Older Women Age Research Articles

Advanced Malignant Melanoma of the Vulva in a 70 years old woman

Vulvar melanoma is a rare malignant tumor of the female genital tract tend to occur in older age women and a high tendency to metastasize because the diagnosis is usually delayed (1). In this case report, we present a 70-year-old para 8 woman who presented with progressively increasing vulvar swelling of 2 years and multiple visit to health institution. Examination revealed 7cm diameter multi-nodular mass with areas of dark and dark blue-violet color filling the introitus that involves the clitoris, labia minora, lower third of the anterior vagina and urethra. Incisional biopsy from the mass showed malignant melanoma. Imaging with CT scan revealed bilateral lung metastasis. Palliative chemotherapy was planned but the patient lost to follow up.

Pregnancy Outcomes in Grand Multiparity Women With Antiphospholipid Antibodies.

In recent years antiphospholipid syndrome (APS) as well as antiphospholipid antibodies (aPL) prevalence has demonstrated an upward trend in women during reproductive age. There is a lack of data concerning its effects on women with grand multiparity (GMP) (parity ≥5). Hence, this study aimed to assess pregnancy outcomes among GMP aPL/APS patients. We retrospectively assembled the births of GMP women with aPL/APS, between 2017 and 2022 in the Sheba Medical Center. We compared their deliveries with those of two control groups: (1) the "aPL/APS-controls"-of pregnant women with aPL/APS and parity <5. (2) The "GMP-controls"- parity ≥5 without aPL/APS. We examined demographics, aPL characteristics, pregnancy, and neonatal outcomes between the groups. In total, 42 deliveries in the study group were compared to 461 deliveries in the "aPL/APS-controls" group and 84 deliveries of the "GMP-controls." Most parameters were similar across groups. However, the study group had a higher rate of obstetric APS diagnosis (64.64%vs. 83.33%, p<0.01) and showed significant differences such as older maternal age, higher BMI, more polyhydramnios cases, and larger babies compared to controls (33.91vs. 36.19, p=0.05; 23.2vs. 28.89, p=0.02; 3.68vs. 11.9, p=0.01; and 2.17vs. 14.28, p<0.01, respectively). Our findings reveal that perinatal outcomes in aPL/APS GMP women are comparable and not inferior to those in aPL/APS women with <5 pregnancies or in comparison to the general GMP population. The minor differences observed may all be related to GMP women's older age and higher BMI.

Sex differences in association between dietary sodium intake and white matter hyperintensity volume

Abstract Background There is limited evidence on the relationship between dietary sodium intake (dNa) and brain health, and very little on sex differences in associations. Purpose To study the relationship between dNa and imaging measures of brain health in men and women from the INSIGHT 46 substudy of the MRC National Survey of Health and Development (British 1946 birth cohort). Methods Participants had measurements (dNa using 5-day food diary, anthropometrics, blood pressure (BP) body mass index (BMI)) at 60-64years. Whole-brain and hippocampal volumes, white matter hyperintensity volume (WMHV) and florbetapir amyloid-β positivity were measured using MRI-PET imaging at 69-71years. Associations (β (95% confidence intervals)) were estimated separately in men and women using generalized linear models with robust standard errors adjusted for potential confounders (age, diet quality, energy intake, socioeconomic status) or potential mediators (BMI, BP). Results Participants’ characteristics are shown in Table 1. In women but not men dNa was positively associated with higher WMHV (β[women]=32(1, 72) %/g; p=0.043; β[men]=-10(-27, 11)%/g; p=0.342); this relationship in women was independent of BMI (β = 32(1, 72)%/g; p = 0.043) or systolic BP (β = 31(1, 70)%/g; p=0.041). dNa was not associated with total brain volume, hippocampal volume or amyloid-β positivity in either sex. Conclusions Elevated sodium consumption in the diet is associated with cerebral small vessel disease in older age women but not men. This association was independent of BMI or BP.Table 1

Knowledge, attitude, and practice regarding the prevention of osteoporosis among middle and old-aged women of Kirtipur Municipality, Nepal.

