European Journal of Epidemiology

, Volume 26, Issue 10, pp 771–778 | Cite as

Early age at menarche associated with increased all-cause mortality

  • Koji Tamakoshi
  • Hiroshi Yatsuya
  • Akiko Tamakoshi
  • For the JACC Study Group


The objective was to examine the association between age at menarche and all-cause mortality. A population-based prospective study involving 55,128 Japanese women aged 40–79 years in 1988–1990 and followed up to December 2006 was used. A total of 6,967 deaths occurred during the follow-up. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, smoking and drinking status, exercise, sleeping hours, parity, menopausal status, and body mass index at baseline were calculated by Cox proportional hazards model. The HRs (95% CI) of all-cause mortality were 1.16 (1.01–1.32), 1.01 (0.92–1.11), 1.00, 0.97 (0.90–1.05), 0.98 (0.91–1.05), 0.92 (0.84–1.01), and 1.05 (0.96–1.14) for women with menarche aged 9–12, 13, 14 (referent), 15, 16, 17, 18–20 years, respectively, indicating an inverse J-shaped association (P for quadratic trend <.01). Moreover, women with menarche aged ≤12 years have a significantly high risk of all-cause mortality compared with those with menarche aged ≥13 years (HR 1.17, 95% CI 1.03–1.33). Comparing between women with menarche aged ≤13 years and ≥14 years, those with earlier age at menarche had borderline significantly high risk of all-cause mortality in both comparisons (HR 1.07, 95% CI 0.99–1.15, P = .082). Japanese women with early age at menarche of ≤12 years were associated with increased risk of all-cause mortality and those with late age at menarche of ≥18 years also had a slightly higher mortality risk. These associations were independent of lifestyle, anthropometric, and reproductive factors.


Menarche Mortality Prospective study 


95% CI

95% confidence interval


Body mass index


Cardiovascular disease


Hazard ratio


Japan collaborative cohort study for evaluation of cancer risk


Relative risk



We wish to express our sincere appreciation to Drs. Kunio Aoki and Yoshiyuki Ohno, Professors Emeritus of the Nagoya University School of Medicine and former chairpersons of the JACC Study. We are also greatly indebted to Dr. Haruo Sugano, former Director of the Cancer Institute, Tokyo, who greatly contributed to the initiation of the JACC Study, Dr. Tomoyuki Kitagawa, Director Emeritus of the Cancer Institute of the Japanese Foundation for Cancer Research and former chairman of the Grant-in-Aid for Scientific Research on Priority Area ‘Cancer’ and to Dr. Kazao Tajima, Aichi Cancer Center and previous chairman of the Grant-in Aid for Scientific Research on Priority Area of Cancer Epidemiology, for their warm encouragement and support of this study.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Koji Tamakoshi
    • 1
  • Hiroshi Yatsuya
    • 2
  • Akiko Tamakoshi
    • 3
  • For the JACC Study Group
  1. 1.Department of NursingNagoya University School of Health SciencesHigashi-ku, NagoyaJapan
  2. 2.Department of Public HealthNagoya University Graduate School of MedicineNagoyaJapan
  3. 3.Department of Public HealthAichi Medical University School of MedicineAichiJapan

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