Old Caucasian Woman Research Articles

Much lower prevalence and severity of spine degenerative changes among older Chinese women than among older Caucasian women and its implication for the interpretation of lumbar spine BMD T-score for Chinese women.

The prevalence and severity of spine degenerative changes have been noted to be lower among older Chinese women than among older Caucasian women. Spine degenerative changes associated with marginal osteophytosis, trabecular thickening, subchondral sclerosis, facet joint arthrosis, and disc space narrowing can all lead to artificially higher spine areal bone mineral density (BMD). The lower prevalence and severity of spine degeneration have important implications for the interpretation of spine areal BMD reading for Chinese women. With fewer contributions from spine degenerative changes, following natural aging, the declines of population group means of spine BMD and T-score are faster for Chinese women than for Caucasian women. While a cutpoint T-score ≤ -2.5 for defining spine densitometric osteoporosis is recommended for Caucasian women, for Chinese women the same cutpoint T-score of ≤ -2.5 inflates the estimated osteoporosis prevalence based on spine BMD measure. In addition to the use of an ethnicity-specific BMD reference database, a stricter cutpoint T-score for defining spine densitometric osteoporosis among older Chinese women should be applied.

Small Doses of Lorazepam Given at 3:30AM and at Bedtime Significantly Decrease early Morning Malignant Blood Pressure Spikes in Patients 65 Years and Older

This study builds upon a 9 year daily case study of a 71-80 year old Caucasian woman who documented at least 6 daily blood pressure readings per day, with a focus on the early morning malignant blood pressure spikes and the variety of blood pressure medications given to her by various physicians in several states. The documentation included time of day, duration of spike, and her perseverance in finding a prophylactic that ended these spikes. The pathophysiology of early morning malignant blood pressure spikes is not completely understood, but the primary cause of malignant blood pressure spikes in the morning may be a misdirected activation of the sympathetic nervous system due to a genetic mutation or deterioration due to age. There are contradictory opinions on the percentage of the elderly experiencing these spikes. Some research reports that these spikes are rare and usually found in men, African Americans and the poor. Other reports contradict these findings and state that malignant early morning spikes are common, but patients are not aware of them. All agree, however, that these early morning malignant spikes had a significant increased risk of cardio vascular event, stroke, heart attacks and death. This study was conducted because the older woman researched was knowledgeable about the human body [studied science, anatomy and physiology, and was a competitive athlete in her youth]. She was trained to know her body and could easily identify when the spikes began in early morning, timed the amount of time blood pressure went from normal to very high [2 minutes], and measured time it took for blood pressure to return to normal. Her way of coping with the 9 years of these stressful spikes was to conduct a research project and hopefully be able to help other senior citizens prolong their own lives.

Associations of combined genetic and epigenetic scores with muscle size and muscle strength: a pilot study in older women.

BackgroundInter‐individual variance in skeletal muscle is closely related to genetic architecture and epigenetic regulation. Studies have examined genetic and epigenetic relationships with characteristics of ageing muscle separately, while no study has combined both genetic and epigenetic profiles in ageing muscle research. The aim of this study was to evaluate the association between combined genetic and methylation scores and skeletal muscle phenotypes in older women.MethodsForty‐eight older Caucasian women (aged 65–79 years) were included in this study. Biceps brachii thickness and vastus lateralis anatomical cross‐sectional area (ACSAVL) were measured by ultrasonography. Maximum isometric elbow flexion (MVCEF) and knee extension (MVCKE) torques were measured by a customized dynamometer. The muscle‐driven genetic predisposition score (GPSSNP) was calculated based on seven muscle‐related single nucleotide polymorphisms (SNPs). DNA methylation levels of whole blood samples were analysed using Infinium MethylationEPIC BeadChip arrays. The DNA methylation score was calculated as a weighted sum of methylation levels of sarcopenia‐driven CpG sites (MSSAR) or an overall gene‐wise methylation score (MSSNP, the mean methylation level of CpG sites located in muscle‐related genes). Linear regression models were built to study genetic and epigenetic associations with muscle size and strength. Three models were built with both genetic and methylation scores: (1) MSSAR + GPSSNP, (2) MSSNP + GPSSNP, and (3) gene‐wise combined scores which were calculated as the ratio of the SNP score to the mean methylation level of promoters in the corresponding gene. Additional models with only a genetic or methylation score were also built. All models were adjusted for age and BMI.ResultsMSSAR was negatively associated with ACSAVL, MVCEF, and MVCKE and explained 10.1%, 35.5%, and 40.1% of the variance, respectively. MSSAR explained more variance in these muscular phenotypes than GPSSNP, MSSNP, and models including both genetic and methylation scores. MSSNP and GPSSNP accounted for less than 8% and 5% of the variance in all muscular phenotypes, respectively. The genotype and methylation level of CNTF was positively related to MVCKE (P = 0.03) and explained 12.2% of the variance. The adjusted R 2 and Akaike information criterion showed that models with only a MSSAR performed the best in explaining inter‐individual variance in muscular phenotypes.ConclusionsOur results improve the understanding of inter‐individual variance in muscular characteristics of older women and suggest a possible application of a sarcopenia‐driven methylation score to muscle strength estimation in older women while the combination with a genetic score still needs to be further studied.