Osteoporosis is a major public health problem that can lead to physical disability, working performance limitations, decreased self-sufficiency, and increased hospitalization and mortality rates. People are unaware of osteoporosis, and it is often undiagnosed until fractures occur. Limited studies have been conducted to determine the knowledge, attitude, and practice regarding osteoporosis among middle-aged women in Nepal. This study aimed to determine existing knowledge, attitude, and practice towards osteoporosis among middle and old-aged women in Nepal. A cross-sectional study was conducted among the selected wards of Kirtipur Municipality to recruit 405 participants. Participants were selected using a stratified random sampling technique. Face-to-face interviews using a structured questionnaire were performed to collect the data. Frequencies, percentages, mean, and standard deviation were used to describe the characteristics of participants. Multivariate logistic regression was used to determine the factors associated with knowledge, attitude, and practice regarding osteoporosis. Pearson's correlation coefficient was used to determine the correlation between knowledge, attitude, and practice regarding osteoporosis. The mean ± SD age of the participants was 46.2 ±9.1 years. Nearly half of the participants (48.8%) had good knowledge, while 57.7% and 51.8% had positive attitudes and good practices regarding osteoporosis, respectively. The occupation and income of the participants were statistically significant and associated with the knowledge level. Meanwhile, age, ethnicity, education, occupation, and monthly household income were associated with attitude level. With a good practice level, ethnicity, family type, and education were statistically significant. The knowledge-attitude (rka = 0.093, p < 0.05), attitude-practice (rap = 0.171, p < 0.001), and knowledge-practice (rkp = 0.274, p < 0.001) for osteoporosis were positively correlated. The study found that still around half of the middle and old-aged women had poor knowledge, negative attitudes, and poor practices regarding osteoporosis. Moreover, it highlighted inadequate dietary practices, such as low consumption of milk, vegetables, fruits, and calcium supplements among women, indicates are at greater risk of osteoporosis. The study emphasized the need for community-based awareness programs for the target population such as housemakers, and lower-income groups, to prevent osteoporosis among women.

Patterns of Sexuality, Adjustment to Aging and Satisfaction with Life: A Cluster Analysis of Adults Across the Lifespan

AbstractSexual satisfaction, adjustment to aging, and satisfaction with life are relevant dimensions of overall well-being across the life cycle. Through cluster analysis procedures, this study aims to describe the specific profile of adjustment to aging, sexual satisfaction and satisfaction with life of adults across the life span. This cross-sectional study involved a community-based sample of 619 Portuguese individuals, aged between 18 and 92 years old (M = 47.53 SD = 18.34) evaluated using a two-step cluster analysis. Fours clusters emerged. The most adjusted participants were mostly of a younger age, women and had a high education. The least adjusted participants globally presented low education, poor perceived health, and poor engagement in leisure activities. Well-being focused participants were mostly women of older age, with high education and spirituality. Finally, moderately satisfied participants were mostly men of older age, had a lower education, and presented poor reported health. Complementary comparative analysis among the identified subgroups was performed. The most adjusted participants had the highest perceived overall sexual well-being, sexual attractiveness, sexual openness and communication, and sexual satisfaction. These data characterize the profile of this population and can be used as the basis for developing efficient strategies aimed a combining adjustment to aging, satisfaction with life and sexual satisfaction for tailored interventions to the specific needs of populations across the lifespan.

Characteristics associated with fruit and vegetable consumption in mid aged and older Chinese men and women: a cross-sectional analysis of the first wave of WHO SAGE China.

Adequate fruit and vegetable consumption is essential for healthy ageing and prevention and management of chronic disease. This study aimed to examine characteristics associated with fruit and vegetable consumption in Chinese men and women aged 50 years and over. Data from the first wave of the Chinese cohort (2008-2010) of the WHO's Study on global AGEing and adult health (SAGE) survey was used. Fruit and vegetable consumption was assessed by self-reported typical consumption in serves/day. Characteristics examined were age, education, financial security, home ownership, marital status, social cohesion and rural location. Associations with fruit and vegetable consumption were assessed using multiple linear regression adjusted for confounders and stratified by sex. Overall, women consumed more serves of fruit per day than men (mean (standard deviation): 2·6 (2·2) and 2·2 (2·1) serves/day, respectively) whereas men consumed more serves of vegetables than women (7·2 (4·0) and 6·7 (3·7)). Lower fruit consumption was associated with lower education, lower social participation, income insecurity, renting, being un-partnered and rural residency in men and women, as well as older age in women. Lower vegetable consumption was associated with older age, lower education and urban residency in men and women and lower social participation in men and being unpartnered in women. This study has identified characteristics associated with fruit and vegetable intake in a sample of mid aged and older Chinese men and women. Further research on the interrelationships between these characteristics and fruit and vegetable intake as well as longitudinal relationships is warranted.

