Aging Women Research Articles

Effect of Rasayan Therapy in Post-Menopausal Geriatric Females: A Holistic and Conceptual Approach

Menopause is just puberty’s evil sister. Geriatric women are passing through various physiological changes of body like premenopausal symptoms, perimenopause and post menopause. Menopause is a normal physiologic process in ageing women. Although many women over age 65 have persistent menopausal symptoms, there are limited data to guide therapy among older women. Approximately 9-16% of women over the age of 65 continue to have menopausal symptoms and 13.7% of those women are using some form of menopausal hormone therapy (HT). In geriatric age cognitive disturbance, urinary symptoms, vasomotor symptoms, psychogenic symptoms, sexual dysfunction, mood changes etc. have been linked to hormonal changes and increasing age among females. These changes are generally due to disturbed Vata dosha and Dhatukhaya. In geriatric women it is better to balance aggravated doshas so that the intensity of these diseases will be far less. This can be restrained with the unique therapeutic method known as Rasayana chikitsa which minimize the intensity of problems occurring during this phase of life. The focus of the article is to describe the pathophysiologic symptoms related to menopausal transition and to review the effect of rasayana therapy in geriatric women with special care of menopausal symptoms. If implemented properly Rasayana can give a better result instead of hormonal replacement therapy.

The time is now: regular exercise maintains vascular health in ageing women.

Although ageing impairs cardiovascular health in both men and women, the timeline is different between the sexes. This is at least partially attributed to the loss of oestrogen in women at midlife, in connection with menopause. Oestrogen has protective effects on the cardiovascular system, and menopause consequently leads to a rapid and significant declineincardiovascularhealth. Notably, oestrogeninteracts with its nuclear and membrane receptors leading to changes in proteins of importance for cardiovascular health. Skeletal muscle activity, which affects the expression of many of the same proteins as oestrogen, could potentially counteract the loss of oestrogen at menopause. The hypothesis that exercise can counteract the loss of oestrogen has been explored in several recent studies. It has been found that regular physical activity opposes the detrimental effects not only of ageing, but also of the menopausal transition, on cardiovascular health. Although, vascular benefits can be gained at allages, initiating physical activity at or soon after menopause may be more effective than at a later time point in life. Intuitively, it is easier to prevent decrements than attempting to regain lost vascular health. This idea is supported by evidence at the molecular level, suggesting that exercise-inducedactivationoftheoestrogen-related receptor-α pathwayismoreeffectivesoonafter menopause compared tolater. Together, although a decline incardiovascular health due to chronological ageing cannot be completely prevented, a physically active lifestyle mitigates age-related cardiovascular impairments. Importantly, regular physical activity through life should always be addressed as the biological norm.

The Longer it is, the Closer One Feels: Perception of Emotional Closeness to the Partner, Relationship Duration, Sexual Activity, and Satisfaction in Married and Cohabiting Persons in Norway

This study explores the connection between relationship duration and feelings of closeness in Norwegian men and women, and the association with sexual satisfaction and activity. A sample of 4160 Norwegians aged 18–89 years was enrolled from a randomly selected web panel of 11,685 Norwegians. This study focused on participants who were married or cohabiting (1432 men, 1207 women). Closeness was the highest for men and women who had been with their partner for 0−6 years. However, among those who had been with their partner for 31 years or longer, men felt closer to their partners than women. Irrespective of relationship duration, the most important factor for both men and women’s perceived closeness with their partner was general sexual satisfaction. Among men who had lived with their partner for 7−20 years and 31 years or longer, having been monogamous in life was significantly associated with “inclusion of others in the self” (IOS). Further, closeness was associated with higher intercourse frequency, lower masturbation frequency, and satisfaction with genital appearance in men who had been with their partners for 31 years or more. Intercourse frequency was significantly associated with IOS in women who had been with their partner for 0−6 years. Furthermore, in women who had been with their partner for 31 years or more, satisfaction with their own weight was important for IOS. In conclusion, men and women reported similar degrees and patterns of IOS up to the point where they had been in their relationship for more than 30 years. Thereafter, women reported feeling less close to their partners, while men’s feelings of closeness increased. This may be related to physiological, psychological, and social changes in the lives of aging men and women.

The association between diabetes type, age of onset, and age at natural menopause: a retrospective cohort study using the Canadian Longitudinal Study on Aging.

