Older Women Age Research Articles

Prevalence, pattern, and correlates of multimorbidity among adult and old aged women in India

Problem consideredThe health outcome of women is generally poor in India. Women are suffering from various chronic illness. So, this study seeks to assess the prevalence, pattern and correlates of multimorbidity among adult and old aged women in India. MethodsThe study used data from the second wave of the Study on Global AGEing and adult health (SAGE), conducted in 2015. The study employed cross-tabulation, Pearson’s chi-square test, and multivariate logistic regression analyses to assess the prevalence and correlates of multimorbidity among adult and old aged women in India. ResultsThe prevalence of multimorbidity among the women was 47.69%. The prevalence of back pain was highest among adult (18-59 years) and old-aged (60+ years) women. The risk of having multimorbidity significantly increases with age. Our study confirmed that all the 16 isolated chronic morbidities have considerable coherence with the types of multimorbidity. Variables like age, education, work status, perceived loneliness, and self-rated health were associated with multimorbidity. ConclusionsThe study suggests that the concern of multimorbidity among women in India should be prioritized with an integrated co-management approach in all diseases-specific programs to reduce and prevent the health burden in the country.

Cross-sectional analysis of the association between personal exposure to household air pollution and blood pressure in adult women: Evidence from the multi-country Household Air Pollution Intervention Network (HAPIN) trial

Elevated blood pressure (BP) is a leading risk factor for the global burden of disease. Household air pollution (HAP), resulting from the burning of biomass fuels, may be an important cause of elevated BP in resource-poor communities. We examined the exposure-response relationship of personal exposures to HAP —fine particulate matter (PM2.5), carbon monoxide (CO), and black carbon (BC) — with BP measures in women aged 40–79 years across four resource-poor settings in Guatemala, Peru, India and Rwanda. BP was obtained within a day of 24-h personal exposure measurements at baseline, when participants were using biomass for cooking. We used generalized additive models to characterize the shape of the association between BP and HAP, accounting for the interaction of personal exposures and age and adjusting for a priori identified confounders. A total of 418 women (mean age 52.2 ± 7.9 years) were included in this analysis. The interquartile range of exposures to PM2.5 was 42.9–139.5 μg/m3, BC was 6.4–16.1 μg/m3, and CO was 0.5–2.9 ppm. Both SBP and PP were positively associated with PM2.5 exposure in older aged women, achieving statistical significance around 60 years of age. The exact threshold varied by BP measure and PM2.5 exposures being compared. For example, SBP of women aged 65 years was on average 10.8 mm Hg (95% CI 1.0–20.6) higher at 232 μg/m3 of PM2.5 exposure (90th percentile) when compared to that of women of the same age with personal exposures of 10 μg/m3. PP in women aged 65 years was higher for exposures ≥90 μg/m3, with mean differences of 6.1 mm Hg (95% CI 1.8–10.5) and 9.2 mm Hg (95% CI 3.3–15.1) at 139 (75th percentile) and 232 μg/m3 (90th percentile) respectively, when compared to that of women of the same age with PM2.5 exposures of 10 μg/m3. Our findings suggest that reducing HAP exposures may help to reduce BP, particularly among older women.

Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial

ObjectiveTo examine the effects and mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization (IVF)-embryo transfer (ET).Design, setting, and participantsThis efficacy study was a multicenter, randomized, controlled clinical trial (RCT) in women receiving IVF-ET. The mechanistic study was a single-center RCT.InterventionsThe participants received TEAS vs. no TEAS treatment.Main outcome measuresIn the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined.ResultsUltimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, P = 0.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all P > 0.05) in the study population. In women > 35 years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (P = 0.004),30.8 vs. 13.9% (P = 0.001) and 34.0% vs. 19.7% (P = 0.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin α1β1/αVβ3, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls.ConclusionTEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity.Trial registrationChiCTR-TRC-13003950.

Gender-specific impact of cognitive impairment on all-cause mortality in older persons: A meta-analysis.