Vitamin D, muscle strength and physical function in UK South Asian older women

AbstractA positive association has been reported between vitamin D status, muscle strength and physical function in older Caucasian women. However, little is known about this relationship in UK South Asian older women. This cross-sectional study aimed to explore the association between vitamin D status, muscle strength and physical function in UK South Asian (Pakistani and Indian) older women.One hundred and twenty community-dwelling women were recruited via visiting community centres, mosques, Indian temples (Gurdwara) and by word of mouth (between January to May 2018). Inclusion criteria were: community-dwelling, South Asian women, age 60 years and above, able to communicate effectively and able to give written or verbal consent. A general interview (demographic, anthropometric, self-reported exhaustion, health history, supplementation use/duration/dose), handgrip strength (kg), short physical performance battery (single chair stand, repeated chair stands, balance, timed up-and-go test), and blood 25 hydroxyvitamin D (25(OH)D, nmol/l) concentration were performed. Dietary intake and self-reported physical activity was also assessed using multiple-pass 24-hour diet recall method and International Physical Activity Questionnaire (IPAQ) short form respectively.Overall, 47% of participants had insufficient blood 25(OH)D concentration (< 50nmol/L) and 53% had sufficient blood 25(OH)D (≥ 50nmol/L) using the IOM classification. As expected 86% of current vitamin D supplement users had adequate vitamin D status and only 14% of women who reported current vitamin D supplement use had insufficient vitamin D status. Amongst supplement non-users 68% had insufficient vitamin D status and only 32% had adequate levels. An inverse correlation (Spearman's analysis) was found between vitamin D status and single chair stand test (sec) (r = -0.25, p = 0.006); repeated chair stand test (sec) (r = -0.29, p = 0.002) and timed up-and-go test (sec) (r = -0.20, p = 0.02). No correlation was observed between vitamin D status and handgrip strength (r = 0.09, p = 0.30).The prevalence of vitamin D insufficiency is high in post-menopausal South Asian women not taking vitamin D supplements. Significant association was observed between vitamin D status and some aspects of muscle strength and physical function. We are now conducting a randomized control trial to investigate whether vitamin D supplementation may restore muscle strength and function in this population.

Exercise, Health, and Falls Risks among Older African American Women

Background of Study: Although exercise has many benefits, older African American (AA) women are less active than older Caucasian women and older AA men. Balance and muscle-strengthening activities are typically recommended for decreased falls, whereas the role of aerobic training alone on falls prevention is controversial. Objective: This was a mixed methods phronetic (pragmatic) study – without an intervention – including quantitative data (falls risks) and qualitative data on exercise behavior and its importance to health and falls prevention; therefore, the studied phenomenon was thoroughly and pragmatically investigated. The first purpose of the study was to examine differences in falls risks based on exercise type (aerobics vs. combination of aerobics, muscle training, and balance activities) and exercise level (active people vs. somewhat active people). Secondly, participants’ exercise values were examined in relation to their health, falls-risk prevention, exercise behavior, and falls risks. Method: Interviews and falls risk assessments were conducted among 12 older AA women in an inner-city community center. Results: ANCOVA and ANOVA showed that the aerobics group performed better in Dynamic Gait Index (DGI) and Timed Up and Go than the combination group (d =0.85, -0.97); the latter surpassed the former in Functional Reach (d = 2.27). The active group (met the 150 minutes/week exercise recommendation) performed better in DGI and Six-Minute Walk than the somewhat active group (d =0.62.,50); the latter outperformed the former in balance-eyes open (d = -0.52). Emerging themes about lifestyle values included: a) reasons for health conditions and staying healthy and b) falls prevention. Conclusion: Exercise programs for fall risk reduction should include not only muscle strengthening and balance activities, but also aerobic exercises. Meeting minimum exercise recommendations is key to falls risk reduction. Beyond healthy diet, the role of exercise on the prevention of health conditions needs to be emphasized.