Older women’s constructions of equality over the lifecourse

Abstract Gender and age are central organising principles of social relations, with socially constructed gendered and age-based norms influencing patterns of social behaviour, power and inequality. Despite recent literature highlighting the importance of subjective measures of equality, including as a significant predictor of wellbeing, there is a gap in studies focused on subjective equality in research on ageing. Drawing on an equality ranking exercise and life herstory interviews with 20 older-aged women (65+) in Aotearoa New Zealand, this article focuses on the intersectionality of age and gender, analysing the ways in which participants constructed their experiences of equality over the lifecourse from their standpoint as older-aged women. The analysis reveals a significant rise in subjective equality from childhood to older age, with more varied responses in childhood and a convergence of responses from adolescence onwards. Participants’ constructions of equality differed: age was the dominant construct of equality women ascribed to their childhood years, while gender inequality came to the fore during their teenage years. In early to mid-adulthood, women found ways to navigate gendered inequality in various life domains, while in older adulthood equality was constructed as freedom and life satisfaction. This trajectory suggests that the frames individuals use to make sense of equality and their personal experiences are not fixed; they are fluid and shift throughout the lifecourse.

Association Between Dietary Acid Load and Grip Strength in Adults 50 Years and Older: A Cross-Sectional Study.

Minimal data exist on whether the acid-base balance of the diet is linked to muscle strength.The aim of this study was to determine if dietary acid load is associated with grip strength in a nationally representative sample of middle- toolder-ageadults. We examined the cross-sectional association of grip strength with dietary acid load quantified through potential renal acid load (PRAL) and net endogenous acid production (NEAP) in 4,059 adults aged 50years and older in the 2011-2014 NHANES survey cycles. PRAL and NEAP were estimated from two 24-h recalls and categorized into sex-specific quartiles. Grip strength was measured on a dynamometer. Multiple linear regression models were used to determine the associations of PRAL and NEAP (as quartiles) with grip strength for men and women separately, adjusting for total energy, age, race/ethnicity, weight, physical activity, smoking, serum 25-hydroxyvitamin D, and estimated glomerular filtration rate. Mean grip strength was 26.8 ± 0.2kg in women and 43.0 ± 0.4kg in men. Adjusted grip strength was inversely associated with quartiles of PRAL (ptrend = 0.049) and NEAP (ptrend = 0.034) in women with quartile 4 vs 1 differences of -1.21 and -1.08kg (both p < 0.05), respectively. Adjusted grip strength was not associated with PRAL or NEAP in men. Overall,we found inverse associations between dietary acid load and grip strength in middle- and older-age women, suggesting that an alkaline diet may be important in maintaining muscle strength in this population. There was no association between dietary acid load and grip strength in men.

Acute Care, Secondary Prevention, and Outcomes after Ischaemic and Haemorrhagic Stroke in Men and Women: A Data-Linkage Study.