Gender-specific impact of cognitive impairment on survival in the general population remains controversial. The objective of this meta-analysis was to assess the gender difference in the impact of cognitive impairment on all-cause mortality in the general population. Two reviewers independently searched PubMed and Embase databases up to September 30, 2021 for cohort studies that reported gender-specific impact of cognitive impairment detected by the mini-mental state examination (MMSE) on all-cause mortality in elderly general population (aged ≥60years) in the same study. Nine articles reporting on 10 studies with a total of 52,134 individuals were included. The pooled multivariate-adjusted risk ratio (RR) of all-cause mortality associated with cognitive impairment compared with those without was 1.48 (95% confidence interval [CI] 1.36-1.61) in women and 1.34 (95% CI 1.24-1.44) in men, after adjusting for potential confounding. The pooled multivariate-adjusted female-to-male ratio of relative risk of all-cause mortality was 1.08 (95% CI 1.02-1.14) for individuals with cognitive impairment versus those without. Cognitive impairment detected by the MMSE is associated with an increased risk of all-cause mortality in older aged women than in men from the general population, even after adjusting sociodemographic factors. Compared with men with cognitive impairment, women with cognitive impairment had an 8% higher risk of all-cause mortality. These findings highlight the importance of early detection and management of cognitive impairment in older adults, particularly in women.

Factors Related to Physical Activity in Midlife and Old Women with Depression

Purpose: This study aimed to examine the effects of self-efficacy, social support, self-esteem, and depressive symptoms on physical activity in midlife and old-aged women with depression.Methods: Midlife and old women (<i>N</i>=83) diagnosed with depression were recruited from the psychiatry outpatient clinic in Seoul. Data were collected via self-report measures, and they were analyzed using descriptive statistics, Pearson correlation coefficients, and hierarchical multiple linear regression.Results: Physical activity had significant positive correlations with self-efficacy, social support, and self-esteem, and it had a significant negative correlation with depressive symptoms. In the hierarchical multiple regression model of physical activity (adjusted R<sup>2</sup>=.34, <i>p</i>=.003), self-efficacy (β=.47, <i>p</i><.001) and depressive symptoms (β=-.42, <i>p</i>=.003) were statistically significant.Conclusion: Self-efficacy and depressive symptoms are important factors influencing physical activity in midlife and old women with depression. To improve the physical activity of this population, nursing interventions should aim to promote self-efficacy and alleviate depressive symptoms.

Is Subjective Age Associated with Physical Fitness in Community-Dwelling Older Adults?

Although subjective age has been associated with a range of health-related outcomes, there has been little systematic study on the relationship between the subjective age and physical fitness in a given population. The purpose of this study was to determine the prospective association between subjective age and physical fitness in community-dwelling older adults. A sample of 276 older people who lived in the community was studied. Subjective age was measured by a face-to-face interview. Grip strength, balancing on one leg with eyes open, the 30 s chair stand test, 4 m habitual walk, and 6 min walk test were measured to reflect physical fitness. Results indicated that the felt younger older adults had a higher level of physical fitness compared to their felt older and felt the same counterparts. Multiple linear regression analysis indicated that all the measured physical fitness items were significantly associated with subjective age in older men. All of the measured physical fitness items except for the 4 m habitual walk were remarkably related to subjective age in older women. The findings suggest that subjective age is closely associated with physical fitness in community-dwelling older adults. Much attention should be paid to the promotion of physical fitness to improve the subjective age of older adults.

