{"id":"https://openalex.org/W7225313000","doi":"https://doi.org/10.1007/s40520-026-03543-9","title":"Menopausal hormone therapy and frailty risk: a nationwide Korean target trial emulation study","display_name":"Menopausal hormone therapy and frailty risk: a nationwide Korean target trial emulation study","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225313000","doi":"https://doi.org/10.1007/s40520-026-03543-9"},"language":"en","primary_location":{"id":"doi:10.1007/s40520-026-03543-9","doi":"https://doi.org/10.1007/s40520-026-03543-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40520-026-03543-9","pdf_url":null,"source":{"id":"https://openalex.org/S107309357","display_name":"Aging Clinical and Experimental Research","issn_l":"1594-0667","issn":["1594-0667","1720-8319"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Aging Clinical and Experimental Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1007/s40520-026-03543-9","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5160908057","display_name":"Hyunjoo Kim","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I83202590","display_name":"Jeju National University","ror":"https://ror.org/05hnb4n85","country_code":"KR","type":"education","lineage":["https://openalex.org/I83202590"]}],"countries":["KR"],"is_corresponding":false,"raw_author_name":"Hyunjoo Kim","raw_affiliation_strings":["College of Pharmacy, Jeju National University, 102 Jejudaehak-ro, Jeju-si, 63243, Republic of Korea"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Pharmacy, Jeju National University, 102 Jejudaehak-ro, Jeju-si, 63243, Republic of Korea","institution_ids":["https://openalex.org/I83202590"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109259121","display_name":"Kyung Suk Choi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2803058125","display_name":"Seoul National University Bundang Hospital","ror":"https://ror.org/00cb3km46","country_code":"KR","type":"healthcare","lineage":["https://openalex.org/I139264467","https://openalex.org/I2802835388","https://openalex.org/I2803058125"]}],"countries":["KR"],"is_corresponding":false,"raw_author_name":"Kyung Suk Choi","raw_affiliation_strings":["Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea","institution_ids":["https://openalex.org/I2803058125"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160849790","display_name":"Eunkyung Euni Lee","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I139264467","display_name":"Seoul National University","ror":"https://ror.org/04h9pn542","country_code":"KR","type":"education","lineage":["https://openalex.org/I139264467"]}],"countries":["KR"],"is_corresponding":false,"raw_author_name":"Eunkyung Euni Lee","raw_affiliation_strings":["Research Institute of Pharmaceutical Sciences, Natural Products Research Institute, College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak- gu, Seoul, 08826, Republic of Korea"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Institute of Pharmaceutical Sciences, Natural Products Research Institute, College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak- gu, Seoul, 08826, Republic of Korea","institution_ids":["https://openalex.org/I139264467"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5062232273","display_name":"Yeon Hee Hong","orcid":"https://orcid.org/0000-0002-9709-4175","observed_orcids":["https://orcid.org/0000-0002-9709-4175"]},"institutions":[{"id":"https://openalex.org/I139264467","display_name":"Seoul National University","ror":"https://ror.org/04h9pn542","country_code":"KR","type":"education","lineage":["https://openalex.org/I139264467"]},{"id":"https://openalex.org/I2803058125","display_name":"Seoul National University Bundang Hospital","ror":"https://ror.org/00cb3km46","country_code":"KR","type":"healthcare","lineage":["https://openalex.org/I139264467","https://openalex.org/I2802835388","https://openalex.org/I2803058125"]}],"countries":["KR"],"is_corresponding":true,"raw_author_name":"Yeon Hee Hong","raw_affiliation_strings":["Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea","Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea","institution_ids":["https://openalex.org/I2803058125"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea","institution_ids":["https://openalex.org/I139264467"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5062232273"],"corresponding_institution_ids":["https://openalex.org/I139264467","https://openalex.org/I2803058125"],"apc_list":{"value":4490,"currency":"USD","value_usd":4490},"apc_paid":{"value":4490,"currency":"USD","value_usd":4490},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10694","display_name":"Menopause: Health Impacts and Treatments","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10694","display_name":"Menopause: Health Impacts and Treatments","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11011","display_name":"Frailty in Older Adults","score":0.0017000000225380063,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11146","display_name":"Hormonal and reproductive studies","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hormone-replacement-therapy","display_name":"hormone replacement therapy","score":0.9950000047683716},{"id":"https://openalex.org/keywords/frailty-risk","display_name":"frailty risk","score":0.871999979019165},{"id":"https://openalex.org/keywords/hospital-frailty-risk-score","display_name":"Hospital Frailty Risk Score","score":0.828000009059906},{"id":"https://openalex.org/keywords/exposure-thresholds","display_name":"exposure thresholds","score":0.7599999904632568},{"id":"https://openalex.org/keywords/tibolone","display_name":"tibolone","score":0.9070000052452087},{"id":"https://openalex.org/keywords/estrogen-only-therapy","display_name":"estrogen-only therapy","score":0.9940000176429749},{"id":"https://openalex.org/keywords/postmenopausal-women","display_name":"postmenopausal women","score":0.8199999928474426},{"id":"https://openalex.org/keywords/functional-decline","display_name":"functional decline","score":0.5690000057220459},{"id":"https://openalex.org/keywords/target-trial-emulation","display_name":"target trial