There is evidence that sex differences exist in stroke presentation, risk factors, severity, treatment, and outcomes. To further understand this, we explored how sex differences influence acute stroke management, secondary prevention prescribing, and mortality outcomes in a well-characterised cohort of first-ever stroke patients in Scotland. This is a retrospective, population-based, data-linkage study of stroke admissions to acute care hospitals in Scotland between January 1, 2011, and December 31, 2018. Data sources included the Scottish Stroke Care Audit (SSCA), the Prescribing Information System (PIS), the Scottish Morbidity Record 01 (SMR01), and the National Records of Scotland (NRS) death records. Multivariable logistic regression was used to explore the association between patient sex, acute stroke care, and secondary prevention prescribing, while Cox proportional hazards models were used to explore the association between patient sex and all-cause mortality up to 1 year after index event. This study included 5,901 patients with a first-ever intracerebral haemorrhage (ICH) and 47,087 patients with a first-ever acute ischaemic stroke (AIS). After an ICH, women had significantly lower odds of receiving all components of the stroke care bundle (adjusted odds ratio [aOR], 0.78; 95% confidence interval [CI], 0.69-0.87) and were less likely to be prescribed antihypertensives within 90 days after discharge to the usual place of residence (aOR, 0.78; 95% CI, 0.63-0.97). There was no sex difference in stroke care bundle achievement for those admitted with AIS; however, women had significantly lower odds of receiving antihypertensives, lipid-lowering drugs, or oral anticoagulants after discharge. The risk of all-cause mortality was lower in women at 1 year after both ICH (adjusted hazard ratio [aHR], 0.90; 95% CI, 0.83-0.98) and AIS (aHR, 0.91; 95% CI, 0.87-0.95) after adjusting for potential confounders. The sex differences in stroke treatment and outcomes may be partly explained by the older age of women at the time of stroke, which influences stroke presentation, severity, and prognosis. However, following adjustment, women had a reduced risk of all-cause mortality after both ICH and AIS.

Mobility of older people in public spaces from agender perspective

For older people, asufficient mobility offer is an essential prerequisite for participation in social life and abetter quality of life. The goal should be self-determined everyday mobility that enables asatisfying and healthy life. Mobility depends on diverse individual abilities and needs. On the other hand, social structures as well as regulatory and spatial framework conditions limit the realisation of mobility services and their transport infrastructure. These framework conditions are characterised by the perception of social roles, the availability of resources and gender-specific attributions. For example, care and caring work is predominantly the responsibility of women in the age group of 50years plus. The availability of transport infrastructure is geared towards goals that are characterised by the needs of gainful employment and not the goals of care work. Conversely, the availability of flexible means of transport, such as cars, also decreases for women in old age for economic reasons. For this reason, mobility planning should take greater account of specific needs, such as orientation towards care objectives, counselling, and health services and place agreater focus on the local area. For elderly people, especially women, security needs are often an important factor in the decision to become mobile or to forego mobility. This includes perceived subjective safety, accessibility and protection from weather conditions such as slippery surfaces or exposure to excessive heat. If these basic principles are taken into account, more people can be guaranteed self-determined participation in social life.

Patient characteristics associated with primary prophylactic granulocyte colony-stimulating factor (G-CSF) use among women treated for early-stage breast cancer.

e12605 Background: The National Comprehensive Cancer Network (NCCN) recommends several chemotherapy regimens for early-stage breast cancer that have elevated risk of neutropenia (&gt;20%). In these regimens, primary prophylactic use of granulocyte colony-stimulating factor (G-CSF) is recommended. Little is known about how patient-level factors relate to receipt of prophylactic G-CSF among women receiving these regimens. Methods: In the Optimal Breast Cancer Chemotherapy Dosing (OBCD) Study, we examined use of G-CSF among women with stage I-IIIA breast cancer between 2005-2019 in Kaiser Permanente Northern California (KPNC) and Kaiser Permanente Washington (KPWA). We evaluated the patient-level factors associated with primary prophylactic G-CSF use (≤7 days before to ≤3 days after first day of chemotherapy) among women receiving chemotherapy regimens with high risk of neutropenia, for which the NCCN guidelines recommend prophylactic G-CSF use. Multivariable-adjusted prevalence ratios (PR) and their corresponding 95% Confidence Intervals (95% CI) were calculated using generalized linear models of the Poisson family with a log link-function and robust standard errors. Results: Overall, while all 3,083 women receiving these regimens ultimately received G-CSF, 2412 (79%) received primary prophylactic G-CSF within the period 7 days prior to 3 days post first cycle. Younger women had higher prevalence of prophylactic G-CSF receipt (82.7% in ages 18-39 years vs. 58.1% in 70+ years). Black women had higher prevalence of receipt compared to white women (82.7% in non-Hispanic Black women vs 76.1% in White women). Women with a higher body mass index (BMI) had lower prevalence of receipt compared to normal weight women (73.3% in 35+ kg/m2 group vs 81.5% in 18.5-&lt;25 kg/m2 group). In multivariable models, older women were less likely to receive prophylactic G-CSF (PR70+ vs 18-39: 0.69; 95% CI: 0.57-0.84; p-trend&lt;0.001), as were those with a higher BMI (PRBMI 35+ vs 18.5-&lt;25: 0.92; 95% CI: 0.85, 0.97; p-trend=0.006), and a later year of diagnosis (PR2016-19 vs 2005-07: 0.81; 95% CI: 0.77, 0.85; p-trend&lt;0.001). Although race/ethnicity was not significantly associated with receipt of prophylactic G-CSF use overall in multivariable models, we observed Non-Hispanic Black women to experience slightly higher likelihood of G-CSF receipt than Non-Hispanic White women (PR: 1.08; 95% CI: 1.02, 1.15). Conclusions: Women of older age and those with higher BMI were less likely to receive primary prophylactic G-CSF, as were women treated in later years. Further research looking at timing of G-CSF use is warranted, as are studies examining provider/facility-level factors in relation to patterns of G-CSF use, G-CSF’s impact on survival outcomes, and the real-world impact of decisions around G-CSF use across age, BMI, and racial/ethnic groups.

