Older Women Research Articles

Blackcurrant Supplementation and Habitual Physical Activity Enhance Functional Capacity and Quality of Life in Previously Sedentary Older Women.

Loss of functional capacity negatively impacts the quality of life in older adults. This single-site randomized controlled study examined whether short- (one week) and long-term (three months) blackcurrant supplementations combined with habitual physical activity would improve functional capacity and quality of life in previously sedentary older women. Thirty sedentary, healthy older women were randomly assigned to receive blackcurrant supplementation (400 mg of blackcurrant extract) (Polyphenol group, n=15; 74.2±10.0 years) or no supplementation (capsules of 400 mg of corn flour) (Placebo group, n=15; 72.8±8.7 years). Each group consumed two capsules daily for one week and three months, with a washout period of one week between the two phases. The polyphenol group was required to increase habitual activity levels. Participants underwent a functional capacity assessment consisting of a sixminute walk, sit-to-stand test, Berg balance scale measurement and quality of life evaluation with the Scale of Life Satisfaction Index (LSI) at the start, after one week, and after three months of supplementation. Walking distance and time to sit-to-stand improved by 2.5% (p=0.005) and 7.5% (p=0.005), respectively, after one week in the polyphenol group. After 3 months, walking distance in the six-minute walk test increased by 12.3% (p=0.001) while the time to sit-to-stand decreased by 16% (p=0.002) in the polyphenol compared to placebo group, respectively. No differences in Berg balance scale were observed. Quality of life, indexed by LSI, improved by 39% (p=0.001) in the polyphenol compared to the placebo group. Blackcurrant supplementation, combined with habitual activity, may enhance functional capacity and quality of life in older women, offering a potential strategy to maintain independence. However, future studies should address longer durations to validate these findings.

The associations of n-3 fatty acid intake with handgrip strength and muscle mass indices in older adults: A cross-sectional study from UK Biobank

ObjectivesTo investigate the associations of n-3 fatty acid intake with handgrip strength and muscle mass indices in older adults. A secondary aim was to investigate whether these associations differed by physical activity status. Research methods & proceduresA cross-sectional study included 53,170 participants aged 60 years and over from the UK biobank (25,324 men and 27,846 women). The primary outcomes were grip strength index and muscle mass index, the predictor variable was n-3 fatty acid intake and the covariates were age, ethnicity, Townsend deprivation index, physical activity, multimorbidity count, total energy intake, body fat percentage and the month of assessment. Multivariable linear regression analyses were performed across 5 models. Model 1 was unadjusted; model 2 adjusted for age, ethnicity, deprivation index and month of assessment; model 3 adjusted as in model 2 plus total energy intake; model 4 as in model 2 plus multimorbidity count; and model 5 as in model 4 plus body fat percentage. ResultsIn model 5, higher n-3 fatty acid intake was positively associated with the grip strength index in women. For each additional gram of n-3 fatty acid consumed per day, there was an increase of 0.03 kg/m2 (95% CI: 0.00 to 0.06 kg/m2) in active women and 0.04 kg/m2 (95% CI: 0.00 to 0.07 kg/m2) in inactive women. However, no significant associations were observed in men, whether active (p = 0.405) or inactive (p = 0.323). Additionally, no significant associations were found between n-3 fatty acid intake and muscle mass index in either active (p = 0.858) or inactive (p = 0.250) men, or in active (p = 0.909) or inactive (p = 0.187) women. ConclusionAlthough n-3 fatty acid intake was associated with grip strength index in older women, regardless of their activity status, the magnitude of this association was very small and unlikely to be clinically relevant. Additionally, n-3 fatty acid was not associated with muscle mass index.

Six Weeks to Wellness: The Role of Breathing Exercises Based on Motor Development Pattern in Improving Fitness and Quality of Life in Overweight Elderly Women.