With growing incidence of type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes, more women are expected to spend a larger proportion of their reproductive years living with a diabetes diagnosis. It is important to understand the long-term implications of premenopausal diabetes type on women's reproductive health including their age at natural menopause (ANM). Baseline data from the Comprehensive Cohort of Canadian Longitudinal Study on Aging were used. Females who reported premenopausal diagnosis of diabetes were considered exposed. Kaplan-Meier cumulative survivorship estimates and multivariable Cox regression models were used to assess the association between diabetes types and ANM. Sociodemographic, lifestyle, and premenopausal clinical factors were adjusted in the final model as covariates. The sample comprised 11,436 participants, weighted to represent 1,474,412Canadian females aged 45 to 85 years. The median ANM was 52 years. After adjusting for ethnicity, education, smoking, and premenopausal clinical factors, early age of diagnosis of both T1D (<30 years) and T2D (30-39 years) were associated with earlier menopause (T1D, <30: hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.05-2.28; T2D, 30-39: HR, 1.82; 95% CI, 1.12-2.94), as compared with nondiabetics. In addition, later age of diagnosis of T2D (≥40 years) was associated with later ANM (T2D: HR, 0.63; 95% CI, 0.50-0.80). No significant association between gestational diabetes and ANM was noted. Our results point to early menopause among young women living with a diabetes diagnosis. These findings should allow for more focused research geared toward understanding the long-term health implications of diabetes on women's reproductive health and aging.

Reproduction, skin aging, and sleep in middle-aged women.

There is a growing trend for women to delay having children, with a significant number of women postponing motherhood until the third or fourth decade of life. At the same time, these middle-aged women may be more concerned about skin aging and use dermatologic procedures to delay or repair the effects of aging, environmental factors, and oxidative stress on the skin. It has been suggested that the use of skin cosmetics and procedures may play a role in the reproductive system, although their possible effects have not yet been clearly elucidated. Another crucial factor that needs to be raised in this context is poor sleep, which seems to have an important relationship with both reduced fertility and accelerated skin aging, especially when it is associated with greater oxidative stress and hormonal imbalance. This review discusses the important triad of sleep, dermatology, and reproduction, a subject that has received relatively little attention; and, given its potentially wide-ranging implications, one that deserves more frequent and detailed consideration in future studies. Understanding this complex web of interactions could help to provide outcomes that include healthier skin, safety, improved self-esteem, and successful fertility treatments, all of which can directly affect quality of life.

ETAPAS DO ENVELHECIMENTO REPRODUTIVO: EFEITOS NOS NÍVEIS DE ADIPOSIDADE, ATIVIDADE FÍSICA E VISITA À NATUREZA

Introduction: Menopause marks an extensive period of hormonal changes in women. Estrogen depletion, combined with the aging process, increases fat mass, particularly intra-abdominal fat, and generates a decrease in muscle and bone mass, affecting women's usual levels of physical activity (PA) and compromising their quality of life. Exposure to the natural environment confers numerous health benefits, however, much remains unknown about the differences in the nature visits according to a woman's reproductive stages, and often PA levels are measured through questionnaires. Purpose: This study analyzed the variation of adiposity levels, PA and nature visits according to the stages of reproductive aging in women. Methods In this cross-sectional study, women aged 18 to 75 were categorized in the reproductive age (G1, n=94), menopausal transition (G2, n=12) and postmenopause (G3, n=36), considering the reproductive aging stages described in STRAW +10. Fat mass (FM, %) and visceral fat area (VFA) were assessed by octopolar bioimpedance (InBody 720). Physical activity (moderate-vigorous and steps/day) was measured using ActiGraph accelerometers (wGT3X-BT) and nature visits were assessed through a questionnaire. Analyses of variance were used to analyze the data. Some transformations of the variables were conducted, to normalize their distribution (moderate-vigorous PA) or to improve their asymmetry (VFA and nature visits). The standard significance level was set a p ≤0.05. Results: A higher percentage of women with obesity (%FM and VFA) and non-recommended levels of moderate-vigorous PA were recorded in group 3 (77.8%, 83.3%, and 72.2% respectively). Half of the women in G2 had high levels of total and central adiposity and levels of MVPA &amp;lt;150 minutes/week. Our results showed that women in G1 had lower percentage (p 0.01) FM values (28.24%) than those exhibited by women in G2 (34.25%) and G3 (36.55%), with 24% of the relative fat mass variation explained by the reproductive aging stages. For a type I error &amp;lt;0.05, there was a greater than 99% probability that percentage FM values varied with reproductive aging stages. The variation of VFA was also explained by reproductive aging stages by 46%, and differences (p &amp;lt;0.01) were identified between groups G1-G2 and G1-G3. Our results further documented that with reproductive aging, there is a decrease in moderate-vigorous PA levels, and differences (p &amp;lt;0.01) were observed between G1-G3. No differences were observed between reproductive stages for steps/day (p &amp;gt;0.05) and nature visits (p =0.17). Conclusions: Our results suggest that postmenopausal women evidence increased levels of total and central adiposity and simultaneously, limited levels of physical activity compared to women in the reproductive phase. These findings underline the need to implement PA programs oriented to weight control and to encourage the regular practice of PA adjusted to the needs evidenced by these women, contributing to a better quality of life for them. Funding: This work is supported by National Funds by FCT-Portuguese Foundation for Science and Technology, under the projects UIDB/04033/2020, UID04045/2020 and UIDB/00073/2020. The investigation was also supported by European funding program Interreg Atlantic Area, under the project (EAPA_772/2018-Triple-C).