Multiple sclerosis in pregnancy: prevalence, sociodemographic features, and obstetrical outcomes

Objective: We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy.Study design: A retrospective cohort study was performed using deliveries in California from 2001 to 2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders.Results: About 1185 out of 4,424,049 deliveries were complicated by MS. MS prevalence increased with maternal age, with Caucasians comprising a higher proportion of MS subjects. MS subjects were older and more likely to have private insurance. Women with MS were more likely to have preexisting medical conditions such as asthma, chronic hypertension, thyroid disease, or cardiac disease. However, no significant antepartum and peripartum morbidities were found to be increased in patients with MS. Urinary tract infection, cesarean delivery, and induction of labor were slightly increased in MS patients.Conclusions: MS is a rare condition which is more likely to affect older Caucasian women of higher socioeconomic status and is associated with several preexisting medical conditions. MS, however, does not appear to pose significant increases in adverse pregnancy outcome. This suggests that pregnant patients with MS may likely experience an uneventful pregnancy.

Age-Related Changes of the Orolabial Region in Caucasian Women: An Anthropometric Analysis

Anthropometric data can provide valuable support for the attending physician in planning surgical and nonsurgical esthetic procedures with regard to a patient's age. The purpose of the present study was to identify age-related orolabial changes in younger and older Caucasian women. In the present cross-sectional study, anthropometric landmarks were identified using indirect anthropometry (2-dimensional photometry) in younger (≤35yr) and older (≥50yr) Caucasian women to analyze age-related parameters and proportions of the orolabial region, especially of the lower and upper lip vermilion areas. The Mann-Whitney U test was applied to compare the results between the younger and older populations. The study population consisted of 45 women. The cohort was divided into a younger population (24 participants; mean age, 27.4yr) and an older population (21 participants; mean age, 58yr) to evaluate age-related differences. Increases of upper lip height, cutaneous height of the upper lip, and cutaneous height of the lower lip were observed in older women. In contrast, the vermilion height of the lower lip decreased significantly with increasing age. These results show changes of the orolabial region occur in Caucasian women with increasing age. The statistically relevant decrease of the vermilion height of the lower lip should be given particular attention for (age-appropriate) diagnostic, esthetic, and prosthetic treatment planning.

ACE I/D and ACTN3 R/X polymorphisms as potential factors in modulating exercise-related phenotypes in older women in response to a muscle power training stimuli

Genetic variation of the human ACE I/D and ACTN3 R577X polymorphisms subsequent to 12 weeks of high-speed power training on maximal strength (1RM) of the arm and leg muscles, muscle power performance (counter-movement jump), and functional capacity (sit-to-stand test) was examined in older Caucasian women [n = 139; mean age 65.5 (8.2) years; 67.0 (10.0) kg and 1.57 (0.06) m]. Chelex 100 was used for DNA extraction, and genotype was determined by PCR-RFLP methods. Muscular strength, power, and functional testing were conducted at baseline (T1) and after 12 weeks (T2) of high-speed power training. At baseline, the ACE I/D and ACTN3 R/X polymorphisms were not associated with muscle function or muscularity phenotypes in older Caucasian women. After the 12-week high-speed training program, subjects significantly increased their muscular and functional capacity performance (p < 0.05). For both polymorphisms, significant genotype-training interaction (p < 0.05) was found in all muscular performance indices, except for 1RM leg extension in the ACE I/D (p = 0.187). Analyses of the combined effects between genotypes showed significant differences in all parameters (p < 0.05) in response to high-speed power training between the power (ACTN3 RR + RX & ACE DD) versus "non-power" muscularity-oriented genotypes (ACTN3 XX & ACE II + ID)]. Our data suggest that the ACE and ACTN3 genotypes (single or combined) exert a significant influence in the muscle phenotypes of older Caucasian women in response to high-speed power training. Thus, the ACE I/D and ACTN3 R/X polymorphisms are likely factors in modulating exercise-related phenotypes in older women, particularly in response to a resistance training stimuli.

