Performance In Postmenopausal Women Research Articles

The Performance of Postmenopausal Women in the Prevention of Osteoporosis Based on Health Belief Model

The Performance of Postmenopausal Women in the Prevention of Osteoporosis Based on Health Belief Model

Low-load resistance training and blood flow restriction improves strength, muscle mass and functional performance in postmenopausal women: a controlled randomized trial

Low-load resistance training and blood flow restriction improves strength, muscle mass and functional performance in postmenopausal women: a controlled randomized trial

Muscle performance in post-menopausal women at different risk of falling: A cross-sectional study

Falls are very common in older people and in post-menopausal osteoporotic women might lead to disability and hospitalization, with a significant health care burden. The relationship among the several risk factors for falls is still not well clarified. The aim of this study was to investigate muscle performance of post-menopausal women, according to their risk of falling. In this cross-sectional multicentre study, we included post-menopausal women aged ≥ 55 years, referring to 10 Italian centers specialized in bone health. The cohort was stratified in three groups according to a fall screening test (FST): mild, moderate, and high-risk of falling. We assessed the physical performance using the Unipedal Stance Test (UST) and the gait speed. According to the FST, 752 women, mean aged 71.6 ± 10.4 years, were divided into 3 groups: 365 (48.6%), 254 (33.8%), and 133 (17.6%) at mild, moderate and high-risk of falling respectively. There were statistically significant differences among the 3 groups for both UST (15.70 ± 15.04 vs. 8.39 ± 10.37 vs. 3.17 ± 2.87; P < 0.001) and gait speed (0.89 ± 0.34 vs. 0.57 ± 0.38 vs. 0.37 ± 0.20; P < 0.001). We observed a significant negative correlation between FST and UST (ρ = −0.527; P < 0.001) and between FST and gait speed (ρ = −0.575; P < 0.001). Our data suggest that the risk of falling is moderately correlated to the reduced muscle function and there is progressive worsening of muscle performance with the increase in the risk of falling.

The combination of vitamin D deficiency and overweight affects muscle mass and function in older post-menopausal women.

It has been suggested that overweight and obese individuals have an increased risk to develop vitamin D deficiency, commonly associated with poor muscle performance. The relationship among fat mass, vitamin D status, and skeletal muscle is still debated. To evaluate the effects of the combination of hypovitaminosis D and overweight on muscle mass and strength, and physical performance in post-menopausal women. In this cross-sectional study, we recruited post-menopausal women referring to a physiatric outpatientservice for the management of osteoporosis over a 36-month period. We compared four groups: (1) normal weight with hypovitaminosis D; (2) overweight with normal serum 25(OH)D3; (3) overweight with hypovitaminosis D; and (4) normal weight with normal serum 25(OH)D3 (control group). Outcome measures were: appendicular lean mass-to-BMI ratio; hand grip strength; and short physical performance battery. We analysed 368 women (mean aged 67.2 ± 7.8years): 95 normal weight with hypovitaminosis D, 90 overweight with normal levels of 25(OH)D3, 96 overweight with hypovitaminosis D, and 87 normal weight with normal levels of 25(OH)D3. Overweight women with hypovitaminosis D had a significant risk of reduced muscle mass (OR 5.70; p < 0.001), strength (OR 12.05; p < 0.001), and performance (OR 5.84; p < 0.001) compared to controls. Normal weight women with hypovitaminosis D had only a greater risk of an impairment of muscle strength (OR 7.30; p < 0.001) and performance (OR 3.16; p < 0.001). According to our findings, both hypovitaminosis D and overweight should be investigated in post-menopausal women because of their negative effects on skeletal muscle mass and function. This study demonstrated that hypovitaminosis D is associated to impaired muscle function and its combination with overweight might lead also to muscle wasting in a cohort of post-menopausal women.

High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial.

