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Alsaeed MI, Ben Waer F. Music and Caffeine Intake Effects on Gait, and Its Relationship with Psychological Parameters, in Middle-Aged Women. J Multidiscip Healthc 2024; 17:4043-4052. [PMID: 39165256 PMCID: PMC11334914 DOI: 10.2147/jmdh.s474951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/07/2024] [Indexed: 08/22/2024] Open
Abstract
Purpose This study aimed to explore the combined effects of caffeine intake and listening to music on walking parameters, and its relationship with psychological variables (fatigue and exercise enjoyment) in middle-aged women. Patients and Methods Sixteen healthy middle-aged women, aged between 50 and 60 years old, participated in this study. Their walking parameters (distance, number of steps, steps number/minute, cadence and walking speed) were assessed using the 6-minute walking test (6MWT) in four task conditions: in no-music/no-caffeine, no-music/with caffeine, with music/no-caffeine, and with music/with caffeine conditions. Besides, exercise enjoyment and fatigue were evaluated using the Physical Activity Enjoyment Scale (PACES-8) and rating of perceived exertion (RPE) questionnaires, respectively. Results As a result, we found that 100 mg of caffeine intake significantly (p < 0.05) improved walking parameters such as distance, cadence and number of steps during both simple (p < 0.05) and dual-task, while listening to preferred music, where optimal results were found (p < 0.01) with a large effect size (η2p >0.14). Listening to music was sufficient to significantly improve the distance (p < 0.001), cadence (p < 0.001), and walking speed (p < 0.05) values. Besides, both caffeine intake and/or listening to music significantly (p < 0.05 with large effect size (η2p >0.14)) decreased the feeling of fatigue and increased exercise enjoyment while walking in healthy middle-aged women. Conclusion In conclusion, caffeine intake seems to positively influence gait capacities, and its combined effects with listening to music, mainly preferred ones, would boost these beneficial effects in middle-aged women.
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Affiliation(s)
- Mohammed Issa Alsaeed
- Department of Biomechanics & Motor Behavior, College of Sport Science & Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Fatma Ben Waer
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
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Ben Waer F, Alexe DI, Lahiani M, Sanchez-Gomez R, Chaari F, Alexe CI, Tohanean DI, Rebai H, Iconomescu TM, Talaghir LG, Sahli S. Pilates versus Zumba training effects on postural control under conflicting sensory conditions in postmenopausal women. Exp Gerontol 2024; 188:112383. [PMID: 38377666 DOI: 10.1016/j.exger.2024.112383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 02/22/2024]
Abstract
The current study aimed to compare the effects of Pilates versus Zumba training on postural performance in middle-aged postmenopausal women. Fifty-seven eligible women, aged between 50 and 60 years, were randomized into three groups: Zumba (ZG) group, Pilates (PG) group or control (CG) group. Postural control was assessed using a force platform under 4 sensory manipulation conditions: on firm and foam surfaces with eyes opened (EO) and closed (EC). Our results showed more marked adaptations in favor of ZG concerning postural performance compared to PG. For the PG, postural control was significantly improved only in simple postural conditions on the firm surface with EO (p < 0.1) and EC (p < 0.05) conditions. However, postural control of the ZG significantly improved in both the simple and complex postural conditions, even under conflicting sensory situations (firm surface/EO (p < 0.001; 95 % CI: [1.34, 4.46]), EC (p < 0.001; 95 % CI: [2.13, 5.24])); foam surface/EO (p < 0.01; 95 % CI: [0.70, 8.57]), EC (p < 0.01; 95 % CI: [0.65, 8.52])). In conclusion, Zumba training seems to be more effective and a better strategy to promote postural control in daily living activities and autonomy in postmenopausal women than Pilates training. These findings are useful for public health practitioners in designing physical interventions for balance disorders.
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Affiliation(s)
- Fatma Ben Waer
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Dan Iulian Alexe
- Department of Physical and Occupational Therapy, Faculty of Movement, Sports and Health, Sciences, "Vasile Alecsandri" University of Bacău, 600115 Bacău, Romania.
| | - Mariam Lahiani
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Rubén Sanchez-Gomez
- Nursing Department, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria, (IDISSC) Hospital Clinico San Carlos, 28040 Madrid, Spain
| | - Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Cristina Ioana Alexe
- Department of Physical Education and Sports Performance, Faculty of Movement, Sports and Health Sciences,"Vasile Alecsandri", University of Bacău, 600115 Bacău, Romania
| | - Dragos Ioan Tohanean
- Department of Motric Performance, "Transilvania" University of Brașov, 600115 Brașov, Romania
| | - Haithem Rebai
- Tunisian Research Laboratory 'Sports Performance Optimization', National Center of Medicine and Science in Sports (CNMSS), (CNMSS-LR09SEP01), Tunis, Tunisia
| | | | - Laurențiu Gabriel Talaghir
- Individual sports and physical therapy Department, "Dunarea de Jos" University of Galati str. Domnesca, nr, 47, Galati 800008, Romania
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
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Walter CS, Narcisse MR, Felix HC, Rowland B, Selig JP, McElfish PA. Association Between Physical Activity and Physical Function in a Marshallese Population with Type 2 Diabetes. J Immigr Minor Health 2024; 26:361-370. [PMID: 37864639 PMCID: PMC10983015 DOI: 10.1007/s10903-023-01551-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 10/23/2023]
Abstract
Physical activity can delay functional decline in people with type 2 diabetes (T2D), but these associations have not been studied within a sample of Native Hawaiian or Pacific Islander adults with T2D. Using data from a randomized control trial in which 218 Marshallese adults with T2D participated in a 10-week diabetes self-management education intervention, this study tested our hypothesis that physical activity would predict physical function when controlling for time and other variables. Levels of physical activity were positively associated with levels of physical function, even after controlling for time and other covariates. These findings provide a more robust understanding of the relationship between physical activity and physical function in a sample of minority adults with T2D. Future studies should further explore levels of physical activity needed to maintain and improve physical function so that culturally appropriate physical activity interventions can be developed.
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Affiliation(s)
- Christopher S Walter
- Department of Physical Therapy, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - James P Selig
- Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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Lahiani M, Ben Waer F, Chaari F, Rebai H, Sahli S. Effect of 12-Week-Zumba Training on Postural Balance, Lower Limb Strength, Mood and Quality of Life in Postmenopausal Women. Exp Aging Res 2024; 50:171-189. [PMID: 36726273 DOI: 10.1080/0361073x.2023.2172304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/20/2023] [Indexed: 02/03/2023]
Abstract
We aimed to investigate 12-week-Zumba training effects on physical and psychological parameters, and quality of life (QoL) in postmenopausal women. Forty-two postmenopausal women were randomly allocated to a control group or a Zumba group (ZG). Postural balance, lower limb strength, mood level, and QoL were assessed before and after the 12-week-Zumba training. The ZG showed significantly better balance performances under all conditions such as on firm and foam surfaces with opened and closed eyes as well as improvements in limb strength, mood and QoL compared to their baselines. Thereby, 12-week-Zumba training was effective in improving postural balance, limb strength, mood and, QoL in postmenopausal women.
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Affiliation(s)
- Mariam Lahiani
- Research Laboratory: Education, Motricity, Sports and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Fatma Ben Waer
- Research Laboratory: Education, Motricity, Sports and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Fatma Chaari
- Research Laboratory: Education, Motricity, Sports and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Research Laboratory: Education, Motricity, Sports and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricity, Sports and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
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Assis Silva SH, Orsatti FL, de Lima ML, Freitas ACDQ, Carneiro MAS, Assumpção CDO, Souza MVC. Assessing the robustness of muscle strength and physical performance measures in women older than 40 years: a test-retest reliability study. Menopause 2024; 31:33-38. [PMID: 38086002 DOI: 10.1097/gme.0000000000002294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
OBJECTIVES This study investigated the test-retest reliability and minimal detectable change (MDC) of muscle strength and physical performance tests in women older than 40 years. METHODS A total of 113 women, aged 58 ± 11 years (82% postmenopausal women), with a body mass index of 28.5 ± 5.8 kg/m 2 , participated in this study. One-repetition maximum (1RM) tests were conducted for seven strength exercises: 45° leg press, bench press, leg extension, pec deck, wide-grip lateral pull-down, leg curl, and seated cable row, with a retest after 48 hours. Timed Up and Go (TUG), 6-minute walk, and 30-second sit-to-stand tests were performed on the same day and retested after 72 hours. The tests and retests were administered by the same evaluators. Relative reliability (consistency of participant rank between test-retest) was assessed using the intraclass correlation coefficient for consistency and agreement, and absolute reliability (precision of score) was assessed using the MDC based on the standard error of prediction. RESULTS The 1RM and performance tests exhibited excellent reliability: 45° leg press (consistency, 0.99; agreement, 0.98), bench press (consistency, 0.96; agreement, 0.96), leg extension (consistency, 0.93; agreement, 0.91), pec deck (consistency, 0.90; agreement, 0.88), wide-grip lateral pull-down (consistency, 0.91; agreement, 0.89), leg curl (consistency, 0.84; agreement, 0.83), seated cable row (consistency, 0.92; agreement, 0.94), TUG (consistency, 0.87; agreement, 0.87), 6-minute walk (consistency, 0.96; agreement, 0.95), and 30-second sit to stand (consistency, 0.85; agreement, 0.80). These tests showed meaningful MDC values, particularly for the 1RM test performed on the machine and the 30-second sit-to-stand test: 45° leg press, 22.2 kg (15%); bench press, 4.9 kg (19%); leg extension, 9.2 kg (35%); pec deck, 8.8 kg (44%); wide-grip lateral pull-down, 9.4 kg (31%); leg curl, 9.2 kg (51%); seated cable row, 11.4 kg (29%); TUG, 1.4 seconds (20%); 6-minute walk, 50.9 m (10%); and 30-second sit to stand, 4.6 reps (30%). CONCLUSIONS Although the muscle strength and physical performance tests demonstrate excellent relative reliability in women older than 40 years, they exhibit low absolute reliability, particularly the 1RM test performed on the machine and the 30-second sit-to-stand test. Therefore, although these tests show good consistency in the positioning of women within the group after repeated measures, their precision measure is relatively low (high fluctuation). Changes in these tests that are smaller than the MDC may not indicate real changes in women at middle age and older.
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Affiliation(s)
- Sebastião Henrique Assis Silva
- From the Applied Physiology Nutrition and Exercise Research Group, Exercise Biology and Aging Laboratory (BioEx), Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | - Mariana L de Lima
- From the Applied Physiology Nutrition and Exercise Research Group, Exercise Biology and Aging Laboratory (BioEx), Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Augusto C de Q Freitas
- From the Applied Physiology Nutrition and Exercise Research Group, Exercise Biology and Aging Laboratory (BioEx), Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marcelo A S Carneiro
- From the Applied Physiology Nutrition and Exercise Research Group, Exercise Biology and Aging Laboratory (BioEx), Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
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Waer FB, Sahli S, Alexe CI, Man MC, Alexe DI, Burchel LO. The Effects of Listening to Music on Postural Balance in Middle-Aged Women. SENSORS (BASEL, SWITZERLAND) 2023; 24:202. [PMID: 38203063 PMCID: PMC10781301 DOI: 10.3390/s24010202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
Listening to music has been found to influence postural balance in both healthy participants and certain patients, whereas no study investigates such effects among healthy middle-aged women. Thus, this study aimed to investigate the effect of music on postural balance in middle-aged women. Twenty-six healthy women aged between 50 and 55 years participated in this study. A stabilometric platform was used to assess their postural balance by recording the mean center of pressure velocity (VmCOP) in the eyes-opened (OE) and -closed (EC) conditions on both firm and foam surfaces. Our results showed that listening to an excerpt of Mozart's Jupiter significantly decreased the VmCOP values in two sensory conditions (firm surface/EO: (p < 0.01; 95% CI: 0.27 to 2.22); foam surface/EC: (p < 0.001; 95% CI: 0.48 to 2.44)), but not in the other two conditions (firm surface/EC and foam surface/EO). We concluded that listening to Mozart's symphony improved postural performance in middle-aged women, even in challenged postural conditions. These enhancements could offer great potential for everyday functioning.