Background: Being overweight is a major global health epidemic of the 20th and 21st centuries, which can affect the movement system function of older adult women. This study evaluated the effects of a breathing exercise based on motor development patterns on functional fitness and quality of life in overweight older adult women. Methods: A randomized controlled trial was conducted with 40 community-dwelling women aged 65-75. Participants were randomly assigned to an intervention group, which completed a 6-week breathing exercise program (three supervised and three home-based sessions per week), or a control group, which maintained usual routines. Outcome measures included cardiovascular fitness, upper and lower body flexibility, muscle strength, dynamic balance, and quality of life, assessed at baseline and post-intervention. Results: The intervention group showed significant improvements in cardiovascular fitness (p < .001, ES = 0.652), upper body flexibility (p < .001, ES = 0.652), lower body flexibility (p < .001, ES = 0.538), upper body strength (p < .001, ES = 0.538), lower body strength (p < .001, ES = 0.538), and dynamic balance (p < .001, ES = 0.475) compared to the control group. Quality of life also significantly improved in the intervention group (p < .001, ES = 0.475). Conclusion: Breathing exercises based on motor development patterns significantly enhance functional fitness and quality of life in overweight older adult women. Incorporating these exercises into regular physical activity routines may promote health and independence in older adults. Further research should explore long-term benefits and optimal exercise parameters for older adults.

The Association Between Urinary Incontinence With Pelvic Pain and Sensory-Motor Function in Older Women With Stroke.

The study aimed to investigate the association between urinary incontinence (UI) severity, pelvic pain, and sensory-motor function in older women with stroke. A cross-sectional prospective study was carried out with 102 older women individuals with stroke. Barthel Index (BI), Incontinence Impact Questionnaire Short Form (IIQ-7), Urogenital Distress Inventory (UDI-6), Pelvic Pain Impact Questionnaire (PPIQ), Somatosensory Amplification Scale (SASS), and Somatic Sensitivity Scale (SeSS) were used for clinical measurements. Partial correlational analyses with age, stroke duration, and BMI as covariates revealed a moderate positive correlation between SASS and IIQ-7 (r = 0.315, p < 0.001) and UDI-6 (r = 0.376, p < 0.001). On the other hand, there was a strong positive correlation between SASS and PPIQ (r = 0.522, p < 0.001). SeSS had a low positive correlation with IIQ-7 (r = 0.198, p < 0.05) and UDI-6 (r = 0.203, p < 0.05). In addition, there was a positive and moderate correlation between SeSS and PPIQ (r = 0.384, p < 0.001). Multivariate linear regression analysis revealed causality of SASS (R2 = 0.381, p < 0.001) and SeSS (R2 = 0.167, p < 0.001) with PPIQ. Increased abnormal sensory sensitivity is associated with increased pelvic pain levels in women with stroke. Clinicians should consider sensory abnormalities, especially pain, within the scope of UI in women with stroke. Our results provide preliminary essential data for sensory and pain awareness during pelvic rehabilitation in stroke patients.

Hormone Receptor Positive Breast Cancer in Young Women: A Review.

The global incidence of hormone-positive breast cancer (HR+ BC) in young women is rising, though the underlying reasons remain unclear. HR+ disease in younger women appears to represent a distinct clinical entity compared to that in older women, exhibiting distinct clinicopathological characteristics, outcomes and responses to treatment. Despite these differences, there is a paucity of large-volume data focusing on young women with HR+ in contemporary literature. Hormone receptor positive breast cancer in young women is associated with poorer prognoses compared to older women. Additionally, early age onset breast cancer presents unique challenges, including concerns related to fertility, the toxic effects of therapeutic agents, and specific surgical considerations. The purpose of this review is to report the existing literature on HR+ disease in young women.

A global research agenda for understanding the role of alcohol consumption in older women’s lives