Optimal osteogenic mechanical loading requires the application of high-magnitude strains at high rates. High-intensity resistance and impact training (HiRIT) applies such loads but is not traditionally recommended for individuals with osteoporosis because of a perceived high risk of fracture. The purpose of the LIFTMOR trial was to determine the efficacy and to monitor adverse events of HiRIT to reduce parameters of risk for fracture in postmenopausal women with low bone mass. Postmenopausal women with low bone mass (T-score < -1.0, screened for conditions and medications that influence bone and physical function) were recruited and randomized to either 8 months of twice-weekly, 30-minute, supervised HiRIT (5 sets of 5 repetitions, >85% 1 repetition maximum) or a home-based, low-intensity exercise program (CON). Pre- and post-intervention testing included lumbar spine and proximal femur bone mineral density (BMD) and measures of functional performance (timed up-and-go, functional reach, 5 times sit-to-stand, back and leg strength). A total of 101 women (aged 65 ± 5 years, 161.8 ± 5.9 cm, 63.1 ± 10.4 kg) participated in the trial. HiRIT (n = 49) effects were superior to CON (n = 52) for lumbar spine (LS) BMD (2.9 ± 2.8% versus -1.2 ± 2.8%, p < 0.001), femoral neck (FN) BMD (0.3 ± 2.6% versus -1.9 ± 2.6%, p = 0.004), FN cortical thickness (13.6 ± 16.6% versus 6.3 ± 16.6%, p = 0.014), height (0.2 ± 0.5 cm versus -0.2 ± 0.5 cm, p = 0.004), and all functional performance measures (p < 0.001). Compliance was high (HiRIT 92 ± 11%; CON 85 ± 24%) in both groups, with only one adverse event reported (HiRIT: minor lower back spasm, 2/70 missed training sessions). Our novel, brief HiRIT program enhances indices of bone strength and functional performance in postmenopausal women with low bone mass. Contrary to current opinion, HiRIT was efficacious and induced no adverse events under highly supervised conditions for our sample of otherwise healthy postmenopausal women with low to very low bone mass. © 2017 American Society for Bone and Mineral Research.

Effect of resistance training volume on walking speed performance in postmenopausal women: A randomized controlled trial

Low muscle strength and high abdominal fatness play an important role in fast and usual walking speeds decrement in postmenopausal women (PW). Low-volume resistance training (RT) improves muscle strength. However, high-volume RT has shown to improve muscle strength and abdominal fatness in PW. Thus, high-volume RT would elicit greater improvement in fast and usual walking speeds than low-volume RT. ObjectiveTo confirm whether the high-volume RT is better than the low-volume RT, we performed a randomized controlled trial (clinical trial registration: RBR-8SBBVP) study to investigated the effects of two different RT volumes (three sets vs. six sets) on fast and usual walking speed performances (fast: one-mile walk test and usual: four-meter walk), muscle strength (1RM test), and abdominal fatness (WC – waist circumference; WC/W waist circumference-to-weight ratio; WHtR – waist-to-height ratio; ABSI – A body shape index; BRI – body roundness index; CI – conicity index) in PW. MethodsThirty-three PW were randomized (simple randomization) in three groups: control group (CT – no exercise), low-volume RT (LV) and high-volume RT (HV). The RT consisted of eight total body exercises at 70% of one repetition maximum for 16weeks performed three times a week. ResultsThe fast walking speed (6.1% [CI 95% 2.3–9.9]), WC (−4.1% [CI 95% −6.9 to −1.4]), WHtR (−4.2% [CI 95% −7.0 to −1.4]) and BRI (−10.3% [CI 95% −17.3 to −3.4]) improved in the HV when compared to the LV and CT. The WC/W (−3.7% [CI 95% −6.5 to −0.93]), ABSI (−3.8% [CI 95% −6.5 to −1.2]) and CI (−3.9% [CI 95% −6.6 to −1.3]) improved in the HV when compared to the CT. Muscle strength improved similarly in trained groups (LV: 49.1% [CI 95% 42.5–55.6] and HV: 43.7% [CI 95% 33.0–54.5]) when compared with the CT. No differences were observed in usual walking speed. ConclusionOur results suggest that high-volume RT (six sets) at 70% of 1RM is necessary to promote an improved fast walking speed performance and abdominal fatness in PW.

Can vitamin D deficiency influence muscle performance in postmenopausal women? A multicenter retrospective study.

The presence of the vitamin D receptor (VDR) has been recently demonstrated in human muscle supporting the theory of a role of vitamin D in the proliferation and differentiation of muscle cells. So far only few studies investigated the association between vitamin D and muscle performance in postmenopausal women. To define the functional impact of vitamin D deficiency. Multicenter retrospective study. Five Italian outpatient services of Physical and Rehabilitation Medicine (PRM). Postmenopausal women. We divided the population in two groups based on the threshold of 30 ng/mL as cut-off to define sufficient and insufficient serum levels of 25-hydroxyvitamin D3 [25(OH)D3]. Outcome measures were: appendicular lean mass (ALM); ALM-to-BMI ratio (ALMBMI); total fat mass (FM); visceral adipose tissue (VAT); Hand Grip Strength (HGS); Knee Isometric Extension Strength (KES); Short Physical Performance Battery (SPPB); 4-meter gait speed (4MGS). We analyzed the data records of 401 postmenopausal women (mean age 66.93±8.47 years): 203 with hypovitaminosis D (mean age 66.81±8.11 years) and 198 with normal levels of 25(OH)D3 (mean age 67.04±8.84 years). The analysis showed a significant difference between the two groups in terms of: ALMBMI (0.002), FM (P<0.001), VAT mass (0.010), VAT volume (P=0.006), HGS (P<0.001), KES (P<0.001), SPPB score (P<0.001), percentage of people with a 4MGS≤0.8 m/s (P<0.001). Furthermore, there were significant correlations (P<0.001) between serum levels of 25(OH)D3 and HGS (r=0.323), KES (r=0.510), and SPPB sit to stand (r=-0.362) and walking sub-scores (r=-0.312). This multicenter study demonstrated that postmenopausal women with vitamin D deficiency had a significant reduction of appendicular muscle strength and physical performance. This study reported the frequency of hypovitaminosis D in postmenopausal women and its influence on the reduction of muscle mass, strength, and physical performance in a typical population referring to the physiatrist for musculoskeletal disorders.