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Affiliation(s)
- Fatma Ben Waer
- Research Laboratory Education, Motricity, Sport and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (F.B.W.); (S.S.)
| | - Sonia Sahli
- Research Laboratory Education, Motricity, Sport and Health, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (F.B.W.); (S.S.)
| | - Cristina Ioana Alexe
- Department of Physical Education and Sports Performance, Faculty of Movement, Sports and Health Sciences, “Vasile Alecsandri” University of Bacau, 600115 Bacau, Romania
| | - Maria Cristina Man
- Department of Physical Education, 1 Decembrie 1918 University of Alba Iulia, 510009 Alba Iulia, Romania
| | - Dan Iulian Alexe
- Department of Physical and Occupational Therapy, Faculty of Movement, Sports and Health Sciences, “Vasile Alecsandri” University of Bacău, 600115 Bacau, Romania;
| | - Lucian Ovidiu Burchel
- Department of Environmental Sciences, Physics, Physical Education and Sports, Faculty of Sciences, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania;
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Shelling AN, Ahmed Nasef N. The Role of Lifestyle and Dietary Factors in the Development of Premature Ovarian Insufficiency. Antioxidants (Basel) 2023; 12:1601. [PMID: 37627595 PMCID: PMC10451748 DOI: 10.3390/antiox12081601] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Premature ovarian insufficiency (POI) is a condition that arises from dysfunction or early depletion of the ovarian follicle pool accompanied by an earlier-than-normal loss of fertility in young women. Oxidative stress has been suggested as an important factor in the decline of fertility in women and POI. In this review, we discuss the mechanisms of oxidative stress implicated in ovarian ageing and dysfunction in relation to POI, in particular mitochondrial dysfunction, apoptosis and inflammation. Genetic defects, autoimmunity and chemotherapy, are some of the reviewed hallmarks of POI that can lead to increased oxidative stress. Additionally, we highlight lifestyle factors, including diet, low energy availability and BMI, that can increase the risk of POI. The final section of this review discusses dietary factors associated with POI, including consumption of oily fish, mitochondria nutrient therapy, melatonin, dairy and vitamins that can be targeted as potential interventions, especially for at-risk women and in combination with personalised nutrition. Understanding the impact of lifestyle and its implications for POI and oxidative stress holds great promise in reducing the burden of this condition.
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Affiliation(s)
- Andrew N. Shelling
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand;
- Centre for Cancer Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Noha Ahmed Nasef
- Riddet Research Institute, Massey University, Palmerston North 4474, New Zealand
- School of Food and Advanced Technology, College of Science, Massey University, Palmerston North 4474, New Zealand
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Walsh GS, Delextrat A, Bibbey A. The comparative effect of exercise interventions on balance in perimenopausal and early postmenopausal women: A systematic review and network meta-analysis of randomised, controlled trials. Maturitas 2023; 175:107790. [PMID: 37343343 DOI: 10.1016/j.maturitas.2023.107790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/17/2023] [Accepted: 06/10/2023] [Indexed: 06/23/2023]
Abstract
In addition to a range of physiological and psychological symptoms, menopause causes a decrement to balance performance and risk of falls. This review aimed to determine the effects of exercise interventions on balance in perimenopausal and early postmenopausal women. Web of Science, PubMed, CINAHL, SPORTDiscus and Cochrane Central Register of Controlled Trials databases were searched. Randomised, controlled trials of exercise interventions in perimenopausal or early postmenopausal populations with an average age of 65 years or younger reporting balance measures were included. Risk of bias was assessed using Cochrane RoB 2. A random effects model network meta-analysis was performed to assess the effect of exercise on balance. Standardised mean differences with 95 % confidence intervals were used as the measure of effect. Twenty-six studies were included after screening. Network meta-analyses were conducted for 5 balance variables. Whole-body vibration (standardised mean difference: 2.25, confidence interval: 0.08; 4.43), balance (standardised mean difference: 1.84, confidence interval: 0.15; 3.53), balance + nutrition (standardised mean difference: 3.81, confidence interval: 1.57; 6.05) and resistance (standardised mean difference: 1.43, confidence interval: 0.41; 2.46) exercise improved Berg balance scale performance. Resistance + aerobic + balance exercise improved one-leg stance (standardised mean difference: 0.80, confidence interval: 0.39; 1.22) and whole-body vibration improved anterior-posterior (standardised mean difference: -0.89, confidence interval: -1.48; -0.31), medio-lateral (standardised mean difference: -0.58, confidence interval: -1.15; -0.01) postural sway and falls indices (standardised mean difference: -0.75, confidence interval: -1.45; -0.04). Exercise improved all balance measures and should be considered as an adjunct therapy in perimenopausal and postmenopausal women. Whole-body vibration was most frequently the highest ranked intervention; resistance and balance training also improved balance.
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Affiliation(s)
- Gregory S Walsh
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK.
| | - Anne Delextrat
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK.
| | - Adam Bibbey
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK.
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Lange-Maia BS, El Khoudary SR, Crandall CJ, Zhang Y, Karvonen-Gutierrez CA, Gabriel KP, Appelhans BM, Strotmeyer ES, Ylitalo KR, Karavolos K, Kravitz HM, Dugan SA, Janssen I. Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women's Health Across the Nation. J Aging Health 2023; 35:383-391. [PMID: 36250945 PMCID: PMC10106523 DOI: 10.1177/08982643221133580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To determine whether physical function (PF) before menopause is related to cardiovascular disease (CVD) risk. METHODS Participants were N = 2950 pre-/early peri-menopausal women (median age 46, (25th-75th percentile: 43-48 years). Physical function was assessed at baseline using the Physical Function subscale of the SF-36 and scores were trichotomized (no, some, or substantial limitations). Clinical CVD events were ascertained at annual/biennial clinical assessments through the 15th follow-up visit. Risk of CVD was determined with Cox proportional hazards models. Results: Women were followed for a median of 19.1 years, during which 220 women had a CVD event. In fully adjusted models, women with substantial limitations at baseline had higher CVD risk compared to women with no limitations (hazards ratio [HR] = 1.55, 95% confidence interval [CI]: 1.12-2.33). Discussion: Substantial PF limitations in pre- and early peri-menopausal women are associated with higher risk of clinical CVD events, consistent with literature in older adults.
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Affiliation(s)
- Brittney S. Lange-Maia
- Rush Alzheimer’s Disease Center Rush University Medical Center
- Department of Family and Preventive Medicine, Rush University Medical Center
| | | | - Carolyn J. Crandall
- Department of Medicine, David Geffen School of Medicine at University of California Los Angeles
| | - Yanyu Zhang
- Rush Bioinformatics and Biostatics Core, Rush University Medical Center
| | | | | | | | | | | | - Kelly Karavolos
- Department of Family and Preventive Medicine, Rush University Medical Center
| | - Howard M. Kravitz
- Department of Family and Preventive Medicine, Rush University Medical Center
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center
| | - Sheila A. Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center
| | - Imke Janssen
- Department of Family and Preventive Medicine, Rush University Medical Center
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Wu Y, Li S, Han D, Zhang M, Zhao J, Liao H, Ma Y, Yan C, Wang J. The Mediating Role of Depression in Association Between Total Sleep Time and Instrumental Activities of Daily Living in China. Int J Public Health 2023; 68:1605678. [PMID: 37081904 PMCID: PMC10110912 DOI: 10.3389/ijph.2023.1605678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/15/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives: This study aims to investigate the mediating role of depression and the moderating effect of gender in the relationship between total sleep time (TST) and instrumental activities of daily living (IADL) in middle-aged and elderly people (aged 45 or above). Methods: The data used in this study is from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 10,460 respondents. Associations between TST, IADL, depression, and gender were analyzed using logistic regression and Karlson, Holm, and Breen (KHB) methods. Results: Short (OR = 1.42, 95% CI = 1.28-1.58 of ≤6 h) and long TST (OR = 1.16, 95% CI = 1.02-1.32 of 8-9 h; OR = 1.35, 95% CI = 1.19-1.54 of >9 h) were both associated with IADL. The mediation effect analyses observed that depression explained 64.80% of the total effect of short TST (≤6 h) and IADL, but was insignificant in long TST (8-9 h and >9 h). Meanwhile, gender has moderating effects on the mediation effect model. Conclusion: The study suggests that health interventions that focused on the dimensions of TST and depression are crucial for preventing functional disability while accounting for gender differences.
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Affiliation(s)
- Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Ma
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaoyang Yan
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China
- Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, China
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11
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Lahiani M, Ben Waer F, Bouchaala F, Laatar R, Rebai H, Sahli S. Time-of-Day Effect on Postural Balance and Its Associations with Menopausal Symptoms in Postmenopausal Women. Percept Mot Skills 2023; 130:5-26. [PMID: 36240107 DOI: 10.1177/00315125221133599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Postmenopausal women suffer from postural balance issues. During a 24-hour time span, postural performance undergoes radical changes as influenced by the circadian rhythm. In this study, we aimed to investigate time-of-day effects on postural balance in postmenopausal women and balance relationships with menopausal symptoms. Two groups of women, aged 40-50 years, participated in this study: a menopausal group and a control group. We evaluated their postural balance and menopausal symptoms (mood, sleepiness and fatigue) in five sessions over the course of a day: at 06:00 hours, at 10:00, at 14:00, at 18:00 and at 22:00. The results showed that postural balance (center of pressure area (CoParea)) values of postmenopausal women were significantly worse (p < .05) at 22:00. Moreover, at this time-of-day, participants in the menopausal group were more tired, less vigilant and experienced a lower mood. We found negative correlations between postural balance and both mood and fatigue levels. However, there was no time-of-day effect on postural balance, mood, fatigue, and sleepiness among participants in the control group. Thus, time-of-day should be considered a factor to control when assessing postural balance and designing intervention studies for postmenopausal women; and it is important for these women to be cautious of fall risks at night, as they are then less stable than at other times-of-day.
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Erlandson KM, Fitch KV, McCallum SA, Ribaudo HJ, Overton ET, Zanni MV, Bloomfield GS, Brown TT, Fichtenbaum CJ, Bares S, Aberg JA, Douglas PS, Fulda ES, Santana-Bagur JL, Castro JG, Moran LE, Mave V, Supparatpinyo K, Ponatshego PL, Schechter M, Grinspoon SK. Geographical Differences in the Self-Reported Functional Impairment of People With Human Immunodeficiency Virus (HIV) and Associations With Cardiometabolic Risk. Clin Infect Dis 2022; 75:1154-1163. [PMID: 35165682 PMCID: PMC9525090 DOI: 10.1093/cid/ciac098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We sought to explore multinational differences in functional status by global burden of disease (GBD) regions in the REPRIEVE cohort. METHODS REPRIEVE is a prospective, double-blind, randomized, placebo-controlled, multicenter, phase III primary cardiovascular prevention study of pitavastatin calcium vs placebo among people with human immunodeficiency virus (HIV, PWH) ages 40-75 on antiretroviral therapy (ART). GBD super regions were defined using World Health Organization classifications. Participants were categorized by impairment on the Duke Activity Status Instrument (DASI: none, some, moderate, severe). Logistic regression models examined risk factors and GBD regions associated with functional impairment. The association between functional impairment and cardiometabolic risk was also explored. RESULTS Of 7736 participants, the majority were from high-income countries (n = 4065), were male (65%), and had received ART for ≥ 10 years. The median DASI score was 58.2 (interquartile range [IQR] 50.2, 58.2); 36% reported at least some impairment. In adjusted analyses, functional impairment was significantly more frequent among participants from Southeast/East Asia. Other factors associated with greater impairment included female sex, Black race, older age, current/former smoking, higher body mass index, use of ART for ≥ 10 years, and select ART regimens; differences were seen in risks across GBD regions. Functional impairment was associated with increased cardiometabolic risk. CONCLUSIONS Over 1/3 of middle-aged and older PWH in a global cohort across diverse GBD regions demonstrate functional impairments. The associations between DASI and cardiometabolic risk suggest that a measure of functional status may improve risk prediction; these longitudinal associations will be further investigated over REPRIEVE trial follow-up.