Sex-specific and hormone-related differences in vascular remodelling in atherosclerosis.

Atherosclerosis, a lipid-driven inflammatory disease, is the main underlying cause of cardiovascular diseases (CVDs) both in men and women. Sex-related dimorphisms regarding CVDs and atherosclerosis were observed since more than a decade ago. Inflammatory mediators such as cytokines, but also endothelial dysfunction, vascular smooth muscle cell migration and proliferation lead to vascular remodelling but are differentially affected by sex. Each year a greater number of men die of CVDs compared with women and are also affected by CVDs at an earlier age (40-70 years old) while women develop atherosclerosis-related complications mainly after menopause (60+ years). The exact biological reasons behind this discrepancy are still not well-understood. From the numerous animal studies on atherosclerosis, only a few include both sexes and even less investigate and highlight the sex-specific differences that may arise. Endogenous sex hormones such as testosterone and oestrogen modulate the atherosclerotic plaque composition and the frequency of such plaques. In men, testosterone seems to act like a double-edged sword as its decrease with ageing correlates with an increased risk of atherosclerotic CVDs, while testosterone is also reported to promote inflammatory immune cell recruitment into the atherosclerotic plaque. In premenopausal women, oestrogen exerts anti-atherosclerotic effects, which decline together with its level after menopause resulting in increased CVD risk in ageing women. However, the interplay of sex hormones, sex-specific immune responses and other sex-related factors is still incompletely understood. This review highlights reported sex differences in atherosclerotic vascular remodelling and the role of endogenous sex hormones in this process.

Age-associated thin hair displays molecular, structural and mechanical characteristic changes

Hair thinning occurs during normal chronological aging in women and in men leading to an increased level of thinner hair shafts alongside original thicker shafts. However, the characteristics of age-associated thin hairs remain largely unknown. Here we analyzed these characteristics by comparing at multiscale thin and thick hairs originated from Caucasian women older than 50 years. We observed that the cortex of thick hair contains many K35(+)/K38(−) keratinocytes that decrease in number with decreasing hair diameter. Accordingly, X-ray diffraction revealed differences supporting that thin and thick hairs are different with regards to the nature of the intermediate filaments making up their cortices. In addition, we observed a direct correlation between hair ellipticity and diameter with thin hairs having an unexpected round shape compared to the elliptic shape of thick hairs. We also observed fewer cuticle layers and a reduced frequency of a medullae in thin hairs. Regarding mechanical properties, thin hairs exhibited a surprising increased rigidity, a decrease of the viscosity and a decrease of the water diffusion coefficient. Hence, aged-associated thin hairs exhibit numerous modifications likely due to changes of hair differentiation program as evidenced by the modulations in the expression of hair keratins and keratin-associated proteins and by the X-ray diffraction specters. Hence, hair thinning with age does not consist simply of the production of a smaller hair. It is rather a more profound process likely relying on the implementation of an “aged hair program” that takes place within the hair follicle.

Sex- and age-related differences in body composition of healthy aging men and women

article: Sex- and age-related differences in body composition of healthy aging men and women - Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2022 June;181(6):393-401 - Minerva Medica - Journals

Polycystic Ovarian Syndrome in Aging Women: An Observational Study.