Effect of a Psychological Empowerment Program on Life Satisfaction and Attitudes Towards Aging in Older Women Living in Tehran, Iran

Background and Aim Old age is a critical period in life. Due to advances in technologies and improvement in healthy conditions, the number of aged population is increasing. Hence, it is necessary to pay attention to their life satisfaction and attitudes towards aging. The present study aims to assess the effectiveness of a psychological empowerment program on life satisfaction and attitude towards aging in older women living in Tehran, Iran. Methods & Materials The study population consists of all women aged 60-70 years referred to a charity foundation in Tehran, Iran in 2020. Of these, 24 women were selected by a convenience sampling method. They were randomly assigned to the intervention (n=12) and control (n=12) groups. Using a pre-test/post-test design, the elderly first completed the life satisfaction index-Z and the attitude towards aging questionnaire. Then, the experimental group received the psychological empowerment program at 8 sessions. After the intervention, the questionnaires were completed again by both groups. Multivariate analysis of covariance was used to analyze the collected data in SPSS software, version 19. Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1400.027). Results There was a significant difference in life satisfaction (F=9.673, P=0.006) and attitudes towards aging (F=8.385, P=0.009) between the two groups. The psychological empowerment program significantly improved life satisfaction and attitudes towards aging in older women. Conclusion The psychological empowerment program is effective in improving life satisfaction and attitude towards aging in older women living in Tehran. It can be used by experts in the fields of counseling, geriatrics, psychology, and health.

PD34-07 PREDICTORS OF SLINGS AFTER URETHRAL DIVERTICULECTOMY: A 5-YEAR LARGE POPULATION ANALYSIS

You have accessJournal of UrologyCME1 May 2022PD34-07 PREDICTORS OF SLINGS AFTER URETHRAL DIVERTICULECTOMY: A 5-YEAR LARGE POPULATION ANALYSIS Allison Sih, Seth Cohen, Fornati Bedell, Karyn Eilber, Victoria Scott, and Kai Dallas Allison SihAllison Sih More articles by this author , Seth CohenSeth Cohen More articles by this author , Fornati BedellFornati Bedell More articles by this author , Karyn EilberKaryn Eilber More articles by this author , Victoria ScottVictoria Scott More articles by this author , and Kai DallasKai Dallas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002585.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management of female urethral diverticula can be challenging and can result in stress urinary incontinence (SUI). Currently there is no consensus on management strategy to perform placement of a urethral sling concomitantly or at a delayed interval. In efforts to further elucidate this, we aimed to characterize those patients who went on to further surgical intervention for SUI after urethral diverticulectomy. METHODS: All women undergoing urethral diverticulectomy in California between January 2013 through December 2018 were identified using the Office of Statewide Health Planning and Development data sets (CPT 53230). Women who underwent a urethral sling procedure for SUI, either autologous fascial or synthetic, were identified from this cohort (CPT 57288). Women who had undergone concomitant sling at time of urethral diverticulectomy were excluded. Patient demographics such as age, race/ethnicity, payor type and comorbidities (diabetes mellitus, hypertension, obesity) were identified. Univariate (t-test and chi-square test) and multivariate analysis (multivariable logistic regression) were performed among the patient factors above and the risk of a future sling procedure. RESULTS: A total of 525 women (mean age 47.2 years) underwent a urethral diverticulectomy during this time period. Of these, 43 (8.2%) underwent a subsequent urethral sling. Limiting the analysis to women who had at least two years of follow up after diverticulectomy, this rate increased to 12.2%. Women of older age (51.6 vs. 41.9, p<0.001), and women with obesity (14.9% vs. 7.1%, p=0.024) were more likely to undergo a subsequent sling procedure. These effects were significant under multivariate analysis, controlling for all other factors. There was no significant effect of patient race or payor status on rates of subsequent sling procedure. CONCLUSIONS: The rate of SUI after treatment of urethral diverticulum for which patients subsequently underwent a urethral sling procedure is not insignificant (12.2% in those with at least two years of follow up). Given that some women with SUI will not elect for surgical intervention, this suggests that an even higher number of women have bothersome incontinence. Women of older age or with obesity have a higher rate of SUI necessitating surgical treatment. Consideration of these factors for sling placement at the time of urethral diverticulum repair may avoid secondary procedures. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e562 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allison Sih More articles by this author Seth Cohen More articles by this author Fornati Bedell More articles by this author Karyn Eilber More articles by this author Victoria Scott More articles by this author Kai Dallas More articles by this author Expand All Advertisement PDF DownloadLoading ...