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Affiliation(s)
| | - Kathleen V Fitch
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sara A McCallum
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Heather J Ribaudo
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Edgar T Overton
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Markella V Zanni
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Todd T Brown
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Sara Bares
- Specialty Care Center, Nebraska Medical Center, Omaha, Nebraska, USA
| | - Judith A Aberg
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Evelynne S Fulda
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Jose G Castro
- University of Miami Infectious Disease Research Unit At Jackson Memorial Hospital, Miami, Florida, USA
| | - Laura E Moran
- Social & Scientific Systems, a DLH Company, Silver Spring, Maryland, USA
| | - Vidya Mave
- Byramjee Jeejeebhoy Medical College, Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India
| | | | - Ponego L Ponatshego
- Gaborone Prevention/Treatment Trials, Princess Marina Hospital, Gaborone, Botswana
| | - Mauro Schechter
- Projeto Praça Onze Pesquisa Em Saúde, Cidade Nova, Rio de Janeiro, Brazil
| | - Steven K Grinspoon
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Depressive symptoms and suicidality by menopausal stages among middle-aged Korean women. Epidemiol Psychiatr Sci 2022; 31:e60. [PMID: 36017644 PMCID: PMC9428901 DOI: 10.1017/s2045796022000439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS There has been increasing evidence of hormonal changes during reproductive events that lead to mood changes. However, studies on the severity of psychological problems according to the menopausal stage are limited. Thus, this study aimed to investigate the association between menopausal stages, depression and suicidality. METHODS A total of 45 177 women who underwent regular health check-ups between 2015 and 2018 at Kangbuk Samsung Hospital were included. Participants were stratified into four groups (pre-menopause, early transition, late transition and post-menopause) based on the Stages of Reproductive Aging Workshop Criteria. The Center for Epidemiological Studies-Depression scale (CESD) was used to evaluate depressive symptoms, and the degree of depressive symptoms was classified as moderate (CESD score 16-24) or severe (CESD score ⩾ 25). To measure suicide risk, we administered questionnaires related to suicidal ideation. RESULTS Overall, the prevalence of CESD scores of 16-24 and ⩾ 25 was 7.6 and 2.8%, respectively. Menopausal stages were positively associated with depressive symptoms in a dose-dependent manner. Multivariable-adjusted prevalence ratios (PRs, 95% confidence intervals) for CESD scores of 16-24 comparing the stages of the early menopausal transition (MT), late MT and post-menopause to pre-menopause was 1.28 (1.16-1.42), 1.21 (1.05-1.38) and 1.58 (1.36-1.84), respectively. The multivariable-adjusted PRs for CESD scores ⩾ 25 comparing the stages of the early MT, late MT and post-menopause to pre-menopause were 1.31 (1.11-1.55), 1.39 (1.12-1.72), 1.86 (1.47-2.37), respectively. In addition, the multivariable-adjusted PRs for suicidal ideation comparing the early MT, late MT and post-menopause stages to the pre-menopause stage were 1.24 (1.12-1.38), 1.07 (0.93-1.24) and 1.46 (1.25-1.70) (p for trend <0.001), respectively. CONCLUSIONS These findings indicate that the prevalence of depressive symptoms and suicidal ideation increases with advancing menopausal stage, even pre-menopause.
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Meng F, Yao H, Li J, Zhuo Y, Yu G, Bu G, Cao X, Du X, Liang Q, Zeng X, Han X. Effects of active immunization against a 13-amino acid receptor-binding epitope of FSHβ on fertility regulation in female mice. Reprod Biol 2022; 22:100669. [PMID: 35772190 DOI: 10.1016/j.repbio.2022.100669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 10/17/2022]
Abstract
Follicle-stimulating hormone (FSH) is crucial for ovarian folliculogenesis and thus essential for female fertility. Here, we developed a novel FSH vaccine based on the tandem of a 13-amino acid receptor-binding epitope of FSHβ (FSHβ13AA-T) and used a mouse model to test its efficacy in female fertility regulation. Compared to placebo-immunized controls, FSHβ13AA-T vaccination: induced a marked (P < 0.05) antibody generation; reduced (P < 0.05) serum concentrations of FSH, inhibin B and 17β-estradiol; disrupted (P < 0.05) normal estrous cyclicity; delayed (P = 0.08) establishment of pregnancy; blocked (P < 0.05) folliculogenesis; and reduced (P < 0.05) litter size. Mechanistically, FSH vaccination reduced (P < 0.05) ovarian estrogen production by decreasing Lhcgr, Cyp19a1 and HSD3β1 expression, and suppressed ovarian follicular development by decreasing ovarian Fshr, Inhα, Foxo3a, Bmp15 and Cdh1 expression. Overall, vaccination of female mice with FSHβ13AA-T substantially disrupted FSH-dependent ovarian steroidogenesis and folliculogenesis, and caused subfertility. Therefore, vaccines based on FSHβ13AA-T have potential as anti-fertility/contraceptive agents in females.
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Affiliation(s)
- Fengyan Meng
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Huan Yao
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Jiaxin Li
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Yong Zhuo
- Key Laboratory for Animal Disease-Resistant Nutrition of the Ministry of Education of China, Animal Nutrition Institute, Sichuan Agricultural University, Chengdu 611130, China
| | - Guozhi Yu
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Guixian Bu
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Xiaohan Cao
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - XiaoGang Du
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Qiuxia Liang
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Xianyin Zeng
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China
| | - Xingfa Han
- Isotope Research Lab, Biological Engineering and Application Biology Department, Sichuan Agricultural University, Ya'an 625014, China.
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Scime NV, Brown HK, Metcalfe A, Brennand EA. Prevalence of Hysterectomy by Self-Reported Disability Among Canadian Women: Findings from a National Cross-Sectional Survey. WOMEN'S HEALTH REPORTS 2021; 2:557-565. [PMID: 34909762 PMCID: PMC8665278 DOI: 10.1089/whr.2021.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 11/25/2022]
Abstract
Introduction: Our objective was to investigate differences in prevalence of hysterectomy by self-reported disability status among Canadian women. Materials and Methods: We analyzed cross-sectional data from the Canadian Community Health Survey 2012 on 30,170 women aged ≥20 years. Disability was defined as reports of sometimes or often (vs. never) experiencing functional limitations or reduction in daily activities at home, school, or work. Frequency of these limitations was used as a proxy for disability severity. The outcome was self-reported hysterectomy status. Modified Poisson regression was used to quantify the prevalence ratio (PR) and 95% confidence interval (CI) for hysterectomy according to any, functional, or activity-limiting disability, after adjustment for household income, employment, education, ethnicity, and marital status. Results were stratified by age at time of data collection, categorized as childbearing (20–44 years), perimenopausal (45–59 years), and postmenopausal (60 years and older). Results: Disability was significantly and consistently associated with higher prevalence of hysterectomy in women. The strength of association was inversely related to age category, and PRs for a given age category were similar across disability types and severity levels. PRs for the association between any disability and hysterectomy were 2.18 (95% CI 1.36–3.50) for childbearing-aged women, 1.48 (95% CI 1.21–1.80) for perimenopausal women, and 1.12 (95% CI 1.02–1.24) for postmenopausal women. Conclusions: Prevalence of hysterectomy is disproportionately higher among women with self-reported disabilities compared with women without disabilities, with these differences most pronounced in women of childbearing age.
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Affiliation(s)
- Natalie V. Scime
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Hilary K. Brown
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Erin A. Brennand
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Alberta, Canada
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Sánchez-Rodríguez MA, Zacarías-Flores M, Correa-Muñoz E, Arronte-Rosales A, Mendoza-Núñez VM. Oxidative Stress Risk Is Increased with a Sedentary Lifestyle during Aging in Mexican Women. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9971765. [PMID: 34733404 PMCID: PMC8560284 DOI: 10.1155/2021/9971765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/01/2021] [Accepted: 10/05/2021] [Indexed: 12/30/2022]
Abstract
Oxidative stress (OS) increases during the human aging process, and the sedentary lifestyle could be a prooxidant factor. In this study, we determine the effect of sedentary lifestyle on OS during the aging process in Mexican women. A longitudinal study of two-year follow-up was carried out with 177 community-dwelling women (40-69 y) from Mexico City. We measured as OS markers plasma malondialdehyde, erythrocyte glutathione peroxidase (GPx) and superoxide dismutase (SOD), total plasma antioxidant status, uric acid level, antioxidant gap, and SOD/GPx ratio. To define OS using all the markers, we defined cut-off values of each parameter based on the 90th percentile of young healthy subjects and, we calculated a stress score (SS) ranging from 0 to 7, which represented the intensity of the marker modifications. All the women answered a structured questionnaire about prooxidant factors, including physical activity specially the type of activity, frequency, and duration, and they answered Spanish versions of self-assessment tests for establishing dysthymia and insomnia as potential confounders. Principal component and Poisson regression analysis were used as statistical tools, being two-year OS the primary outcome. The OS was considerate as SS ≥ 4 and sedentary lifestyle as <30 min/day of physical activity, beside several prooxidant factors and age that were covariables. SS is higher in sedentary lifestyle women after the two-year follow-up; although, the difference was statistically significant only in older women. Four principal components were associated with the OS, and 7 out of 8 prooxidant factors were important for the analysis, which were included in the Poisson model. The predictive factors for OS were the sedentary lifestyle (adjusted PR = 2.37, CI95%: 1.30-4.30, p < 0.01), and age, in which the risk increases 1.06 (CI95%:1.02-2.11, p < 0.01) by each year of age. Our findings suggest that a sedentary lifestyle increases the OS during the aging in Mexican women.
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Affiliation(s)
- Martha A. Sánchez-Rodríguez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico, Av. Guelatao No. 66, Col. Ejército de Oriente, Iztapalapa, Ciudad de Mexico, CP 09230, Mexico
| | - Mariano Zacarías-Flores
- Division of Obstetrics and Gynecology, Hospital Gustavo Baz Prada, Institute of Health of the State of Mexico, Nezahualcóyotl, State of Mexico CP 57300, Mexico
| | - Elsa Correa-Muñoz
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico, Av. Guelatao No. 66, Col. Ejército de Oriente, Iztapalapa, Ciudad de Mexico, CP 09230, Mexico
| | - Alicia Arronte-Rosales
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico, Av. Guelatao No. 66, Col. Ejército de Oriente, Iztapalapa, Ciudad de Mexico, CP 09230, Mexico
| | - Víctor Manuel Mendoza-Núñez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico, Av. Guelatao No. 66, Col. Ejército de Oriente, Iztapalapa, Ciudad de Mexico, CP 09230, Mexico
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Nakamura K, Sawada N, Kitamura K, Watanabe Y, Tsugane S. Menstrual and reproductive factors and limitations in activities of daily living: A case-control study within the Japan Public Health Center-based Prospective Study. J Obstet Gynaecol Res 2021; 47:3903-3912. [PMID: 34482606 DOI: 10.1111/jog.14959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/23/2021] [Accepted: 07/22/2021] [Indexed: 02/07/2023]
Abstract
AIM Although menstrual/reproductive factors are known to be associated with physical disability, little is known about these associations in relation to activities of daily living (ADL). This study aimed to clarify associations between menstrual/reproductive factors and ADL limitations in peri- and postmenopausal women. STUDY DESIGN A nested case-control study of the Japan Public Health Center-based Prospective (JPHC) Study. METHODS The main outcome measure was self-reported ADL levels in the 10-year follow-up questionnaire survey of the JPHC Study conducted between 2000 and 2004 (N = 36 460). Women who "live inside almost independently, but go out with assistance" or had a lower level of activity were considered to have ADL limitations ("cases"), and all others served as controls. Candidate menstrual/reproductive predictors were as follows: menarcheal age, menopausal status, menopausal age, regularity of menses, menstrual cycle, number of pregnancies, age at first pregnancy, number of deliveries, age at first delivery, and breast feeding. Multiple logistic regression analyses were conducted, and odds ratios adjusted for age and past lifestyle were calculated. RESULTS Mean ages of cases (N = 592) and controls (N = 38 656) were 68.3 (SD = 7.6) and 61.1 (SD = 7.7) years, respectively. With respect to menopausal age, groups aged <45 and ≥55 years had significantly higher adjusted ORs (1.44, 95% CI: 1.09-1.90 and 1.55, 95%CI: 1.09-2.18, respectively) than the reference group (50-54 years). Multiparous women had significantly lower ORs than nulliparous women. CONCLUSION Our findings suggest that menopausal age and parity may predict future ADL limitations in women.