Abstract Background The alcohol industry has targeted women for profit and resisted global efforts to address the impact of alcohol on women’s health. Scholars have called for research that moves beyond individual determinants of alcohol consumption in women, to investigate the range of social, environmental, and commercial factors that may contribute to women’s alcohol attitudes, risk/benefit perceptions, and consumption behaviours. While qualitative research has explored younger and midlife women’s perspectives on alcohol consumption, there is a notable lack of research focusing on older women. Methods This study investigated the factors that influence how older Australian women drinkers conceptualised the role of alcohol in their lives, using data collected from an online qualitative survey with n = 144 women aged 60-88 years. Qualitative responses were analysed using a ‘Big Q’ reflexive approach to thematic analysis. Results Participants perceived alcohol consumption as a socially accepted and normalised activity within Australian culture. For some women, alcohol served as a coping mechanism for life changes, such as retirement, and for managing stressful situations. Alcohol also formed part of daily routines and rituals, such as having wine with dinner. Participants had personal expectancies regarding ‘responsible drinking’, often aligning with alcohol industry messaging and resulting in a reduced perception of alcohol-related risks. Conclusions This research provides global lessons for future public health research examining the factors that may shape older women’s alcohol consumption beliefs and behaviours. The authors consider the unique needs and potential vulnerabilities of older women drinkers, and how these may be potentially exploited by the alcohol industry. Further public health research and policy attention should focus on the impact of alcohol industry messaging on older women’s knowledge, attitudes, and behaviours about alcohol risks and harms. Key messages • This research highlights the role of alcohol in older women’s lives, urging further public health research and policy attention to prevent alcohol-related harms in older women. • Older women’s perceptions of responsible alcohol consumption mirror the ambiguous messaging employed by the alcohol industry, highlighting the necessity for targeted interventions.

Dialogue between researchers and older immigrant women in Norway post COVID-19: A qualitative study

Abstract Background In the wake of the COVID-19 pandemic, marginalized groups, particularly older immigrant women, have faced new challenges, prompting an urgent need for research to understand their post-pandemic needs and foster inclusive healthcare systems. In view of this, older immigrant women and researchers developed a project based on dialogue, holding monthly meetings for a year, with the aim of improving health literacy for the women, and enlightening the researchers on the women’s challenges. This study has sought to understand the experiences of the dialogue between older immigrant women and researchers. Methods We utilized participant observation in five dialogical meetings between older immigrant women and researchers, followed by semi-structured interviews with 8 older immigrant women and 7 researchers in Bergen. Data was analyzed using thematic analysis, supported by audio-recorded and transcribed interviews, alongside notes from participant observations. Results Analysis yielded three main themes of health knowledge, collaboration, and power dynamics. The dialogue was seen as a positive experience by both older immigrant women and researchers, with a view to establishing collaboration and trust. It also encouraged user participation in research, for the women, and carrying out research that was relevant to this otherwise ‘invisible’ population to the health system, for researchers, whilst empowering the women with knowledge to improve and maintain their own health. Conclusions This study sheds light on the crucial role of dialogue between older immigrant women and researchers in understanding post-COVID-19 needs. The findings underscore the importance of fostering collaboration, trust, and user participation in research, empowering marginalized populations while addressing gaps in the healthcare system. By amplifying the older immigrant women voices’ and promoting inclusive research practices, we can foster responsive and equitable healthcare systems. Key messages • Dialogue between older immigrant women and researchers is essential for understanding post-COVID-19 needs, fostering collaboration and trust. • User participation empowers marginalized groups, while relevant research improves healthcare inclusivity and outcomes for all.

Mediterranean diet score linked to cognitive functioning in women: evidence from the Czech Republic

Abstract Background Evidence suggests that adherence to the Mediterranean diet (MED) may be beneficial in preventing cognitive decline, although findings are inconsistent. We aimed to explore this association in the Czech population of older adults. Methods A total of 6,028 males and females from the Czech arm of the Health Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study were included in the analysis. Dietary data were collected using a food frequency questionnaire, and MED was calculated based on nine food groups. The MED score ranged from 0 to 16 points and was categorized into three groups: 0-7, 8-10, and 11-16 points. Cognitive function was measured using four tests assessing verbal memory and learning, verbal fluency, and attention, mental speed and concentration, from which single z-scores were computed. The composite score of cognitive function was computed as the mean of z-scores. The cross-sectional associations between MED and composite score of cognitive function were analyzed using multivariate linear regression. Results Females with a dietary score of 8-10 points (Beta=0.05, 95% CI: -0.002; 0.097), and those with a score of 11-16 points (Beta=0.08, 95% CI: 0.016; 0.140) had a higher composite cognitive score than women in lowest adherence group. Looking at specific domains, women in the highest adherence group had significantly better immediate verbal memory (Beta=0.12, 95% CI: 0.031; 0.205) and delayed recall (Beta=0.12, 95% CI: 0.027; 0.212), respectively, than those in the lowest adherence group. There were no associations in males. Conclusions Higher adherence to the MED was associated with better cognitive functioning in verbal memory and composite cognitive score in Czech females. The results suggest that the Mediterranean diet may help to improve cognitive functioning in older women. #NGEU Key messages • Findings suggest that Mediterranean diet may be beneficial in cognitive functioning in older women. • Higher adherence to the Mediterranean diet is connected to better cognitive function particularly in verbal memory domain.