emulation","score":0.7080000042915344}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8432999849319458},{"id":"https://openalex.org/C2778562196","wikidata":"https://www.wikidata.org/wiki/Q177708","display_name":"Menopause","level":2,"score":0.5920000076293945},{"id":"https://openalex.org/C2780275930","wikidata":"https://www.wikidata.org/wiki/Q1628266","display_name":"Hormone therapy","level":4,"score":0.5175999999046326},{"id":"https://openalex.org/C2779668873","wikidata":"https://www.wikidata.org/wiki/Q6693756","display_name":"Lower risk","level":3,"score":0.5153999924659729},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5008999705314636},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.46380001306533813},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.450300008058548},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.4075999855995178},{"id":"https://openalex.org/C2994039464","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative risk","level":2,"score":0.3878999948501587},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.36230000853538513},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.33070001006126404},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.32089999318122864},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.3165000081062317},{"id":"https://openalex.org/C88879693","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative incidence","level":3,"score":0.3091000020503998},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3084000051021576},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.295199990272522},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.27309998869895935},{"id":"https://openalex.org/C2780159708","wikidata":"https://www.wikidata.org/wiki/Q17003363","display_name":"Hormone replacement therapy (female-to-male)","level":3,"score":0.2718000113964081},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.27079999446868896},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.2685999870300293},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.25780001282691956},{"id":"https://openalex.org/C149810388","wikidata":"https://www.wikidata.org/wiki/Q5374873","display_name":"Emulation","level":2,"score":0.2517000138759613}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1007/s40520-026-03543-9","doi":"https://doi.org/10.1007/s40520-026-03543-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40520-026-03543-9","pdf_url":null,"source":{"id":"https://openalex.org/S107309357","display_name":"Aging Clinical and Experimental Research","issn_l":"1594-0667","issn":["1594-0667","1720-8319"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Aging Clinical and Experimental Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1007/s40520-026-03543-9","doi":"https://doi.org/10.1007/s40520-026-03543-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40520-026-03543-9","pdf_url":null,"source":{"id":"https://openalex.org/S107309357","display_name":"Aging Clinical and Experimental Research","issn_l":"1594-0667","issn":["1594-0667","1720-8319"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Aging Clinical and Experimental Research","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4307264107","https://openalex.org/W7127963206","https://openalex.org/W4289526363","https://openalex.org/W2801524230","https://openalex.org/W7127889950","https://openalex.org/W4285391238","https://openalex.org/W4388568838","https://openalex.org/W4280529309","https://openalex.org/W2055029444","https://openalex.org/W4414573585"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Menopause":[2],"is":[3],"associated":[4,32,133,230],"with":[5,33,69,118,134,171,231],"functional":[6],"decline,":[7],"but":[8],"evidence":[9],"linking":[10],"menopausal":[11],"hormone":[12],"therapy":[13],"(MHT)":[14],"to":[15,71,80,155,234],"frailty":[16,35,82,174,199,236],"risk":[17,36,83,137,147,175,200,237],"remains":[18],"limited.":[19],"Aims":[20],"To":[21],"evaluate":[22],"whether":[23],"achievement":[24],"of":[25,53,74,100,105,138,222],"a":[26,48,113,135,197],"prespecified":[27],"MHT":[28,38,63,101,207,216,226],"exposure":[29,227],"threshold":[30,228],"was":[31,78,95,132,160,194,229],"lower":[34,136,232],"among":[37,163],"initiators.":[39],"Methods":[40],"Using":[41],"the":[42,128,209,223],"NHIS-HEALS":[43],"database":[44],"(2002\u20132019),":[45],"we":[46],"conducted":[47],"nationwide":[49],"new-user":[50],"cohort":[51],"study":[52],"31,294":[54],"women":[55,164],"aged":[56,165],"\u2265":[57,96,166],"45":[58],"years":[59,73,168],"who":[60],"initiated":[61],"systemic":[62],"and":[64,169,180,202],"were":[65,108],"non-frail":[66],"at":[67],"baseline,":[68],"up":[70],"10":[72],"follow-up.":[75],"The":[76,92,158,192],"outcome":[77,193],"transition":[79,139,233],"high":[81,235],"status":[84],"(Hospital":[85],"Frailty":[86],"Risk":[87],"Score":[88],"[HFRS]":[89],">":[90],"15).":[91],"target":[93,114,129],"strategy":[94],"28":[97],"cumulative":[98],"days":[99,104],"within":[102,112],"60":[103],"initiation.":[106],"Strategies":[107],"compared":[109],"by":[110,182],"clone\u2013censor\u2013weighting":[111],"trial":[115],"emulation":[116],"framework,":[117],"doubly":[119],"robust":[120],"estimation.":[121],"Results":[122],"Overall,":[123],"25,907":[124],"participants":[125],"(82.8%)":[126],"achieved":[127],"strategy,":[130],"which":[131],"(aHR,":[140],"0.88;":[141],"95%":[142,151],"CI,":[143,152],"0.85\u20130.92;":[144],"adjusted":[145],"10-year":[146],"difference,":[148],"\u2212":[149,153,156],"3.7%;":[150],"4.7":[154],"2.8).":[157],"association":[159],"more":[161],"pronounced":[162],"50":[167],"those":[170],"intermediate":[172],"baseline":[173],"(HFRS":[176],"5\u201315;":[177],"aHR,":[178],"0.77),":[179],"differed":[181],"formulation":[183],"(tibolone,":[184],"aHR":[185,189],"0.63;":[186],"estrogen-only":[187],"therapy,":[188],"0.94).":[190],"Discussion":[191],"based":[195],"on":[196],"claims-derived":[198],"score,":[201],"because":[203],"both":[204],"groups":[205],"comprised":[206],"initiators,":[208],"findings":[210],"reflect":[211],"early":[212,225],"adherence":[213],"rather":[214],"than":[215],"use":[217],"versus":[218],"non-use.":[219],"Conclusions":[220],"Achievement":[221],"specific":[224],"status.":[238]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-11-06T00:00:00"}