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Affiliation(s)
- Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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18
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Napoleone JM, Boudreau RM, Lange-Maia BS, El Khoudary SR, Ylitalo KR, Kriska AM, Karvonen-Gutierrez CA, Strotmeyer ES. Metabolic Syndrome Trajectories and Objective Physical Performance in Mid-to-Early Late Life: The Study of Women's Health Across the Nation (SWAN). J Gerontol A Biol Sci Med Sci 2021; 77:e39-e47. [PMID: 34216218 PMCID: PMC8824556 DOI: 10.1093/gerona/glab188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Little is known about how adverse, midlife metabolic profiles affect future physical functioning. We hypothesized that a higher number of midlife metabolic syndrome (MetS) components are associated with poorer physical performance in early old age for multiethnic women. METHODS MetS status from 1996 to 2011 (8 visits) and objective physical performance in 2015/2016 (Short Physical Performance Battery [SPPB; 0-12], 40-foot walk [meter/second], 4-meter gait speed [meter/second], chair stands [seconds], stair climb [seconds]) were assessed in the Study of Women's Health Across the Nation (SWAN; n = 1722; age 65.4 ± 2.7 years; 26.9% African American, 10.1% Chinese, 9.8% Japanese, 5.5% Hispanic). Poisson latent class growth modeling identified MetS component trajectory groups: none (23.9%), 1 = low-MetS (28.7%), 2 = mid-MetS (30.9%), and ≥3 = high-MetS (16.5%). Adjusted linear regression related MetS groups to physical performance outcomes. RESULTS High-MetS versus none had higher body mass index, pain, financial strain, and lower physical activity and self-reported health (p < .0001). Compared with White, African American and Hispanic women were more likely to be in the high-MetS groups and had worse physical functioning along with Chinese women (SPPB, chair stand, stair climb, and gait speed-not Hispanic). After adjustments, high-MetS versus none demonstrated significantly worse 40-ft walk (β: -0.08; 95% CI: -0.13, -0.03), gait speed (β: -0.09; 95% CI: -0.15, -0.02), SPPB (β: -0.79; 95% CI: -1.15, -0.44), and chair stands (β: 0.69; 95% CI: 0.09, 1.28), but no difference in stair climb. CONCLUSIONS Midlife MetS groups were related to poor physical performance in early old age multiethnic women. Midlife management of metabolic function may improve physical performance later in life.
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Affiliation(s)
- Jenna M Napoleone
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
- Address correspondence to: Jenna M. Napoleone, PhD, MPH, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, USA. E-mail:
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Samar R El Khoudary
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Andrea M Kriska
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | | | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
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Cho H, Gu MS, Won CW, Kong HH. Impact of premature natural menopause on body composition and physical function in elderly women: A Korean frailty and aging cohort study. Medicine (Baltimore) 2021; 100:e26353. [PMID: 34160403 PMCID: PMC8238278 DOI: 10.1097/md.0000000000026353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/31/2021] [Indexed: 01/04/2023] Open
Abstract
Induced premature menopause accelerates the rate of body composition changes (decrease in skeletal muscle mass and increase in fat mass) and deteriorating physical function. However, few studies have focused on the impact of premature natural menopause. This study aimed to investigate the impact of age at natural menopause (ANM) on body composition and physical function in elderly women.Using data from the Korean Frailty and Aging Cohort Study, 765 community-dwelling elderly women aged 70 to 85 years who experienced natural menopause were recruited in this study. Body composition was measured using dual-energy X-ray absorptiometry. Physical function was evaluated by grip strength, the timed up and go test (TUG), and the short physical performance battery (SPPB). Participants were categorized into 4 groups according to their ANM: <40 (premature natural menopause, PNM), 40 to 44 (early natural menopause, ENM), 45 to 54 (normal menopause, NM), and ≥55 (late menopause, LM) years.There were no significant differences in the body composition parameters, such as the appendicular skeletal muscle mass index (PNM: 5.90 ± 0.90 vs ENM: 5.91 ± 0.70 vs NM: 5.85 ± 0.73 vs LM: 5.90 ± 0.75, kg/m2, P = .75) and trunk fat mass index (PNM: 19.4 ± 3.9 vs ENM: 19.9 ± 4.4 vs NM: 19.9 ± 3.9 vs LM: 20.0 ± 3.8, %, P = .87) between the groups. In the physical function evaluation, there was no significant difference between the groups in grip strength (PNM: 19.8 ± 0.6 vs ENM: 20.3 ± 0.4 vs NM: 20.6 ± 0.2 vs LM: 20.6 ± 0.4, kg, P = .53). However, in the TUG (PNM: 11.8 ± 0.4 vs ENM: 10.3 ± 0.3 vs NM: 10.6 ± 0.1 vs LM: 10.2 ± 0.3, seconds, P < .01) and SPPB (PNM: 10.0 ± 0.2 vs ENM: 10.5 ± 0.2 vs NM: 10.6 ± 0.1 vs LM: 10.8 ± 0.2, points, P < .05), the PNM group showed significantly lower values than the other groups did. There was no difference in physical function between the groups except the PNM.Premature natural menopause did not affect the body composition in elderly women but was associated with physical function deterioration. Therefore, more attention should be paid to the prevention of the physical function deterioration caused by premature natural menopause in elderly women.
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Affiliation(s)
- Hangyeol Cho
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju
| | - Min Su Gu
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Hyun Ho Kong
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju
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Laatar R, Ben Waer F, Rebai H, Sahli S. Caffeine consumption improves motor and cognitive performances during dual tasking in middle-aged women. Behav Brain Res 2021; 412:113437. [PMID: 34182008 DOI: 10.1016/j.bbr.2021.113437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/27/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
The aim of the present study was to explore the effect of caffeine consumption (CC) on cognitive motor interference while walking and maintaining balance in middle-aged women. Twenty middle-aged women (52 ± 2.0 years; height 158 ± 2.0 cm; body mass 77 ± 14.9 kg; body mass index ±3.4 kg/m2, mean ± SD) participated in this study. Participants completed measures of a single task (ST) cognitive, a ST motor and a dual task (DT) cognitive-motor tests before and after either caffeine (100 mg) or placebo ingestion. Results showed that before CC, both motor (P < 0.0005) and cognitive (P < 0.05) performances decreased in the DT condition compared to the ST one. After CC, no significant difference in the motor performances between ST and DT conditions was observed. In fact, both standing and walking DT performances were improved as indicated by a significant (P < 0.05) decrease in the dual task cost (DTC) of motor performances. In conclusion, middle-aged women showed difficulties to manage DT situations in which a cognitive and a motor task must be performed concurrently. Caffeine is an effective ergogenic aid to improve both cognitive and motor performances during DT conditions and could be an alternative to nullify the deteriorating effect of DT when maintaining balance and walking in middle-aged women. These enhancements could offer great potential for everyday functioning.
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Affiliation(s)
- Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Fatma Ben Waer
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Haithem Rebai
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
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21
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Shaaban CE, Rosano C, Cohen AD, Huppert T, Butters MA, Hengenius J, Parks WT, Catov JM. Cognition and Cerebrovascular Reactivity in Midlife Women With History of Preeclampsia and Placental Evidence of Maternal Vascular Malperfusion. Front Aging Neurosci 2021; 13:637574. [PMID: 34017243 PMCID: PMC8129174 DOI: 10.3389/fnagi.2021.637574] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/09/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Preeclampsia is emerging as a sex-specific risk factor for cerebral small vessel disease (SVD) and dementia, but the reason is unknown. We assessed the relationship of maternal vascular malperfusion (MVM), a marker of placental SVD, with cognition and cerebral SVD in women with and without preeclampsia. We hypothesized women with both preeclampsia and MVM would perform worst on information processing speed and executive function. Methods: Women (n = 45; mean 10.5 years post-delivery; mean age: 41 years; 42.2% Black) were classified as preeclampsia-/MVM-, preeclampsia+/MVM-, or preeclampsia+/MVM+. Information processing speed, executive function, and memory were assessed. In a pilot sub-study of cerebrovascular reactivity (CVR; n = 22), cerebral blood flow during room-air breathing and breath-hold induced hypercapnia were obtained via arterial spin labeling MRI. Non-parametric tests and regression models were used to test associations. Results: Between-group cognitive differences were significant for information processing speed (p = 0.02); preeclampsia+/MVM+ had the lowest scores. Cerebral blood flow increased from room-air to breath-hold, globally and in all regions in the three groups, except the preeclampsia+/MVM+ parietal region (p = 0.12). Lower parietal CVR (less change from room-air breathing to breath-holding) was correlated with poorer information processing speed (partial ρ = 0.63, p = 0.005) and executive function (ρ = 0.50, p = 0.03) independent of preeclampsia/MVM status. Conclusion: Compared to women without preeclampsia and MVM, midlife women with both preeclampsia and MVM have worse information processing speed and may have blunted parietal CVR, an area important for information processing speed and executive function. MVM in women with preeclampsia is a promising sex-specific indicator of cerebrovascular integrity in midlife.
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Affiliation(s)
- C Elizabeth Shaaban
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Theodore Huppert
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - James Hengenius
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - W Tony Parks
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Janet M Catov
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, United States
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22
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Gong B, Wu C. The mediating and moderating effects of depression on the relationship between cognitive function and difficulty in activities of daily living among postmenopausal women. Menopause 2021; 28:667-677. [PMID: 33857954 DOI: 10.1097/gme.0000000000001773] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cognitive function and depression impact critically the daily functioning of menopausal women. This study aimed to explore the mediating and moderating effects of depressive symptoms on the association between cognitive function and activities of daily living (ADL) difficulty in postmenopausal women. METHODS A total of 2,596 postmenopausal women from the China Health and Retirement Longitudinal Study completed the Chinese version of the Mini-Mental State Examination, basic ADL (BADL) and instrumental ADL (IADL) scales, and 10-item Short-Form Center for Epidemiological Studies Depression. We constructed structural equation modeling to examine the association between cognitive function, depressive symptoms, and BADL/IADL difficulty. RESULTS The prevalence of BADL/IADL difficulty in postmenopausal women was 22.5% and 31.5%, respectively. After adjustments for demographic and health-related covariates, cognitive decline (contributed by four cognitive dimensions with different weights) was significantly associated with BADL/IADL difficulty (contributed by six-item daily activities with different weights). Depressive symptoms mediated and explained 28.8% and 23.2% of cognitive function associations with BADL and IADL difficulty, respectively. The Johnson-Neyman technique identified a threshold of eight and four for depressive symptoms, beyond which the protective effect of cognitive function on BADL and IADL emerged. CONCLUSIONS Depressive symptoms mediated and moderated the association between cognition and BADL/IADL difficulty in postmenopausal women. Compared with BADL, IADL may be more sensitive to changes in cognitive function. More strength should be put on developing comprehensive intervention techniques focusing on simultaneous intervention of multidimensional cognitive function and depression to maintain and improve the quality of life of postmenopausal women.