The Effects of Physiotherapy Programmes, Aided by Virtual Reality Solutions, on Balance in Older Women: A Randomised Controlled Trial

Background: Modern technologies are being applied to maintain and improve the functional performance of older adults. Fully immersive virtual reality (VR) combined with a scope of dual-task (DT) activities may effectively complement conventional physiotherapy programmes for seniors. The study aimed to compare the effectiveness of a fully immersive virtual reality (VR) environment combined with a scope of dual-task activities regarding balance in older women. Methods: Eighty women were recruited to the study protocol and, following randomisation, allocated to two equally sized groups, one pursuing conventional OTAGO exercises, the other one the VR-solutions-aided exercise programme combined with a scope of DT activities. Physiotherapy sessions spanned 6 weeks, each one lasting 60 min, three times a week, in both groups. Results: Homogeneity analysis of both study groups indicated no statistically significant differences at the first measurement point. After the intervention, both study groups achieved significantly improved scores on all tests. The VR + DT group obtained better results in dual-task gait and single-leg standing, whereas the greatest difference was observed during SLS CL (1.52 s vs. 2.33 s—difference 0.81 s 53.2% change, p = 0.001). The OTAGO group performed better in the TUG single-task gait (11.35 s vs. 12.60 s, p &lt; 0.001) and in the Berg balance scale. Conclusions: The VR + DT training is effective in improving individual balance as well as in reducing fall risks. VR-assisted physiotherapy should complement conventional physiotherapy programmes (e.g., OTAGO). The benefits of applying VR solutions indicate that older women might well use this form of activity regularly under the guidance of a therapist or a family member.

National survey to estimate seroprevalence for toxoplasmosis among pregnant women in France, 2021

Abstract Background Toxoplasmosis during pregnancy can result in congenital malformations and fetal death. In France, universal antenatal screening and monthly re-testing of seronegative pregnant women has been established since the 1970s. However, decreasing Toxoplasma gondii seroprevalence among pregnant women and lower incidence of congenital toxoplasmosis may challenge the cost-effectiveness of such programs. The aim of this study was to estimate the current seroprevalence among pregnant women participating in the 2021 national perinatal survey (ENP). Methods All adult women giving birth in France between 15-21 March 2021 were invited to participate in the ENP. Data collected included demographic information, nationality, socio-economic status, education level and Toxoplasma gondii serology. We classified a woman as seropositive if she had IgG antibodies prior to pregnancy or seroconverted during it. Univariable and multivariable regression analyses using Poisson model were conducted to estimate prevalence ratios (PRs) and identify significant factors associated with seropositivity. Results Among the 15,605 participating women, 0.22% seroconverted during pregnancy. The overall seroprevalence was 25.95%. Seropositivity was higher with increasing age (∼5% per 5 years), among residents of French overseas territories Guadeloupe/Saint Martin (PRs:1.07; 95%-CI: 1.03-1.10), La Réunion (PRs:1.10; 95%-CI: 1.08-1.13) and Mayotte (PRs:1.27; 95%-CI: 1.23-1.31), with lower education (PRs:1.22; 95%-CI: 1.04-1.42) and African nationality (PRs:1.11; 95%-CI: 1.02-1.20). Conclusions High seroprevalence for Toxoplasma gondii was found in older women, which may reflect their higher risk of past exposure. The observed geographical differences in seroprevalence may mirror dietary and environmental diversity. Declining seroprevalence among pregnant women in France can affect screening effectiveness and warrants a comprehensive review to determine appropriate future prevention strategies. Key messages • Older women and residents of French overseas territories show higher toxoplasmosis seroprevalence, possibly due to past exposure risks and diverse diets/environments. • Declining toxoplasmosis seroprevalence among pregnant women in France can affect screening effectiveness and warrants a comprehensive review to determine appropriate future prevention strategies.