Serum Sclerostin and Risk of Hip Fracture in Older Caucasian Women

Sclerostin, a protein secreted by osteocytes, inhibits bone formation. Individuals with genetic mutations that decrease the availability of sclerostin have very high bone mass. The aim of this study was to examine the hypothesis that elevated serum sclerostin levels are associated with increased risk of hip fracture in older women. This was a case-cohort study of a prospective, community-based cohort of 9704 women aged 65 yr or older. Sclerostin levels were measured in serum collected in 1989-1990 in 228 women with incident hip fractures and 227 women in a randomly selected sample; average follow-up time was 9.8 yr. Serum sclerostin levels were correlated with total hip bone mineral density (BMD; r = 0.27, P < 0.001). The risk of hip fracture increased across quartiles of serum sclerostin (test for trend, P < 0.001) and was significantly elevated among those in the fourth quartile (hazard risk 3.4, 95% confidence interval 1.7-7.0) compared with women in the lowest quartile, after adjusting for age, body mass index, estrogen use, history of fracture since age 50 yr, and total hip BMD. When dividing the cohort into eight groups by sclerostin quartile and median hip BMD, women with lower total hip BMD in the highest sclerostin quartile had a 22.3-fold (95% confidence interval 5.8-86.3) increased risk of fracture compared with women with higher total hip BMD in the lowest sclerostin quartile. We conclude that higher serum sclerostin levels are associated with a greater risk of hip fractures in older women. In addition, the risk of hip fracture is amplified when high sclerostin levels are combined with lower BMD.

Which fractures are most attributable to osteoporosis?

Background Determining anatomic sites and circumstances under which a fracture may be a consequence of osteoporosis is a topic of ongoing debate and controversy that is important to both clinicians and researchers. Methods We conducted a systematic literature review and generated an evidence report on fracture risk based on specific anatomic bone sites and fracture diagnosis codes. Using the Research and Development/University of California at Los Angeles appropriateness process, we convened a multidisciplinary panel of 11 experts who rated fractures according to their likelihood of being because of osteoporosis based on the evidence report. Fracture sites (as determined by International Classification of Diseases Clinical Modification codes) were stratified by four clinical risk factor categories based on age, sex, race/ethnicity (African American and Caucasian), and presence or absence of trauma. Results Consistent with current clinical experience, the fractures rated most likely because of osteoporosis were the femoral neck, pathologic fractures of the vertebrae, and lumbar and thoracic vertebral fractures. The fractures rated least likely because of osteoporosis were open proximal humerus fractures, skull, and facial bones. The expert panel rated open fractures of the arm (except proximal humerus) and fractures of the tibia/fibula, patella, ribs, and sacrum as being highly likely because of osteoporosis in older Caucasian women but a lower likelihood in younger African American men. Conclusion Osteoporosis attribution scores for all fracture sites were determined by a multidisciplinary expert panel to provide an evidence-based continuum of the likelihood of a fracture being associated with osteoporosis.

Estrogen Receptor Alpha and Matrix Metalloproteinase 2 Polymorphisms and Age-related Maculopathy in Older Women

In this study, the authors sought to determine whether single nucleotide polymorphisms in the estrogen receptor alpha (ESR1) and matrix metalloproteinase 2 (MMP2) genes are associated with age-related maculopathy (ARM) in older women. Subjects comprised a random sample of Caucasian women aged > or =74 years participating in the Study of Osteoporotic Fractures year 10 follow-up (n = 906) in 1997-1998. Fundus photographs were graded for ARM using a modification of the Wisconsin Age-Related Maculopathy Grading System. The prevalences of early ARM and late ARM were 46% and 4%, respectively. The MMP2 rs2287074 single nucleotide polymorphism (G-->A) was associated with ARM. The A allele was present in 47%, 43%, and 30% of subjects with no, early, and late ARM, respectively (p = 0.01), and was associated with lower odds of any ARM (for AG vs. GG, odds ratio = 0.80, 95% confidence interval: 0.65, 0.99; for AA vs. GG, odds ratio = 0.64, 95% confidence interval: 0.42, 0.98). An interaction with use of postmenopausal hormone therapy was significant (p = 0.02). The MMP2 rs2287074 A allele may be associated with a lower likelihood of ARM in older Caucasian women, particularly those who have never used hormone therapy. The role of MMP2 rs2287074 in ARM should be further elucidated.

