当前期刊: Maturitas Go to current issue    加入关注   
显示样式:        排序: 导出
我的关注
我的收藏
您暂时未登录!
登录
  • Association of serum vitamin D with frailty in older Korean adults
    Maturitas (IF 3.654) Pub Date : 2020-01-20
    Jinhee Kim; Yunhwan Lee; Chang Won Won; Seunghee Kye; Jee-Seon Shim

    Objectives The association between serum levels of vitamin D and frailty in older Korean adults was examined. Study design Cross-sectional study. Older people living in the community across 10 study centers throughout South Korea. The baseline data (2016-2017) of 2872 participants aged 70-84 years in the Korean Frailty and Aging Cohort Study were evaluated. Main outcome measures Serum vitamin D level was assessed with an electro-chemiluminescence immunoassay. Frailty was defined using Fried’s frailty index. A multinomial logistic regression analysis was used to examine the association between serum levels of vitamin D and frailty. Results The percentages of those with serum vitamin D levels of <25 nmol/L, 25-49 nmol/L, 50-74 nmol/L, and ≥75 nmol/L were 4.1%, 37.0%, 37.8%, and 21.0%, respectively. The prevalence of frailty was 9.7%. Those with lower serum vitamin D levels, compared with ≥75 nmol/L, tended to have higher odds of being frail than being non-frail (OR: 1.58, 95% CI: 1.05-2.39 for 50-74 nmol/L; OR: 1.49, 95% CI: 0.98-2.26 for 25-49 nmol/L; OR: 1.37, 95% CI: 0.65-2.88 for <25 nmol/L). Among the components of frailty, low grip strength was significantly associated with lower serum levels of vitamin D. Conclusions Low serum levels of vitamin D are associated with an increased likelihood of frailty in community-dwelling older adults, suggesting a potentially protective role of vitamin D against frailty.

    更新日期:2020-01-21
  • Physical multimorbidity and sedentary behavior in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA)
    Maturitas (IF 3.654) Pub Date : 2020-01-13
    A. Kandola; B. Stubbs; A. Koyanagi

    Background Physical multimorbidity, defined as the presence of two or more chronic physical conditions, is widespread and reduces life expectancy and quality of life in older adults. Sedentary behavior (SB) is increasingly identified as a risk factor for a range of chronic physical conditions, independent of physical activity. Objectives To investigate associations between physical multimorbidity and SB in older adults. Study design We used cross-sectional data from a population-based sample of 6,903 adults aged ≥50 years who participated in the Irish Longitudinal Study on Ageing (TILDA) in 2009-2011. We conducted multivariable linear and logistic regression analyses to assess associations between multimorbidity and SB. Main outcome measures Self-reported minutes/day of SB and high SB (≥ 8 hours/day). Results We found that most of the 14 individual chronic physical conditions included here were associated with greater SB. Those with stroke (OR = 2.63, 95% CI = 1.69, 4.10) and cirrhosis (OR = 2.53, 95%CI = 1.19, 5.41) were the most likely to be classified with high SB. Time spent in SB and the prevalence of high SB increased linearly with number of chronic conditions. Multivariable regression models adjusting for sociodemographic and psychological factors, disability, social network, and physical activity showed that, compared with people with none, those with ≥4 chronic physical conditions had 1.45 times greater odds (OR = 1.45, 95% CI = 1.09, 1.93) of high SB and higher mean minutes/day of SB (β = 21.37, 95% CI = 5.53, 37.20). Conclusions Our results suggest that physical multimorbidity is associated with SB and highlight the need for prospective research to examine the directionality and mechanisms of these associations.

    更新日期:2020-01-13
  • Participatory art-based activity, community-dwelling older adults and changes in health condition: Results from a pre–post intervention, single-arm, prospective and longitudinal study
    Maturitas (IF 3.654) Pub Date : 2020-01-13
    Olivier Beauchet; Thomas Bastien; Mary Mittelman; Yoko Hayashi; Andy Hau Yan Ho

    Background Participatory art-based activities enhance the well-being and quality of life of patients. Few studies have examined the effects of these activities in community-dwelling older adults. This study aims to examine changes in well-being, quality of life and frailty associated with a weekly art-based activity, known as “Thursday at the Museum”, performed at the Montreal Museum of Fine Arts (MMFA) in community-dwelling older adults. Methods Based on a pre–post intervention, single-arm, prospective and longitudinal design, 130 community-dwelling older adults (mean age 71.6 ± 4.9, 91.5% female) were enrolled and completed this experimental study. The intervention was a participatory art-based activity carried out at the MMFA. Groups of participants (30 to 45 individuals) met for 1.5 hours once a week for a 12-week period (defining a session). Before and after the first (M0), the fifth (M1), the ninth (M2) and the twelfth (M3) workshops, well-being was assessed. Quality of life, frailty, physician visits and hospitalizations were also assessed. Results The mean well-being score improved after each workshop compared with baseline (P ≤ 0.001), i.e., from M0 to M3. The magnitude of this change in well-being was significant at M3 when M0 was used as a reference value (coefficient of regression beta (ß) = 3.22 with P = 0.037). Quality of life gradually increased from M1 to M3 (ß increased from -0.50 to -2.1 with all P-values ≤0.003). The proportion of vigorous participants increased significantly, whereas the proportion of mild frail participants decreased at M3 only (ß=-0.70 with P = 0.001). Conclusion The MMFA participatory art-based activity session had multidimensional positive effects on mental and physical health outcomes. These results suggest that museums may become key partners in public health policy initiatives for health prevention in older populations. Trialregistration NCT03557723.

    更新日期:2020-01-13
  • Factors associated with sarcopenia: a cross-sectional analysis using UK Biobank
    Maturitas (IF 3.654) Pub Date : 2020-01-08
    Fanny Petermann-Rocha; Minghao Chen; Stuart R Gray; Frederick K Ho; Jill P Pell; Carlos Celis-Morales

    Introduction The critical sociodemographic, lifestyle and diseases factors influencing sarcopenia, defined by the current European Working Group on Sarcopenia 2 (EWGSOP2) classification and cut-off points, have not yet been fully elucidated. This study aimed, therefore, to determine sociodemographic, anthropometric, lifestyle and health-related factors associated with sarcopenia using the new EWGSOP2 definition. Study design 396,283 participants (52.8% women, age 38-73 years) were included in this cross-sectional study. The potential factors associated with sarcopenia were allocated to four categories: sociodemographic (sex, age, education, income and professional qualification), anthropometric (nutritional status, abdominal obesity, body fat and birth weight), lifestyle (physical activity, smoking, sleeping and sitting time, TV viewing, alcohol, and dietary intakes) and health status (self-reported prevalent diseases). P-values were corrected for multiple testing using the Bonferroni method. Results Age, women, lower education, higher deprivation, underweight, lower birth weight, and chronic diseases such as rheumatoid arthritis, chronic bronchitis and osteoporosis were associated with a higher likelihood of sarcopenia. Conversely, overweight, obesity, as well as a self-reported higher intake of energy, protein, vitamins (B12 and B9) and minerals (potassium, calcium and magnesium) were associated with lower odds of sarcopenia. Conclusion Women, people aged over 65 years, underweight people and those with rheumatoid arthritis were most likely to have sarcopenia. Considering the increase in the ageing population, sarcopenia is likely to become more prevalent. Identifying factors associated with sarcopenia could inform future strategies for early identification of individuals at high risk of sarcopenia and therefore the implementation of preventive strategies against the disease.

    更新日期:2020-01-09
  • Low muscle mass is associated with osteoporosis: A nationwide population-based study
    Maturitas (IF 3.654) Pub Date : 2020-01-08
    Sung-Young Jang; Jong Park; So-Yeon Ryu; Seong-Woo Choi

    Objectives To assess the association between low muscle mass and osteoporosis in the Korean general population. Methods We analyzed 14,429 participants (6,261 men and 8,168 women) from the 2009–2011 Korean National Health and Nutrition Examination Survey (KNHANES) aged 20 years or more. Main Outcome Measure The association of low muscle mass with osteoporosis was investigated using multivariate logistic regression models that included age, marital status, residence, current smoking, monthly drinking, physical activities, strength exercise, comorbidity, and the use of dietary supplements, and in women postmenopausal status and experience of pregnancy. Results After adjusting for covariates, low muscle mass was significantly associated with osteoporosis in the lumbar spine and femoral neck in both men (lumbar spine: OR 1.73, 95% CI 1.08–2.76; femoral neck: OR 3.39, 95% CI 1.69–6.80) and women (lumbar spine: OR 1.52, 95% CI 1.17–1.97; femoral neck: OR 2.09, 95% CI 1.56–2.80). Also, the association between low muscle mass and osteoporosis was significant in men and women in every age group except for men aged 50-64 years. Conclusion Low muscle mass was significantly associated with osteoporosis in both men and women for all age groups, except for men aged 50-64 years.

    更新日期:2020-01-08
  • Aspirin moderates the association between cardiovascular risk, brain white matter hyperintensity total lesion volume and processing speed in normal ageing
    Maturitas (IF 3.654) Pub Date : 2020-01-07
    Mina Khezrian; Jennifer M.J. Waymont; Phyo K. Myint; Christopher J. McNeil; Lawrence J. Whalley; Roger Staff; Alison D. Murray

    Objectives Cardiovascular risk is associated with cognitive decline and this effect is attributed to brain pathology, including white matter hyperintensity (WMH) burden. Low-dose aspirin is frequently recommended for reducing vascular events. We investigated the effect of taking aspirin on the association between cardiovascular risk, WMH burden and cognitive function. Study design The study sample was drawn from 318 dementia-free adults aged 67-71 years. Brain magnetic resonance imaging (MRI) scans were acquired from 239 participants. Main outcome measures WMH total lesion volumes (TLV) were extracted using the automated lesion segmentation algorithm. We measured cardiovascular risk by calculating ASSIGN score. Cognitive ability was measured using a test of processing speed. We developed structural equation models to test our hypothesis. Results Sixty-eight participants (47.1% male, mean age = 68.8 years) reported that they took aspirin. The demographic measures did not differ significantly by aspirin use. Among aspirin users, there was a strong negative association between WMH TLV and cognition (β = -0.43, p-value < 0.001), while in non-users of aspirin the only significant predictor of poorer cognition was cardiovascular risk (β= -0.17, p-value = 0.001). Conclusions Aspirin use moderates the negative effect of WMH burden on cognition. Considering WMH burden in addition to cardiovascular risk could improve the prediction of cognitive decline in older adults with aspirin use.

    更新日期:2020-01-07
  • Educational Differences in Trajectories and Determinants of Healthy Ageing in Midlife and Older Americans
    Maturitas (IF 3.654) Pub Date : 2020-01-07
    Sara J. McLaughlin; Seonjin Kim; Lydia W. Li; Jiaan Zhang

    Objectives To advance knowledge of the influence of educational level on trajectories and determinants of healthy ageing in midlife and older Americans. Study design Data are from the Health and Retirement Study, a nationally representative, longitudinal survey of Americans aged 51 and over. We used generalized estimating equations to examine trajectories and determinants of healthy aging by level of education among 17,591 adults followed over a 14-year period. Educational level was categorized as less than a high school diploma, high school diploma, some college education, and a college or higher degree. Potential determinants included demographic factors, early-life characteristics (childhood health and childhood poverty), health-related factors (health behaviours, physical and mental health conditions), and psychosocial characteristics (perceived neighbourhood safety, volunteerism, and work status). Main outcome measures Informed by earlier work, we defined healthy ageing as freedom from cognitive impairment, freedom from disability, and high physical functioning. Results The log odds of healthy ageing declined over time in all educational groups. Importantly, the decline was smaller in adults with a college or higher degree than in those without a high school diploma. Age, gender, wealth, health behaviours, productive engagement, depressive symptoms, and the presence of chronic conditions predicted healthy ageing across the educational spectrum; however, the impact of several factors (age, gender, race/ethnicity, childhood poverty, and volunteerism) varied by educational level. Conclusions Education shapes trajectories of healthy ageing in the United States. Similarities and differences in determinants of healthy ageing are evident across levels of education.Findings highlight broad-based and education-specific targets for intervention.

    更新日期:2020-01-07
  • Vasomotor menopausal symptoms and cardiovascular disease risk in midlife: a longitudinal study
    Maturitas (IF 3.654) Pub Date : 2019-12-24
    V. Dam; A.J. Dobson; N.C. Onland-Moret; Y.T. van der Schouw; G.D. Mishra

    Objective To ascertain the association between vasomotor menopausal symptoms (VSM), hot flushes and night sweats, and cardiovascular disease, coronary heart disease and cerebrovascular disease. Study design The study sample comprised 8,881 women (aged 45-50 years) with available hospital separation data from the 1946-51 cohort (1996-2016) of the ongoing Australian Longitudinal Study on Women’s Health, a national prospective cohort study. Main outcome measures First fatal or non-fatal cardiovascular disease, coronary heart disease, and cerebrovascular disease events were obtained through linkage with hospital admission data, the National Death Index, and Medicare Benefits Schedule. Hot flushes and night sweats were assessed via questionnaires at each main survey. Additionally, we calculated the duration of symptoms based on whether or not women reported vasomotor menopausal symptoms in each survey. Results There were 925 cardiovascular disease, 484 coronary heart disease and 154 cerebrovascular disease events. There was no consistent evidence of any association with vasomotor menopausal symptoms, hot flushes and night sweats. We did find marginally statistically significant associations between presence of night sweats and cardiovascular disease (Hazard Ratio = 1.18, 95% Confidence Interval: 1.01-1.38), and between the duration of vasomotor menopausal symptoms [years] and coronary heart disease (Hazard Ratioper year = 1.03, 95% Confidence Interval: 1.00-1.05). However, given the number of associations tested, these findings could very well have arisen by chance. Conclusion In this large longitudinal study with 20 years of follow-up and clinical outcomes we did not find a convincing association between vasomotor menopausal symptoms, hot flushes, night sweats and cardiovascular disease, coronary heart disease and cerebrovascular disease.

    更新日期:2019-12-25
  • Non-pharmacological, non-surgical interventions for urinary incontinence in older persons: a systematic review of systematic reviews. The SENATOR project ONTOP series
    Maturitas (IF 3.654) Pub Date : 2019-12-23
    Kirsty A. Kilpatrick; Pamela Paton; Selvarani Subbarayan; Carrie Stewart; Iosief Abraha; Alfonso J. Cruz-Jentof; Denis O’Mahony; Antonio Cherubini; Roy L. Soiza

    Background Urinary incontinence is especially common in older age. Non-pharmacological therapies are particularly desirable in this group. Objective To define optimal evidence-based non-pharmacological, non-surgical therapies for urinary incontinence in older persons. Methods A Delphi process determined critical outcome measures of interest. Studies of any non-pharmacological intervention reporting critical outcomes were identified through database searches for relevant systematic reviews in Medline, Embase, CINAHL, PsycInfo and Cochrane up to June 2018. Primary trials with a population mean age ≥65years were identified, from which data were extracted and risk of bias was assessed. Qualitative analysis and meta-analysis, when possible, were undertaken, followed by grading of the evidence using GradePro software. Finally, bullet-point recommendations were formulated for the indications and contraindications for non-pharmacological interventions for urinary incontinence in older persons. Results Frequency of incontinence was identified as a critically important outcome. In total, 33 systematic reviews were identified with 27 primary trials meeting inclusion criteria. Evaluated therapies included exercise therapy, habit retraining, behavioural therapy, electrical stimulation, transcutaneous tibial nerve stimulation, magnetic stimulation, caffeine reduction and acupuncture. From meta-analysis, group exercise therapy and behavioural therapy in women were beneficial in reducing episodes of incontinence (mean reduction of 1.07 (95%CI 0.69-1.45) and 0.74 (95%CI 0.42-1.06) episodes per day respectively, evidence grade ‘moderate’). Evidence for other interventions was limited and of insufficient quality. Conclusions There is sufficient evidence to warrant recommendation of group exercise therapy for stress incontinence and behavioural therapy for urgency, stress or mixed urinary incontinence in older women. Evidence was insufficient to recommend any other non-drug therapy.

    更新日期:2019-12-23
  • Evaluation of Femaxeen® for control of urinary incontinence in women: a randomized, double-blind, placebo-controlled study
    Maturitas (IF 3.654) Pub Date : 2019-12-16
    Santiago Palacios; Marieta Ramirez; Mariella Lilue; Bárbara Vega Salazar

    Background and aims Urinary incontinence (UI) is common in women, with up to 50% experiencing involuntary loss of urine at some point. Femaxeen®, a formulation containing purified and specific cytoplasmic extracts of pollen, pumpkin seed extract and vitamin E (referred to hereafter as Femaxeen), is indicated for control of UI in women. This study investigated the efficacy and safety of Femaxeen for the prevention and treatment of UI symptoms in women. Methods In this randomized, double-blind, placebo-controlled trial, 81 women with moderate, severe, or very severe urge (43.4%), stress (31.6%) or mixed (25.0%) UI were allocated to receive Femaxeen or placebo once daily for 90 days. Treatment efficacy was assessed using three validated questionnaires. Findings Thirty-eight patients per group were analyzed. Femaxeen produced statistically significant improvements from baseline to day 90 (p < 0.001 for all comparisons) in scores on the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), Measurement of Urinary Handicap (MHU) questionnaire, and Sandvik Incontinence Severity Index. Reduction from baseline in ICIQ-SF and MHU scores at day 60 and day 90 was significantly greater with Femaxeen than placebo (p < 0.05 for all comparisons). Femaxeen significantly reduced ICIQ-SF and MHU scores from baseline to day 60 and day 90 in all UI types (p < 0.05 for all comparisons except ICIQ-SF scores for stress UI). Femaxeen and placebo were well tolerated. Associated adverse events were few and mild in intensity. Conclusions Femaxeen is effective for treating UI, and has a safety profile comparable to that of placebo.

    更新日期:2019-12-17
  • Psychological behavior patterns and coping with menopausal symptoms among users and non-users of hormone replacement therapy in Finnish cohorts of women aged 52–56 years
    Maturitas (IF 3.654) Pub Date : 2019-12-12
    Jaana Jalava-Broman; Niina Junttila; Lauri Sillanmäki; Juha Mäkinen; Päivi Rautava

    Objective To identify subgroups of women who differ with respect to self-evaluated stress, hostility, optimism and sense of coherence, and to identify differences, if any, in whether these subgroups use or do not use hormone replacement therapy (HT). Study design and methods This time-trend study is based on the Finnish national HeSSup study, in which nationwide cohorts of Finnish women aged 52-56 years randomly selected in 2000 (n = 1321) and in 2010 (n = 1389) responded to postal questionnaires related to four psychological behavior patterns. Main outcome measures Relationships between psychological behavior patterns (stress, hostility, optimism and sense of coherence) and how menopausal symptoms are experienced and how this relates to the use of HT. Results The proportion of HT users was higher among those with more stress and hostility and less optimism and sense of coherence than among those low in stress and hostility and high in optimism and sense of coherence. Conclusions Differences in psychological behavior patterns influence the perception of menopausal symptoms and the use of HT. When the treatment of women at menopause is planned, psychological behavior patterns should be considered, as these reflect the ability to cope with menopausal symptoms.

    更新日期:2019-12-13
  • Efficacy and effectiveness of bulking agents in the treatment of stress and mixed urinary incontinence: A systematic review and meta-analysis
    Maturitas (IF 3.654) Pub Date : 2019-12-11
    Giampiero Capobianco, Laura Saderi, Francesco Dessole, Marco Petrillo, Margherita Dessole, Andrea Piana, Pier Luigi Cherchi, Salvatore Dessole, Giovanni Sotgiu

    The objective of this systematic review and meta-analysis was to evaluate the efficacy and the effectiveness, as well as the safety and tolerability, of urethral bulking agents (UBAs) in women with mixed or stress urinary incontinence. PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were used to identify relevant articles. In total, 3,510 records were found. A total of 42 full texts were evaluated but only 21 (48.8%) were selected for the qualitative and quantitative analysis. The pooled improvement rate in studies with a follow-up of ≤1 and >1 year was 46.0% (95% CI: 37.0%-57.0%; I2: 88.9%) and 57.0% (95% CI: 39.0%-74.0%; I2: 89.6%), respectively. The outcome ‘cure/dryness’ ranged from 9.1% to 56.7%. The pooled cure rate was 26.0% (95% CI: 21.0%-32.0%; I2: 89.9%) and 21.0% (95% CI: 16.0%-27.0%; I2: 34.2%) in females with a follow-up of ≤1 and >1 year, respectively. The treatment success rate ranged from 32.7% to 93.3% in 12 studies; it was objectively assessed with different tools (e.g., the Stamey scale in 5 studies). The pooled objective treatment success rate was 7.0% (95% CI: 59.0.0%-75.0%; I2: 82.4%) and 46.0% (95% CI: 37.0%-55.0%; I2: 55.3%) in women with a follow-up of ≤12 and >12 months, respectively. The percentage of adverse events was 0.4% (vaginal infection, irritation, lichen sclerosus, worsening urinary incontinence). However, the use of UBAs as the first-line therapy should be demonstrated in more comparative studies (randomized studies MUSs vs. UBAs). UBAs should be considered a first-line surgical therapy only for women with SUI and mixed UI with high anaesthesia risk, elderly patients, or patients reluctant to undergo surgery. Thus, UBAs should not be offered as first-line therapy for those women desiring a “one-time” durable solution for primary or recurrent SUI.

    更新日期:2019-12-11
  • Distribution and trajectory of handgrip strength in Chinese non-institutionalized middle-aged and older adults: a longitudinal descriptive analysis
    Maturitas (IF 3.654) Pub Date : 2019-12-09
    Hui Xie, Yuanyuan Zhang, Yiting Wei

    Using a national sample, we explored the distribution of and longitudinal trajectory of handgrip strength (HGS) in Chinese non-institutionalized middle-aged and older adults. We included a total of 12292 participants in the cross-sectional distribution analysis and a total of 7193 in the longitudinal trajectory analysis. The mean HGS was significantly higher (P < 0.001) in males (38.88 kg) than in females (26.52 kg). The HGS centiles and mean HGS in both males and females decreased as age increased. HGS declined with time in a nonlinear manner. HGS declined faster in males than in females.

    更新日期:2019-12-09
  • Can Exergames contribute to improving walking capacity in older adults? A Systematic Review and Meta-Analysis
    Maturitas (IF 3.654) Pub Date : 2019-12-09
    Ana Isabel Corregidor-Sánchez, Antonio Segura-Fragoso, Marta Rodríguez-Hernández, Juan José Criado-Alvarez, González-Gonzalez Jaime, Begoña Polonio-López

    Background The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. Objective To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. MATERIAL AND METHODS: The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. Results We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95% CI: -0.90, -0.21; p = 0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95%: -1.70, -0.35; P = 0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. Conclusions Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.

    更新日期:2019-12-09
  • Trans-specific Geriatric Health Assessment (TGHA): An Inclusive Clinical Guideline for The Geriatric Transgender Patient in A Primary Care Setting
    Maturitas (IF 3.654) Pub Date : 2019-12-06
    Reid M. Gamble, Shayne S. Taylor, Adam D. Huggins, Jesse M. Ehrenfeld

    There is a growing concern in the field of geriatric medicine that transgender health is often overlooked and under-reported. Not only does this impact the health and safety of the aging transgender community, but it also often influences the ability of physicians to provide high-quality evidence-based care. This article reviews the current knowledge base for geriatric transgender health and aims to organize evidence-based clinical recommendations for the primary care provider. Our proposed guideline, the Trans-specific Geriatric Health Assessment (TGHA), highlights areas of current clinical practice that do not address the geriatric transgender experience and modifies them to include trans-specific clinical recommendations found in the literature. The TGHA emphasizes topics such as cognitive function, vision and hearing, gait and stability, nutrition, sleep, functional/social status, urogenital health, psychiatric health, hormone replacement therapy, cancer screening, disease prevention and advanced care planning. Our review also addresses the limitations of certain clinical topics and where there is significant need for supportive research.

    更新日期:2019-12-07
  • A 5-year longitudinal study of changes in body composition in women in the perimenopause and beyond
    Maturitas (IF 3.654) Pub Date : 2019-12-05
    Joseph C.H. Wong, Sheila O’Neill, Belinda R. Beck, Mark R. Forwood, Soo Keat Khoo

    Objective Most studies of the age-related changes in body composition are cross-sectional in design: there have been few longitudinal studies. The aim of this 5-year study was to document body composition changes in perimenopausal and older women. Study design Prospective, longitudinal observational study. Methods 489 women were randomly selected from the electoral roll and stratified into 4 age groups by decade: 40-49, 50-59, 60-69 and 70-79 years. Dual-energy x-ray absorptiometry (DXA) was performed in the first and fifth years of the study. Total body mass (TBM), total fat mass (TFM), total lean mass (TLM), abdominopelvic fat mass, and appendicular fat and lean mass were determined. Results There were significant increases in TBM (p < 0.001), TFM (p < 0.01), TLM (p < 0.05), arm fat mass (p < 0.05), leg fat mass (p < 0.001) and leg lean mass (p < 0.05) within the 40-49 age decade. TBM, TFM and abdominopelvic fat started to decline from the 50-59 decade. Abdominopelvic fat reduction was significant from the 50-59 decade to the later decades (p = 0.05 to p < 0.001). Arm lean mass showed a significant reduction from the 50-59 decade (p < 0.01). Leg lean mass declined from the 60-69 decade, reaching significance in the 70-79 decade (p = 0.05). Conclusion TFM and abdominopelvic fat declined from the 50-59 age decade, which is earlier than is suggested in the literature. Conversely, the decline in appendicular lean mass with age occurred later, from the 50-59 decade, with earlier and greater loss in the arms, which has implications for exercise strategies to maintain muscle mass from midlife on.

    更新日期:2019-12-05
  • Intracranial calcifications under vitamin K antagonists or direct oral anticoagulants: Results from the French VIKING study in older adults
    Maturitas (IF 3.654) Pub Date : 2019-12-03
    Gaëlle Annweiler, Mathieu Labriffe, Pierre Ménager, Guylaine Ferland, Antoine Brangier, Cédric Annweiler

    Objectives The use of vitamin K antagonists (VKA) is associated with the onset of vascular and soft-tissue calcifications. Whether there are more intracranial calcifications under VKA remains unclear. The objective of this study was to determine whether the regular use of VKA in older adults was associated with an increased burden of intracranial calcifications compared with the use of direct oral anticoagulant (DOA). Study design Nineteen patients aged 70 years or more using VKA for more than 3 months and 19 controls (matched for age, gender and indication for anticoagulation) using DOA for more than 3 months were consecutively included in this study. Main outcomes measures The burden of intracranial calcifications was graded by an experienced neuroradiologist from 0 (no burden) to 3 (high burden) according to the quantity, size, intensity and confluence of calcifications on computed tomography scan of the brain. Age, gender, frontal assessment battery (FAB) score, hypertension, dyslipidaemia, carotid artery stenosis, kidney failure and indication for anticoagulation were investigated as potential confounders. Results The 19 patients using VKA (median[IQR], 84years[7]; 10females) exhibited a greater burden of falcian calcifications than the 19 controls using DOA (respectively, 2[1] versus 1[2], P = 0.025). Overall, we found that using VKA was directly associated with the global burden of intracranial calcifications (β = 1.54, P = 0.049). No correlation was found with calcifications in sites other than the falx cerebri. Conclusions The use of VKA was associated with a greater burden of intracranial calcifications compared with the use of DOA, specifically in the falx cerebri. This finding may explain part of the neurocognitive morbidity met with VKA.

    更新日期:2019-12-04
  • Is vitamin D deficiency related to a higher risk of hospitalization and mortality in veterans with heart failure?
    Maturitas (IF 3.654) Pub Date : 2019-12-03
    Raquel Aparicio-Ugarriza, Douglas Salguero, Yaqub Nadeem Mohammed, Juliana Ferri-Guerra, Dhanya J Baskaran, Seyed Abbas Mirabbasi, Alexis Rodriguez, Jorge G. Ruiz

    Objectives 25-hydroxyvitamin D [25(OH)D] deficiency is related to an increase in cardiovascular risk but the association between low 25(OH)D and hospitalization and mortality in heart failure (HF) patients remains unclear. The objective of this study was therefore to determine whether 25(OH)D deficiency is associated with a higher risk of all-cause hospitalizations and mortality in veterans with HF, as well as the differential effect of frailty. Study design A retrospective cohort study of veterans with HF. Main outcome Association between 25(OH)D deficiency and risk of hospitalization and mortality. Measures 25(OH)D status was dichotomized as deficiency (<30 ng/mL) and non-deficiency (≥30 ng/mL). A 44-item Frailty Index (FI) was constructed and used to categorize patients as non-frail (FI < .21) or frail (FI ≥ .21). The association of 25(OH)D deficiency with recurrent hospitalization was analyzed through an Andersen-Gill model and the association with mortality using Cox regression. Results We identified 284 patients, of whom 141 (50%) exhibited 25(OH)D deficiency (67.3 ± 10.5 years of age). The mean 25(OH)D levels in the deficiency and non-deficiency groups were 21.3±5.9 ng/mL and 40.9 ± 10.9 ng/mL, respectively. Over a median follow-up of 1136 days (IQR = 691), there were 617 hospitalizations (68% in those with 25(OH)D deficiency) and 131 deaths (40% in those with 25(OH)D deficiency). A significantly higher risk of hospitalization was found in patients with 25(OH)D deficiency: hazard ratio (HR) = 1.8 (95% CI:1.3-2.5),p < 0.001. Frail veterans had a greater risk of hospitalization than non-frail veterans: HR = 1.7 (95% CI:1.2-2.7),p < 0.05. Mortality did not show any significant association with 25(OH)D deficiency. Conclusions 25(OH)D deficiency was an independent risk factor for hospitalization in patients with HF and the effect persisted in those with frailty.

    更新日期:2019-12-04
  • THE MEDITERRANEAN DIET: A HISTORICAL PERSPECTIVE on FOOD FOR HEALTH
    Maturitas (IF 3.654) Pub Date : 2019-12-03
    Juan José Hidalgo-Mora, Alicia García-Vigara, María Luz Sánchez-Sánchez, Miguel-Ángel García-Pérez, Juan Tarín, Antonio Cano

    The Mediterranean diet (MedDiet) represents the crystallisation of the centuries-old cooking legacies of different civilisations. The association of the MedDiet with longevity and low cardiovascular risk prompted the Seven Countries Study, which provided epidemiological evidence on the health effects of diet. This led to further studies, both epidemiological and interventional. Scales to measure adherence as well as studies of food components have consolidated a body of knowledge that is of great interest to institutions and governmental agencies. The recognition of its benefits for health has made the widespread introduction of the MedDiet an urgent challenge. Parallel efforts are being made to extend research through experimental and clinical studies. The purpose of this review is to present the historical background of the MedDiet, the main steps leading to the recognition of its health benefits, and the current strategy to facilitate its global implementation.

    更新日期:2019-12-04
  • Risk of hand osteoarthritis in new users of hormone replacement therapy: A nested case-control analysis
    Maturitas (IF 3.654) Pub Date : 2019-11-27
    Theresa Burkard, Marlene Rauch, Julia Spoendlin, Daniel Prieto-Alhambra, Susan S. Jick, Christoph R. Meier

    Objective To estimate the risk of hand osteoarthritis (HOA) associated with hormone replacement therapy (HRT). Methods We conducted a nested case-control study using data from the UK-based Clinical Practice Research Datalink (1998-2017). In the study inception cohort comprised women at age 45. We matched women with incident HOA during follow-up (cases) to osteoarthritis-free controls on age and calendar date (index date, ID), in a ratio of 1:4. We applied conditional logistic regression to calculate odds ratios (OR) with 95% confidence intervals (CI) of HOA associated with new HRT use compared with non-use overall, and for women with recorded menopause we calculated separate ORs according to the time between menopause and HRT initiation (current users), and the time between HRT cessation and the ID (past users), versus non-users. Results There were 3440 cases and 13,760 controls (mean age: 50.9 ± 4.1 years). We observed an adjusted OR (aOR) of HOA of 1.32 (95% CI 1.17-1.48) in HRT users (versus non-users), which attenuated to 0.98 (95% CI 0.85-1.14) in women with recorded menopause. Current users (versus non-users) who initiated HRT 3 months before or after menopause had an aOR of 0.72 (95% CI 0.55-0.96), while aORs increased with later HRT initiation. Among past users (versus non-users), we observed an aOR of 1.25 (95% CI 0.86-1.81) when HRT use was stopped ≤18 months before the ID, approaching the null with increasing duration between HRT cessation and the ID. Conclusion Current HRT use was associated with a decreased risk of HOA if initiated around menopause, but the risk reduction disappeared after HRT cessation.

    更新日期:2019-11-28
  • Trabecular bone score and bone quantitative ultrasound in Spanish postmenopausal women. The Camargo cohort study
    Maturitas (IF 3.654) Pub Date : 2019-11-27
    José M. Olmos, José L. Hernández, Emilio Pariente, Josefina Martínez, Carmen Valero, Jesús González-Macías

    Objective To evaluate trabecular bone score (TBS) in Spanish postmenopausal women from our area. To analyze its relationship with bone mineral density (BMD), bone quantitative ultrasound (QUS) and serum concentrations of 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (PTH) and bone turnover markers. Study design A total of 1,450 postmenopausal women aged 44-94 (62 ± 10) participated in this cross-sectional study nested in a population-based cohort. BMD and TBS were assessed by DXA. QUS measurements were performed using a Sahara Clinical Sonometer. Serum 25(OH)D, PTH, P1NP,β-CTX were determined by electrochemiluminescence. Results Mean TBS of postmenopausal women in our region was 1.341 ± 0.111. Nearly 50% of them had normal values. Only 11% had scores compatible with a clearly degraded microarchitecture. TBS decreased with age, correlated negatively with BMI and was lower in current smokers than in non-smokers. An association was observed between TBS and QUS, although the association was weak and lower than that found between TBS and BMD or QUS and BMD. No association was found between TBS and 25(OH)D, PTH or bone turnover markers. Conclusions Half of postmenopausal women in our region have TBS values that indicate a preserved microarchitecture. Only about 10% have scores compatible with a clearly degraded microarchitecture. A weak association was observed between TBS and QUS, suggesting that the two techniques capture different aspects of bone microarchitecture. The absence of association with 25(OH)D, PTH, and bone turnover markers may be due to the fact that TBS assesses a specific (mostly trabecular) part of the skeleton, whilst the three serum factors are related to the whole skeleton.

    更新日期:2019-11-28
  • NUTRITIONAL Strategies for Maintaining Muscle MASS AND STRENGTH from Middle Age to Later Life: A NARRATIVE REVIEW
    Maturitas (IF 3.654) Pub Date : 2019-11-27
    Alfonso J. Cruz-Jentoft, Bess Dawson Hughes, David Scott, Kerrie M. Sanders, Rene Rizzoli

    Progressive age-related reductions in muscle mass and strength (sarcopenia) can cause substantial morbidity. This narrative review summarizes evidence of nutritional interventions for maintaining muscle mass and strength from midlife through old age. PubMed and Cochrane databases were searched to identify studies of dietary intake and nutritional interventions for sustaining muscle mass and strength. The benefits of progressive resistance training with and without dietary interventions are well documented. Protein and amino acid (particularly leucine) intake should be considered, and supplementation may be warranted for those not meeting recommended intakes. Vitamin D receptors are expressed in muscle tissue; meta-analyses have shown that vitamin D benefits muscle strength. Data suggest that milk and other dairy products containing different bioactive compounds (i.e. protein, leucine) can enhance muscle protein synthesis, particularly when combined with resistance exercise. Omega-3 s can improve muscle mass and strength by mediating cell signaling and inflammation-related oxidative damage; no studies were specifically conducted in sarcopenia. Low-dose antioxidants (e.g. vitamins C and E) can protect muscle tissue from oxidative damage, but relevant studies are limited. Magnesium is involved with muscle contraction processes, and data have shown benefits to muscle strength. Acidogenic diets increase muscle protein breakdown, which is exacerbated by aging. Alkalizing compounds (e.g. bicarbonates) can promote muscle strength. Small studies of probiotics and plant extracts have generated interest, but few large studies have been conducted. Based on available data, dietary and supplemental interventions may add to the benefits of exercise on muscle mass and strength; effects independent of exercise have not been consistently shown.

    更新日期:2019-11-28
  • Effects of red clover (Trifolium pratense) isoflavones on the lipid profile of perimenopausal and postmenopausal women - a systematic review and meta-analysis
    Maturitas (IF 3.654) Pub Date : 2019-11-10
    Wieslaw Kanadys, Agnieszka Baranska, Marian Jedrych, Urszula Religioni, Mariola Janiszewska

    Aim The aim of this systematic review and meta-analysis was to clarify the effect of a specific standardised extract of red clover (Trifolium pratense) on the lipid profile of perimenopausal and postmenopausal women. Methods Medline (PubMed), EMBASE, and Cochrane Library electronic databases were searched for papers in English reporting randomized controlled trials published up to 2017. Reference lists from those papers were checked for further relevant publications. Studies were identified and reviewed for their eligibility for inclusion in this review. The changes from baseline in the levels of individual components of the lipid profiles were used to assess differences between the active treatment and placebo groups. Weighted mean differences and 95% confidence intervals were calculated for continuous data using a random-effects model. Results Ten eligible studies (twelve comparisons) with 910 peri- and postmenopausal women were selected for systematic review. The meta-analysis showed changes in serum levels: total cholesterol, −0.29 (95% CI: −0.53 to −0.06) mmol/L [–11.21 (95% CI: –20.49 to –13.92) mg/dL], p = 0.0136; LDL-cholesterol, −0.13 (95% CI: −0.35 to 0.09) mmol/L [–5.02 (95% CI: –13.53 to 3.48) mg/dL], p = 0.2418; triglycerides, −0.15 (95% CI: −0.32 to 0.01) mmol/L [–13.28 (95% CI: –28.34 to 0.88) mg/dL], p = 0.0592; and HDL-cholesterol, 0.14 (95% CI: −0.08 to 0.36) mmol/L [5.41 (95% CI: –3.09 to 13.92) mg/dL], p = 0.2103. TheI2 statistic ranged from 87.95% to 98.30%, indicating significant heterogeneity. Conclusions The results suggest that a red clover extract is efficacious in reducing the concentrations of total cholesterol; however, changes in HDL-C, LDL-C and triglycerides are not as pronounced. Potentially, this means that women takingTrifolium pratense for menopausal symptoms can derive additional benefits from the plant’s specific effect that corrects abnormal cholesterol levels. Additional studies are needed to assess its effects on post-menopausal women.

    更新日期:2019-11-11
  • Analysis of NR5A1 in 142 patients with premature ovarian insufficiency, diminished ovarian reserve, or unexplained infertility
    Maturitas (IF 3.654) Pub Date : 2019-11-09
    Sylvie Jaillard, Rajini Sreenivasan, Marion Beaumont, Gorjana Robevska, Christèle Dubourg, Ingrid M. Knarston, Linda Akloul, Jocelyn van den Bergen, Sylvie Odent, Brittany Croft, Guilhem Jouve, Sonia R. Grover, Solène Duros, Céline Pimentel, Marc-Antoine Belaud-Rotureau, Katie L. Ayers, Célia Ravel, Elena J. Tucker, Andrew H. Sinclair

    Ovarian deficiency, including diminished ovarian reserve and premature ovarian insufficiency, represents one of the main causes of female infertility. Little is known of the genetic basis of diminished ovarian reserve, while premature ovarian insufficiency often has a genetic basis, with genes affecting various processes. NR5A1 is a key gene required for gonadal function, and variants are associated with a wide phenotypic spectrum of disorders of sexual development, and are found in 0.26-8% of patients with premature ovarian insufficiency. As there is some debate about the extent of involvement of NR5A1 in the pathogenesis of ovarian deficiency, we performed an in-depth analysis of NR5A1 variants detected in a cohort of 142 patients with premature ovarian insufficiency, diminished ovarian reserve, or unexplained infertility associated with normal ovarian function. We identified rare non-synonymous protein-altering variants in 2.8% of women with ovarian deficiency and no such variants in our small cohort of women with infertility but normal ovarian function. We observed previously reported variants associated with premature ovarian insufficiency in patients with diminished ovarian reserve, highlighting a genetic relationship between these conditions. We confirmed functional impairment resulting from a p.Val15Met variant, detected for the first time in a patient with premature ovarian insufficiency. The remaining variants were associated with preserved transcriptional activity and localization of NR5A1, indicating that rare NR5A1 variants may be incorrectly curated if functional studies are not undertaken, and/or that NR5A1 variants may have only a subtle impact on protein function and/or confer risk of ovarian deficiency via oligogenic inheritance.

    更新日期:2019-11-11
  • Predictive Factors for the Efficacy of Er:YAG Laser Treatment of Urinary Incontinence
    Maturitas (IF 3.654) Pub Date : 2019-11-09
    C. Tamer Erel, Deniz Inan, Aysegul Mut

    Objectives To determine the efficacy and predictive factors for the success of Er:YAG laser treatment in patients with urinary incontinence (UI). Methods Eighty-two patients with UI were treated by Er:YAG laser in this cohort study. The patients were evaluated by ICIQ-SF and KHQ-UI before and after the procedure. Improvement was categorized as: none (0-25%), mild (26-50%), moderate (51-75%), or high (76-100%). The duration of the treatment effect was evaluated at follow-up in relation to maximum improvement time (MIT) and total improvement time (TIT). Results Forty-two patients were determined to have SUI and 40 patients MUI. The mean ISIQ-SF and KHQ-UI scores significantly improved after the procedure (p<0.0001). The SUI patients responded to the laser treatment significantly better (p<0.008). Younger women had significantly better results (p<0.008), while premenopausal women (p<0.032) and women in the early postmenopausal years (p<0.032) also saw a positive response to the Er:YAG laser treatment. Women with a lower BMI had greater improvement (p<0.011). The total laser energy expenditure during the sessions may also be a predictive parameter for the success of Er:YAG laser treatment of UI (p = 0.059). MIT and TIT were significantly longer among the patients in the high-improvement group. Conclusion Er:YAG laser treatment of the symptoms of UI, especially SUI, is more efficacious and of longer duration for younger, premenopausal or early postmenopausal women with normal BMI.

    更新日期:2019-11-11
  • To STOPP or to START? Potentially inappropriate prescribing in older patients with falls and syncope
    Maturitas (IF 3.654) Pub Date : 2019-11-07
    Susanne C. de Ruiter, Sophie S. Biesheuvel, Ingrid M.M. van Haelst, Rob J. van Marum, René W.M.M. Jansen

    Objectives To investigate the prevalence of potentially inappropriate prescribing (PIP) according to the revised STOPP/START criteria in older patients with falls and syncope. Study design We included consecutive patients with falls and syncope aged ≥65 years at the day clinic of the Northwest Clinics, the Netherlands, from 2011 to 2016. All medication use before and after the visit was retrospectively investigated using the revised STOPP/START criteria. Main outcome measures The prevalence/occurrence of PIP before the visit, persistent PIP after the visit, and unaddressed persistent PIP not explained in the patient’s chart. Results PIP was present in 98% of 374 patients (mean age 80 (SD ± 7) years; 69% females). 1564 PIP occurrences were identified. 1015 occurrences persisted (in 91% of patients). 690 occurrences (in 80% of patients) were not explained in the patient’s chart. The most frequent unaddressed persistent forms of PIP were prescriptions of vasodilator drugs for patients with orthostatic hypotension (16%), and benzodiazepines for >4 weeks (10%) or in fall patients (8%), and omission of vitamin D (28%), antihypertensive drugs (24%), and antidepressants (17%). 54% of all medication changes were initiated for reasons beyond the scope of the STOPP/START criteria. Conclusions Almost every patient in our study population suffered from PIP. In 80%, PIP continued after the clinical visit, without an explanation in the patient’s chart. The most frequent PIP concerned medication that increased the risk of falls or syncope, specifically vasodilator drugs and benzodiazepines. Physicians should be aware of PIP in older patients with falls and syncope. Further studies should investigate whether a structured medication review may improve clinical outcomes.

    更新日期:2019-11-08
  • Reproductive factors and age at natural menopause: A systematic review and meta-analysis
    Maturitas (IF 3.654) Pub Date : 2019-11-06
    Alejandra Andrea Roman Lay, Carla Ferreira do Nascimento, Bernardo Lessa Horta, Alexandre Dias Porto Chiavegatto Filho

    Objectives To systematically review the evidence on the association between age at natural menopause (NM) and reproductive factors such as age at menarche, parity and ever use of oral contraceptives. Study design A literature search was carried out in PubMed, Scielo, Scopus and LILACS databases, without restriction of publication year until July 6, 2017. We excluded clinical trials, case-control studies, case reports and studies using statistical methods other than Cox proportional hazard models to assess the factors associated with age at NM. Cross-sectional studies evaluating women aged <50 years were also excluded. Random-effects models were used to pool the estimates. We registered the systematic review in the International Prospective Register of Systematic Review (PROSPERO) in August 2018, CRD42018099105. Results We identified 30 articles to include in the meta-analysis. We found that previous ever use of oral contraceptives (OC) (HR = 0.87, CI = 0.82, 0.93), age at menarche ≥13 years (HR = 0.90, CI = 0.84, 0.96), and having at least one live birth (HR = 0.79, CI = 0.74, 0.85) were associated with a later age of NM. Conclusions Despite differences in results between countries and study design, our findings suggest that previous use of OC, age at menarche ≥13 and having at least one live birth are associated with later menopause. The results suggest that these factors could be markers of later ovarian aging.

    更新日期:2019-11-06
  • Management of depressive symptoms in peri- and postmenopausal women: EMAS Position Statement
    Maturitas (IF 3.654) Pub Date : 2019-11-05
    Petra Stute, Areti Spyropoulou, Vasilios Karageorgiou, Antonio Cano, Johannes Bitzer, Iuliana Ceausu, Peter Chedraui, Fatih Durmusoglu, Risto Erkkola, Dimitrios G. Goulis, Angelica Lindén Hirschberg, Ludwig Kiesel, Patrice Lopes, Amos Pines, Margaret Rees, Mick van Trotsenburg, Iannis Zervas, Irene Lambrinoudaki

    Introduction Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70% greater in women. The perimenopause is considered to be a time of increased risk for the development of depressive symptoms and major depressive episodes. Aim The aim of this position statement is to provide a comprehensive model of care for the management of depressive symptoms in perimenopausal and early menopausal women, including diagnosis, treatment and follow-up. The model integrates the care provided by all those involved in the management of mild or moderate depression in midlife women. Materials and methods Literature review and consensus of expert opinion. Summary recommendations Awareness of depressive symptoms, early detection, standardized diagnostic procedures, personalized treatment and a suitable follow-up schedule need to be integrated into healthcare systems worldwide. Recommended treatment comprises antidepressants, psychosocial therapies and lifestyle changes. Alternative and complementary therapies, although widely used, may help with depression, but a stronger evidence base is needed. Although not approved for this indication, menopausal hormone therapy may improve depressive symptoms in peri- but not in postmenopausal women, especially in those with vasomotor symptoms.

    更新日期:2019-11-06
  • Psychological resilience during the perimenopause
    Maturitas (IF 3.654) Pub Date : 2019-11-05
    Hannah Süss, Ulrike Ehlert

    The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during the menopause. Nevertheless, the majority of women cope adequately with this reproductive transition phase and thus appear to be resilient. We assert that a variety of psychological factors influence the menopausal transition and result in an individual state on a continuum from successful adjustment to maladjustment. The purpose of this review is to offer a conceptual framework of resilience factors during the menopausal transition and to reveal which dimensions of resilience have already been verified for a healthy menopausal transition. We searched the databases PubMed and PsycINFO for studies investigating resilience factors during the menopausal transition which influence psychological and physical adjustment or maladjustment. A total of 23 articles were included. Altogether, we identified 15 different resilience factors, assessed with 23 different questionnaires. These factors can be grouped into six categories: core resilience, spirituality, control, optimism, emotion and self-related resilience. They are associated with a better adjustment to menopausal symptoms, milder physical symptoms, a better quality of and satisfaction with life, better well-being, less perceived stress and fewer depressive symptoms compared with women with lower levels of the respective resilience factors. Our conceptual framework includes resilience factors which have already been verified by empirical data. Further research is needed to determine whether these resilience factors can be assigned to a common factor and to incorporate biological resilience markers.

    更新日期:2019-11-06
  • The impact of physical exercise on cognitive and affective functions and serum levels of brain-derived neurotrophic factor in nursing home residents: a randomized controlled trial
    Maturitas (IF 3.654) Pub Date : 2019-11-05
    Haritz Arrieta, Chloe Rezola-Pardo, Maider Kortajarena, Gotzone Hervás, Javier Gil, José J. Yanguas, Miren Iturburu, Susana M. Gil, Jon Irazusta, Ana Rodriguez-Larrad

    Objectives To determine the effects of a multicomponent physical exercise program on cognitive and affective functioning among nursing home residents and to clarify whether there are any changes in serum levels of brain-derived neurotrophic factor (BDNF) among participants. Study design This was a single-blind randomized controlled trial in ten nursing homes in Gipuzkoa, Spain. The study included 112 men and women. Participants in the control group engaged in routine activities while those in the intervention group participated in a six-month individualized, progressive, multicomponent physical exercise program focused on strength, balance, and walking. Main outcome measures Cognitive and affective functions were assessed at baseline and at six months. Serum BDNF levels were assessed via ELISA. Results After six months, a group by time interaction in favor of the intervention group was observed on the Montreal Cognitive Assessment (MOCA), symbol search and De Jong-Gierveld Loneliness Scale (P < 0.05). The control group scored more poorly on the MOCA, WAIS-IV (coding and symbol search), verbal fluency, and semantic fluency tests after six months (P < 0.05) than they did at baseline. The intervention group showed poorer results on the coding test (P < 0.05). Loneliness perception was reduced in the intervention group (P < 0.05). No changes in serum BDNF were observed (group x time and within groups, P > 0.05). Conclusion A six-month individualized, progressive, multicomponent physical exercise intervention is effective at maintaining cognitive function and decreasing perceptions of loneliness among nursing home residents. Blood levels of BDNF were not affected by the intervention.

    更新日期:2019-11-06
  • Age at menarche and heart failure risk: The EPIC-NL study
    Maturitas (IF 3.654) Pub Date : 2019-11-05
    Mitchell V.L. Plompen, Yvonne T. van der Schouw, Frans H. Rutten, W.M. Monique Verschuren, Jolanda M.A. Boer, Folkert W. Asselbergs, N. Charlotte Onland-Moret

    Aims Early age at menarche has been reported to be associated with increased risks of developing type 2 diabetes (T2D) and coronary heart disease (CHD) in adulthood, but a late menarche has also been found to be associated with an increased risk of CHD. Both T2D and CHD are important risk factors for developing heart failure (HF). We examined the relationship between age at menarche (AAM) and HF incidence in women from the European Prospective Investigation into Cancer and Nutrition – Netherlands (EPIC-NL) cohort study. Methods and results The EPIC-NL cohort comprised 28,504 women aged 20-70 years at baseline (1993-1997). Mean age at menarche was 13.3 (standard deviation 1.6) years. During a median follow-up of 15.2 years HF occurred in 631 women. Cox proportional hazard regression models, stratified by cohort and adjusted for potential confounders, were used to investigate the associations between AAM and HF incidence. After confounder adjustment, each year of older age at menarche was associated with a 5% lower risk of HF (hazard ratio 0.95 (95% CI, 0.91-1.00), p-value 0.048). Further adjusting for body mass index (BMI), prevalent CHD, hypertension, or prevalent T2D as potential mediators between early menarche and risk of HF attenuated the associations between AAM and risk of HF to non-significance. Conclusion Older AAM reduced the risk of HF in this study. BMI, prevalent CHD, hypertension and prevalent T2D seemed to mediate this association. Future research with a longer follow-up should establish whether there is an independent effect of AAM on HF risk. Also, further phenotyping of HF cases is necessary to enable whether the associations differ for the various subtypes of HF.

    更新日期:2019-11-06
  • Decreased bone mineral density and osteoporotic fractures are associated with the development of echogenic plaques in the carotid arteries over a 10-year follow-up period: The Japanese Population-based Osteoporosis (JPOS) Cohort Study
    Maturitas (IF 3.654) Pub Date : 2019-11-04
    Hamada Masami, Etsuko Kajita, Junko Tamaki, Katsuyasu Kouda, Yuho Sato, Takahiro Tachiki, Akiko Yura, Kuniyasu Kamiya, Akemi Nitta, Sadanobu Kagamimori, Masayuki Iki

    Objectives To investigate whether low bone mineral density (BMD) and history of fracture at baseline are associated with the development of echogenic carotid plaques over a 10-year follow-up period. Study Design A prospective cohort study. Main outcome measures: Development of echogenic plaques identified by ultrasonography of the carotid arteries. Methods Among 1048 women aged 40 or more who completed the baseline survey of the Japanese Population-based Osteoporosis (JPOS) cohort study, 500 women who completed the first decade of follow-up and 267 women who completed the second decade of follow-up were included. We identified history and incidence of clinical osteoporotic fracture during the follow-up through medical interviews, and determined vertebral fractures by morphometry of absorptiometric images. Results We identified 67 (13.4%) and 31 (11.6%) women with echogenic plaques at the end of first and second decade of follow-up, respectively. Participants with echogenic plaques were significantly older, exhibited lower spine BMD, and had a higher prevalence of osteoporotic fracture, diabetes, and hypertension. A generalized estimating equation analysis was used to combine the participants from the two follow-up periods into a single cohort, and showed that osteoporotic BMD and osteoporotic fractures were significantly associated with the development of echogenic plaques, after adjusting for atherosclerosis risk factors (odds ratio (OR): 2.15, 95% confidence interval (95% CI): 1.04, 4.44; OR: 1.84, 95% CI: 1.03, 3.28, respectively). Conclusion Osteoporotic BMD and osteoporotic fracture history were significantly, and independently, associated with an increased occurrence of echogenic plaques. Ultrasonographic screening of the carotid artery may benefit patients with osteoporosis.

    更新日期:2019-11-04
  • Menopausal hormone therapy and breast cancer: Need to put risks in perspective.
    Maturitas (IF 3.654) Pub Date : 2019-09-26
    Irene Lambrinoudaki,Eleni Armeni

    更新日期:2019-11-01
  • Dementia in LATE Life - Where to from here?
    Maturitas (IF 3.654) Pub Date : 2019-07-13
    Andrew H Ford,Leon Flicker

    更新日期:2019-11-01
  • Treating hypothyroidism in people over 70.
    Maturitas (IF 3.654) Pub Date : null
    Irene Lambrinoudaki

    更新日期:2019-11-01
  • Sex and time: A new complexity in research.
    Maturitas (IF 3.654) Pub Date : null
    Walter A Rocca

    更新日期:2019-11-01
  • A CRISPR edit for heart disease: Not a universal panacea.
    Maturitas (IF 3.654) Pub Date : 2019-07-30
    Angela H E M Maas

    更新日期:2019-11-01
  • Uterine stem cells: potential and pitfalls.
    Maturitas (IF 3.654) Pub Date : null
    Reshef Tal,Jacqueline Kisa

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Menopause modulates the association between thyrotropin levels and lipid parameters: The SardiNIA study.
    Maturitas (IF 3.654) Pub Date : 2016-09-14
    Alessandro P Delitala,Maristella Steri,Maria Grazia Pilia,Mariano Dei,Sandra Lai,Giuseppe Delitala,David Schlessinger,Francesco Cucca

    OBJECTIVE Thyroid hormone influences lipoprotein metabolism. The role of menopausal status in this association has not been extensively studied. The aim of the present study is to evaluate the association between lipid parameters and mild elevations of thyrotropin (TSH), and whether menopause influences this relationship. STUDY DESIGN A cross-sectional study was conducted with a sample of 2,914 women (aged 14-102 years) from the SardiNIA study. MAIN OUTCOME MEASURES The association of TSH with blood lipid levels was examined using regression analyses, according to menopausal status. RESULTS Postmenopausal women had lower serum TSH concentrations and higher levels of total cholesterol, low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), and triglycerides than did premenopausal women (p=0.001 or less for all). In premenopausal women, after adjusting for the confounders age, BMI, smoking, insulin and glycaemia, TSH showed a direct relation to the levels of total cholesterol (β=0.046, p=0.010), LDLc (β=0.044, p=0.016) and triglycerides (β=0.085, p<0.001), but no association with HDLc level. In the postmenopausal group, TSH was directly associated only with triglyceride levels (β=0.103, p=0.014). CONCLUSIONS The association between mild elevation of TSH and lipid levels is influenced by menopausal status. Further research is needed to clarify this finding.

    更新日期:2019-11-01
  • Estimating cut points: A simple method for new wearables.
    Maturitas (IF 3.654) Pub Date : 2015-10-23
    A Hickey,J Newham,M M Slawinska,D Kwasnicka,S McDonald,S Del Din,F F Sniehotta,P A Davis,A Godfrey

    UNLABELLED Wearable technology is readily available for continuous assessment due to a growing number of commercial devices with increased data capture capabilities. However, many commercial devices fail to support suitable parameters (cut points) derived from the literature to help quantify physical activity (PA) due to differences in manufacturing. A simple metric to estimate cut points for new wearables is needed to aid data analysis. OBJECTIVE The purpose of this pilot study was to investigate a simple methodology to determine cut points based on ratios between sedentary behaviour (SB) and PA intensities for a new wrist worn device (PRO-Diary™) by comparing its output to a validated and well characterised 'gold standard' (ActiGraph™). STUDY DESIGN Twelve participants completed a semi-structured (four-phase) treadmill protocol encompassing SB and three PA intensity levels (light, moderate, vigorous). The outputs of the devices were compared accounting for relative intensity. RESULTS Count ratios (6.31, 7.68, 4.63, 3.96) were calculated to successfully determine cut-points for the new wrist worn wearable technology during SB (0-426) as well as light (427-803), moderate (804-2085) and vigorous (≥ 2086) activities, respectively. CONCLUSION Our findings should be utilised as a primary reference for investigations seeking to use new (wrist worn) wearable technology similar to that used here (i.e., PRO-Diary™) for the purposes of quantifying SB and PA intensities. The utility of count ratios may be useful in comparing devices or SB/PA values estimated across different studies. However, a more robust examination is required for different devices, attachment locations and on larger/diverse cohorts.

    更新日期:2019-11-01
  • The Mediterranean diet among British older adults: Its understanding, acceptability and the feasibility of a randomised brief intervention with two levels of dietary advice.
    Maturitas (IF 3.654) Pub Date : 2015-09-01
    Jose Lara,Edel Turbett,Agata Mckevic,Kate Rudgard,Henrietta Hearth,John C Mathers

    OBJECTIVES To assess (i) understanding, acceptability and preference for two graphical displays of the Mediterranean diet (MD); and (ii) feasibility of a brief MD intervention and cost of adherence to this diet among British older adults. DESIGN Two studies undertaken at the Human Nutrition Research Centre, Newcastle University are reported. In study-1, preference and understanding of the MD guidelines and two graphical displays, a plate and a pyramid, were evaluated in an educational group session (EGS). In study-2, we evaluated the feasibility of a three-week brief MD intervention with two levels of dietary advice: Group-1 (level 1) attended an EGS on the MD, and Group-2 (level 2) attended an EGS and received additional support. MD adherence using a 9-point score, and the cost of food intake during intervention, were assessed. RESULTS STUDY-1: No differences in preference for a MD plate or pyramid were observed. Both graphic displays were rated as acceptable and conveyed clearly these guidelines. STUDY-2: The intervention was rated as acceptable. No significant differences were observed between groups 1 and 2. Analysis of the combined sample showed significant increases from baseline in fish intake (P=0.01) and MD score (P=0.05). The cost of food intake during intervention was not significantly different from baseline. CONCLUSION British older adults rated a MD as an acceptable model of healthy eating, and a plate and a pyramid as comprehensible graphic displays of these guidelines. A brief dietary intervention was also acceptable and revealed that greater adherence to the MD could be achieved without incurring significantly greater costs.

    更新日期:2019-11-01
  • iCap: Instrumented assessment of physical capability.
    Maturitas (IF 3.654) Pub Date : 2015-04-29
    A Godfrey,J Lara,S Del Din,A Hickey,C A Munro,C Wiuff,S A Chowdhury,J C Mathers,L Rochester

    OBJECTIVES The aims of this study were to (i) investigate instrumented physical capability (iCap) as a valid method during a large study and (ii) determine whether iCap can provide important additional features of postural control and gait to categorise cohorts not previously possible with manual recordings. STUDY DESIGN Cross-sectional analysis involving instrumented testing on 74 adults who were recruited as part of a pilot intervention study; LiveWell. Participants wore a single accelerometer-based monitor (lower back) during standardised physical capability tests so that outcomes could be compared directly with manual recordings (stopwatch and measurement tape) made concurrently. MAIN OUTCOME MEASURES Time, distance, postural control and gait characteristics. RESULTS Agreement between manual and iCap ranged from moderate to excellent (0.649-0.983) with mean differences between methods low and deemed acceptable. Additionally, iCap successfully quantified (i) postural control characteristics which showed sensitivity to distinguish between 5 variations of the standing balance test and (ii) 14 gait characteristics known to be sensitive to age/pathology. CONCLUSIONS Our findings show that iCap can provide robust quantitative data about physical capability during standardised tests while also providing sensitive (age/pathology) postural control and gait characteristics not previously quantifiable with manual recordings. The methodology which we propose may have practical utility in a wide range of clinical and public health surveys and studies, including intervention studies, where assessment could be undertaken within diverse settings. This will need to be tested in further validation studies in a wider range of settings.

    更新日期:2019-11-01
  • Estimation of the optimum dose of vitamin D for disease prevention in older people: rationale, design and baseline characteristics of the BEST-D trial.
    Maturitas (IF 3.654) Pub Date : 2015-02-28
    Robert Clarke,Connie Newman,Joseph Tomson,Harold Hin,Rijo Kurien,Jolyon Cox,Michael Lay,Jenny Sayer,Michael Hill,Jonathan Emberson,Jane Armitage

    BACKGROUND Previous large trials of vitamin D for prevention of fractures and other disease outcomes have reported conflicting results, possibly because the doses tested were insufficient to maintain optimum blood levels of vitamin D (25[OH]D) predicted by the observational studies. This report describes the design and baseline characteristics of the BEST-D (Biochemical Efficacy and Safety Trial of vitamin D) trial which aims to establish the best dose of vitamin D to assess in a future large outcome trial. METHODS The BEST-D trial will compare the biochemical and other effects of daily dietary supplementation with 100 μg or 50 μg vitamin D3 or placebo, when administered for 12 months, in 305 ambulant community-dwelling older people living in Oxfordshire, England. The primary analyses will compare 12-month mean plasma concentrations of 25(OH)D as well as the proportion of participants with a 12-month concentration >90 nmol/L between participants allocated 100 μg and participants allocated 50 μg daily. Secondary analyses will compare the two active doses (both separately and when combined) with placebo. Additional end-points include biochemical assessments of safety, blood pressure, arterial stiffness, falls, fractures, heel and wrist bone density, grip strength and physical performance and echocardiographic assessments of cardiac function in a random sample of participants. RESULTS About one-third of eligible participants agreed to participate in the trial. The mean age was 72 (SD 6) years with equal numbers of men and women. About one third reported a prior history of fracture or hypertension, one-fifth reported a prior cardiovascular event, and one tenth reported diabetes or a fall in the previous 6 months. CONCLUSIONS The results of this trial will help determine the optimum dose of vitamin D to test in a larger trial investigating whether vitamin D supplementation can reduce the risk of fractures, cardiovascular disease or cancer.

    更新日期:2019-11-01
  • Towards measurement of the Healthy Ageing Phenotype in lifestyle-based intervention studies.
    Maturitas (IF 3.654) Pub Date : 2013-08-13
    Jose Lara,Alan Godfrey,Elizabeth Evans,Ben Heaven,Laura J E Brown,Evelyn Barron,Lynn Rochester,Thomas D Meyer,John C Mathers

    INTRODUCTION Given the biological complexity of the ageing process, there is no single, simple and reliable measure of how healthily someone is ageing. Intervention studies need a panel of measures which capture key features of healthy ageing. To help guide our research in this area, we have adopted the concept of the "Healthy Ageing Phenotype" (HAP) and this study aimed to (i) identify the most important features of the HAP and (ii) identify/develop tools for measurement of those features. METHODS After a comprehensive assessment of the literature we selected the following domains: physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we hoped would provide a reasonably holistic characterisation of the HAP. We reviewed the literature and identified systematic reviews and/or meta-analysis of cohort studies, and clinical guidelines on outcome measures of these domains relevant to the HAP. Selection criteria for these measures included: frequent use in longitudinal studies of ageing; expected to change with age; evidence for strong association with/prediction of ageing-related phenotypes such as morbidity, mortality and lifespan; whenever possible, focus on studies measuring these outcomes in populations rather than on individuals selected on the basis of a particular disease; (bio)markers that respond to (lifestyle-based) intervention. Proposed markers were exposed to critique in a Workshop held in Newcastle, UK in October 2012. RESULTS We have selected a tentative panel of (bio)markers of physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we propose may be useful in characterising the HAP and which may have utility as outcome measures in intervention studies. In addition, we have identified a number of tools which could be applied in community-based intervention studies designed to enhance healthy ageing. CONCLUSIONS We have proposed, tentatively, a panel of outcome measures which could be deployed in community-based, lifestyle intervention studies. The evidence base for selection of measurement domains is less well developed in some areas e.g. social wellbeing (where the definition of the concept itself remains elusive) and this has implications for the identification of appropriate tools. Although we have developed this panel as potential outcomes for intervention studies, we recognise that broader agreement on the concept of the HAP and on tools for its measurement could have wider utility and e.g. could facilitate comparisons of healthy ageing across diverse study designs and populations.

    更新日期:2019-11-01
  • Understanding dyspnea as a complex individual experience.
    Maturitas (IF 3.654) Pub Date : 2013-07-16
    Anja Hayen,Mari Herigstad,Kyle T S Pattinson

    Dyspnea is the highly threatening experience of breathlessness experienced by patients with diverse pathologies, including respiratory, cardiovascular, and neuromuscular diseases, cancer and panic disorder. This debilitating symptom is especially prominent in the elderly and the obese, two growing populations in the Western world. It has further been found that women suffer more strongly from dyspnea than men. Despite optimization of disease-specific treatments, dyspnea is often inadequately treated. The immense burden faced by patients, families and the healthcare system makes improving management of chronic dyspnea a priority. Dyspnea is a multidimensional sensation that encompasses an array of unpleasant respiratory sensations that vary according to underlying cause and patient characteristics. Biopsychological factors beyond disease pathology exacerbate the perception of dyspnea, increase symptom severity and reduce quality of life. Psychological state (especially comorbid anxiety and depression), hormone status, gender, body weight (obesity) and general fitness level are particularly important. Neuroimaging has started to uncover the neural mechanisms involved in the processing of sensory and affective components of dyspnea. Awareness of biopsychological factors beyond pathology is essential for diagnosis and treatment of dyspnea. Increasing understanding the interactions between biopsychological factors and dyspnea perception will enhance the development of symptomatic treatments that specifically address each patient's most pressing needs at a specific stage in life. Future neuroimaging research can provide objective markers to fully understand the role of biopsychological factors in the perception of dyspnea in the hope of uncovering target areas for pharmacologic and non-pharmacologic therapy.

    更新日期:2019-11-01
  • Reporting clinical research: guidance to encourage accurate and transparent research reporting.
    Maturitas (IF 3.654) Pub Date : 2012-03-24
    Iveta Simera,Shona Kirtley,Douglas G Altman

    To encourage accurate, complete, and transparent reporting of research studies we provide a brief overview of generic guidelines for reporting the main types of clinical research: randomised trials, observational studies in epidemiology, and systematic reviews. These and many other guidelines developed to help authors to achieve the highest standards in their research publications are available on the EQUATOR (Enhancing the Quality and Transparency of Health Research) Network website (www.equator-network.org).

    更新日期:2019-11-01
  • Testosterone, SHBG and differential white blood cell count in middle-aged and older men.
    Maturitas (IF 3.654) Pub Date : 2012-01-10
    Judith S Brand,Yvonne T van der Schouw,Mitch Dowsett,Elizabeth Folkerd,Robert N Luben,Nicholas J Wareham,Kay-Tee Khaw

    OBJECTIVE Low-grade chronic inflammation is increasingly being implicated in cardiovascular disease (CVD) etiology and may represent an alternative pathway through which testosterone and sex hormone-binding globulin (SHBG) influence CVD risk. We examined the associations between endogenous testosterone, SHBG and total and differential white blood cell (WBC) counts in men. METHODS Cross-sectional study of 2418 men aged 40-78 years from the Norfolk population of European Prospective Investigation into Cancer (EPIC-Norfolk) who had no history of CVD or cancer and complete data on sex hormones (total testosterone (TT), SHBG and free testosterone (FT)) and WBC counts. Associations between sex hormones and WBC counts were assessed using linear regression models. RESULTS Higher SHBG and TT levels were associated with lower WBC counts. After adjustment for age, BMI, smoking, physical activity and diabetes status, total WBC count decreased by 0.163 (95% CI -0.236; -0.091) and 0.102 (-0.170; -0.034) per standard deviation (SD) increase in SHBG and TT respectively. Associations of SHBG and TT with total WBC count were mainly accounted for by a lower granulocyte count (β coefficient=-0.132 (-0.194; -0.070) per SD increase in SHBG and β coefficient=-0.104 (-0.161; -0.046) per SD increase in TT). No associations between FT and total and differential WBC counts were found. CONCLUSIONS Endogenous TT and SHBG levels are inversely associated with total WBC and granulocyte count in middle-aged and older men. Even though the underlying mechanism and causal directionality requires further exploration, these results support a link between hormonal status and low-grade inflammation.

    更新日期:2019-11-01
  • Measuring anti-Müllerian hormone for the assessment of ovarian reserve: when and for whom is it indicated?
    Maturitas (IF 3.654) Pub Date : 2011-11-29
    R A Anderson,S M Nelson,W H B Wallace

    Our understanding of female reproductive function has been hampered by our inability to directly assess the number of non-growing primordial follicles present in the ovary, the ovarian reserve. Female reproductive hormones (FSH and LH, the inhibins and steroids) reflect the activity of the larger growing follicles and thus are largely informative of peri-ovulatory ovarian activity. In contrast anti-Müllerian hormone (AMH) is a product of the granulosa cells of small growing follicles, whose number (and therefore circulating AMH concentrations) is reflective of the ovarian reserve. AMH declines with age in adult women, and emerging data suggest a relationship with remaining reproductive lifespan and age at the menopause. Early studies demonstrated that AMH concentrations are stable across the menstrual cycle, adding to its clinical utility. The most established role for AMH measurement is in women about to start IVF treatment, where it is predictive of the ovarian response and is of clear value in identifying women at risk of ovarian hyperstimulation syndrome or whose response will be poor and thus their expectations can be tailored. AMH is detectable in childhood, and although relationships to puberty are not yet available, it appears that AMH rises to a peak in the early 20s. Developing indications include in assessment and individualisation of the risk to fertility from chemotherapy, in the diagnosis of PCOS and as a tumour marker in granulosa cell tumours. The increasingly routine use of AMH by IVF clinics heralds much wider adoption in a range of clinical situations across the reproductive lifespan.

    更新日期:2019-11-01
  • Relationship of obesity-related disturbances with LH/FSH ratio among post-menopausal women in the United States.
    Maturitas (IF 3.654) Pub Date : 2011-11-18
    Hind A Beydoun,May A Beydoun,Natasha Wiggins,Laurel Stadtmauer

    OBJECTIVES Although luteinizing hormone to follicular stimulating hormone (LH/FSH) ratio is a controversial criterion for identifying a sub-group of infertile women with polycystic ovary syndrome (PCOS) and abnormalities at the level of the hypothalamic-pituitary-ovarian axis, an elevated LH/FSH ratio is frequently observed in PCOS cases. Obesity and insulin resistance are highly prevalent among PCOS women. To date, no studies have examined the associations of LH/FSH ratio with these co-morbid conditions outside the context of pre- and peri-menopausal PCOS women. The objective of this study is to evaluate whether the LH/FSH ratio is associated with obesity, insulin resistance, metabolic disturbances and chronic inflammation among post-menopausal U.S. women, 35-60 years of age. STUDY DESIGN Cross-sectional study of 693 women who participated in the 1999-2002 National Health and Nutrition Examination Survey. MAIN OUTCOME MEASURES Body mass index, waist circumference, triglycerides, high-density lipoprotein (HDL) cholesterol, systolic and diastolic blood pressures, fasting glucose, metabolic syndrome, Homeostasis Model Assessment for Insulin Resistance and C-reactive protein (CRP). RESULTS Age- and hysterectomy-adjusted regression models suggest that CRP level is positively associated with LH/FSH ratio and LH/FSH>1, high glucose level and LH/FSH>2 are inversely related and HDL<50mg/dL is positively associated with both LH/FSH>1 and LH/FSH>2. CONCLUSIONS In a nationally representative sample of post-menopausal women, markers of chronic inflammation and dyslipidemia which are characteristics of PCOS-associated morbidities were also significantly associated with LH/FSH ratio, meriting further investigation.

    更新日期:2019-11-01
  • How the 1932 and 1947 mental surveys of Aberdeen schoolchildren provide a framework to explore the childhood origins of late onset disease and disability.
    Maturitas (IF 3.654) Pub Date : 2011-06-28
    Lawrence J Whalley,Alison D Murray,Roger T Staff,John M Starr,Ian J Deary,Helen C Fox,Helen Lemmon,Susan J Duthie,Andrew R Collins,John R Crawford

    OBJECTIVES To describe the discovery and development of the Aberdeen 1921 and 1936 birth cohort studies. STUDY DESIGN The Aberdeen birth cohort studies were started in 1998 when the Scottish Mental Survey archives of the Scottish Council for Research in Education were re-discovered and permissions granted to follow-up survivors born in 1921 or 1936 and then aged about 77 or 64 years and who had entered (or were about to enter) the age of greatest risk for Alzheimer's disease (AD). MAIN OUTCOME MEASURES Sources of attrition from the study, exposures to childhood adversity, nutritional, genetic and life style factors of possible relevance to extent of age-related cognitive decline and the timing of onset of dementia. RESULTS By 2010, the feasibility of following up more than 75% of Scottish Mental Survey survivors living in the Aberdeen area without dementia was well-established, dementia ascertainment to age about 88 years was completed in the 1921 birth cohort and was underway in the 1936 born cohort. CONCLUSION These databases are available to other bone fide research groups wishing to test specific hypotheses that may either replicate their own findings or make best use of the data collected in the Aberdeen studies.

    更新日期:2019-11-01
  • Sex differences in blood cell counts in the Lothian Birth Cohort 1921 between 79 and 87 years.
    Maturitas (IF 3.654) Pub Date : 2011-06-07
    John M Starr,Ian J Deary

    BACKGROUND Haematological abnormalities are important to detect. In older adults there are few data that inform about normal ranges and the change in blood cell counts with ageing. These few data indicate that sex differences in blood cell counts persist beyond 70 years. OBJECTIVE To determine normal ranges for blood cell counts and changes in counts and to examine the relationship between different blood cell counts for men and women. METHODS The sample comprised Lothian Birth Cohort 1921 (LBC1921) participants seen at a mean of about 79 and 87 years of age. Full blood count was measured on each occasion. Also recorded were weight, smoking status, years of full-time education, and main occupation, serum B12, folate and creatinine. RESULTS We examined blood cell counts in 495 community-resident people with mean age 79.1 (range 77.8-80.6) and repeated this in 157 of them at mean age 86.7 (range 85.7-87.4) years. Normal ranges were similar for men and women for all blood cell types at both ages, but men had persistently significantly higher mean red cell and monocyte counts, and women significantly higher platelet counts. Between 79 and 87 years, red cell, lymphocyte and eosinophil counts fell significantly, neutrophil and platelet counts increased, and monocyte count was stable. Worsening renal function was associated with a decrease in mean red cell count. CONCLUSION Changes in blood cell counts in this cohort are consistent with persistent sex differences, age-related changes in renal function (red cells), background inflammation (neutrophils and platelets) and immunosenescence (lymphocytes).

    更新日期:2019-11-01
  • Comparing TCM textbook descriptions of menopausal syndrome with the lived experience of London women at midlife and the implications for Chinese medicine research.
    Maturitas (IF 3.654) Pub Date : 2010-05-07
    Volker Scheid,Trina Ward,Veronica Tuffrey

    Almost without exception clinical research seeking to evaluate the effectiveness of Chinese medicine relies on TCM textbook knowledge - accessed directly or via practitioners' clinical usage - in order to frame its hypotheses. Recent historical research shows that these textbooks, products of a politically directed process of modernisation, constitute complex hybrids of western and Chinese knowledge that are designed to facilitate the integration of Chinese medicine into biomedically dominated contexts of practice. As such they produce a number of unresolved and generally unacknowledged tensions, such as between the emphasis on local illness experience in the Chinese medical tradition and the universality aspired to by biomedical knowledge. To examine the effect of these tensions we have carried out a study that compares local symptom patterns experienced by post-menopausal women in London with the universal patterns described in TCM textbooks. The results of this study confirm our proposition, namely that the TCM textbook descriptions of disease are not always grounded in clinical experience even if that is what textbooks claim. This raises questions about the relation of textbooks to clinical practice, and about the validity of clinical research based on textbooks and textbook derived normative practice. We argue that only a multidisciplinary approach that includes an understanding of the historical construction of contemporary Chinese medical knowledge and its relation to clinical practice can overcome these problems and enable a meaningful evaluation and utilisation of Chinese medicine in the context of 21st century evidence-based healthcare.

    更新日期:2019-11-01
  • A life course approach to reproductive health: theory and methods.
    Maturitas (IF 3.654) Pub Date : 2010-01-19
    Gita D Mishra,Rachel Cooper,Diana Kuh

    Taking a life course approach to the study of reproductive health involves the investigation of factors across life and, also across generations, that influence the timing of menarche, fertility, pregnancy outcomes, gynaecological disorders, and age at menopause. It also recognises the important influence of reproductive health on chronic disease risk in later life. Published literature supports the use of an integrated life course approach to study reproductive health, which examines the whole life course, considers the continuity of reproductive health and the interrelationship between the different markers of this. This is in contrast to more traditional approaches that tend to focus only on contemporary risk factors and which consider each marker of reproductive health separately. For instance, we found evidence linking early life factors such as growth, socioeconomic conditions, and parental divorce with ages at menarche and menopause, although the nature of the relationship differs. We discuss the different theoretical models that are used within life course epidemiology and which postulate pathways linking exposures across the life course to health outcomes, using examples of relevance to the study of reproductive health. These highlight the importance of examining timing of exposures, such as during critical periods in early life, and the temporal order of exposures. How life course frameworks of reproductive health can be developed to help identify hypotheses to be tested is also demonstrated. This approach has implications for the development of effective health policy that moves beyond identifying not only the type of intervention but also the most appropriate time across life to intervene.

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Associations between childhood intelligence (IQ), adult morbidity and mortality.
    Maturitas (IF 3.654) Pub Date : 2009-11-03
    Alixe H M Kilgour,John M Starr,Lawrence J Whalley

    Intelligence is a life-long trait that exerts powerful influences on educational success, occupational status, use of health services, life style and recreational choices. Until recently, the influence of cognitive performance on time to death was thought largely to be based on failing cognition in the time immediately before death or because lower mental ability was associated with low socioeconomic status and socioeconomic disadvantage. Children who were systematically IQ tested early in the twentieth century have now completed most of their life expectancy and permit evaluation of a possible link between childhood IQ and survival. This link is discussed as it affects people with intellectual disability and as a possible contributor to the acquisition of a healthy life style or use of health services. Studies on the topic are affected by many methodological pitfalls. Recently, as cohorts IQ tested as adolescents have completed middle age, new relevant data have become available. These suggest that earlier attempts to tease out the confounding effects of socioeconomic status on the relationship between childhood IQ and mortality did not take account of the full effects of childhood adversity on IQ and disease risk. When statistical models that include childhood adversity are tested, these attenuate and sometimes remove the contribution of IQ to morbidity and premature death.

    更新日期:2019-11-01
  • A longitudinal investigation of the impact of typology of urinary incontinence on quality of life during midlife: results from a British prospective study.
    Maturitas (IF 3.654) Pub Date : 2009-10-20
    Gita D Mishra,Tim Croudace,Linda Cardozo,Diana Kuh

    Using prospective data from 983 British women born in 1946, the study aims to describe the profiles of symptoms of stress, urge, and severe incontinence, and to relate these to change in quality of life. Based on the longitudinal patterns of symptoms experienced, four groups of women were defined: 'low symptom', 'onset', 'recovering', and 'chronic'. Childhood enuresis was associated with being in the 'chronic' group for urge and severe incontinence. Women in the 'recovering' group for stress incontinence experienced an improvement in the physical health domain (regression coefficient (95% CI): 0.1(0.02, 0.18)) compared with women without symptoms. This relationship existed beyond the effects of ageing, menopausal status, current life stress, and reproductive, lifestyle, and social factors. More research is needed to understand the mechanism that link childhood enuresis to being in the 'chronic' group for urge and severe incontinence.

    更新日期:2019-11-01
  • Body mass index trajectories and age at menopause in a British birth cohort.
    Maturitas (IF 3.654) Pub Date : 2008-04-15
    Rebecca Hardy,Gita D Mishra,Diana Kuh

    OBJECTIVE This study investigates the influence of body mass index (BMI) at ages 15, 20, 26, 36, and 43, and of BMI trajectories from 20 to 36 years on the timing of menopause and hormone therapy (HT) use until age 57 years. METHODS A nationally representative British cohort of 1583 women born in March 1946 with prospective data across the life course. RESULTS By age 57, a total of 695 women had experienced natural menopause while 431 women had started HT prior to menopause. Cox regression models indicated no significant associations between BMI at any age, or BMI trajectory, and timing of natural menopause. At every age BMI was strongly (p< or =0.01) and linearly associated with age at HT use and BMI from 26 years onwards was associated with age at first event (menopause or HT use). Decreasing BMI was associated with earlier HT use at all ages. These associations were not accounted for by parity, cigarette smoking or childhood and adult social class. CONCLUSION BMI across the reproductive lifespan did not influence age at menopause to an extent that would be clinically relevant for postmenopausal health. Lower BMI at all ages and underweight trajectory were related to an earlier start of HT. Further studies are required to understand whether such relationships are due to underweight women experiencing menopause earlier (and because of menopausal symptoms starting HT earlier) than heavier women, or having behavioural characteristics related to earlier HT use, independent of menopause.

    更新日期:2019-11-01
  • 更新日期:2019-11-01
Contents have been reproduced by permission of the publishers.
导出
全部期刊列表>>
2020新春特辑
限时免费阅读临床医学内容
ACS材料视界
科学报告最新纳米科学与技术研究
清华大学化学系段昊泓
自然科研论文编辑服务
加州大学洛杉矶分校
上海纽约大学William Glover
南开大学化学院周其林
课题组网站
X-MOL
北京大学分子工程苏南研究院
华东师范大学分子机器及功能材料
中山大学化学工程与技术学院
试剂库存
天合科研
down
wechat
bug