Background: Polycystic ovarian syndrome (PCOS) in aging women has not been extensively studied, although it is a very common disorder. Most of the research has been conducted on women of the reproductive age group, although PCOS is a disease occurring in all age groups. This study aims to provide an idea of the PCOS pattern prevalent in aging women presenting at a tertiary care center in Eastern India.Methods: This was a prospective, single-center, observational cohort study conducted over three years, from October 2016 to September 2019. A total of 36 patients between 35 and 65 years of age were found to have PCOS according to Rotterdam’s criteria during this period. These patients were prospectively followed up to study their demographic characteristics, symptoms, management, and outcomes.Results: A total of 80% of the women were below 40 years of age, while only 20% were above 40. In total, 70% of the women were overweight or obese. Infertility was seen in 75% of patients below 40 years of age and 28% of patients above 40. Among these, 23 (95%) conceived successfully after proper management. The main presenting complaints were infertility and menstrual irregularities. With aging, diabetes increased from 24%, in below 40, to 28%, in above 40; hypertension increased from 13% to 28%. The occurrence of impaired oral glucose tolerance test (OGTT) and impaired lipid profile increased with age: from 48% to 57% and 13% to 28%, respectively.Conclusion: PCOS in aging women causes considerable morbidity and greatly affects the quality of life, although it is less understood. Further research in this field is very much needed to understand and appropriately manage the problems in aging women, to improve their quality of life.

Impact of Balance Training on Fear of Falling and Fall Rate in Older Women

Background: Fear of falling is one of the factors that threaten the quality of life in old age and increases the risk of falling by limiting physical activity. The purpose of this study was to investigate the effect of balance training on the efficacy of fear of falling and the rate of falling in older women. Methods: In this randomized controlled trial, 70 aging women with a fear of falling were selected and randomly assigned to experimental (n=35) and control (n=35) groups. The intervention group received 10 sessions of 1-hour balance exercise, along with training in falling prevention strategies, but the control group received only routine care. Data were collected using the Falls Efficacy Scale-International questionnaire and the new elderly health services package of the Ministry of Health of Iran. Fear of falling was evaluated as the primary outcome 1 month and 3 months after balance training, and frequency of falling was assessed as a secondary outcome one year after the intervention. Data were analyzed by ANOVA, independent t test, and paired t test. Results: The results showed that the mean score of fear of falling in the experimental group was significantly lower than in the control group 1 month (P = 0.005) and 3 months (P &lt; 0.001) after balance training. The mean score of fear of falling in the control group represented no significant difference between the three times (P = 0.64). Finally, one year after the balance training, the frequency of falling in the experimental group was significantly lower in comparison to the control group (P = 0.035). Conclusion: A balance training program is recommended as a preventive approach for reducing the frequency of falling in older women.

Global burden and trends of pelvic organ prolapse associated with aging women: An observational trend study from 1990 to 2019.

PurposeWorldwide, about 40% of women will experience pelvic organ prolapse (POP), and this proportion is expected to increase with the aging of the population. We investigated the global, regional and national influenza burden in the past 30 years through the age and sociodemographic index (SDI).Patients and methodsData were extracted from the Global Burden of Disease (GBD) 2019 database for 195 countries and territories between 1990 and 2019. Estimated annual percentage changes (EAPCs) were used to explore the age-standardized incidence rate (ASIR) and age-standardized disability adjusted life years (AS-DALYs) trends, and the corresponding 95% uncertainty intervals (UI). In addition, the time cut-off points of 1990 and 2019 were used to separately analyze the incidence rate and DALYs.ResultsIn 2019, the global ASIR and AS-DALYs for POP were 316.19 (95%UI: 259.84–381.84) and 10.37 (95%UI: 5.79–17.99) per 100,000 population, respectively. Moreover, from 1990 to 2019, the ASR of both showed a downward trend, and EAPCs were −0.46 (95%CI: −0.52 to −0.4) and −0.53 (95%CI: −0.58 to −0.47), respectively. In addition, DALYs of POP also showed a downward trend in most regions and countries with high SDI. From 1990 to 2019, the global incidence rate and DALYs rate were highest in the 65–75 and ≥60 age groups, respectively.ConclusionOver the past three decades, the incidence and DALY of POP have been decreasing from 1990 to 2019. However, POP remains a major health problem, especially among females in less developed countries. Primary and secondary prevention measures of POP should be integrated into the practice of healthcare professionals dealing with aging women.