Estrogen receptor alpha haplotypes and breast cancer risk in older Caucasian women

Life-long exposure to estrogen is an established risk factor for breast cancer development. The underlying mechanism has been suggested to be the binding of estrogen-to-estrogen receptors in mammary tissue, which in turn promotes the proliferation and differentiation of breast tissue. Polymorphisms and haplotypes in estrogen receptor alpha (ESR1) have been reportedly associated with breast cancer risk; however, the results are not fully consistent. In this study, we investigated breast cancer risk associated with genotypes and haplotypes resulting from four ESR1 single nucleotide polymorphisms (SNPs), rs746432, rs2234693, rs9340799, and rs1801132. Genotyping has been performed on 393 breast cancer cases and 790 randomly selected controls in 1,183 Caucasian women over age 65 from the Study of Osteoporotic Fractures (SOF). We observed an allelic protective effect for SNP rs9340799 with an estimated odds ratio (OR) of 0.82 (95% CI = 0.68-1.00; P = 0.04) after adjustment for age, BMI and hip BMD. A protective effect of this SNP has been reported before in several different studies. We did not replicate the previously reported C-C-A-G haplotype association to breast cancer-the C-C-A-G haplotype from these SNPs was rare in this study (estimated frequency below 0.001% in cases and controls). No other statistically significant associations were observed between ESR1 haplotypes from the same four SNPs and the risk of breast cancer in older Caucasian women.

Variation in the Ciliary Neurotrophic Factor Gene and Muscle Strength in Older Caucasian Women

To determine whether genetic variants in the ciliary neurotrophic factor (CNTF) gene are associated with muscle strength in older women. Cross-sectional analysis of baseline data from the Women's Health and Aging Studies I (1992) and II (1994), complementary population-based studies. Twelve contiguous ZIP code areas in Baltimore, Maryland. Three hundred sixty-three Caucasian, community-dwelling women aged 70 to 79. Participants were genotyped at the CNTF locus for eight single nucleotide polymorphisms (SNPs), including the null allele rs1800169. The dependent variables were grip strength and the frailty syndrome, identified as presence of three or more of five frailty indicators (weakness, slowness, weight loss, low physical activity, exhaustion). In addition to genotypes, independent variables of body mass index (BMI) and osteoarthritis of the hands were included. Using multivariate linear regression, single SNP analysis identified five SNPs significantly associated with grip strength (P<.05), after adjusting for age, BMI, and osteoarthritis. Haplotype analysis was performed, and a single haplotype associated with grip strength was identified (P<.01). The rs1800169 null allele fully explained the association between this haplotype and grip strength under a recessive model, with individuals homozygous for the null allele exhibiting a 3.80-kg lower (95% confidence interval=1.01-6.58) grip strength. No association was seen between the CNTF null allele and frailty. Individuals homozygous for the CNTF null allele had significantly lower grip strength but did not exhibit overt frailty. Larger prospective studies are needed to confirm this finding and extend it to additional populations.

Association of estrogen receptor α polymorphisms with breast cancer risk in older Caucasian women

Estrogens exert their effect on the breast through the estrogen receptor. We prospectively investigated breast cancer risk associated with 2 polymorphic sites in the estrogen receptor alpha gene (ESR1). A total of 4,248 Caucasian women from the Study of Osteoporotic Fractures were genotyped for the -401 T/C and -354 A/G polymorphisms in ESR1. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between genotypes and breast cancer. During a mean follow-up of 12.4 years, 252 (5.9%) women developed breast cancer. The HR (95% CI) for breast cancer were 0.928 (0.708, 1.22) and 0.834 (0.538, 1.29) for the -354 A/G and A/A genotypes, respectively. Interactions with -354 variant were observed for smoking (HR = 1.52 and 1.56 for A/G and A/A smokers, respectively; HR = 0.74 and 0.60 for A/G and A/A non-smokers, respectively; interaction p = 0.03) and walking (HR = 0.75 and 1.15 for A/G and A/A walkers, respectively; HR = 0.18 and 0.49 for A/G and A/A non-walkers, respectively; interaction p = 0.01). There were no differences in the HR for the -401 T/C genotypes. An interaction between parity and carriage of the T allele was found (HR = 0.60 vs. 1.12 for nulliparous vs. parous women; interaction p = 0.03). ESR1 polymorphisms in combination with lifestyle factors may be associated with breast cancer risk in older Caucasian women.

The relationship between convenience of destinations and walking levels in older women.

