Reproduction history and health-promoting behaviors are associated with successful aging and survival

The postmenopausal decrease in estrogen production contributes to a significant increase in the risk of age-related diseases. There is an identified gap in the field regarding the effectiveness of targeted interventions for specific groups of women at increased risk, and whether these interventions can support successful aging and reduce mortality. Data regarding 2239 Caucasian female participants of the PolSenior study aged 65 and over were analyzed. Based on strict criteria, participants were divided into successfully aging (SA) and not successfully aging (UA), and the differences in reproduction system-related factors on aging trajectory and survival were investigated. The mean age of menarche and menopause and the mean length of the reproductive period were similar in SA and UA women. However, the mean number of pregnancies and the percentage of women who gave birth to at least four children were higher in UA than in SA women (P < 0.001). SA women were more commonly involved in the reproductive health-promoting behaviors (all P < 0.001). In a multifactorial fully adjusted analysis, the number of pregnancies was negatively associated with SA. Kaplan-Meier survival curves showed that being nulliparous and having four or more children was associated with a shorter survival of UA (P < 0.0001) but not SA women, while regular gynecological examination, cytology, mammography, and breast self-examination were associated with a better survival in both SA and UA women. In Cox regression models adjusted for all confounding factors significant in univariate analysis, these health-promoting behaviors remained independent predictors of better survival in UA women while in SA women, only breast self-examination remained an independent predictor. Successful aging and survival of women are associated with the reproduction history and reproduction system-related health-promoting behaviors. Reproduction system-related health-promoting behaviors endure the effect of the reproduction history.