The Course of Pregnancy and the Outcome of Childbirth in Women of Older Reproductive Age

The purpose of the study was to determine the frequency and structure of complications of pregnancy and childbirth in pregnant women of the older age group according to the history data. Materials and methods. We examined 90 pregnant women aged 35-44 years. The groups were divided as follows: the main group (I) consisted of 30 patients, the comparison group (group II) – 30 patients and the control group (group III) – 30 patients. All patients, according to the existing standards of obstetric examination, underwent clinical and laboratory tests. Randomization was carried out according to age, social factors, concomitant gynecological and extragenital diseases. For the study, a questionnaire was developed, which, along with the social characteristics of women (age, education level, marital status), included questions about women's employment, reproductive behavior, the presence of sexually transmitted diseases, and inflammatory diseases of the female genital organs. Results and discussion. In women of older reproductive age, the course of the gestational period is reliably more often complicated by gestosis – (40.0-46.7%), the threat of termination of pregnancy (36.7-5%), premature childbirth (26.7-33.3%). In childbirth, this contingent of women is more likely to have weakness in labor (10.0-13.3%). The results of the study show that in women of the main group, pregnancies ended with spontaneous abortions significantly more often – 9 (30%), the number of operative deliveries was significantly higher – 4 (13.3%), in the comparison group there were 9 (30%) and 2 (6.7%) such women, respectively. The main complaints in previous pregnancies were pain in the lumbar region and lower abdomen – 53.3% and 46.6% among pregnant women in the main group and the comparison group. Nausea and vomiting were observed in 9 (30%) and 8 (26.6%) women, respectively, in both groups, however, in the control group, the incidence of this complaint was also quite high (16.6%). In 5 (16.6%) and 7 (23.3%) women, bloodstroke from the in vitro fertilization was revealed. In all three groups, the most common complaint was neurovegetative symptoms: sleep disturbance (8-26.6%, 10-33.3% and 4-13.3%), and appetite disturbance (10-33.3%, 6.0-20%, 9-30%). Also, 5 (16.6%) pregnant women of the main group and 6 (20%) of the comparison group complained of increased blood pressure from 8-10 weeks of pregnancy. Pregnancy in patients aged 35 years and older should be classified as pathological already in the pregravid period. Conclusion. Thus, pregnant women aged 35 and older have an extremely unfavorable background from the obstetric-gynecological history and the frequency of abdominal delivery is by 2.5-3 times higher than in the control group

Association of ABO Blood Group, Age, Body Mass Index and Symptomatic COVID-19 Infection with Signal Levels of Antibodies to COVID-19

Objective: To determine if ABO blood group, age, body mass index (BMI), or symptomatic COVID-19 infection are associated with COVID-19 antibody response in unvaccinated COVID-19 antibody positive pregnant women at time of delivery. Methods: At the time of delivery, 2,499 consecutive pregnant women were tested for ABO blood group and antibodies to both the spike protein and nucleocapsid protein of the COVID-19 virus. The DiaSorin assay was used for antibody to spike protein analysis and the Roche assay for antibody to nucleocapsid protein. Gamma regression models with a log link were used to compare antibody signals, with blood group, age, and BMI as the predictors. Results: 260 (10.4%) of 2,499 women who had not been vaccinated for COVID-19, were positive for both spike and nucleocapsid protein antibodies to COVID-19. The mean signal for COVID-19 nucleocapsid antibody was significantly lower for blood group AB (p=0.028) compared with blood group O. A relationship between blood group and presence of symptomatic COVID-19 was detected (p = 0.028), with asymptomatic individuals having blood group B at a higher rate than the symptomatic individuals do. No other significant pairwise differences between blood groups were detected. There was no significant difference in signal level of antibodies to COVID-19 spike protein between any of the blood groups. Mean signals for antibodies to spike and nucleocapsid proteins were significantly higher in older women (p=0.001 for spike protein antibody and p=0.002 for nucleocapsid antibody). Significantly higher signal levels of antibody to spike and nucleocapsid proteins were found in women with class 2/3 obesity (p=0.022 and p=0.003, respectively). Conclusions: Pregnant women of AB blood group had lower antibody signal to nucleocapsid protein compared to the O blood group, and women of older age and greater BMI had higher antibody signal to COVID-19 spike and nucleocapsid proteins. There was a significant association between women with blood group B and asymptomatic infections.