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Affiliation(s)
- Bingyan Gong
- Peking University School of Nursing, Beijing, China
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23
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Lange-Maia BS, Karvonen-Gutierrez CA, Kazlauskaite R, Strotmeyer ES, Karavolos K, Appelhans BM, Janssen I, Avery EF, Dugan SA, Kravitz HM. Impact of Chronic Medical Condition Development on Longitudinal Physical Function from Mid- to Early Late-Life: The Study of Women's Health Across the Nation. J Gerontol A Biol Sci Med Sci 2021; 75:1411-1417. [PMID: 31732730 DOI: 10.1093/gerona/glz243] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic medical conditions (CMCs) often emerge and accumulate during the transition from mid- to late-life, and the resulting multimorbidity can greatly impact physical function. We assessed the association of CMC presence and incidence on trajectories of physical function from mid- to early late-life in the Study of Women's Health Across the Nation. METHODS Physical function was assessed at eight clinic visits (average 14 years follow-up) using the physical function subscale of the Short Form-36. CMCs included osteoarthritis, diabetes, stroke, hypertension, heart disease, cancer, osteoporosis, and depressive symptomatology, and were considered cumulatively. Repeated-measures Poisson models estimated longitudinal change (expressed as percent difference) in physical function by chronic CMCs. Change-points assessed physical function change coincident with the development of a new condition. RESULTS Women (N = 2,283) followed from age 50.0 ± 2.7 to 64.0 ± 3.7 years; 7.3% had zero CMCs through follow-up, 22.5% (N = 513) had no baseline CMCs but developed ≥1, 22.7% women had ≥1 baseline CMC but never developed another, and 47.6% had ≥1 baseline CMC and developed ≥1 more. Each additional baseline CMC was associated with 4.0% worse baseline physical function and annual decline of 0.20%/year. Women with more baseline CMCs had greater decline in physical function with a new CMC (-1.90% per condition); and annual decline when developing a new condition accelerated by -0.33%/year per condition. CONCLUSIONS Self-reported physical function changes are evident from mid- to early late-life with the development of CMCs. Preventing or delaying CMCs may delay declines in physical function, and these potential pathways to disability warrant further research.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Preventive Medicine, Chicago, Illinois.,Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | | | - Rasa Kazlauskaite
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh
| | | | | | - Imke Janssen
- Department of Preventive Medicine, Chicago, Illinois
| | - Elizabeth F Avery
- Department of Preventive Medicine, Chicago, Illinois.,Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | - Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Chicago, Illinois
| | - Howard M Kravitz
- Department of Preventive Medicine, Chicago, Illinois.,Department of Psychiatry, Rush University Medical Center, Chicago, Illinois
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24
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GATA3 somatic mutations are associated with clinicopathological features and expression profile in TCGA breast cancer patients. Sci Rep 2021; 11:1679. [PMID: 33462316 PMCID: PMC7814117 DOI: 10.1038/s41598-020-80680-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022] Open
Abstract
The effect of somatic mutations and the gene expression profiles on the prognosis is well documented in cancer research. This study was conducted to evaluate the association of GATA3 somatic mutations with tumor features, survival, and expression profiles in breast cancer. Clinicopathological information was compared between TCGA-BRCA patients with GATA3-mutant and non-mutant tumors in all patients as well as in ER-positive subgroup. Cox-regression method was used to evaluate the association of the GATA3 mutation status with overall survival time. Differential gene expression, functional annotation, and protein-protein interaction analyses were performed using edgeR, Metascape, DAVID, STRING and CytoNCA. GATA3-mutant and non-mutant samples had significantly different clinicopathological features (p < 0.05). While GATA3 mutation status was not associated with the overall survival in the entire cohort (padj = 0.52), the GATA3-wild type ER-positive cases had a better prognosis than mutant ones (padj = 0.04). GATA3 expression was higher in tumors than normal tissues. Several pathways were different between mutant and non-mutant groups (p < 0.05). Interleukin-6 was found as the highest scored gene in both comparisons (normal vs. mutant and normal vs. non-mutant groups) in the entire patient and in the ER-positive subgroup, suggesting the association of IL6 with breast tumorigenesis. These findings suggest that GATA3 mutations can be associated with several tumor characteristics and influence the pattern of gene expression. However, GATA3 mutation status seems to be a prognostic factor for the disease only in ER-positive patients.
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25
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Possible association of early menopause with worse physical function: a systematic review. ACTA ACUST UNITED AC 2021; 28:467-475. [PMID: 33399317 DOI: 10.1097/gme.0000000000001712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Menopause at younger ages is associated with a greater risk of adverse health outcomes such as osteoporosis, chronic diseases, and death. However, the association with physical function has not been well established. OBJECTIVE Assess the association between timing of menopause and different measures of physical function. EVIDENCE REVIEW Searches on the PubMed, Cochrane Library, SciELO, LILACS, and Web of Science databases were conducted. Observational studies on the association between age at menopause and measures of physical function were included, with no restriction for publication date or language. Methodological quality was assessed by the "Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies." FINDINGS Four cross-sectional studies were included, totaling 13,846 participants. These investigated five measures of physical function: gait speed, grip strength, standing balance, chair stand, and self-reported functional limitations. Poor physical function was associated with premature (<40 y) or early menopause (<45 y) in all the studies, with significant results only for grip strength, gait speed, and functional limitation. Premature and early menopause were associated with weaker grip strength [between 2.58 kg (95% CI = 0.74 to 4.43) and 5.21 kg (2.18 to 8.25)], and lower gait speed [between 0.03 m/s (0.01 to 0.06) and 0.06 m/s (0.02 to 0.09)]. Menopause after the age of 50 is associated with less likelihood of functional limitation [OR between 0.52 (95% CI = 0.29 to 0.95) and 0.61 (0.40 to 0.95)] compared with premature and early menopause. Two measures of physical function (chair stand test and standing balance) were not significantly associated with age at menopause. CONCLUSION Only four cross-sectional studies showed that earlier ages at menopause are associated with poor physical function (grip strength, gait speed, and self-reported functional limitations), but given the high heterogeneity of the studies, no consensus is possible. Longitudinal studies are needed to explore the association between age at menopause and different measures of physical function as well as the influence of different socioeconomic conditions between countries on functioning.
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26
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Disability prevalence in midlife (aged 55-65 years): Cross-Country comparisons of gender differences and time trends. Womens Midlife Health 2021; 7:1. [PMID: 33386080 PMCID: PMC7777402 DOI: 10.1186/s40695-020-00061-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 12/02/2020] [Indexed: 12/02/2022] Open
Abstract
Background Prior literature on disability has centered on disability prevalence among older adults ages 65 and older, providing only limited insight to potential gender differences in disability prevalence in mid-life. Midlife is, however, a critical time to be examined, as it is typically the time in the life course when large inequalities in physical health first emerge. Methods Using the Harmonized data files provided by the Gateway to Global Aging Data, we estimate disability prevalence of nationally representative adults ages 55–65 from 23 countries (N = 79,465). We examine gender differences in two disability indicators, limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs) in two time periods, 2004/05 and 2014/15. Results There are substantial cross-country variations in IADL and ADL disability prevalence in midlife. Within countries, we find that women have higher IADL prevalence than men in only one out of five countries. Similarly, for ADL prevalence, women have higher ADL prevalence than men in only one out of ten countries. Further, comparing disability prevalence in two time periods, we observe different country-specific time trends. Conclusions In the majority of mid and high-income countries, there is no significant gender difference in IADL and ADL prevalence, but there are few countries where women show higher prevalence of disability than men in mid-life. This finding calls for future research into what contributes to cross-country variations.
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27
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Yang Y, Huang W, Yuan L. Effects of Environment and Lifestyle Factors on Premature Ovarian Failure. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1300:63-111. [PMID: 33523430 DOI: 10.1007/978-981-33-4187-6_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Premature ovarian insufficiency (POI) or primary ovarian failure is defined as a cessation of the menstrual cycle in women younger than 40 years old. It is strictly defined as more than 4 months of oligomenorrhea or amenorrhea in a woman <40 years old, associated with at least two follicle-stimulating hormone (FSH) levels >25 U/L in the menopausal range, detected more than 4 weeks apart. It is estimated that POI was affected 1 and 2% of women. Although 80% of POI cases are of unknown etiology, it is suggested that genetic disorder, autoimmune origin, toxins, and environmental factors, as well as personal lifestyles, may be risk factors of developing POI. In this section, we will discuss the influences of environmental and lifestyle factors on POI. Moreover updated basic research findings regarding how these environmental factors affect female ovarian function via epigenetic regulations will also be discussed.
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Affiliation(s)
- Yihua Yang
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.
| | - Weiyu Huang
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lifang Yuan
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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28
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Percent body fat, but not lean mass, is associated with objectively measured physical function in middle-aged women. Maturitas 2020; 142:11-16. [PMID: 33158482 DOI: 10.1016/j.maturitas.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/02/2020] [Accepted: 06/09/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The relationship between components of body composition and physical function is not well characterized among middle-aged women. This cross-sectional study examined the strength of the associations between lean mass and percent fat and physical function in middle-aged women. STUDY DESIGN Body composition, physical function and physical activity were objectively measured in 80 women (mean age 52.58 ± 6.10 years; range = 40-63 years). MAIN OUTCOME MEASURES Adiposity (%Fat) and lean mass were measured via dual-energy x-ray absorptiometry. Steps/day and minutes of low-, moderate- and vigorous-intensity physical activity were assessed via accelerometer. Physical function was measured via a seated transfer task, 30-second chair stand, a six-minute walk task, 8-foot timed up and go, and a lift and carry task. RESULTS When controlling for steps/day, measures of lean mass were related to performance on the seated transfer task (r = .25) and 30-second chair stand (-.26) (both p > 0.05), while %Fat was related to performance on the seated transfer task (r = .53), 8-foot timed up and go (r = .32), 30-second chair stand (r = -.35), and six-minute walk (r = -.48; all p ≤ 0.05). Linear regression analyses revealed: (1) age, steps/day, and %Fat were independently related to performance on the seated transfer task and 30-second chair stand (both p ≤ 0.05), (2) %Fat was associated with six-minute walk and 8-foot up-and-go performance (p ≤ 0.01); none of the variables included were associated with lift and carry. CONCLUSIONS Adiposity but not lean mass was associated with objectively measured physical function in middle-aged women. Interventions that focus on reducing body fat may be an effective method for improving functional performance among women in this age group.
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29
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Matthews KA, Chang Y, Brooks MM, Crawford SL, Janssen I, Joffe H, Kravitz HM, Thurston RC, El Khoudary SR. Identifying women who share patterns of reproductive hormones, vasomotor symptoms, and sleep maintenance problems across the menopause transition: group-based multi-trajectory modeling in the Study of Women's Health Across the Nation. Menopause 2020; 28:126-134. [PMID: 33038144 PMCID: PMC9238015 DOI: 10.1097/gme.0000000000001663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify groups of women who share levels and patterns of change in follicle-stimulating hormone (FSH), self-reported sleep maintenance problems, and frequent vasomotor symptoms (VMS) up to 10 years before and after their final menstrual period and to evaluate their premenopausal characteristics. METHOD Group-based multi-trajectory modeling grouped 1,407 women from the Study of Women's Health Across the Nation who had an observed natural menopause and did not use hormone therapy, based on repeated measures of FSH, sleep maintenance problems, and frequent VMS relative to final menstrual period. Multivariable analyses assessed race/ethnicity, body mass index, smoking, and depressive symptoms as predictors of group membership. RESULTS Women formed five distinct groups: (1) low symptoms (low VMS/sleep problems)/high FSH rise (N = 552; 39.2%); (2) moderate VMS and sleep problems/low FSH rise (N = 169; 12.0%); (3) dominant sleep problems (lower VMS/high sleep problems)/high FSH rise (N = 203; 14.4%); (4) dominant VMS (high VMS/lower sleep problems)/high FSH rise (N = 297; 21.1%)); and (5) high symptoms (high VMS/high sleep problems)/intermediate FSH rise (N = 186; 13.2%)). Multivariate analyses showed that race/ethnicity, premenopausal body mass index and depressive symptoms, and increasing depressive symptoms during the early phase of the transition predicted group membership. CONCLUSIONS Women can be classified based on shared levels and patterns of FSH, sleep maintenance problems, and frequent VMS across the menopause transition. Either VMS or sleep maintenance problems can be dominant in the face of high FSH. Experiencing one menopause-related symptom or hormone profile does not automatically imply that another is also being experienced.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Yuefang Chang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA
| | - Maria M Brooks
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Sybil L Crawford
- Department of Medicine, University of Massachusetts, Worcester, MA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
- Department of Psychiatry, Rush University Medical Center, Chicago, IL
| | - Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
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30
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Karvonen-Gutierrez CA, Strotmeyer ES. The urgent need for disability studies among midlife adults. Womens Midlife Health 2020; 6:8. [PMID: 32864148 PMCID: PMC7453534 DOI: 10.1186/s40695-020-00057-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/30/2020] [Indexed: 11/11/2022] Open
Abstract
Issues of poor physical functioning and disability are burdensome for midlife adults and evidence suggests that the prevalence of these conditions is increasing temporally. Physical functioning during the midlife period, however, may be highly amendable to intervention given the highly dynamic nature of functioning during this life stage. Thus, efforts to improve or forestall poor physical functioning and/or disability during midlife may not only improve the health status and quality of life for midlife adults but may have important ramifications on the health of these individuals who will become older adults in the future. This thematic series on women and disability includes contributions addressing issues of person, place and time with respect to disability in midlife and into late adulthood. The purpose of this commentary is to provide a summary overview of the major themes of the series and to offer insight into areas of most promise for intervention among midlife populations to improve physical functioning and prevent disability.