A scoping review on sociodemographic inequalities in breast cancer screening attendance in Germany

Abstract Background Organized breast cancer screening (BCS) programs are effective measures among women aged 50-69 for preventing the fifth cause of death in Germany. However, still participation rates have not yet reached EU standards. It is unclear which and how sociodemographic factors are related to BCS attendance. This scoping review aims to identify sociodemographic inequalities in BCS attendance among 50-69-year-old women following implementing the Organized Screening Program in Germany. Methods Following PRISMA guidelines, we searched the Web of Science, Scopus, MEDLINE, PsycINFO, and CINAHL. We included primary studies with a quantitative study design and reviews examining BCS attendance among women aged 50-69 with data from 2005 onwards in Germany. Harvest plots depicting effect size direction for the different identified sociodemographic inequalities were developed. Results We screened 476 titles and abstracts and 33 full texts. In total, 27 records were analysed, 14 were national reports, and 13 peer-reviewed articles. Eight sociodemographic variables were identified and summarised in the harvest plots: age, education, income, migration status, type of district, employment status, partnership cohabitation and health insurance. Older women, women with lower incomes and migration backgrounds who live in rural areas and lack private insurance, respond more favourably to BCS invitations. However, from a lifetime perspective, these associations only hold for migration background, are reversed for income and urban residency, and are complemented by partner cohabitation. Finally, women living in the federal states of Lower Saxony, Saxony, Mecklenburg-Western Pomerania, Saxony-Anhalt, and Thuringia showed higher attendance rates in the last two years. Conclusions High-quality research is needed to identify women at higher risk of not attending BCS in Germany, particularly as the overall attendance rate still falls below European standards. Key messages • High-quality research is needed to identify women at higher risk of not attending BCS in Germany, particularly as the overall attendance rate still falls below European standards. • Women without migration background, high income, living in rural areas, and not cohabitating with their partners are at higher risk of never attending BCS in Germany.

Circulating Galectin-3 distinguishes global aortic aging among older women

Abstract Background Traditional cardiovascular risk factors may underestimate age-associated cardiovascular risk, particularly in estimating discrepant risks between sexes. As a marker of adverse cardiovascular events, aortic stiffness may improve risk assessment, but the requirement for advanced imaging equipment restrict widespread translation of this paradigm. Conversely, circulating blood biomarkers may augment mechanistic understanding and distinguish sex-based differences in aortic stiffness. Purpose Hypothesizing that Galectin-3 (Gal-3) is associated with aortic aging among older adults, we examined sex-based differences between Gal-3 and global aortic stiffness as assessed by a novel cardiac magnetic resonance (CMR)-derived measurement of aortic global longitudinal strain (AOGLS). Methods Community older adults without cardiovascular disease underwent simultaneous CMR with serum Gal-3 quantification using chemiluminescent microparticle immunoassays. Poorer AOGLS was defined as values below the 75th percentile of AOGLS measurements. Multivariable regression models were used to assess the association of Gal-3 with AOGLS. Results Of 255 participants (mean age 70.8 ±9.1 years, LVEF 66.3 ±8.3%), 44.3% were women. Poorer AOGLS was characterized by higher Gal-3 (B coefficient = -0.101, 95%CI [-0.167, -0.034], p = 0.003), mean age (B = -0.126, 95%CI [-0.154, -0.098], p &amp;lt;0.001), male sex (B = -0.991, 95%CI [-0.409, -1.572], p = 0.001), history of hypertension (B = -0.777, 95%CI [-1.364, -0.189], p = 0.010), diabetes mellitus (B = -0.888, 95%CI [-1.617,-0.158], p = 0.017), smoking (B = -1.346, 95%CI [-2.15, -0.542], p=0.001), pulse rate (B = -0.032, 95%CI [-0.055, -0.01], p = 0.005), systolic BP (B = -0.014, 95%CI [-0.025, -0.004], p = 0.009), and diastolic BP (B = -0.033, 95%CI [-0.06, -0.006], p = 0.018) on univariable linear regressions; no associations were observed with urine albumin-to-creatinine ratio, serum NT-ProBNP, or hs-Troponin I. After multivariable adjustments for sex, age, significant cardiovascular risk factors (hypertension, diabetes, smoking), and pulse rate, the inverse relationship between Gal-3 and AOGLS (Figure 1) persisted (B = -0.071 95%CI [-0.135, -0.008], adj. p = 0.028, R2 = 0.217). The association between Gal-3 and AOGLS was more marked among women (Figure 2), compared to men. Among women, higher Gal-3 characterized women with poorer AOGLS (17.04 ±3.73 ng/mL vs 15.48 ±3.55 ng/mL p = 0.040) (B = -0.120, OR 0.887, 95% CI [0.787, 0.999], adj. p = 0.048), independent of age. Conclusions Galectin-3 was adversely associated with novel CMR-derived AOGLS. Among these older adults with age-associated observations in AOGLS, Gal-3 highlighted sex-based differences in AOGLS and differentiated women with poorer AOGLS from women with better AOGLS. Serum Gal-3 measurements may be useful for detecting adverse patterns of aortic aging, particularly as an early approach in community older adults.