A Life-Course Approach to the Relationship Between Education, Family Trajectory and Late-Life Loneliness Among Older Women in Europe

The aim of this study is to expand our knowledge about the factors that condition late-life loneliness from a longitudinal perspective. We assess the long-term relationship between education, late-life loneliness and family trajectories in terms of the role of partnership and motherhood, as well as their timing for older women. We set two initial hypotheses: (1) family trajectory has a mediating effect and (2) education has a selection effect. Cross-sectional and retrospective data are drawn from the three waves of the SHARE survey (3rd, 5th and 7th waves), selecting a subsample of women aged 65 and over from 11 European countries (N = 10,615). After distinguishing eight different family trajectories by carrying out a Sequence Analysis, the Karlson-Holm-Breen method is used to assess the mediator effect of family trajectory on the relationship between education and loneliness. Multinomial analysis is used to explore whether the probability of different family trajectories of older European women is defined by their level of education. Our results show that education has a selection effect on family trajectories: a higher educational level increases the probability of a non-standardised family trajectory. Significant results of the mediator effect of family trajectory are however only observed for women with medium-level education, as being single and childless at older ages increases the probability of loneliness among these women. Adopting a life-course perspective has permitted us to introduce the longitudinal dimensions of life events, education and family trajectories to the study of feelings of loneliness among women in old age.

POS-816 DE NOVO KIDNEY ALLOGRAFT RENAL CELL CARCINOMA: A RARE UNSALVAGEABLE CAUSE OF ALLOGRAFT LOSS IN A VERY LATE POST-TRANSPLANT PERIOD

Renal cell carcinoma (RCC) is a common malignancy in end-stage kidney disease (ESKD) from acquired cystic kidney disease (ACKD). With a net state of immunosuppression, kidney transplant recipients (KTR) are even at higher risk for RCC; however, RCC in the kidney allograft is uncommon unless it results from donor-derived disease. We report a case of old-aged woman with kidney allograft masses at the very late post-transplant period. Explanted transplant allograft revealed RCC.

Correlation Between Age and Hormone Receptor Status in Women With Breast Cancer.

IntroductionBreast cancer is a leading cause of death among women. This study aimed to evaluate the association between age and hormonal receptor status (HRS) in women with breast cancer presented at a public hospital in Karachi, Pakistan.MethodsA cross-sectional study was conducted at the Department of Medical Oncology, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan, from January 2021 to August 2021. All women of age more than 18 years with a confirmed diagnosis of breast cancer were included in the study using non-random consecutive sampling techniques. Women who underwent artificial menopause or hysterectomy, women who had chemotherapy-induced menopause, and pregnant women were excluded from the study. Data were collected from all patients regarding socio-demographics and tumor characteristics. Immunohistochemistry (IHC) was performed to evaluate the status of hormonal receptors.ResultsThe mean age at the time of presentation of females with breast cancer was 46.57±11.45 years. Among 317 females, 180 females had positive estrogen receptor (ER) expression (56.8%), 173 had positive progesterone receptor (PR) expression (54.6%), and 121 had positive human epidermal growth factor receptor 2 (HER2/neu) expression (38.2%). The highest proportions of positive ER (36.7%), PR (38.2%), and HER/2 neu (37.2%) expression were observed in the age group 41-50 years, respectively. There was a statistically significant association between age and ER expression (p=0.017) and age and PR expression (p=0.003) while no association was found between age and HER/2 neu expression (p=0.335). ConclusionThe present study indicated that the majority of the patients were diagnosed with breast cancer in their 40s. Most of the women in the younger age groups were estrogen receptor (ER), progesterone receptor (PR), and HER2/neu negative while the older aged women were more frequently ER, PR, and HER2/neu positive albeit, the association between age or HER2/neu was not significant. In short, we can expect that the older aged patients may have better survival rates and patient prognosis. However, this is just a conjecture and further large-scale, multicenter, and long-term studies are required to understand the true relationship between age and patient survival rates. We hope that the current study will serve as a catalyst for future breast-cancer related studies.