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Affiliation(s)
- Carrie A Karvonen-Gutierrez
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N Bellefield Avenue, Suite 300, Pittsburgh, PA 15213 USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N Bellefield Avenue, Suite 300, Pittsburgh, PA 15213 USA
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31
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Kekäläinen T, Laakkonen EK, Terracciano A, Savikangas T, Hyvärinen M, Tammelin TH, Rantalainen T, Törmäkangas T, Kujala UM, Alen M, Kovanen V, Sipilä S, Kokko K. Accelerometer-measured and self-reported physical activity in relation to extraversion and neuroticism: a cross-sectional analysis of two studies. BMC Geriatr 2020; 20:264. [PMID: 32727379 PMCID: PMC7391808 DOI: 10.1186/s12877-020-01669-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Personality reflects relatively stable and pervasive tendencies in feeling, thinking and behaving. While previous studies have found higher extraversion and lower neuroticism to be linked to higher self-reported physical activity levels, larger studies using accelerometer-measured physical activity are lacking. This study investigated the cross-sectional associations of extraversion and neuroticism with both accelerometer-measured and self-reported physical activity and the role of these personality traits in possible discrepancies between these two measures of physical activity among Finnish adults. METHODS Two community-dwelling samples were used in this study: a) 47-55-yr-old women (n = 1098) and b) 70-85-yr-old women and men (n = 314). In both samples, extraversion and neuroticism were assessed by the 19-item short form of the Eysenck Personality Inventory. Physical activity was assessed with hip-worn tri-axial accelerometers and self-reported questions. Regression analyses were adjusted by age, BMI and education. RESULTS In the middle-aged women, neuroticism was negatively associated with accelerometer-measured leisure time moderate-to-vigorous physical activity (β = -.07, p = .036) and with self-reported physical activity (β = -.08, p = .021), while extraversion was positively associated with self-reported physical activity (β = .10, p = .005). No associations of extraversion or neuroticism with physical activity were found in the older men and women. Older adults who scored high in neuroticism reported less physical activity than what was measured by accelerometers (β = -.12, p = .039). Extraversion was not associated with discrepancy between self-reported and accelerometer-measured leisure time physical activity in either sample. CONCLUSIONS Neuroticism was associated with lower leisure-time physical activity levels and extraversion with higher self-reported physical activity among middle-aged women. Neuroticism and extraversion were unrelated to physical activity among older adults, but older adults with high neuroticism seemed to underreport their physical activity level. The role of personality in the discrepancy between self-reported and device-based physical activity warrants further research.
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland.
| | - Eija K Laakkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Matti Hyvärinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Timo Rantalainen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Vuokko Kovanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
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Lange-Maia BS, Karavolos K, Avery EF, Strotmeyer ES, Karvonen-Gutierrez CA, Appelhans BM, Janssen I, Dugan SA, Kravitz HM. Contribution of common chronic conditions to midlife physical function decline: The Study of Women's Health Across the Nation. Womens Midlife Health 2020; 6:6. [PMID: 32742664 PMCID: PMC7385881 DOI: 10.1186/s40695-020-00053-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/13/2020] [Indexed: 12/25/2022] Open
Abstract
Background Chronic conditions are associated with worse physical function and commonly develop during midlife. We tested whether the presence of 8 chronic conditions, or the development of these conditions, is associated with declines in physical function among midlife women as they transition into early late life. Methods Participants (N = 2283) were from the Study of Women’s Health Across the Nation. Physical function was assessed at 8 visits starting at the study’s fourth clinic visit in 2000/2001 through follow-up visit 15 (2015/2017) using the Short Form-36 Physical Function subscale. Chronic conditions included diabetes, hypertension, osteoarthritis, osteoporosis, stroke, heart disease, cancer, and depressive symptoms. Repeated-measures Poisson regression modeled associations between 1) prevalent chronic conditions at analytic baseline (visit 4) and longitudinal physical function, and 2) change in physical function associated with developing a new condition. Models were adjusted with the total number of other chronic conditions at visit 4. Results In separate fully-adjusted longitudinal models, prevalent heart disease and osteoporosis were associated with 18% (IRR = 0.815, 95% confidence interval [CI]: 0.755–0.876) and 12% (IRR = 0.876, 95% CI: 0.825–0.927) worse initial physical function, respectively. Prevalent osteoarthritis was associated with approximately 6% (IRR = 0.936, 95% CI: 0.913–0.958) worse initial physical function, and a slight additional worsening over time (IRR = 0.995, 95% CI: 0.994–0.996). A 12% (IRR = 0.878, 95% CI: 0.813–0.950) decrease in physical function concurrent with stroke development was evident, as was accelerated decline in physical function concurrent with heart disease development (IRR = 0.991, 95% CI: 0.988–0.995). Conclusions Initial prevalent conditions related to the musculoskeletal system were associated with worse initial physical function, with some evidence of accelerated decline in physical function with osteoarthritis. Stroke and heart disease are less common than osteoarthritis in this age group, but the severe effects of these conditions on physical function shows the need for a greater focus on cardiovascular health during midlife. Women who develop chronic conditions during midlife may be at particular risk for poor physical function as they age, warranting disability prevention efforts focused on this population.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA.,Center for Community Health Equity, Rush University Medical Center, Chicago, IL USA
| | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA
| | - Elizabeth F Avery
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA.,Center for Community Health Equity, Rush University Medical Center, Chicago, IL USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | | | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA
| | - Sheila A Dugan
- Department of Physical Medicine & Rehabilitation, Rush University Medical Center, Chicago, IL USA
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL USA
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El Khoudary SR, Chen X, Nasr A, Shields K, Barinas-Mitchell E, Janssen I, Everson-Rose SA, Powell L, Matthews K. Greater Periaortic Fat Volume at Midlife Is Associated with Slower Gait Speed Later in Life in Women: The SWAN Cardiovascular Fat Ancillary Study. J Gerontol A Biol Sci Med Sci 2020; 74:1959-1964. [PMID: 30977813 DOI: 10.1093/gerona/glz095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Higher perivascular adipose tissue (PVAT) contributes to adverse physiologic alterations in the vascular wall, and thus could potentially limit normal physical function later in life. We hypothesize that higher PVAT volume at midlife is prospectively associated with slower gait speed later in life, independent of overall adiposity and other risk factors. METHODS Participants from the Study of Women's Health Across the Nation (SWAN) cardiovascular fat ancillary study were included. PVAT volume around the descending aorta was quantified using existing computed tomography scans at midlife, while gait speed was measured after an average of 10.4 ± 0.7 years. RESULTS Two hundred and seventy-six women (aged 51.3 ± 2.8 years at PVAT assessment) were included. Mean gait speed was 0.96 ± 0.21 m/s. Adjusting for study site, race, education level, menopausal status, and length of descending aorta at PVAT assessment, and age, body mass index, difficulty paying for basics, overall health and smoking status at gait speed assessment, a higher midlife PVAT volume was associated with a slower gait speed later in life (p = .03). With further adjustment for presence of any comorbid conditions by the time of gait speed assessment, the association persisted; every 1SD increase in log-PVAT was associated with 3.3% slower gait speed (95% confidence interval: 0.3-6.3%; p = .03). CONCLUSION Greater PVAT in midlife women may contribute to poorer physical function in older age supporting a potential role of midlife PVAT in multiple domains of healthy aging. Additional research is needed to fully elucidate the physiologic changes associated with PVAT that may underlie the observed associations.
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Affiliation(s)
- Samar R El Khoudary
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Xirun Chen
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Alexis Nasr
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Kelly Shields
- Enterprise Analytics, Highmark Health, Pittsburgh, Pennsylvania
| | - Emma Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | - Susan A Everson-Rose
- Department of Medicine and Program in Health Disparities Research, University of Minnesota, Minneapolis
| | - Lynda Powell
- Department of Medicine and Program in Health Disparities Research, University of Minnesota, Minneapolis
| | - Karen Matthews
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania
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Validity and Reliability of a Single Question for Leisure-Time Physical Activity Assessment in Middle-Aged Women. J Aging Phys Act 2020; 28:231-241. [PMID: 31585436 DOI: 10.1123/japa.2019-0093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the validity and test-retest reliability of a single seven-level scale physical activity assessment question (SR-PA L7) and its three-level categorization (SR-PA C3). METHODS The associations of SR-PA L7 and C3 with accelerometer-measured leisure-time physical activity (ACC-LTPA) and with the results of four different physical performance tests (6-min walk [n = 733], knee extension [n = 695], vertical jump [n = 731], and grip force [n = 780]) were investigated among women aged 47-55 years participating in the Estrogenic Regulation of Muscle Apoptosis study (n = 795). The reliability was studied using Spearman correlations with 4-month test-retest period (n = 152). RESULTS SR-PA L7 and C3 had low correlations with ACC-LTPA (rs = .105-.337). SR-PA L7, SR-PA C3, and ACC-LTPA explained comparable but small amount of variance of the physical performance test results. The reliability analysis provided moderate agreement (rs = .707 and .622 for SR-PA L7 and C3, respectively). CONCLUSIONS SR-PA L7 and C3 demonstrated limited validity and reasonable repeatability.
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Dantas LADS, Fernandes SGG, Vieira MCA, Maciel ÁCC, Câmara SMAD. Capacidade de avaliação de testes de desempenho físico para identificar baixa massa muscular em mulheres de meia-idade e idosas. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.200244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Resumo Objetivo Verificar a capacidade de avaliação de testes de desempenho físico na identificação da baixa massa muscular (MM) em mulheres de meia-idade e idosas. Método Estudo transversal realizado com 540 mulheres de meia-idade (40-59 anos) e idosas (≥60 anos), nos municípios de Parnamirim e Santa Cruz, no Rio Grande do Norte, Brasil. Foram avaliadas MM, força de preensão palmar, extensão de joelho e velocidade da marcha. A baixa MM foi definida pelo índice de massa muscular esquelética menor que os 20% mais baixos para cada grupo de idade. Foram utilizados os testes: t de Student, qui-quadrado, análise de curva ROC para calcular a área sob a curva e ponto de corte de cada teste na discriminação das participantes com baixa MM. Foi considerado p<0,05 e IC de 95%. Resultados Para o grupo de meia-idade, as forças de preensão palmar e de extensão do joelho apresentaram sensibilidade (71,6% e 72,5%, respectivamente) e especificidade (59,4% e 56,0%, respectivamente) moderadas na identificação de baixa MM. Para as idosas, a velocidade da marcha e a força de preensão manual apresentaram boa sensibilidade (77,8% e 81,6%, respectivamente) e especificidade moderada (51,4% e 64,5%, respectivamente). A capacidade discriminatória da velocidade da marcha para as mulheres de meia-idade e da força de extensão do joelho para as mulheres idosas foi insatisfatória. Conclusão As medidas de força muscular são úteis para a triagem de baixa MM em mulheres de meia-idade, enquanto os testes de força de preensão manual e velocidade de marcha são úteis para idosas.
