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Association between anxiety and severe quality-of-life impairment in postmenopausal women: analysis of a multicenter Latin American cross-sectional study

Núñez-Pizarro, Jorge L. MD1; González-Luna, Alejandro MD1; Mezones-Holguín, Edward MD, MSc1,2,3; Blümel, Juan E. MD, PhD3,4; Barón, Germán MD3; Bencosme, Ascanio MD3; Benítez, Zully MD3; Bravo, Luz M. MD3; Calle, Andrés MD3; Flores, Daniel MD3; Espinoza, María T. MD3; Gómez, Gustavo MD3; Hernández-Bueno, José A. MD3; Martino, Mabel MD3; Lima, Selva MD3; Monterrosa, Alvaro MD3; Mostajo, Desiree MD3; Ojeda, Eliana MD3; Onatra, William MD3; Sánchez, Hugo MD3; Tserotas, Konstantinos MD3; Vallejo, María S. MD3; Witis, Silvina MD3; Zúñiga, María C. MD3; Chedraui, Peter MD, PhD3,5

doi: 10.1097/GME.0000000000000813
Original Articles

Objective: To evaluate associations between anxiety and severe impairment of quality of life (QoL) in Latin American postmenopausal women.

Methods: This was a secondary analysis of a multicenter cross-sectional study among postmenopausal women aged 40 to 59 from 11 Latin American countries. We evaluated anxiety (The Goldberg Depression and Anxiety Scale), and QoL (Menopause Rating Scale [MRS]), and included sociodemographic, clinical, lifestyle, and anthropometric variables in the analysis. Poisson family generalized linear models with robust standard errors were used to estimate prevalence ratios (PRs) and 95% CIs. There were two adjusted models: a statistical model that included variables associated with the outcomes in bivariate analyses, and an epidemiologic model that included potentially confounding variables from literature review.

Results: Data from 3,503 women were included; 61.9% had anxiety (Goldberg). Severe QoL impairment (total MRS score ≥17) was present in 13.7% of women, as well as severe symptoms (MRS subscales): urogenital (25.5%), psychological (18.5%), and somatic (4.5%). Anxiety was independently associated with severe QoL impairment and severe symptoms in the epidemiological (MRS total score: PR 3.6, 95% CI, 2.6-5.0; somatic: 5.1, 95% CI, 2.6-10.1; psychological: 2.8, 95% CI, 2.2-3.6; and urogenital: 1.4, 95% CI, 1.2-1.6) and the statistical model (MRS total score: PR 3.5, 95% CI, 2.6-4.9; somatic: 5.0, 95% CI, 2.5-9.9; psychological: 2.9, 95% CI, 2.2-3.7; and urogenital: 1.4; 95% CI, 1.2-1.6).

Conclusions: In this postmenopausal Latin American sample, anxiety was independently associated with severe QoL impairment. Hence, screening for anxiety in this population is important.

1Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Perú

2Intendencia de Investigación y Desarrollo, Superintendencia Nacional de Salud (SUSALUD), Lima, Perú

3Collaborative Group for Research of the Climacteric in Latin America (REDLINC)

4Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile

5Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.

Address correspondence to: Edward Mezones-Holguín, MD, MSc, Prolongación Primavera 2390, Monterrico, Santiago de Surco, Lima, Perú. E-mail:

Received 17 May, 2016

Revised 26 October, 2016

Accepted 26 October, 2016

Financial disclosure/conflicts of interest: K.T. states a financial relationship with Abbott and Merck Sharp & Dohme.

© 2017 by The North American Menopause Society.