The pathophysiology of osteoporosis in obesity and type 2 diabetes in aging women and men: The mechanisms and roles of increased bone marrow adiposity.

Osteoporosis is defined as a systemic skeletal disease characterized by decreased bone mass and micro-architectural deterioration leading to increased fracture risk. Osteoporosis incidence increases with age in both post-menopausal women and aging men. Among other important contributing factors to bone fragility observed in osteoporosis, that also affect the elderly population, are metabolic disturbances observed in obesity and Type 2 Diabetes (T2D). These metabolic complications are associated with impaired bone homeostasis and a higher fracture risk. Expansion of the Bone Marrow Adipose Tissue (BMAT), at the expense of decreased bone formation, is thought to be one of the key pathogenic mechanisms underlying osteoporosis and bone fragility in obesity and T2D. Our review provides a summary of mechanisms behind increased Bone Marrow Adiposity (BMA) during aging and highlights the pre-clinical and clinical studies connecting obesity and T2D, to BMA and bone fragility in aging osteoporotic women and men.

The Role of PEDF in Reproductive Aging of the Ovary.

Reproductive aging is characterized by a decline in ovarian function and in oocytes’ quantity and quality. Pigment epithelium-derived factor (PEDF), a pivotal player in ovarian angiogenic and oxidative balance, was evaluated for its involvement in reproductive aging. Our work examines the initial stage of reproductive aging in women and mice, and the involvement of PEDF in the process. Granulosa cells from reproductively-aged (RA) women and mice (36–44 years old and 9–10 months old, respectively) indicated an increase in the level of PEDF mRNA (qPCR), with yet unchanged levels of AMH and FSHR mRNAs. However, the PEDF protein level in individual women showed an intra-cellular decrease (ELISA), along with a decrease in the corresponding follicular fluid, which reflects the secreted fraction of the protein. The in vitro maturation (IVM) rate in the oocytes of RA mice was lower compared with the oocytes of young mice, demonstrated by a reduced polar body extrusion (PBE) rate. The supplementation of PEDF improved the hampered PBE rate, manifested by a higher number of energetically-competent oocytes (ATP concentration and mtDNA copy number of individual oocytes). Our findings propose PEDF as an early marker of reproductive aging, and a possible therapeutic in vitro agent that could enhance the number of good-quality oocytes in older IVF patients.

Lifetime discrimination in low to middle income mothers and cellular aging: A prospective analysis

BackgroundExperiences of discrimination on the basis of race, ethnicity, and other characteristics are associated with adverse health outcomes, including elevated rates of morbidity in later life and earlier mortality. Acceleration of biological aging is a plausible pathway linking discrimination to disease risk. The objective of this study was to examine the relationship of self-reported lifetime and everyday discrimination to women's telomere length several years after birth of a child in a longitudinal cohort study. MethodsThe Community Child Health Network (CCHN) conducted a community-based participatory research project focused on racial, ethnic, and socioeconomic disparities in maternal and child health. Data for the current substudy are from a longitudinal cohort study in 3 of the 5 project sites. This multi-site community-based longitudinal study was conducted in Lake County, IL north of Chicago, Washington, D.C., and rural North Carolina. Participants were low to middle-income mothers (N = 103) with a primary identity of Hispanic/Latina, Black, or non-Hispanic White who rated their experience of everyday and lifetime discrimination during an at-home interview one-month postpartum. Buccal samples were collected to assay buccal cell telomere length several years later when a consecutive child was 3–5 years of age. Telomere length derived from buccal cells was used as a biomarker indicating cellular aging and a risk factor for age-related disease. ResultsMothers (18–39 years old) who reported higher lifetime discrimination had shorter telomere length an average of 5.6 years later (B = −0.22 [SE = 0.04], p < 0.001). Mother's reports of everyday discrimination were not significantly related to telomere length (0.01[0.01], p = 0.15). ConclusionsThese findings suggest that lifetime exposure to discrimination, but not necessarily current reports of everyday discrimination, may increase biological aging as indicated by shorter buccal cell telomere length, providing evidence of a plausible route through which discrimination contributes to increased risk for earlier onset aging and age-related disease in women.