Disability during the last ten years of life: Evidence from a register-based study in Austria

Abstract Background Many older adults experience disability in activities of daily living during the last years of life, but survey-based analyses suffer from non-representative samples due to selective participation and attrition. Here, we use individual-level register data on the receipt of the Austrian long-term care allowance (ALTCA) as a proxy for late-life disability. Methods In this retrospective mortality follow-back study, we analyse receipt of ALTCA, a cash benefit based on physician assessed disability during the last 10 years of life, among all decedents aged 65 years and over from 2020 in Austria (n = 76,781). The impact of sex, age of death, and cause of death on the duration and probability of receipt of ALTCA was assessed with regression models. Results 10 years before death 10% of older men and 25% of older women received ALTCA, which increased to 27% and 51% at 5 years, 56% and 77% at 1 year, and finally to 70% and 87% at 1 month before death. On average, ALTCA was received for 3.2 years in men and 4.5 years in women. The probability to receive ALTCA and its duration increased sharply with age at death and varied by underlying causes of death: those who died from cancer, myocardial infarction, and external causes of death were less likely to receive ALTCA and experienced shorter durations of it, while those who died from dementia, Parkinson’s disease, chronic heart disease, or chronic obstructive lung disease were more likely to receive ALTCA and longer so. Conclusions Most older adults received ALTCA for multiple years before death, and this increased strongly with age at death and varied across causes of death. Our register-based estimates of late-life disability were twice as high as survey-based estimates, which points to an underestimation in previous studies. Policy-makers should be aware that costs of long-term care will likely increase as life expectancy rises and deaths from dementia and organ failure increase in ageing European societies. Key messages • A large majority of older adults in Austria experience late-life disability. On average, older men were disabled for 3.2 and older women for 4.5 years. • Probability and duration of late-life disability increased steeply with age at death and was higher for those who died from dementia, Parkinson’s disease, or chronic heart or lung disease.

Cranberries for the Prevention of UTIs in Older Women.

Cranberries for the Prevention of UTIs in Older Women.

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

Regional disparities and socio-demographic factors associated with eight or more antenatal care visits in Ghana