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El Khoudary SR, Greendale G, Crawford SL, Avis NE, Brooks MM, Thurston RC, Karvonen-Gutierrez C, Waetjen LE, Matthews K. The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). Menopause 2019; 26:1213-1227. [PMID: 31568098 PMCID: PMC6784846 DOI: 10.1097/gme.0000000000001424] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women. METHODS This review summarizes the central findings of SWAN to date that can inform women and their healthcare providers about the impact of the MT and midlife aging on overall health and well-being. RESULTS SWAN characterized changes in reproductive axis and menstrual cycle patterns that informed the development of the reproductive aging staging system Staging of Reproductive Aging Workshop+10; MT-related symptoms and mental health (vasomotor symptoms, sleep complaints, psychological symptoms, cognitive performance, and urogenital and sexual health); and physiological systems and functions (cardiovascular and cardiometabolic health, bone health, physical function performance) that are influenced by the MT. SWAN demonstrated substantial interrelations among these changes and significant racial/ethnic differences in the rate and magnitude of change in multiple health indictors in midlife women. The findings point to midlife as a critical stage for adopting healthy behavior and preventive strategies. CONCLUSIONS Over the past 23 years, SWAN has advanced our understanding of the impact of the MT and midlife aging on health and well-being in women. SWAN will be instrumental to determine whether MT-related changes during midlife are related to unfavorable health and well-being in early old age.
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Affiliation(s)
- Samar R. El Khoudary
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
| | - Gail Greendale
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Sybil L. Crawford
- University of Massachusetts Medical School, Graduate School of Nursing, Worcester, MA
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Maria M. Brooks
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
| | - Rebecca C. Thurston
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | | | - L. Elaine Waetjen
- Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Sacramento, CA
| | - Karen Matthews
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Cortés YI, Catov JM, Brooks M, El Khoudary SR, Thurston RC, Matthews KA, Isasi CR, Jackson EA, Barinas-Mitchell E. Pregnancy-related events associated with subclinical cardiovascular disease burden in late midlife: SWAN. Atherosclerosis 2019; 289:27-35. [PMID: 31446211 DOI: 10.1016/j.atherosclerosis.2019.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 06/10/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS Reproductive factors are associated with later life CVD in women (e.g., age at first birth, preeclampsia, gestational diabetes), but studies have focused largely on premenopausal women. We examined the relationship of reproductive factors with subclinical CVD burden in late midlife women. METHODS We included 964 parous women from the Study of Women's Health Across the Nation (SWAN), who completed a reproductive history questionnaire at the 13th SWAN visit (2011-2012), and a carotid ultrasound and brachial-ankle pulse wave velocity (baPWV) assessment. The primary outcomes were carotid intima-media thickness, plaque, and baPWV; our secondary outcome was a composite subclinical CVD index created using these measures. Linear and logistic regression was performed to examine associations with individual subclinical CVD measures, and multinomial logistic regression was used in analyses of the composite index. Models adjusted for socio-demographics and cardiovascular risk factors. RESULTS Mean age at subclinical CVD assessment was 60.2 years (SD ± 2.7). History of gestational hypertension/preeclampsia was associated with greater carotid IMT (β: 0.038, p = 0.004). Earlier age at first birth was associated with subclinical CVD, but not when accounting for CVD risk factors. History of gestational diabetes was associated with greater baPWV, but not related to our composite index. CONCLUSIONS Pregnancy history is an important marker of subclinical CVD in late midlife and may impact the vasculature through distinct pathways. Future studies are necessary to evaluate racial/ethnic differences in the observed associations and to assess the benefit of a composite subclinical CVD index for earlier CVD risk modification in midlife women.
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Affiliation(s)
- Yamnia I Cortés
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Janet M Catov
- Departments of Obstetrics, Gynecology, and Reproductive Sciences and Epidemiology, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA, USA; Department of Magee-Women's Research Institute, Pittsburgh, PA, USA
| | - Maria Brooks
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Samar R El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Rebecca C Thurston
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Karen A Matthews
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elizabeth A Jackson
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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Abstract
OBJECTIVE The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience. METHODS Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change. RESULTS Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ(9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χΔ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT. CONCLUSIONS Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.
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Lange-Maia BS, Karvonen-Gutierrez CA, Strotmeyer ES, Avery EF, Appelhans BM, Fitzpatrick SL, Janssen I, Dugan SA, Kravitz HM. Factors Influencing Longitudinal Stair Climb Performance from Midlife to Early Late Life: The Study of Women's Health Across the Nation Chicago and Michigan Sites. J Nutr Health Aging 2019; 23:821-828. [PMID: 31641731 PMCID: PMC6818752 DOI: 10.1007/s12603-019-1254-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To quantify the longitudinal change in stair climb performance (a measure indicative of both physical function and muscle power), determine whether physical activity is related to slower decline in performance, and to identify factors that modify the longitudinal change in performance among women from midlife to late life. DESIGN Longitudinal cohort study with up to 15 study visits. SETTING Two sites of the Study of Women's Health Across the Nation. PARTICIPANTS Black (n=411) and white (N=419) women followed from median age 47.0 (44.6-49.6) to 62.0 (55.8-65.3) years. INTERVENTIONS N/A. MEASUREMENTS Performance on a stair climb test (ascend/descend 4 steps, 3 cycles) was timed. Physical activity (PA) was assessed using the Kaiser Physical Activity Survey (KPAS; possible range 0-15 points). Sociodemographic and health factors were assessed via self-report. BMI was calculated with measured height and weight. Mixed-effects regression modeled longitudinal change in stair climb performance. RESULTS Average baseline stair climb time was 18.12 seconds (95% CI: 17.83-18.41), with 0.98% (95% CI: 0.84%-1.11%) annual slowing. In fully adjusted models, higher levels of PA were associated with faster stair climb times (2.09% faster per point higher, 95% CI: -2.87%- -1.30%), and black women had 5.22% (95% CI: 2.43%-8.01%) slower performance compared to white women. Smoking, financial strain, diabetes, osteoarthritis, fair/poor health, and stroke were associated with 3.36% (95% CI: 0.07%-6.65%), 7.56% (95% CI: 4.75%-10.37%), 8.40% (95% CI: 2.89%-13.92%), 8.46% (95% CI: 5.12%-11.79%), 9.16% (95% CI: 4.72%-13.60%), and 16.94% (95% CI: 5.37%-28.51%) slower performance, respectively. In separate models, higher BMI (per 1-unit), osteoarthritis, fair/poor health, and diabetes, were each associated with 0.06% (95% CI:0.04%-0.08%), 0.48% (95% CI:0.12%-0.84%), 0.81% (95% CI:0.35%-1.28%), and 0.84% (95% CI:0.22%-1.46%), additional slowing per year over time. CONCLUSION Significant declines in function were evident as women transitioned from midlife to early late life. Declines were amplified by indicators of poor health, emphasizing the importance of health in midlife for promoting healthy aging.
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Affiliation(s)
- B S Lange-Maia
- Brittney Lange-Maia, PhD, MPH, 1700 W. Van Buren St., Suite 470, Chicago, IL 60612, Phone: 312-942-9697; Fax: 312-942-8119;
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Velez MP, Rosendaal N, Alvarado B, da Câmara S, Belanger E, Pirkle C. Age at natural menopause and physical function in older women from Albania, Brazil, Colombia and Canada: A life-course perspective. Maturitas 2018; 122:22-30. [PMID: 30797526 DOI: 10.1016/j.maturitas.2018.12.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/18/2018] [Accepted: 12/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Grip strength and gait speed are objective measures of physical function, which in turn is an indicator of biological aging. We evaluate the association between age at natural menopause (ANM) and physical functioning in a sample of postmenopausal women drawn from the International Mobility in Aging Study (IMIAS). STUDY DESIGN Retrospective cohort study of 775 women aged 65-74, from Albania, Brazil, Colombia and Canada, who had experienced natural menopause. MAIN OUTCOME MEASURES Gait speed and grip strength were obtained following standardized protocols. The association between self-reported ANM (<40, 40-44, 45-49, 50-54 and ≥55) and gait speed (m/s) and grip strength (kg) was assessed by linear regression analyses adjusting for several life-course economic and reproductive exposures, height, BMI and smoking. RESULTS Overall, women with ANM ≥ 55 had higher gait speed than those with ANM 50-54 (β = 0.05; 95%CI: 0.01, 0.10). Women with ANM < 40 had significantly lower grip strength compared with all other groups (β= -2.58; 95%CI: -4.43, -0.74). In region-specific analyses, ANM was associated with grip strength in Albania and Latin America and with gait speed in Albania only. No associations were observed in Canada. CONCLUSIONS ANM is associated with markers of physical functioning. Differences across study sites suggest that women in socially disadvantaged areas may reach menopause with different physiological reserves than those from more advantaged settings, leading to greater losses in muscle strength in postmenopausal years. More work comparing distinct populations is needed to better understand the underlying mechanisms.
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Affiliation(s)
- M P Velez
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Queen's University, Victory 4, 76 Stuart St., Kingston, ON, K7L 2V7, Canada; Department of Public Health Sciences, Queen's University, Carruthers Hall 2nd Floor, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada.
| | - N Rosendaal
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Queen's University, Victory 4, 76 Stuart St., Kingston, ON, K7L 2V7, Canada.
| | - B Alvarado
- Department of Public Health Sciences, Queen's University, Carruthers Hall 2nd Floor, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada.
| | - S da Câmara
- Faculty of Health Sciences of Trairí, Universidade Federal do Rio Grande do Norte, Rua Teodorico Bezerra, 2-122, Santa Cruz, RN, 59200-000, Brazil.
| | - E Belanger
- Center for Gerontology and Healthcare Research, Department of Health Services, Policy and Practice, School of Public Health, Brown University, 121 South Main Street, Providence, RI, 02903, USA.
| | - C Pirkle
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 E West Rd, Biomedical Bldg D104H, Honolulu, HI, 96822, USA.
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Dugan SA, Gabriel KP, Lange-Maia BS, Karvonen-Gutierrez C. Physical Activity and Physical Function: Moving and Aging. Obstet Gynecol Clin North Am 2018; 45:723-736. [PMID: 30401553 PMCID: PMC6226270 DOI: 10.1016/j.ogc.2018.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Evidence supports that the physical disablement process starts earlier than previously thought, in midlife when women still have many years to live. Physical activity participation and interventions have been successful in preventing disability in older adults and may be promising for maintaining function at younger ages. Changing the conversation to more relevant topics in midlife, like positive changes in body composition, sleep, and improved mood, may move the dial on participation, as midlife women do not meet guidelines for physical activity. Exploring the role of reproductive aging beyond chronologic aging may provide gender-specific insights on both disablement and participation.
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Affiliation(s)
- Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center, 1725 W. Harrison Street, Suite 885, Chicago, IL 60612, USA; Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA.
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Michael and Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA; Department of Women's Health, The University of Texas at Austin, Dell Medical School, Medical Park Tower, 1301 W. 38th Street, Suite 705, Austin, TX 78705, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA; Rush University Medical Center, Center for Community Health Equity, 600 S. Paulina Street, Suite 480, AAC, Chicago, IL 60612, USA
| | - Carrie Karvonen-Gutierrez
- Department of Epidemiology, University of Michigan, School of Public Health, 1415 Washington Heights, Room 6618, Ann Arbor, MI 48109-2029, USA
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Huang Y, Chatooah ND, Qi T, Wang G, Ma L, Ying Q, Lan Y, Song Y, Li C, Chu K, Chen P, Xu W, Wan H, Cai Y, Zhou J. Health-related quality of life and its associated factors in Chinese middle-aged women. Climacteric 2018; 21:483-490. [PMID: 29856658 DOI: 10.1080/13697137.2018.1476133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Y. Huang
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - N. D. Chatooah
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - T. Qi
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - G. Wang
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - L. Ma
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Q. Ying
- Zhejiang Cancer Institute, Zhejiang Cancer Hospital, Hangzhou, People’s Republic of China
| | - Y. Lan
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Y. Song
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - C. Li
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - K. Chu
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - P. Chen
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - W. Xu
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - H. Wan
- Maternal and Child Health & Family Planning Service Center, Gongshu District, Hangzhou, People’s Republic of China
| | - Y. Cai
- Maternal and Child Health & Family Planning Service Center, Gongshu District, Hangzhou, People’s Republic of China
| | - J. Zhou
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
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Fu XY, Chen HH, Zhang N, Ding MX, Qiu YE, Pan XM, Fang YS, Lin YP, Zheng Q, Wang WQ. Effects of chronic unpredictable mild stress on ovarian reserve in female rats: Feasibility analysis of a rat model of premature ovarian failure. Mol Med Rep 2018; 18:532-540. [PMID: 29749518 DOI: 10.3892/mmr.2018.8989] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/19/2018] [Indexed: 11/05/2022] Open
Abstract
Premature ovarian failure (POF) results from a number of disorders. The POF model is primarily based on chemotherapeutic injury, and hence is not suitable for assessing the effects of chronic stress on ovarian function. Therefore, improved animal models are required to analyze the effects of chronic stress on ovarian reserve. The feasibility of the chronic unpredictable mild stress (CUMS) method for establishing a model of POF was examined. The depressive behavior exhibited by rats was evaluated with the open field and sucrose preference tests. Vaginal smears were obtained for assessment of the estrous cycle. The ovarian reserve of the animals was evaluated using the estrous cycle, ovarian histology and serum levels of gonadotropin releasing hormone (GnRH), follicle‑stimulating hormone (FSH), estradiol (E2), and anti‑Müllerian hormone (AMH). Compared with the control group, body weight, time spent in the center, horizontal movement, vertical frequency, consumption of sucrose, sucrose preference, number of small follicles from the rats, and serum E2, AMH and GnRH levels were significantly decreased in the CUMS group (all P<0.05). However, the estrous cycle was prolonged significantly (P<0.05) and serum FSH levels were increased significantly (P<0.01). These results suggested that the CUMS model rats exhibited depression‑like behaviors. CUMS may induce psychological stress and decrease ovarian reserve in female rats. Thus, the CUMS model may be used to assess the effects of chronic stress on female reproductive function.