고령여성의 빈곤대책으로서의 공적연금과 기초연금 - 한국과 독일 비교

Purpose: Korea reached an aging rate of 18.4% in 2023, and it is expected to reach 20.6% in 2025, making it a super-aged society. Meanwhile, Germany became a super-aged society in 2008, with an aging rate over 21%. In Korea and Germany, social concern about the elderly's poverty is increasing as the aging rate increases. However, there is a large difference between Korea and Germany in the relative poverty rate of the elderly, in particular for elderly women. This paper focuses on women's pension rights in the public pension and the basic security benefit in old age as measures against poverty of elderly women in Korea and Germany. Research design, data, and methodology: This paper examines the following two points as measures against poverty for the elderly in Korea and Germany, and compares the characteristics, similarities and differences between the two countries: First, the structures of women's pension rights and the pension amounts in the public pensions of Korea and Germany are compared. Second, as public pension and public assistance that guarantee stable income and minimum sociocultural standard of living for the elderly, Korea's “Basic Pension(BP)” and Germany's “Basic Security Benefit for the Elderly (GS: Grundsicherung)” and “Basic Pension(GR: Grundrente)” are compared. Results: The research results are the following three points. First, the relative poverty rate for elderly women in Germany is much lower than that in Korea, and one of the main reasons for this is consideration given to child-rearing period and short-time employment under the Pension law. In particular, the child-rearing period is an important factor for strengthening women's pension rights. Second, as a basic security benefit for the elderly, there is a “Basic Pension(BP)” in Korea, and there is a “Basic Security Benefit for the Elderly(GS)” in Germany. Although the two systems have similarities in terms of financial resources and means test methods, there are significant differences in the scope of eligible beneficiaries of benefit. Third, the basic pension(BP) in Korea and basic pension(GR) in Germany have the same name, and the financial resource for the benefits is borne by the government. But they are completely different systems. The basic pension(BP) in Korea is a public assistance, and its legal basis is similar to Basic Security Benefits for the Elderly(GS)''in Germany. The basic pension(GR) in Germany is an additional benefit added to the statutory public pension amounts and has the effect of increasing pension amount of elderly women in particular. Implications: Public pension and public assistance that guarantee the stable income and the sociocultural minimum subsistence level for women in old age are becoming more important than before. The public pension system in both countries have similarities in that the pension contribution is based on '' individual units'' and a dependent spouse is classified as Voluntary Insured Person. And both countries are enforcing ''basic pension'' as measures against poverty for the elderly. But the relative poverty rate for elderly women in Korea is 48.3%, much higher than 10.4% in Germany. The main reason for this difference between the two countries is the support in the pension system that takes into account women's child-rearing period, working style and low pension amount. Statutory public pension of Germany has the function of social compensation and burden distribution for child care. Korea, which needs to cope with its declining birthrate and aging society, needs to consider the achievements and effects of Germany, which takes into account the child-rearing support and the poverty measure for elderly women in its pension system.