To examine the relationship between physical activity and (1) convenience of destinations, measured by whether destinations (such as a park, trail, businesses, and services) are within walking distance of the home, and (2) participants' perception of the quality of their neighborhood surroundings for walking, captured with a global neighborhood "walkability" rating. Cross-sectional analysis of data obtained in 1999. Community in southwest Pennsylvania. Older Caucasian women (n = 149, mean age = 74.2 years). Response rate = 79%. Walking levels, leisure-time physical activity, and features of the neighborhood environment were measured with interviewer-administered questionnaires. Physical activity was also measured objectively with a pedometer. Living within walking distance (defined as within a 20-minute walk of home) of a park; biking or walking trail; or department, discount, or hardware store was related to higher pedometer readings (p < .01). In addition, there was a positive trend between the sum of destinations within walking distance of home and activity levels measured by pedometer and questionnaire (p < .01). There was also a positive trend between participants' neighborhood "walkability" rating and activity levels measured by pedometer and questionnaire (p < .01). These findings suggest that the ability to make utilitarian walking trips from home and the perception of having favorable neighborhood surroundings for walking are associated with increased physical activity levels in older women.

Assessment of energy requirements in elderly populations.

The daily energy requirements of older adults are unclear. Aging results in a decline in daily energy expenditure and intake, which are associated with greater gains in body fatness and a subsequently higher risk of morbidity and mortality. Understanding the energy requirements of older populations, therefore, has important clinical implications. Current world-wide recommendations suggest that energy needs of individuals above 50 y are of 1.51 times resting energy expenditure. Limited data suggest that this may be an underestimation of energy needs in older Caucasian women and men. In contrast, current energy requirement recommendations may be appropriate for older African-American women, because of their low rate of daily energy expenditure for their metabolic size. Aging is also associated with Alzheimer's and Parkinson's and recent data suggest that individuals with these chronic diseases actually have energy requirements that are at or below current recommendations. Physical activity is the most modifiable and variable component of daily energy expenditure and, therefore, energy requirements. Current data suggest that an inexpensive and simple measurement of physical activity is difficult in older adults, which limits our ability to accurately determine energy needs. Overall, current data suggest that energy needs of older adults may be higher than current world-wide recommendations, although future prospective data are needed in healthy, ethnic, and diseased populations. Accurate, unobtrusive, and inexpensive methods to measure physical activity are also needed to assess energy requirements.

Central markers of body fat distribution are important predictors of plasma lipids in elderly men and women

We determined the contribution of body fat distribution, peak VO2, fat mass, and dietary intake to variation in plasma lipids in elderly individuals. Volunteers were a healthy cohort of older Caucasian women (n = 75, mean age +/- SD, 72 +/- 5 years) and older men (n = 101, 72 +/- 5 years). We determined fat mass from underwater weighing, fat patterning from waist circumference, as well as peripheral and truncal skinfolds, exercise capacity from peak VO2, and dietary intake from three-day food diaries. Plasma lipid levels were measured in the fasting state and included total cholesterol, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), and fasting triglycerides. Older women weighted less than older men, but had higher fat mass, truncal, and peripheral skinfolds. Waist circumference and peak VO2 were lower in older women than older men. Older women had higher total cholesterol (217 +/- 31 vs. 197 +/- 30; p < 0.01), HDL-C (54 +/- 12 vs. 49 +/- 14; p < 0.05), and LDL-C (133 +/- 26 vs. 121 +/- 27; p < 0.01) when compared with older men. No gender differences were noted in fasting triglycerides. Truncal skinfolds were the best predictor of plasma lipids in older men, accounting for between 9% and 30% (r2) of the variation in plasma lipids. Similarly, in older women, central markers of fatness (i.e., waist circumference and truncal skinfolds) were the best predictors of plasma lipids (r2 = 3% to 24%). Total fat mass, peak VO2 and dietary intake were not independent predictors of plasma lipids in older men and women. Indices of central body fatness, rather than total fat mass, peak VO2 or dietary intake are stronger predictors of plasma lipids in healthy older men and women.

Older women's attitudes to cervical screening and cervical cancer: a New Zealand experience.

An in-depth series of interviews was undertaken amongst a small group of older, caucasian women, in Auckland, New Zealand. The study was part of the region's cervical screening programme. The aim of the study was to determine how the older woman's perceptions of cervical cancer and cervical screening services might be affecting her health-seeking behaviour. Healthy, caucasian women between 45 and 70 years of age were invited to participate. These women had either declined or delayed having regular cervical smears. Interviews were recorded and transcribed, then subjected to thematic analysis. Although small, the study is important in that it highlights cognitive, emotional, socio-economic and ego integrity barriers to regular cervical screening. Nurse clinicians have a major role in disease prevention and education for healthy older women. The findings provide a useful background for developing strategies to increase the uptake of cervical smears amongst older Caucasian women. They may also be viewed as a pilot for the development of questionnaires, or for further investigation of perceptions of older women in other ethnic groups.