Hypertension and contraceptive use among women of child-bearing age in the United States from 2001 to 2018.

Hypertension (HTN) in pregnancy is a leading cause of maternal mortality in the United States. Contraception is widely used, and estrogen-based combined hormonal forms are known to increase blood pressure (BP). With nearly half of pregnancies unplanned and many antihypertensive medications teratogenic, appropriate contraception is critical in child-bearing age women with HTN. Using the National Health and Nutrition Examination Surveys (NHANES) from 2001 to 2018, we evaluated contraception and antihypertensive medication use in women of child-bearing age (20-50 years). Women who had undergone sterilization or menopause were excluded. HTN was defined based on a self-reported provider diagnosis and BP ≥130/80 mm Hg or antihypertensive medication use. Contraception included non-barrier methods (pills/patch/ring, injections, long-acting reversible contraceptives) or consistent condom use. Multivariable logistic regression was used to model the odds of contraception use. Temporal trends in contraception use were reported. Of the 8726 women, 12.4% had HTN with mean age (standard error) 36.0 (0.3) years. In women with HTN, 9.2% used non-barrier contraception and 10.4% used condoms only. Over half (52.7%) of women with HTN on antihypertensive medications were taking medications contraindicated in pregnancy, with no difference seen by contraceptive status. In logistic regression models, contraceptive use was lower in the older-aged women. In women with HTN on non-barrier contraception, combined hormonal contraceptive use declined, from 100% (2001-2006) to 81.4% (2013-2018, P < 0.001). Many women with self-reported HTN are not using adequate contraception. Of the small proportion on non-barrier contraceptives, the majority are using estrogen-based, BP-raising methods.

Возрастные изменения площади мозолистого тела человека

Objective: to carry out a comparative analysis of the area of the corpus callosum in men and women in adolescence, old age, and old age according to magnetic resonance imaging data. Material and methods. The results of magnetic resonance imaging studies of the brain of 138 patients (72 men and 66 women) were analyzed. The entire study material was divided into three groups. The first group included 44 adolescents (21 men and 23 women aged 16-21 years); the second group included 50 elderly people (27 men and 23 women aged 56-74 years); the third group included 44 seniors (24 men and 20 women aged 75-88 years). We determined the area of the corpus callosum in the sagittal projection along the midline. Results. The analysis of the results of the study revealed a tendency for the prevalence of cerebellar area parameters in boys and girls in comparison to the elderly and senile age representatives (p&gt;0.05). There was a tendency for prevalence of cerebral body area parameters in elderly subjects over elderly ones (p&gt;0.05). In all age groups there was a tendency for superiority of cerebral body area parameters in men compared to women (p&gt;0.05). Conclusion. The obtained results of the in vivo comparative analysis of the area of the corpus callosum in humans in adolescence, old age and senile age extend the scientific knowledge of its age-specific features. Thus, these data can serve as a benchmark of age-related anatomical norm in various instrumental examinations, such as magnetic resonance imaging and computed tomography, and provide a foundation for further clinical research.

Promoting healthy aging in older women: A call to action

Promoting healthy aging in older women: A call to action

Is a Low Intensity Walking Intervention Successful in Reducing Depression Symptoms in Middle to Older Age Women?