Walking net O2 rises with advancing age in older women: where to go from here?

Walking net O2 tends to increase with advancing age; however, factors contributing to this relationship have not been widely described. The implications of such findings could inform targeted strategies to promote independent mobility in older adults. Herein, we evaluated the relationship between net O2 and age at two submaximal workloads while exploring potential moderators of this relationship. Secondary analyses were performed on 35 older (65 ± 3years) women who completed a battery of physical assessments including fixed-speed, non-graded and graded (+ 2.5%) treadmill walking with indirect calorimetry to determine net O2. Maximal oxygen uptake ( O2max), knee extensor maximal isometric voluntary contraction (MVC), peak rate of torque development (RTD), and plantar flexor range-of-motion (PFROM) were also measured. Bivariate correlations showed non-graded (r = 0.403, p = 0.017) and graded (r = 0.413, p = 0.014) net O2 were positively related to age. Notably, these relationships strengthened after adjusting for O2max. Regression modeling showed age, RTD:MVC ratio (composite of muscle performance), and PFROM together explained 49% and 34% of the variance in non-graded and graded net O2, respectively. Further analyses suggested knee extensor MVC moderates the relationship between non-graded net O2 and age, accounting for 9% of the variance [ΔR2 = 0.090, F (1,31) = 4.13, p = 0.05]. These data support the premise that, in older women, walking net O2 rises with advancing age, and additionally, the RTD:MVC ratio and PFROM are independent correlates of non-graded net O2. Exercise interventions with a high degree of training specificity including explosive, velocity-based elements may promote independent mobility in older women.

Sex differences in Alzheimer's disease blood biomarkers in a Caribbean population of African ancestry: The Tobago Health Study.

Alzheimer's disease (AD) is increasing in the Caribbean, especially for persons of African ancestry (PAA) and women. However, studies have mostly utilized surveys without AD biomarkers. In the Tobago Health Study (n = 309; 109 women, mean age 70.3±6.6), we assessed sex differences and risk factors for serum levels of phosphorylated tau-181 (p-tau181), amyloid-beta (Aβ)42/40 ratio, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Blood samples were from 2010 to 2013 for men and from 2019 to 2023 for women. Women were more obese, hypertensive, and sedentary but reported less smoking and alcohol use than men (age-adjusted p<0.04). Compared to men, women had worse levels of AD biomarkers, with higher p-tau181 and lower Aβ42/40, independent of covariates (p<0.001). In sex-stratified analyses, higher p-tau181 was associated with older age in women and with hypertension in men. GFAP and NfL did not differ by sex. Women had worse AD biomarkers than men, unexplained by age, cardiometabolic diseases, or lifestyle. Studying risk factors for AD in PAA is warranted, especially for women earlier in life.

Tobacco use and its associated factors among middle and old-aged women in India using LASI wave-1 data.

Despite a global decline in tobacco use reported by the Global Adult Tobacco Survey (GATS), India stands out for its high number of tobacco users. While research in India often focuses on tobacco use among young adults, there's a notable lack of studies addressing tobacco use among middle and old-aged women. However, the national prevalence of tobacco use among middle and old-aged (45 years and above) women in India is 18.2%. Thus, this study seeks to identify the factors influencing tobacco consumption among middle and old-aged women in the country. The study has utilized secondary data from Longitudinal Aging Study in India (LASI) conducted in 2017-18. This study exclusively included a total of 38,180 middle and old-aged women who reported tobacco use. The analysis encompassed the utilization of Chi-square tests and Binary logistic regression to pinpoint the risk factors linked to tobacco use among middle and old-aged women. Our study reveals a heightened likelihood of tobacco use among middle and old-aged women residing in the northeastern region of India. The study underscores the imperative to direct targeted efforts toward middle and old-aged women who fall into specific categories, including those who are widowed, separated, or unmarried, individuals who consume alcohol, those with lower socioeconomic and educational standings, residents of rural areas, those living in solitude, individuals experiencing depressive symptoms, and those who self-report poor health. Given the heightened susceptibility of these demographic groups to tobacco use, it is crucial to prioritize tobacco prevention and cessation initiatives specifically tailored to their needs and circumstances.