BackgroundAntenatal care is vital for maternal health and wellbeing, with the World Health Organization recommending a minimum of eight visits during pregnancy. In this study, we examined the regional disparities and factors associated with eight or more antenatal care visits in Ghana.MethodsWe performed a cross-sectional analysis of data from the 2022 Ghana Demographic and Health Survey. Our study comprised 3,893 women of reproductive age with birth history in the last two years before the survey. Regional disparities in the proportion of eight or more antenatal care visits were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was conducted to determine the factors associated with eight or more antenatal care visits using a four-modeled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI).ResultsThe prevalence of eight or more antenatal care visits in Ghana was 38.4% [95% CI = 36.0–41.0]. The regions with the highest prevalence were Eastern, Greater Accra, Western, and Volta. Those with the lowest prevalence were Northern, North East, Savannah, and Oti. The odds of eight or more antenatal care visits were lower among women aged 40–49 [aOR = 0.42, 95% CI = 0.18–0.96], women with four or more children [aOR = 0.57, 95% CI = 0.36–0.93], women who wanted pregnancy later [aOR = 0.63, 95% CI = 0.46–0.85], and women in five regions: Western North [aOR = 0.43, 95% CI = 0.19–0.94], Bono [aOR = 0.33, 95% CI = 0.14–0.76], Northern [aOR = 0.29, 95% CI = 0.13–0.66], Savannah [aOR = 0.30, 95% CI = 0.14–0.65] and North East [aOR = 0.33, 95% CI = 0.14–0.75]. Women in the richer [aOR = 1.99, 95% CI = 1.19–3.33] and richest [aOR = 4.82, 95% CI = 2.45–9.51] wealth index showed a higher likelihood of completing eight or more antenatal care visits relative to women in the poorest wealth index.ConclusionA significant proportion of women in Ghana fall short of the recommended eight or more antenatal care visits. Age, parity, desired pregnancy timing, wealth status, and region of residence are associated with the number of antenatal care visits. Women in five regions (Bono, Northern, North East, Savannah, and Western North) are significantly less likely to have eight or more antenatal care visits than those in the Western region. The government and policymakers should design programs to address the needs of older women, those with high parity, and women who want to delay pregnancy. Increased healthcare resources, educational campaigns, and addressing regional barriers to antenatal care access are crucial. Promoting public health initiatives to emphasise the importance of completing the recommended number of antenatal care visits for a healthy pregnancy is essential.

10.F. Skills building seminar: How public health professionals can use the right to health to advance climate action and justice

Abstract The climate crisis is the single biggest threat to global health, peace and security, a crisis multiplier, and a significant driver of health inequalities. In many areas of public health policy, legal action and litigation have delivered significant and long-lasting impacts. In April 2024, the European Court of Human Rights concluded that Switzerland had violated the right to health of older women in Switzerland by failing to meet its past greenhouse gas (GHG) emissions reduction targets and set future GHG targets. State-of-the-art public health evidence provided by the Intergovernmental Panel on Climate Change and Lancet Countdown on Health and Climate Change were vital to the Court’s decision, which has implications for all Council of Europe member states, and globally. Rigorous scientific evidence of health harms, including but not limited to heat stress, can inform other climate litigation grounded in the right to health. Public health researchers and practitioners are essential to this litigation. In recognition of this emerging role, in November 2023 the Faculty of Public Health (UK) and the Aletta Jacobs School of Public Health launched ‘From analysis to action: climate change litigation. A guide for public health professionals’ at the 16th European Public Health Conference. The guide was also endorsed by ASPHER, ASPPH, EUPHA, Global Consortium on Climate and Health Education, Global Network for Academic Public Health, Lancet Countdown, Public Health Ethics and Law Global Network, and WFPHA. This workshop will familiarise participants with recent rights-based climate litigation and explore the role of public health professionals in identifying, collecting, storing, assessing and presenting this evidence in a form that is accessible to court officials without medical training. First, there will be short presentations on 1) the role of the law in climate action and the role of scientific evidence of health harms in human rights litigation, and 2) How to collect and use scientific evidence of health harms in climate litigation (15 minutes). Small group discussions will follow, addressing questions such as: The health harm of climate change-related heat stress was a major factor in the 2024 decision of the European Court of Human Rights in KlimaSeniorinnen v. Switzerland: What other health harms could support future cases? In what population groups? What opportunities do you see today for public health researchers and practitioners to compile such evidence to make the most compelling case? How can public health researchers and practitioners work more closely with legal experts and affected communities to bring this evidence to court? (20 minutes) The workshop will conclude with a plenary discussion of these questions and the small group responses. (25 minutes) As a result of the workshop, participants will be better prepared to identify opportunities to contribute compelling evidence of health harms in climate litigation. Key messages • Rigorous scientific evidence of climate change-related health harms is proving central to success in rights-based climate litigation. • Public health professionals have a key role in identifying and presenting compelling evidence of health harms in climate litigation. Speakers/Panelists David Patterson University of Groningen, Groningen, Netherlands Farhang Tahzib Faculty of Public Health, Haywards Heath, UK