The current study sought to determine the influence of initial sleep quality and body mass index on the cognitive and mood outcomes of a community-based cardio-dance exercise program. Thirty-two older African Americans who participated in a five-month cardio-dance exercise program were propensity-matched to 32 no-contact controls (ages 60 to 88). Participants completed neuropsychological tests of attention, executive function, and memory and a self-reported depression measure at baseline and post-test. Among exercise participants, we observed significant improvements in depression (ηp2=.12, p=.009) and attention (ηp2=.12, p=.009) relative to controls. Improvements in executive function and attention were most pronounced among exercise participants with poor sleep quality (ηp2=.41, p=.04) and with obesity (ηp2 = .30, p=.001), respectively. This study provides novel evidence that cardio-dance exercise has the potential to improve depression in older African Americans. For those with poor sleep quality or obesity, exercise can also improve some cognitive outcomes.

Correlation of Metered Dose Inhaler Use Technique and Asthma Control Level in Asthma Patients at a Hospital in Bandung, West Java, Indonesia

Background: Asthma is still a major health problem in global population, including Indonesia. Antiasthma drugs available in various dosage forms, including inhaler. However, several problems related to inhalation route were found due to its unique device form and spesific use technique. One of the major problems related to inhalation route is inappropriate use technique of inhaler device, which could lead to treatment failure. Therapy outcome can be measured through Asthma Control Test (ACT). Objectives: This study was aimed to evaluate correlation between metered dose inhaler (MDI) use technique and asthma control level in patients. Material and Methods: A cross-sectional analytic study was conducted in May - June 2021. Thirty patients who met inclusion criteria were enrolled in this study. Patients’ MDI use technique and asthma control level were evaluated using a valid and standardized questionnaire. Statistics analysis was performed to determine the correlation between MDI use technique and asthma control level. Results: This study showed that most of asthmatic patients were women in older age, with mild asthma severity for more than 10 years. The most prevalent medication used was Fenoterol HBr, followed by salbutamol, and salmeterol/fluticasone combination. Inappropriate MDI use was found in 70,0% patients, with major problem found in patients’ breathing technique before and during MDI use. Asthma control test was performed and showed that 90,0% of asthmatic patients involved in this study have an uncontrolled asthma. Statistical analysis using Pearson product-moment correlation test showed a positive correlation between proper use of MDI and asthma control level (r=0.425, p&lt;0.05). Conclusions: Patient who properly use MDI may have a higher score in asthma control test, thus have a better control of asthma. This study emphasized pharmacist role as patient educator in ensuring appropriate inhaler use in order to achieve therapeutic goals.

December 2021 Stroke Highlights

December 2021 <i>Stroke</i> Highlights

Body Image and Sexual Function Improve after Both Myomectomy and Hysterectomy for Symptomatic Fibroids.

To determine the factors that influence the choice of myomectomy, uterine fibroid embolization (UFE), or hysterectomy in women with symptomatic uterine fibroids and to assess women's perception of body image and sexual functioning before and after treatment. In this prospective observational cohort pilot study, women scheduled to undergo hysterectomy, myomectomy, or UFE were surveyed before surgery and again at 3 to 6 months after their procedure to assess body image and sexual function using the validated 10-item Body Image Scale and 19-item Female Sexual Function Index. Logistic regression was used to determine predictive factors for surgery choice and paired t tests were used to determine changes in perceived sexual function and body image. Of the 71 women surveyed, 69 underwent their scheduled procedure and 68 participants completed the preoperative questionnaire completely (98%). A total of 33 participants completed the postoperative questionnaire (49%). The predictive factor for hysterectomy versus myomectomy/UFE was older age (odds ratio 1.13, P = 0.017, 95% confidence interval [CI] 1.02-1.24). Regardless of surgery type, there were significant improvements in perceived body image and sexual function, including an increase in the overall sexual satisfaction of the participant (mean difference 0.50, P = 0.021, 95% CI 0.92-0.08) and less likely to feel less sexually attractive because of their menstrual bleeding problem (P < 0.0001, 95% CI 0.637-1.675). Women of older age are more likely to choose hysterectomy over myomectomy or UFE for the treatment of symptomatic uterine fibroids. In addition, women who underwent any treatment for fibroids have increases in perception of body image and sexual functioning after their procedure.