Does Retirement and Work Stoppage Impact Body Weight and Waist Circumference Changes in Middle- and Older-Aged Women and Men? Results From the Canadian Longitudinal Study on Aging.

This study aimed to examine the impact of employment transitions (ETs) on anthropometric changes among middle-aged and older workers (ages 45y+). Using two waves of data from the Canadian Longitudinal Study on Aging, we analyzed the impact of ETs (stayed working, entered retirement, and stopped working) on change in body weight and waist circumference (WC) on continuous scales as well as categories (≥5% cut-off). Analyses were sex/gender-stratified. Women did not show significant weight or WC change that differed across ETs, but estimated directions suggested those who stopped working were more likely to have ≥5% change in weight. Estimated directions of continuous outcomes for women who stopped working relative to continued workers showed less weight gain and more WC gain. Men who retired gained less weight and had smaller WC gain compared to reference. The findings imply that the short-run impact of exiting the labor force may not exacerbate weight gain.

Weight loss induced by a hypocaloric diet with or without fish oil supplementation re-established iron and omega-3 fatty acid homeostasis in middle-aged women with obesity: A post-hoc analysis of a randomized controlled trial

ObjectiveMiddle-aged women with obesity are at increased risk of iron overload and iron disorder is known to disrupt n-3 polyunsaturated fatty acid homeostasis. We evaluated relationships between pretreatment hemoglobin and n-3 polyunsaturated fatty acid levels, and tested whether pretreatment hemoglobin contributed to inter-individual variability in weight loss with special focus on changes in body weight, iron and n-3 polyunsaturated fatty acid profiles. Study design117 middle and older aged women with obesity and more than two metabolic abnormalities were randomized to a 12-week hypocaloric diet without or with fish oil supplementation. Blood iron biomarker and erythrocyte membrane phospholipid profiles were evaluated. Main outcomeThe absolute change from baseline to week 12 in serum iron and erythrocyte n-3 polyunsaturated fatty acid levels according to pretreatment hemoglobin tertiles and fish oil supplementation. ResultsA Pearson correlation analysis showed that pretreatment hemoglobin levels were negatively correlated with linoleic acid (r = −0.231), α-linoleic acid (r = −0.279), and n-3 polyunsaturated fatty acid (r = −0.217) (all p < 0.05). Dietary weight loss markedly enhanced erythrocyte membrane lipids of linoleic acid, α-linoleic acid, and n-6 and n-3 polyunsaturated fatty acid only in those women with the highest pretreatment hemoglobin levels (tertile 3) (all p < 0.05). Fish oil supplementation increased bioavailable iron in women with moderate pretreatment hemoglobin levels (tertile 2) (p < 0.05) and, to a lesser extent, prevented a reduction in circulating iron in those with the lowest hemoglobin levels (tertile 1). ConclusionDietary weight loss is an effective treatment program to manage obesity-related iron and n-3 polyunsaturated fatty acid disorders, particularly for middle-aged women with obesity and iron overload.

Bacterial Persistence in Urinary Tract Infection Among Postmenopausal Population.

Urinary tract infections (UTIs) are common in older-aged women. Our study examined bacterial persistence with commonly prescribed antibiotics. Bacterial growth was demonstrated despite antibiotic treatment. The aims of this study were to quantify the bacterial persister phenotype in urine collected from postmenopausal women with acute and recurrent UTI and to determine the capabilities of first-line antibiotics to effectively treat persister cells. This was an institutional review board-approved cross-sectional analysis within a large academic referral center. Uropathogens were cultured from postmenopausal women with acute or recurrent UTI and screened for persister cells using persistence assays. Demographic and clinical variables were collected and analyzed. The entire experimental process was repeated in triplicate. Data were analyzed for significance (P < 0.05) between the persister culture and antibiotic treatments using a 1-way analysis of variance with multiple comparisons in Prism 9.3.0. Forty participants were included: 62.5% White, 22.5% Black, 3% Asian, and 2% Hispanic with a mean age of 72.3 ± 11.62 years. The persister phenotype was demonstrated in all of Escherichia coli isolates. Treatment with fosfomycin demonstrated reduced colony-forming units per milliliter compared with control (P < 0.01). Among recurrent isolates, there was a statistically significant decrease in colony-forming units per milliliter after antibiotic treatment with all 4 antibiotics (P < 0.05). This study demonstrated in vitro bacterial persistence in uropathogens from urogynecology patients despite treatment with commonly prescribed antibiotics. Fosfomycin generated the least amount of persister cells. Results suggest that persistence may be one bacterial defense mechanism involved in UTIs. Further research is needed to understand the clinical implications.

