European Geriatric Medicine (2018) 9:301–310
History of induced abortions and frailty in older Greek women: results
from the HELIAD study
· M. Yannakoulia
· E. Ntanasi
· M. H. Kosmidis
· C. A. Anastasiou
· E. Dardiotis
· G. Hadjigeorgiou
· P. Sakka
· N. Scarmeas
Received: 5 January 2018 / Accepted: 20 March 2018 / Published online: 9 April 2018
© European Geriatric Medicine Society 2018
Purpose Women are almost twice as likely as men to develop frailty and early-traumatic experiences related to reproduction
may have a role to play. The purpose of this study was to investigate the association between a history of induced abortions
and risk of frailty.
Methods 1062 women aged ≥ 65 years from the HELIAD study were included in the present cross-sectional study. Frailty
was assessed by frailty index and Fried deﬁnitions. The history of abortion and of other reproductive experiences (age onset
of menstruation, age of menopause, number of oﬀspring, and number of miscarriages) was obtained by all participants.
Logistic and linear regression analyses were performed to examine whether the number of abortions was related to frailty.
Results When frailty was deﬁned with frailty index, women with 1 or 2 abortions had 1.7 higher risk of frailty compared to
women with no history of abortions, while those with more than 3 abortions had more than a twofold higher risk of frailty.
Two supplementary analyses excluding women with surgical operations’ history and women with dementia revealed similar
results. When frailty was deﬁned with Fried deﬁnition, the analysis was marginally signiﬁcant when abortion was inserted
as a categorical variable. Women with more than 3 abortions showed 2.4 higher risk of frailty compared to women with no
history of abortion.
Conclusion The number of induced abortions was associated with moderate higher odds of frailty, when frailty was deﬁned
according to frailty index. A similar trend was revealed in the model with Fried deﬁnition after trichotomization of abortions.
Keywords Frailty · Abortions · Women · Greece
Population aging is becoming one of the most important
social problems of the 21st century. By 2050, the global
population aged 65 or older is estimated to more than quad-
ruple its size in 2004 (461 million), reaching nearly 2.1 bil-
lion , with tremendous implications for the health care
Electronic supplementary material The online version of this
article (https ://doi.org/10.1007/s4199 9-018-0047-1) contains
supplementary material, which is available to authorized users.
* N. Scarmeas
Department of Social Medicine, Psychiatry and Neurology,
1st Neurology Clinic, Aeginition Hospital, National
and Kapodistrian University of Athens, Vasilissis Soﬁas 72,
115 28 Athens, Greece
Department of Nutrition and Dietetics, Harokopio University,
Lab of Cognitive Neuroscience, School of Psychology,
Aristotle University of Thessaloniki, Thessaloniki, Greece
School of Medicine, University of Thessaly, Larissa, Greece
Biomedicine Diagnostic Laboratory, Athens, Greece
Athens Association of Alzheimer’s Disease and Related
Disorders, Marousi, Greece
Department of Neurology, The Gertrude H. Sergievsky
Center, Taub Institute for Research in Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY,