[Influence of various ways of rehabilitation on functional and immunological indicators of the organism of materials of maturity aged by an extreme injury.]

The purpose of the study is to study the effect of various methods of rehabilitation after a fracture of the radius in a typical location on the heart rate variability and the state of innate immunity factors, the content of IL-1, -2, -4, -6, -8, -10 in elderly women. In 50 women at the age of 63,5±1,5 years, the indicators of the spectral analysis of the heart rhythm were studied on the 3, 7, 14 days of rehabilitation procedures. The state of the cellular factors of innate immunity was assessed by the phagocytic activity and oxygen-dependent metabolism of neutrophilic granulocytes in the nitric blue tetrazolium reduction test. The cytokine status included the determination of IL-1, -2, -4, -6, -8, -10 by enzyme immunoassay. For the statistical analysis, the Shapiro-Wilks test, one-sided Fisher's exact test, and Student's t test were calculated. It has been shown that the influence of rehabilitation measures using the method of post-isometric muscle relaxation decreases the heart rate variability of elderly women, restores the balance between the sympathetic and parasympathetic parts of the autonomic nervous system, normalizes the functional and metabolic status of neutrophilic granulocytes and Th1/Th2 lymphocytes. The results obtained allow us to recommend the inclusion of the method of post-isometric muscle relaxation in the complex of rehabilitation measures for fractures of the radius in a typical place.

Phase Angle Reflects Loss of Functionality in Older Women

OBJECTIVE

This study verified if the phase angle (PA) formed by the resistance (R) and reactance (Xc) obtained from bioimpedance (BIA) might be a useful tool to identify functionality.

DESIGN AND PARTICIPANTS

It was conducted a cross-sectional study with 152 women ≥ 65 years old from the community.

MEASUREMENTS

weight, height, body mass index (BMI), calf circumference (CC), hand grip strength (HGS), gait speed (GS), fat free mass (FFM), body fat (BF), PA with R and Xc from the BIA were measured. Spearman's and Pearson's correlations and the odds ratio (OR) were performed using the IBM SPSS software version 22.0.

RESULTS

Sixty-four percent (n=98) women are with PA below the reference. Negative moderate significant correlation was found between PA and age (r =- 0.440*; p<0.001). Moderate significant correlation was observed between PA and GS (r = 0.484**; p<0.001). Weak significant correlation was found between PA and HGS (r = 0.177*; p = 0.029). Odds ratio (OR) demonstrated that individuals with PA above the mean value have 4.77 times more chances of having increased GS (confidence interval 2.40-9.48; 95%). Women aged below the mean value have 4.02 times more chances of having higher PA (confidence interval 2.02-7.99; 95%). Younger aged women showed 4.02 times more chances of having higher PA (confidence interval 2.02-7.99; 95%).

CONCLUSIONS

Phase angle can be associated with functional tests, such as gait speed and hand grip strength, in older women.

The effects of a strong desire to void on gait for incontinent and continent older community-dwelling women at risk of falls

AIMS

The fall rate in urgency urinary incontinence (UUI) and mixed UI (MUI) older women is higher when compared with that of continent women. One hypothesis is that a strong desire to void (SDV) could alter gait parameters and therefore increase the risk of falls. The aim of this study was to investigate and compare the effect of SDV on gait parameters in UUI/MUI and continent older women who experienced falls. The secondary aim was to determine the relationship between UI severity and gait parameters in incontinent women.

METHODS

A quasi-experimental pilot study was conducted with two groups of healthy community-dwelling women who experienced at least one fall in the last year: continent (n = 17; age: 74.1 ± 4.3) and UUI/MUI (n = 15; age: 73.5 ± 5.9). We recorded, analyzed, and compared spatiotemporal gait parameters for participants in each group with both SDV and no desire to void condition.

RESULTS

A pattern of reduced velocity (P = 0.05) and stride width (P = 0.02) was observed in both groups with SDV. Incontinence severity was correlated with reduced velocity (r_s  = -0.63, P = 0.01), increased stance time (r_s = 0.65, P = .01) and stance time variability (r_s  = 0.65, P = .01) in no desire to void condition and with reduced velocity (r_s  = -0.56, P = .03) and increased stride length variability (r_s  = 0.54, P = .04) in SDV condition.

CONCLUSIONS

SDV reduced gait velocity and stride width regardless of continence status in older women at risk of falls. Further, UI severity in the UUI/MUI women was correlated to reduced gait velocity and increased variability. Our findings could explain the higher fall rate in this population.

The Effects of 12 Weeks of a Combined Exercise Program on Physical Function and Hormonal Status in Elderly Korean Women

Aging causes a decline in physical function and hormonal balance. Exercise can improve these parameters. However, the beneficial effects of a combined exercise program (Korean dance and yoga) on physical function and hormonal status in elderly women remain unknown. This study aims to investigate the effects of a 12-week combined exercise program on balance, flexibility, muscle strength, and hormonal status in elderly Korean women. Twenty-five healthy elderly women were recruited and randomly divided into the control (CON) and exercise (EXE) groups. The EXE group underwent the combined exercise program (60 min/day and 3 times/week) for 12 weeks. The two groups did not differ in body weight, lean body mass, fat mass, body fat percentage, or body mass index at baseline or in the changes following the experimental conditions. A significant time × group interaction was detected for anterior and posterior dynamic balance, static balance, and growth hormone (GH). After the combined exercise program, anterior dynamic balance, posterior dynamic balance, static balance, flexibility, muscle strength, GH, dehydroepiandrosterone-sulfate, and estrogen significantly increased in the EXE group compared to the CON group. In conclusion, the combined exercise program contributed to improvements in overall health, including physical function and hormonal status, in elderly Korean women.

Effects of Pet Insects on Cognitive Function among the Elderly: An fMRI Study

Animal-assisted therapy has positive effects on cognitive function, depression, performance ability, and social functioning in elderly patients. The aim of this study was to evaluate the effects of rearing pet insects on the cognitive function of healthy elderly participants, with fMRI (functional magnetic resonance imaging) being used for this purpose. Community-dwelling right-handed elderly women (≥60 years) with normal cognitive function were enrolled and randomized at a 1:1 ratio into two groups: insect-rearing and control (n = 16) groups, with the insect-rearing group being further classified into two groups for analysis according to the subjects' scores in the Wisconsin Card Sorting Test, WCST) at the baseline fMRI: Insect-rearing group I with a relatively high score (n = 13), and insect-rearing group II with a relatively low score (n = 6). The insect-rearing groups received and reared crickets as pet insects for 8 weeks. The WCST consisted of two variations, a high level baseline (HLB) and semi-WCST version. There was a significant difference accuracy of the HLB-semi-WCST (p < 0.05) in insect-rearing group II after 8 weeks from the baseline test. In the fMRI analysis involving the WCST reaction test, increased activation was observed in the right dorsal lateral prefrontal cortex and parietal cortex in insect-rearing group II when the semi-WCST, rather than the HLB, was performed. Rearing pet insects showed positive effects on executive functions and performance improvement in elderly women. Further larger studies on the effects of pet insects on cognitive function are warranted.

Factors Associated with Physical Frailty in Elderly Women with Low Socioeconomic Status in Urban Communities: A Cross-Sectional Study

BACKGROUND

there are differences in factors associated with frailty syndrome in elderly population. The aim of this research was to determine frailty status (fit, pre-frail and frail) and to identify factors associated with physical frailty in urban community-dwelling elderly women.

METHODS

a cross-sectional study of community-dwelling women aged 60 years and older was conducted in West and Central Jakarta regions, Indonesia, from July until September 2017. The Cardiovascular Health Study (CHS) score was used to determine frailty status (fit/ pre-frail/ frail). Chi-Square Test and logistic regression analysis were used to determine association between independent variables and physical frailty.

RESULTS

there were 325 female subjects with a median age of 67 (60-94) years; 95.7% had income below the Provincial Minimum Income of DKI Jakarta in 2017 (<3.3 million IDR≈238 USD/month), and 92.6% had a level of education ≤9 years. Subjects were classified into this following groups: fit (12.6%), pre-frail (63.4%) and frail (24%). Factors associated with physical frailty were age above 70 years old with OR 5.27, lower Barthel Index for Activities of Daily Living (B-ADL) with OR 2.85, depressive symptoms with OR 6.79, and Euro Quality of Life-5 Dimensions (EQ-5D) index with OR 1.96.

CONCLUSION

elderly women in the urban community with low socioeconomic status were classified as fit (12.6%), pre-frail (63.4%) and frail (24%). Factors associated with physical frailty were age above 70 years old, depressive symptoms, lower functional status and health-related quality of life index.

Intake of Coffee Associated With Decreased Depressive Symptoms Among Elderly Japanese Women: A Multi-Center Cross-Sectional Study

Background

Depression in elderly people is a major global concern around the world. Epidemiological evidence of the association of beverages with depressive symptoms has received research attention; however, epidemiological studies on the association of coffee and green tea consumption with depressive symptoms among the elderly population are limited. The objective of this study is to cross-sectionally examine the association of depressive symptoms with the intake of coffee, green tea, and caffeine and to verify the antidepressant effect of caffeine.

Methods

The subjects were 1,992 women aged 65–94 years. Intakes of coffee, green tea, and caffeine, as well as depressive symptoms, were assessed with a validated brief dietary history questionnaire (BDHQ) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Multiple logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for depressive symptoms with adjustments for potential confounders.

Results

Coffee intake was associated with a lower prevalence of depressive symptoms, the ORs of which for the 4th versus the 1st quartiles of intake was 0.64 (95% CI, 0.46–0.88, P for trend = 0.01) in a fully adjusted model. Caffeine intake was marginally associated with depressive symptoms, but the association was not statistically significant (OR 0.75; 95% CI, 0.55–1.02, P for trend = 0.058).

Conclusion

The result suggests that the inverse association of coffee intake with depressive symptoms might be associated with not only caffeine intake but also some other substances in coffee or factors related to coffee intake. Because of the cross-sectional design of the present study, longitudinal studies are required to confirm the present finding.

Efficacy of Physiotherapy in Reducing Back Pain and Improve Joint Mobility in Older Women

BACKGROUND

Pain of the spine and large appendicular joints may limit the functional mobility of elderly persons and affect their biological fitness. This paper assesses the effects of comprehensive physical therapy in women with lumbar and cervical pain and compares flexibility in the upper and lower body and the range of motion in selected joints.

MATERIAL AND METHODS

Thirty-three women aged 60-75 years completed a 6-week intervention involving group gymnastics to prevent back pain, relaxation techniques, classic massage, transcutaneous electrical nerve stimulation, and ultrasound therapy to the lumbosacral and cervicothoracic regions. Patient outcomes were assessed by measuring upper and lower body flexibility, upper and lower extremity joint and spinal ROM, and self-reported back pain using a Visual Analogue Scale. Differences in means between successive measurements were calculated with a Student t test for dependent groups, while differences in the range of motion in the joints of the right and left limbs were calculated with the NIR test.

RESULTS

The physical therapy significantly improved flexibility of the upper and lower body by increasing the range of motion in selected joints of the limbs and the spine. On completion of the intervention, the intensity of back pain was reduced by 2.9 points in the VAS scale.

CONCLUSIONS

1. The 6-week physical therapy programme desig-ned by us constitutes an effective therapy for pain relief in patients with degenerative changes of the spine. 2. The proposed combination of sonotherapy, elec-tro-therapy and classic massage procedures with general fitness exercises in low positions and au-to-genic training contributed significantly to im-provement in flexibility of the upper and lower part of the body and increasing the range of mo-tion in joints of the lower and upper extremities and the spine in women over 60 years of age. 3. The proposed set of procedures and exercises may be used in women over 60 years of age with the aim of improving selected components of biolo-gical fitness.

Comparative effectiveness of radiotherapy for early-stage hormone receptor-positive breast cancer in elderly women using real-world data

BACKGROUND

Radiotherapy is the recommended treatment after breast-conserving surgery (BCS) for early-stage breast cancer (BC). However, there is no clear evidence whether radiotherapy after BCS improves the survival of elderly women diagnosed with early-stage hormone receptor-positive (HR+) BC. The aim of this study was to investigate the survival benefit associated with radiotherapy plus hormonal therapy vs hormonal therapy alone after BCS for early-stage HR+ BC patients.

METHODS

Using the Surveillance, Epidemiology, and End Results linked with Medicare data, we identified elderly (65 years and older) women diagnosed with early-stage HR+ BC (2006-2011) who received hormonal therapy with or without radiotherapy after BCS. A log-rank test, Cox proportional hazards models, and propensity score matching were used to estimate the overall survival (OS) benefit associated with radiotherapy after BCS.

RESULTS

Of the 5688 patients, there were 303 deaths from any cause. One hundred and eighty-five (61%) of these deaths occurred in the hormonal therapy group, and 118 (39%) deaths occurred in the radiotherapy plus hormonal therapy group. The mean survival time in the radiotherapy plus hormonal therapy group was 5.32 ± 1.86 years compared with 4.92 ± 1.86 years in the hormonal therapy group. Based on the adjusted and propensity score matching analysis, patients in the adjuvant radiotherapy group had a lower risk of death compared with those who did not receive radiotherapy. Radiotherapy plus hormonal therapy decreased the risk of death by 32%. The effect estimates were similar in the adjusted and matched cohorts.

CONCLUSIONS

Radiotherapy plus hormonal therapy resulted in a significant improvement in the OS of elderly women diagnosed with HR+ BC.

[Pregnancy and delivery for women aged 40 years and over at the reference health center of commune II of Bamako district, Mali]

GOAL

The aim of this study was to compare the maternal-fetal prognosis of pregnancies at 40 years of age and above with that of pregnancies obtained before 40 years of age in the obstetric gynecology department of the reference health center of commune II of Bamako district.

MATERIALS AND METHODS

This was a prospective cohort study that was conducted at the maternity ward of Reference Health Center of Commune II of Bamako district from 1st January to 31 December 2012. Were included in our study as patients exposed, all the pregnant women of 40 years and over and as unexposed patients, pregnant women aged 20-39 who gave birth in our service. Teenage pregnancies were not included in this study. The statistical tests used were Pearson's Khi2 and Fisher's test with a significance level of 5%.

RESULTS

The frequency of pregnancy among women aged 40 and over was 1.68%. These were large multiparas unschooled patients in 60% of cases, with hypertension in 6.7% of cases. Pregnancy in her patients was associated with a high rate of caesarean section in 16.7% of cases, term overrun in 6.7% of cases, seat presentation in 6.7% of cases, macrosomia in 6.7% of cases and fetal malformation in 1.7% of cases.

CONCLUSION

Slight account of its many maternal-fetal complications, pregnancies in women 40 years and older deserve special attention.

Preponderance of endometrial carcinoma in elderly patients

Elderly patients with endometrial carcinoma (EMC) are considered to have a poor clinical outcome. The present study included 79 patients aged ≥70 years with EMC stage I or II according to the International Federation of Gynecology and Obstetrics classification, and it was conducted to analyse the clinicopathological significance of histological type (I or II), depth of myometrial invasion (<1/2 or ≥1/2), lymphovascular invasion (+ or -) and immunohistochemical profile. The aim of these analyses was to determine whether these factors may adversely affect the patient outcome and the underlying mechanisms. The immunohistochemical markers used were estrogen receptor (ER), Ki-67 and p53. The expression of these markers was evaluated as high (+) or low (-). Accordingly, the patients were divided into groups as follows: 54 cases type I vs. 25 cases type II; 48 cases with myometrial invasion <1/2 vs. 31 cases without myometrial invasion ≥1/2; 63 cases with lymphovascular invasion vs. 16 cases without lymphovascular invasion; 57 cases with ER (+) vs. 22 cases with ER (-); 24 cases with Ki-67 (+) vs. 55 cases with Ki-67 (-); and 29 cases with p53 (+) vs. 50 cases with p53 (-). In conclusion, close attention must be paid to elderly patients with EMC due to the tumor's intrinsic aggressiveness, which may include the ER (-) and p53 (+) pattern as an independent poor prognostic factor.

Association of size-fractionated indoor particulate matter and black carbon with heart rate variability in healthy elderly women in Beijing

Associations between size-fractionated indoor particulate matter (PM) and black carbon (BC) and heart rate variability (HRV) and heart rate (HR) in elderly women remain unclear. Twenty-nine healthy elderly women were measured for 24-hour HRV/HR indices. Real-time size-fractionated indoor PM and BC were monitored on the same day and on the preceding day. Mixed-effects models were applied to investigate the associations between pollutants and HRV/HR indices. Increases in size-fractionated indoor PM were significantly associated with declines in power in the high-frequency band (HF), power in the low-frequency band (LF), and standard deviation of all NN intervals (SDNN). The largest decline in HF was 19% at 5-minute moving average for an interquartile range (IQR) increase (24 μg/m³ ) in PM_0.5 . The results showed that smaller particles could lead to greater reductions in HRV indices. The reported associations were modified by body mass index (BMI): Declines in HF at 5-minute average for an IQR increase in PM_0.5 were 34.5% and 1.0% for overweight (BMI ≥25 kg/m² ) and normal-weight (BMI <25 kg/m² ) participants, respectively. Moreover, negative associations between BC and HRV indices were found to be significant in overweight participants. Increases in size-fractionated indoor PM and BC were associated with compromised cardiac autonomic function in healthy elderly women, especially overweight ones.

Pelvic Floor Morphometric Differences in Elderly Women with or without Urinary Incontinence

Purpose: Urinary incontinence (UI) affects as many as 50% of women aged 60 years and older, but UI pathophysiology, specifically in elderly women, remains unclear. A better understanding of morphometric differences between continent and urinary incontinent elderly women is needed to improve the effectiveness of conservative treatment approaches. We hypothesized that morphometric differences in the pelvic floor muscles (PFM) among elderly women with and without UI could be observed using three- and four-dimensional (3D/4D) transperineal ultrasound (TPU) imaging. Method: A total of 40 elderly women (20 women with and 20 women without UI), with a mean age of 67.10 (SD 4.94) years, participated in the study. This was a case-control study in which TPU images were taken under three conditions: rest, maximal voluntary contraction (MVC), and Valsalva. Independent t-tests were conducted to compare measurements between the groups. Results: The study revealed statistically significant differences between the groups. At rest, the levator hiatal area and transverse diameter were bigger, and the PFM position was lower in the incontinent group. During MVC, all axial plane parameters were bigger in the incontinent group. In the sagittal plane, PFM position was again lower in the incontinent group. During Valsalva, the anorectal angle was wider in the women with incontinence. Conclusion: PFM morphometric differences were present and were observed using 3D/4D TPU imaging in elderly women with and without UI.

Elevated serum adiponectin and tumor necrosis factor-α and decreased transthyretin in Japanese elderly women with low grip strength and preserved muscle mass and insulin sensitivity

OBJECTIVE

To determine if adiponectin levels are associated with low grip strength among the elderly independently of insulin resistance and inflammation.

RESEARCH DESIGN AND METHODS

Cross-sectional associations were analyzed by logistic regression between low grip strength and body composition, elevated serum adiponectin (≥20 mg/L), and biomarkers of nutritious stasis, insulin resistance and inflammation in 179 community-living Japanese women. Sarcopenia was evaluated using the Asian criteria.

RESULTS

No women had sarcopenia. In bivariate analyses, low grip strength (n=68) was positively associated with age, log tumor necrosis factor-α (TNF-α) and hyperadiponectinemia (n=37) and inversely with body weight, height, skeletal muscle mass, serum albumin, transthyretin (TTR), fat mass, serum zinc and hemoglobin (all p<0.01). In a fully adjusted model, TTR (0.90: 0.83-0.98, p=0.01) in addition to age (p=0.007), height (p=0.004) and skeletal muscle mass (p=0.008) emerged as independent determinants of low grip strength. When TTR was removed from the full model, TNF-α was associated with low grip strength (7.7; 1.3-45.8, p=0.02). Mean waist circumference and high-density lipoprotein cholesterol did not differ between women with and without low grip strength and were within the respective normal range. Women with hyperadiponectinemia had higher percentage of women with low grip strength and lower grip strength (both p<0.01).

CONCLUSIONS

Hyperadiponectinemia and elevated TNF-α in addition to decreased TTR, a biomarker of age-related catabolic states, were found in community-living Japanese elderly women with low grip strength and preserved muscle mass and insulin sensitivity.

[Research of therapeutic physical exercise impact on functional status of elderly women.]

The article presents the results of a complex research of the impact of therapeutic exercise training on physical fitness indicators of elderly women with structural, metabolic and functional changes. 12 women aged 61-66 participated in the research, all of them underwent physical examination, risk factor assessment, electrocardiography, duplex scanning of extracranial vessels; glycemic level dynamics in the fasted state and PPG as well as fats indices, functional tests and hemodynamics parameters were assessed. The obtained results show that individual complexes of therapeutic exercises can significantly slow down the paracmastic processes and enhance the quality of life.

[Characteristic of the behavioral response and cognitive evoked potentials at 60-74 aged women.]

The article presents the results of the study of the characteristics of behavioral response and cognitive visual event related potentials in 90 elderly women. To analyze a behavioral reaction the computer complex KPFC-99 «PSYCHOMAT», which includes the computer test system Binatest (Moscow) was used. The event related potentials were registered for all participants with using of 128-channel system GES-300. Latency of P300-wave and reaction time were calculated. It is shown that time reaction in stochastic, probabilistic and deterministic environmental conditions increase with age. The search activity is random, that leads to restriction of adaptive capacity of the organism. The increase in the number of errors in older women indicates a lack of mobility of mental processes. According to the temporal characteristics of the wave P300 it has been revealed that latent time increases with age mainly in the posterior-temporal, parieto-occipital and occipital areas of the right hemisphere. The inter-hemispheric asymmetry with a predominance of the left hemisphere was noted. The obtained age-related changes are most likely due to sensory deficiency, reduced neurotransmission and displacement of the locus of cognitive activity in the left hemisphere.

Characterization of the urinary microbiota of elderly women and the effects of type 2 diabetes and urinary tract infections on the microbiota

Evidence shows that urine has complex bacterial profiles with considerable variation between individuals. Aging and age-related conditions can lead to the changes to the composition of urine, which means that the available nutrition for bacteria in the bladder changes with age. We explored the characteristics of the urinary microbiota of elderly women and whether these are associated with age-related conditions such as diabetes and urinary tract infections. An elderly and a non-elderly cohort of women were included. Magnetic beads were used to isolate bacterial genomic DNA, which was analyzed based on the V3-V4 hypervariable region of the 16S rRNA gene. There were significant differences between the elderly and non-elderly regarding thirteen genera of bacteria. For example, the relative abundance of Lactobacillus was dramatically reduced in the elderly compared with the non-elderly; it also decreased with age in the elderly cohort and it was not correlated with urine pH. The relative abundance of Peptococcus increased with age in the elderly while the abundance of Bifidobacteria decreased with age. The abundance of Escherichia coli was the same in the two cohorts, and it increased with water intake and was not associated with urinary tract infection events. Higher levels of Lactobacillus (including Lactobacillus iners) in the elderly were associated with diabetes, and lower levels of Peptoniphilus and Dialister were correlated with asymptomatic bacteriuria. The urinary microbiota of women is affected by ageing, type 2 diabetes mellitus and asymtomatic bacteriuria.

Extreme QT prolongation in elderly women after non-ST elevation myocardial infarct

This is a brief report of three cases of non-ST elevation myocardial infarction presenting with giant T wave inversion and prolonged QT interval. Searching the medical literature revealed a handful of similar cases. There were quite a few common characteristics among these cases suggesting an uncommon but distinctive presentation.

Effects of different periods of Tai Chi exercise on the kinesthesia of the lower limb joints of elderly women

This study investigated the effects of different periods of Tai Chi exercise on knee and ankle joint kinesthesia. A total of 20 Tai Chi practitioners and 19 controls completed the final test. Customized devices were used to measure the kinesthesia of the knee and ankle joints at the start, after 24 weeks and after 48 weeks of the intervention. Results showed that the 24-week Tai Chi intervention considerably improved the kinesthesia of the knee flexion and extension and ankle dorsiflexion. The 48-week Tai Chi intervention improved the kinesthesia towards knee flexion and extension, ankle dorsiflexion and plantar flexion. Moreover, the 48-week Tai Chi intervention had better kinesthesia towards knee extension and ankle dorsiflexion compared with the 24-week Tai Chi intervention. Our results suggest that long-term (48 weeks versus 24 weeks) Tai Chi exercise benefits the knee and ankle kinesthesia of elderly women.

Association of lipid peroxidation and antioxidant status with metabolic syndrome in Iranian healthy elderly women

The interconnection between aging and metabolic syndrome (MetS) and their effect on oxidative stress (OxS) status lacks adequate information. Additionally, the age-related changes of antioxidant defenses and OxS in senior women with MetS in comparison to healthy senior women are not yet established. We analyzed the correlation between oxidative defense status and OxS with MetS components. Through further examination of MetS and aging, we aimed to determine their independent effects on OxS and oxidative defense status. This community-based cross-sectional study was conducted in the rural area of Babol, Iran. A total of 75 women of ≥60 years of age with MetS along with 89 women with similar conditions without the MetS, serving as the control group, were studied. Blood glucose, lipid profile, malondialdehyde (MDA) and total antioxidant capacity (TAC) were determined. Data were analyzed using multiple linear regression, ANOVA and independent t-tests. MDA and TAC levels independently showed a significant correlation with triglyceride (TG), waist circumference, fasting blood glucose and high-density lipoprotein cholesterol (HDL-C). As suggested by the standardized B (0.810, -0.783, P<0.001; -0.052, P<0.001, 0.047, P<0.01), TG followed by HDL-C were the most strongly correlated factors with MDA and TAC. Furthermore, MetS and age were independent risk factors for antioxidant activity reduction and OxS. However, MetS had a much higher predictive power than age (standardized B 0.573 for MetS and 0.376 for age, P<0.001). Aging and MetS, both lead to OxS, but the impact of MetS on this disorder was far greater than the effect of age. However, their cumulative effects can lead to a worsening of the situation. Therefore, early diagnosis and treatment of MetS, especially in the elderly can prevent any adverse impact of MetS.

Evaluation of the clinical benefits of adjuvant capecitabine monotherapy in elderly women with breast cancer: A retrospective study

Capecitabine is orally administered and may be safely and conveniently used in patients with cancer. The antitumor activity of capecitabine in breast cancer was mostly demonstrated in the salvage therapy setting, whereas the effect of adjuvant capecitabine monotherapy in breast cancer remains unclear. The aim of the present study was to evaluate adjuvant capecitabine monotherapy in elderly women with breast cancer. A total of 251 patients were enrolled and survival was compared between elderly breast cancer patients who received adjuvant capecitabine monotherapy and those who received no chemotherapy. Cancer-specific and disease-free survival curves were compared using log-rank tests and survival curves were calculated using the Kaplan-Meier method. Multivariate analyses were conducted using Cox's proportional hazard regression model. There was no significant difference between the clinicopathological characteristics, including age, tumor size, lymph node status, histological grade and hormone status, between patients in the two groups. The breast cancer-specific survival rate was 89.3% in the capecitabine monotherapy group vs. 81.3% in the no chemotherapy group; the difference was not statistically significant (P=0.128). The disease-free survival rate was 81.7% in the capecitabine monotherapy group vs. 65.3% in the no chemotherapy group. Kaplan-Meier analysis indicated a longer disease-free survival in the capecitabine monotherapy group (P=0.015). On Cox regression analysis, capecitabine monotherapy was found to be associated with the disease-free survival rate (P=0.014, hazard ratio=0.500) but not with the cancer-specific survival rate (P=0.181). The adverse events of capecitabine monotherapy were recorded and there was no chemotherapy interruption due to severe adverse reactions. Therefore, adjuvant capecitabine monotherapy in elderly women with breast cancer is a safe and effective option, as well as a viable alternative for elderly breast cancer patients who refuse standard adjuvant therapy.

Prevalence of eating disorders and picking/nibbling in elderly women

OBJECTIVE

The aim of this study was to examine the point prevalence of eating disorders and picking/nibbling in elderly women.

METHODS

This was a two-stage epidemiological study that assessed 342 women aged 65-94 years old. In Stage 1, the following screening measures were used to identify possible cases: the Mini-Mental State Examination, to screen and exclude patients with cognitive impairment; Weight Concerns Scale; SCOFF (Sick, Control, One, Fat, Food) Questionnaire; Eating Disorder Examination Questionnaire-dietary restraint subscale; and three questions to screen for picking/nibbling and night eating syndrome. Women selected for Stage 2 (n = 118) were interviewed using the diagnostic items of the Eating Disorder Examination.

RESULTS

According to the DSM-5, the prevalence of all eating disorders was 3.25% (1.83-5.7, 95% C.I.). Prevalence of binge-eating disorder was 1.68% (0.82-3.82, 95% C.I.), of other specified feeding or eating disorders was 1.48% (0.63-3.42, 95% C.I.), and of bulimia nervosa 0.3% (.05-1.7, 95% C.I.)]. Binge-eating episodes were reported by 5.62% of women. No cases of anorexia nervosa or night eating syndrome were identified. The prevalence of picking/nibbling was 18.9%. Picking/nibbling was associated with increased body mass index (t(322) = -3.28, p < .001) and binge-eating episodes (χ² (1) = 5.65, p < .017).

DISCUSSION

Prevalence rates of eating disorders on elderly Portuguese women were comparable to those found on young women. Our data support the literature that suggests that binge-eating disorder is particularly prevalent in older adults. Picking/nibbling was the most prevalent eating behavior and we provide further evidence for its association with weight and disordered eating.

First signs of elderly gait for women

BACKGROUND

The aims of this study have been twofold: to attempt to reduce the number of spatiotemporal parameters used for describing gait through the factor analysis and component analysis; and to explore the critical age of decline for other gait parameters for healthy women.

MATERIAL AND METHODS

A total of 106 women (aged ≥ 40 years old (N = 76) and ≤ 31 years old (N = 30)) were evaluated using a pressure-sensitive mat (Zebris Medical System, Tübingen, Germany) for collecting spatiotemporal gait parameters.

RESULTS

The factor analysis identified 2 factors - labelled Time and Rhythm - that accounted for 72% of the variation in significant free-gait parameters; the principal component analysis identified 4 of these parameters that permit full clinical evaluation of gait quality. No difference was found between the groups in terms of the values of parameters reflecting the temporal nature of gait (Rhythm), namely step time, stride time and cadence, whereas significant differences were found for total double support phase (p < 0.001). Next, seeking evidence of a critical decline in gait, we selected 3 parameters: total double support, stride time and velocity. We concluded that the women taking part in the experiment manifested significant signs of senile gait after the age of 60 years old, with the first symptoms thereof already manifesting themselves after 50 years of age.

CONCLUSIONS

We show that among 26 spatiotemporal parameters that may be used for characterizing gait, at least a half of them may be omitted in the assessment of gait correctness; a finding that may be useful in clinical practice. The finding that the onset of senile gait occurs in the case of women after the age of 60 years old, in turn, may be useful in evaluating the ability for performing types of physical work that mainly require ambulation. Med Pr 2017;68(4):441-448.

Longitudinal Assessment of PTH in Community-Dwelling Older Women-Elevations Are Not Associated With Mortality

Context:

In older women, the magnitude of elevated parathyroid hormone (PTH) and its consequence is unclear.

Objective:

To describe normal PTH profiles over time and the association with mortality.

Design and Participants:

There were 1044 community-dwelling women in the Malmö Osteoporosis Prospective Risk Assessment cohort (OPRA) who attended baseline (age 75 years). Follow-ups were attended by 715 (age 80 years) and 382 (age 85 years).

Main Outcome Measures:

PTH, estimated glomerular filtration rate (eGFR), 25-hydroxyvitamin D (25OHD) and mortality.

Results:

At age 75 years, PTH levels for most (n = 877, 88%) were within the normal reference range (NRR) (i.e., <6.9 pmol/L). Longitudinally, between ages 75 and 80 years, PTH increased in 60% of all women (n = 390) but increases of up to 50% above baseline values (64%; n=250) still resulted in PTH levels within the NRR. These women had lower 25OHD levels (74 vs 83 nmol/L, P = 0.001). Only when increases were >50% was PTH elevated beyond the NRR (mean 7.1 ± 3.3). Here, a pronounced decline in eGFR (56 vs 61 mL/min/1.73 m², P = 0.002) was found, despite no further changes in 25OHD. Extending the observational period until age 85 years gave similar results. Baseline PTH levels above NRR were associated with mortality (hazard ratio, 1.4; 95% confidence interval (CI), 1.1-1.8; P = 0.007), although not after adjustment for covariates (P = 0.082).

Conclusions:

Most women remained within normal PTH ranges despite large increases of up to 50%. PTH elevated above normal is not independently associated with mortality; impaired kidney function and low 25OHD status may be more prognostic in the very old.

Cough physiology in elderly women with nontuberculous mycobacterial lung infections

Elderly white, thin, nonsmoking women appear to be more susceptible to lung infections with Mycobacterium avium complex and other nontuberculous mycobacteria (NTM). It has been postulated that such disease in women is related to suppression of their cough. We hypothesized that patients with pulmonary NTM (pNTM) infections may have altered cough physiology compared with unaffected control subjects. We used capsaicin-induced cough to assess the cough reflex in pNTM subjects. Eight elderly white women with stable chronic pNTM infections and six unaffected age-matched control subjects were recruited. There was no significant difference between groups in capsaicin-elicited cough motor response, airflow pattern, or cough frequency. The urge-to-cough (UTC) score at the lowest capsaicin concentration was significantly lower in pNTM than control subjects (P < 0.05). There were no significant differences in the UTC score between pNTM and control subjects at >50 μM capsaicin. These results suggest lower UTC sensitivity to the lowest concentration of capsaicin in pNTM than control subjects. In other words, the pNTM subjects do not sense a UTC when the stimulus is relatively small.NEW & NOTEWORTHY This study investigates the cough motor response and cough sensitivity in patients with nontuberculous mycobacteria (NTM) infection. In elderly white female pulmonary NTM subjects, we demonstrated a capacity to produce coughs similar to that of age-matched control subjects but decreased cough sensitivity in response to a low dose of capsaicin compared with control subjects. These findings are important to understand the pathophysiological mechanisms resulting in NTM disease in elderly white women and/or the syndrome developing in elderly white female NTM patients.