Estrogen levels and mortality in elderly and senile women

Background: High estrogen levels in young and middle-aged women are considered a primary factor associated with lower mortality and morbidity rates due to cardiovascular diseases compared to men. However, population studies investigating the influence of estradiol on mortality in postmenopausal women have yielded mixed results. Aim: To evaluate the impact of estrogen levels on life expectancy in elderly and senile women. Materials and methods: A CRYSTAL prospective cohort study was conducted using a random sample of women aged 65 years and older (n = 280). The study collected data through surveys, medical record analyses, and laboratory tests. Key parameters included chronic co-morbidities, comprehensive geriatric assessments, and laboratory measurements of estradiol, thyroid-stimulating hormone, glycated hemoglobin, total protein, albumin, C-reactive protein, vitamin D, creatinine, complete blood count, and lipid profiles over a six-year follow-up period. Results: Analysis of the relationship between estradiol levels and six-year survival showed a positive association between high estradiol levels and increased all-cause mortality, with a hazard ratio of 1.005 (95% confidence interval 1.000–1.009). The average survival time over the six-year observation period for women with estradiol levels below 73 pmol/L was 62.9 ± 1.2 months, compared to 49.9 ± 3.0 months for women with estradiol levels of 73 pmol/L or higher. After adjusting for age, history of acute cerebrovascular events, obesity, elevated C-reactive protein, glycated hemoglobin, and reduced cognitive function, women with estradiol levels of 73 pmol/L or higher had a 1.6-fold higher risk of all-cause mortality compared to women with estradiol levels below 73 pmol/L. Conclusions: An estradiol level of 73 pmol/L or higher is an independent risk factor for mortality in postmenopausal women.