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Affiliation(s)
- Xiao-Yan Fu
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Hao-Hao Chen
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Ning Zhang
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Ming-Xing Ding
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Ying-Er Qiu
- Laboratory Animal Center, Jinhua Institute for Drug and Food Control, Jinhua, Zhejiang 321000, P.R. China
| | - Xiao-Ming Pan
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Yuan-Shu Fang
- Laboratory Animal Center, Jinhua Institute for Drug and Food Control, Jinhua, Zhejiang 321000, P.R. China
| | - Yi-Ping Lin
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Qun Zheng
- Center of Clinical Reproductive Medicine, Jinhua People's Hospital, Jinhua, Zhejiang 321000, P.R. China
| | - Wen-Qian Wang
- Department of Medical Sciences, Medical College, Jinhua College of Polytechnic, Jinhua, Zhejiang 321007, P.R. China
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Harville EW, Chen W, Guralnik J, Bazzano LA. Reproductive history and physical functioning in midlife: The Bogalusa Heart Study. Maturitas 2018; 109:26-31. [PMID: 29452778 DOI: 10.1016/j.maturitas.2017.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/30/2017] [Accepted: 12/06/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the relationship between reproductive history, pregnancy complications, and later physical function. STUDY DESIGN The Bogalusa Heart Study is a long-running study of cardiovascular health in a semirural community. 761 women were interviewed about their pregnancy history and complications, and underwent tests of physical function. Logistic models for dichotomous outcomes and linear models for continuous outcomes were used, adjusted for covariates. MAIN OUTCOME MEASURES Overall scores on the Short Physical Performance Battery (SPPB), which combines scores for balance, gait speed, and chair stands. Additional tests were a 6-min walk, knee extension strength, grip strength, and a pegboard challenge. RESULTS Nulliparity was associated with lower scores on the walking and balance portions of the SPPB, less distance covered in the 6-min walk, less knee and grip strength, and higher pegboard time, especially among pre-menopausal women. A history of gestational diabetes was associated with more problems on the walk portion of the SPPB (aOR 2.44, 1.06-5.65), higher chair stand time, and lower knee strength. Young age at first birth (<16 or 18 years) was associated with a shorter chair stand time and a better pegboard score. CONCLUSIONS Nulliparity was associated with worse physical functioning, while high parity and early pregnancy were not, suggesting that fertility is associated with better health later in life. Pregnancy complications were associated with worse physical functioning, even after controlling for body mass index. Future studies should attempt to establish the pathways by which reproductive health relates to overall physical functioning.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States.
| | - Wei Chen
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Jack Guralnik
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, United States
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
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Hysterectomy and perceived physical function in middle-aged Australian women: a 20-year population-based prospective cohort study. Qual Life Res 2018; 27:1501-1511. [PMID: 29450856 DOI: 10.1007/s11136-018-1812-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Hysterectomy is one of the most common gynaecological procedures worldwide. Changes in endocrine function may impact age-associated decline in physical function and these changes may be accelerated by hysterectomy. The aim of this study was to investigate associations between hysterectomy status and self-reported physical function limitations. METHODS Our study sample (n = 8624) came from the mid-cohort (born 1945-1950) of the Australian Longitudinal Study on Women's Health (ALSWH). Self-report of physical function was measured by the Physical Functioning (PF) subscale of the Medical Outcomes Study Short Form Health Survey (SF-36) over seven surveys (1998-2016), categorised into substantial, moderate and minimal PF-limitations. The associations between hysterectomy status and de novo substantial or moderate PF-limitations versus minimal PF-limitations were investigated using log-multinomial regression. RESULTS By Survey 8 (2016), 20% of the study sample had a hysterectomy with ovarian conservation (hysterectomy only) and 9% had a hysterectomy and both ovaries removed (hysterectomy-bilateral oophorectomy). Women with a hysterectomy only had a small increase in risk of substantial PF-limitations (versus minimal PF-limitations) compared to women with no hysterectomy (relative risk [RR]: 1.13; 95% confidence interval [95% CI] 1.00-1.27); the point estimate was stronger for women with a hysterectomy-bilateral oophorectomy (RR: 1.26; 95% CI 1.09-1.46). In a supplementary analysis, the increased risk of substantial PF-limitations was seen only in women who had surgery before the age of 45 years. CONCLUSIONS Compared to women with no hysterectomy, women with hysterectomy-bilateral oophorectomy were at increased risk of substantial PF-limitations versus minimal PF-limitations over 18 years of follow-up.
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Cortés YI, Catov JM, Brooks M, Harlow SD, Isasi CR, Jackson EA, Matthews KA, Thurston RC, Barinas-Mitchell E. History of Adverse Pregnancy Outcomes, Blood Pressure, and Subclinical Vascular Measures in Late Midlife: SWAN (Study of Women's Health Across the Nation). J Am Heart Assoc 2017; 7:e007138. [PMID: 29288157 PMCID: PMC5778964 DOI: 10.1161/jaha.117.007138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/30/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Adverse pregnancy outcomes, such as preterm birth (PTB), have been associated with elevated risk of maternal cardiovascular disease, but their effect on late midlife blood pressure (BP) and subclinical vascular measures remains understudied. METHODS AND RESULTS We conducted a cross-sectional analysis with 1220 multiethnic parous women enrolled in SWAN (Study of Women's Health Across the Nation) to evaluate the impact of self-reported history of adverse pregnancy outcomes (PTB, small-for-gestational-age, stillbirth), on maternal BP, mean arterial pressure, and subclinical vascular measures (carotid intima-media thickness, plaque, and pulse wave velocity) in late midlife. We also examined whether these associations were modified by race/ethnicity. Associations were tested in linear and logistic regression models adjusting for sociodemographics, reproductive factors, cardiovascular risk factors, and medications. Women were on average aged 60 years and 255 women reported a history of an adverse pregnancy outcome. In fully adjusted models, history of PTB was associated with higher BP (systolic: β=6.40; SE, 1.62 [P<0.0001] and diastolic: β=3.18; SE, 0.98 [P=0.001]) and mean arterial pressure (β=4.55; SE 1.13 [P<0.0001]). PTB was associated with lower intima-media thickness, but not after excluding women with prevalent hypertension. There were no significant associations with other subclinical vascular measures. CONCLUSIONS Findings suggest that history of PTB is associated with higher BP and mean arterial pressure in late midlife. Adverse pregnancy outcomes were not significantly related to subclinical cardiovascular disease when excluding women with prevalent hypertension. Future studies across the menopause transition may be important to assess the impact of adverse pregnancy outcomes on midlife progression of BP.
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Affiliation(s)
- Yamnia I Cortés
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Janet M Catov
- Departments of Obstetrics, Gynecology, and Reproductive Sciences and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Magee, Women's Research Institute, Pittsburgh, PA
| | - Maria Brooks
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Siobán D Harlow
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Elizabeth A Jackson
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health Systems, Ann Arbor, MI
| | - Karen A Matthews
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Rebecca C Thurston
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
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Sharifi N, Jalili L, Khazaeian S, Nia ASN. The Relationship between Physical Activity and General Health among Menopausal Women in Ahvaz, Iran. Electron Physician 2017; 9:3639-3645. [PMID: 28243418 PMCID: PMC5308506 DOI: 10.19082/3639] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 09/22/2016] [Indexed: 01/29/2023] Open
Abstract
Introduction Most women experience significant changes in their general health status during menopause, which negatively affects their quality of life. Physical activity has also been shown to enhance quality of life. However, little is known about the effect of physical activity on women’s health during the menopausal transition. This study aimed to determine the relationship between physical activity and general health among menopausal women in Ahvaz, Iran. Methods This cross sectional study was carried out on 600 menopausal women using cluster random sampling during 2013–2014. Data collection tools were three questionnaires; women’s demographic characteristics, the Goldenberg’s questionnaire, and International physical activity questionnaire (IPAQ). Data were analyzed using descriptive and inferential statistics through SPSS version 19. The statistical tests were performed at the 95% confidence interval. Results There was a significant relationship between the total score of physical activity and physical health, social functioning, anxiety and depression (p<0.05), but no significant relationship was found between subscales related to physical activity and general health (p>0.05). Conclusion Physical activity is effective in improving general health in menopausal women. Proper training and effective interventions for regular physical activity can be important steps to promote the general health of menopausal women.
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Affiliation(s)
- Nasibeh Sharifi
- M.Sc. of Midwifery, Menopause Research Center, Department of Midwifery, School of Nursing and Midwifery Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Lida Jalili
- M.Sc. of Midwifery, Menopause Research Center, Department of Midwifery, School of Nursing and Midwifery Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Somayeh Khazaeian
- M.Sc. of Midwifery, Pregnancy Health Research Center, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Anvar-Sadat Nayebi Nia
- M.Sc. of Midwifery, Faculty Member, Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University of Karaj, Karaj, Iran
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Sternfeld B, Colvin A, Stewart A, Dugan S, Nackers L, El Khoudary SR, Huang MH, Karvonen-Gutierrez C. The Effect of a Healthy Lifestyle on Future Physical Functioning in Midlife Women. Med Sci Sports Exerc 2017; 49:274-282. [PMID: 27669444 PMCID: PMC5271600 DOI: 10.1249/mss.0000000000001109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE This study aimed to examine the prospective association between healthy lifestyle behaviors and objectively measured physical function in midlife women. METHODS Participants included 1769 racially/ethnically diverse women, ages 56-68 yr, from the Study of Women's Health Across the Nation cohort. Physical function was assessed at the 13th follow-up visit with the Short Physical Performance Battery (4-m walk, repeated chair stands, and balance test) and grip strength. A healthy lifestyle score (HLS), which ranged from 0 to 6, was calculated by averaging as many as three repeated measures of self-reported smoking, physical activity, and diet, all assessed before the 13th follow-up. Multivariable linear and logistic regressions modeled each component of physical performance as a function of HLS and, in separate models, of each lifestyle behavior, adjusted for the other behaviors. RESULTS In multivariable analyses, the time for the 4-m walk was 0.06 s faster (P = 0.001) for every 1 point increase in the HLS. The time for the repeated chair stands was significantly shorter by approximately 0.20 s. Neither grip strength nor balance problems were significantly associated with the HLS (P = 0.28 and P = 0.19, respectively). The model examining the individual health behaviors showed that only physical activity was significantly associated with physical performance. CONCLUSION Regular physical activity in early midlife has the potential to reduce the likelihood of physical functional limitations later in midlife.
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Affiliation(s)
| | - Alicia Colvin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Andrea Stewart
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | | | | | | | - Mei-Hua Huang
- Division of Geriatrics, University of California Los Angeles, Los Angeles, CA
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Gibson CJ, Gray KE, Katon JG, Simpson TL, Lehavot K. Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans. Womens Health Issues 2016; 26:225-31. [DOI: 10.1016/j.whi.2015.09.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 10/22/2022]
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