A Review of the Evolution of the NCS-NCVS Police Reporting and Response Questions and Their Application to Older Women Experiencing Violent Victimization

Little attention is given to the history of the data that underlie research on crime trends and patterns. This article considers the evolution of the National Crime Victimization Survey’s (NCVS) police reporting and response questions. These questions are particularly important as the NCVS is the only nationally representative source of information on whether crime is reported to the police and citizen views of police actions. In addition, the current NCVS redesign is set to substantially add to these items. To provide a context for this discussion, this article applies the police reporting and response questions to an understudied victim group, specifically older women who experience violent victimization. This application illustrates the research opportunities and challenges for working with these data.

Legal perspectives on climate change and inequalities

Abstract In many areas of public health policy, litigation has delivered significant, long-lasting impacts. Examples include tobacco control, increasing access to treatments for HIV, and addressing air pollution and climate change. Litigation is an established part of public health’s advocacy toolbox in national courts, and increasingly in international courts and tribunals. In responding to climate change, in addition to potential policy and law reform, climate change litigation creates opportunities for public scrutiny and debate by raising awareness of inaction or harm caused by governments or private sector polluters, and sparking wider community mobilisation for climate action. Where climate change litigation is based on human rights claims, credible science-based evidence of the health and other human rights impacts of climate change is essential. Public health professionals are increasingly involved in assembling and presenting such evidence, often focusing on vulnerable populations. However, the multiple intersecting identities of vulnerable populations have not been sufficiently explored. For example, how does intersectional disadvantage influence the ways in which evidence of the impact of climate change is assembled and assessed? How are these issues addressed in the courts? Examples include older women (KlimaSeniorinnen v. Switzerland), young people, from both the global South and global North, in urban or remote areas, or with different pre-existing health conditions (Sacchi et al. v. Argentina et al), and Indigenous people, including women and children (Daniel Billy and others v. Australia; Teitiota and others v. New Zealand). Multiple identities can compound vulnerability. For example, young people may be more vulnerable both due to their physical immaturity and due to eco-anxiety and other mental health impacts. This presentation will explore these issues, and the critical role of public health professionals in legal action to address climate change.

Long-Term Physical Activity Mitigates Inflammaging Progression in Older Adults Amidst the COVID-19 Pandemic

Background: Inflammaging and physical performance were investigated in older adults before and after the COVID-19 pandemic. Methods: Older women (n = 18) and men (n = 7) (mean age = 73.8 ± 7.1) were evaluated before the COVID-19 pandemic (PRE), 12 months after the lockdown (POST), and 10 months after resuming exercise training (POST-TR). Physical tests [gait speed (GS) and timed-up-and-go (TUG)]; muscle strength (handgrip—HG); and serum cytokine levels were assessed. Results: Older women showed higher GS and TUG at POST than PRE and POST-TR but lower HG at POST-TR than PRE, whereas older men exhibited lower HG at POST and POST-TR than PRE. Both groups presented (1) lower IL-10 and IL-12p70 values in contrast to higher IL-6/IL-10 and IL-8/IL-10 ratios at POST than PRE; (2) higher IL-10 values and lower IL-8/IL-10 ratio at POST-TR than POST; (3) higher IL-12p70/IL-10 ratio at POST-TR than PRE and POST. Particularly, older women showed (4) lower IL-6 values at POST and POST-TR than PRE; (5) lower IL-8 and IL-10 values at POST-TR than POST; (6) and higher TNF-α/IL-10 and IFN-γ/IL-10 ratios at POST than PRE and POST-TR. Significant correlations between the variables were found in both groups. Discussion: During the COVID-19 pandemic, detraining and resumption of exercise training promoted distinct alterations in physical capacity and inflammaging among older women and older men.