism and Prevention of Cardiovascular DiseasesS. Raffaele HospitalMilanoItaly
  4. 4.Don Gnocchi FoundationPozzolatico, FirenzeItaly
  5. 5.Epidemiology, Demography and Biometry LaboratoryNational Institute on Aging (NIH)BethesdaUSA

Personalised recommendations