Multiple Gestations: Neonatal and Maternal Characteristics

Introduction Multiple gestation neonates are commonly found in older age women along with increasing use of assisted reproductive techniques. They are at an increased risk of complications and also impose financial, emotional, social, and psychological burdens on the family. There is a paucity of studies on multiple gestations in India, hence this study was conducted to evaluate the clinical profile and associated comorbidities in neonates born through multiple gestations which can help in anticipating, preparing, and managing possible complications. Methodology This was a prospective observational study conducted in a Level III neonatal intensive care unit of a tertiary care hospital. All intramural neonates delivered with multiple gestations were included. Data regarding the antenatal, perinatal, and hospital course of the neonates were documented. Results A total of 75 intramural neonates (36 twins and 1 triplet) were enrolled in the study. About 67.6% were delivered via caesarean section and 81.1% were spontaneous conception. The most common maternal complications observed were hyperemesis gravidarum (56.76%) followed by pregnancy-induced hypertension (PIH) (40.54%). About 80% of twin neonates were diamniotic dichorionic (DADC) and 42% of twin neonates had vertex-vertex presentation. Almost 22.7% of neonates required neonatal resuscitation and 98% had a birth weight &lt;2.5 kg. Initiation of breastfeeding was delayed, and longer hospital stay was observed in preterm neonates with birth weight ≤1.5 kg and birth weight discordance. Conclusion Multiple gestations are associated with significant neonatal complications owing to prematurity and low birth weight. Thorough knowledge of these complications helps in better fetal and neonatal surveillance and prevention of adverse outcomes.

Trajectories of physical activity from mid to older age in women: 21 years of data from the Australian Longitudinal Study on Women’s Health

BackgroundWomen’s physical activity varies across the adult lifespan. However, changes in physical activity among mid-aged women are not well understood. We analysed 21 years of data from women born in 1946–51 to identify: (1) trajectories of physical activity in the transition from mid- to old-age and (2) determinants of different physical activity trajectories.MethodsData were from the 1946–51 cohort of the Australian Longitudinal Study on Women’s Health (N = 10,371). Surveys were mailed at three-year intervals from 1998 (age 47–52) to 2019 (age 68–73) to collect data on physical activity, sociodemographic factors (country of birth, area of residence, educational attainment, marital status, income management, paid work hours, living with children age < 18, providing care), health indicators (menopause status, BMI, physical and mental health, chronic conditions), and health behaviours (smoking, alcohol status). Group-based trajectory modelling was used to identify trajectories of physical activity. Multinomial logistic regression models were used to examine the determinants of physical activity trajectories.ResultsFive trajectories were identified: Low-stable (13.3% of participants), Moderate-stable (50.4%), Moderate-increasing (22.2%), High-declining (7.7%), and High-stable (6.6%). Sociodemographic characteristics (area of residence, education, income management, living with children, and providing care) were determinants of physical activity trajectories, but the strongest factors were BMI, physical and mental health. Women who were overweight/obese and had poor physical and mental health were less likely to be in the High-stable group than in any other group. Changes in these variables (increasing BMI, and declining physical and mental health) and in marital status (getting married) were positively associated with being in trajectories other than the High-stable group.ConclusionsAlthough most women maintained physical activity at or above current guidelines, very low physical activity levels in the Low-stable group, and declining levels in the High-declining group are concerning. The data suggest that physical activity promotion strategies could be targeted to these groups, which are characterised by socioeconomic disadvantage, high (and increasing) BMI, and poor (and worsening) physical and mental health. Removing barriers to physical activity in these women, and increasing opportunities for activity, may reduce chronic disease risk in older age.