The medieval biological clock? Gendered reproductive aging in medieval western medicine

This paper examines discussions of women's and men's reproductive aging in a series of western European medical texts written in the period 1100–1300. It uses the modern image of the biological clock to explore how far physicians in earlier periods understood reproductive aging to be a process of slow decline before a final age at which fertility ended (menopause for women, or a less defined ‘old age’ for men), and how far they viewed women's reproductive aging as different from men's. The article argues that, in contrast to modern medical and popular understandings, medieval physicians assumed men and women were broadly fertile up to a final cut-off point, and had little interest in viewing age-related fertility decline as a slow process beginning well before menopause. This was true in part because there was no realistic prospect of treatment for age-related reproductive disorders. The article also argues that in many respects – although not all – medieval writers viewed men's and women's reproductive aging as similar processes. Overall the model of reproductive aging they offered was flexible and offered room for individual variation. In this way the article demonstrates how changing understandings of the body, reproduction, and aging, demographic and social change, and changing medical treatments influence concepts of reproductive aging.

Lower Subendocardial Viability Ratio With Aging In Women Is Dependent On Cardiorespiratory Fitness

Lower Subendocardial Viability Ratio With Aging In Women Is Dependent On Cardiorespiratory Fitness

OC14.02: *The EVA study: outlining early vascular aging in women with history of pre‐eclampsia

OC14.02: *The EVA study: outlining early vascular aging in women with history of pre‐eclampsia

Abstract P102: A History Of Preeclampsia Is Associated With Accelerated Aging And Multimorbidity Later In Life

Background: Preeclampsia (PE) is a pregnancy-specific hypertensive disorder which affects up to 7% of all pregnancies. It is associated with increased risk for cardiovascular disease later in life. We have recently reported increased senescence and accelerated aging in women with PE. We hypothesize that senescence burden remains after PE. The aim of this study was to compare senescence profiles, and history of individual chronic conditions and multimorbidity, a marker of accelerated aging, in women with and without a history of PE. Methods: Forty women with histories of PE and 40 with histories of normotensive pregnancy confirmed by manual chart review were age- and parity-matched. None of the women had a history of CVD at the time of recruitment. Markers of senescence (p16, p21 and Klotho) and metabolic syndrome (leptin, adiponectin) were measured and compared between women with and without histories of preeclampsia using conditional logistic regression. The rates of chronic conditions and multimorbidity between the groups were also compared. Results: Urinary Klotho/creatinine levels were significantly lower (median [IQR]: 117 [87.4, 224] vs. 205 [101, 359], respectively, p=0.042), while leptin/adiponectin ratio was significantly higher (median [IQR]: 0.25 [0.13, 0.45] vs. 0.05 [0.02, 0.12], p=0.027) among women with histories of PE compared to controls. There were no significant differences observed in plasma p21 or p16 concentrations. Women with histories of PE experienced a higher prevalence of two or more co-morbidities compared to women with normotensive pregnancies [67.5% (27/40) vs. 22.5% (9/40), p&lt;0.05]. Results were similar after removing hypertension as a comorbidity [45% (18/40) vs. 20.0% (8/40), p&lt;0.05]. Conclusion: Women with a history of PE had altered markers of senescence, metabolic syndrome and multimorbidity decades after PE.

Urinary Levels of miR-491-5p and miR-592 as Potential Diagnostic Biomarkers in Female Aging Patients with OAB: A Pilot Study

Women with overactive bladder syndrome (OAB) have a lower urinary ratio of nerve growth factor (NGF) to its precursor (proNGF) compared to healthy controls. MicroRNAs related to NGF and proNGF metabolism and to their receptors may be present in urine and may possess diagnostic value. Urine and blood samples from 20 control and 20 OAB women (50–80 years) were obtained, together with validated questionnaires and other clinical parameters. The relative expression of urinary microRNAs was measured with RT-qPCR. MiR-491-5p, which negatively controls the translation of the matrix metalloproteinase-9 (MMP-9), the main enzyme degrading NGF, was significantly decreased in OAB. Similarly, miR-592, which represses p75NTR receptor synthesis, was down-regulated in OAB. Age, renal function and insulin resistance did not affect these results. ROC curves confirmed the high sensitivity of miR-491-5p and miR-592 for diagnosis. On the other hand, miRNAs involved in the expression of proNGF, of survival receptor TrkA and of markers of nerve integrity were similar between groups. The detection of miR-491-5p and miR-592 in urine could be a useful and non-invasive tool for the diagnosis of OAB syndrome in aging women.