Circulating sex hormones are associated with memory performance in postmenopausal women

Background: The association between memory disorders and sex hormones has not been clearly defined. We aimed to evaluate the association of circulating sex hormones with memory function in postmenopausal women.

Is testosterone important for women as they age?

In women, is testosterone an obligatory precursor for extra-gonadal estradiol production after menopause, and has important direct androgenic genomic and nongenomic effects. Testosterone levels in women decline with age from the 4th decade, reaching a nadir in the 7th decade of life. Testosterone levels are positively associated with sexual function in women, and multiple randomised placebo-controlled trials have shown that testosterone therapy can be effective for the treatment of female sexual dysfunction in postmenopausal women. However, low testosterone in ageing women has multiple potential undesirable consequences that have been somewhat ignored. In the brain, testosterone exhibits neuroprotection against oxidative stress, serum deprivation-induced apoptosis and soluble amyloid beta toxicity, and clinical trials suggest exogenous testosterone enhances cognitive performance in postmenopausal women. Lower free testosterone in older women is associated with a decline in bone mineral density and a greater risk of hip fracture. Observational studies implicate testosterone as having favourable cardiovascular effects measured by surrogate outcomes, however associations between endogenous testosterone and CVD risk, and total mortality, particularly in older women are yet to be established.

Associations between pathologic tumor features and preadjuvant therapy cognitive performance in women diagnosed with breast cancer.

Intertumor heterogeneity has been proposed as a potential mechanism to account for variability in cognitive performance in women diagnosed with breast cancer. The purpose of this study was to explore associations between variation in pathologic tumor features (PTFs) and variability in preadjuvant therapy cognitive performance in postmenopausal women newly diagnosed with early‐stage breast cancer. Participants (N = 329) completed a comprehensive battery of neuropsychological tests to evaluate cognitive performance after primary surgery but prior to initiation of adjuvant anastrozole±chemotherapy. PTF data were abstracted from medical records. Robust multiple linear regression models were fit to estimate associations between individual PTFs and the cognitive function composite domain scores. All models controlled for age, estimated intelligence, and levels of depressive symptoms, anxiety, fatigue, and pain. Diagnosis of a HER2‐positive tumor contributed to poorer verbal (b = −0.287, P = 0.018), visual (b = −0.270, P = 0.001), and visual working (b = −0.490, P < 0.001) memory performance compared to diagnosis of a HER2‐negative tumor. Similarly, as HER2 immunohistochemistry classification score increased, verbal (b = −0.072, P = 0.093), visual (b = −0.081, P = 0.003), and visual working (b = −0.170, P < 0.001) memory performance score decreased. Associations with performance were also noted between location, focality/centricity, hormone receptor expression, cellular proliferation (i.e., Ki67), and Oncotype DX ® Breast Cancer Assay Recurrence Score®.) Our results suggest that certain PTFs related to more aggressive tumor phenotypes or inferior breast cancer prognosis may be implicated in poorer preadjuvant therapy cognitive performance. Follow‐up studies that include a cognitive assessment before primary surgery should be conducted to further delineate the role of intertumor heterogeneity on cognitive performance.

Effects of once-weekly shallow water aerobic exercise on functional performance in elderly women

The purpose of this study was to examine the effects of 24-week shallow-water aerobic exercise on functional performance in postmenopausal women. Thirty-seven women aged 60+ (mean age 67.2 ± 4.8 years) were self-selected to a water exercise group (n = 21) or to a comparison group (n = 16). The training consisted of a 24-week (60 min.day−1, 1 d.wk−1) supervised and guided exercise programme that included aerobic and strength training using an aquatic noodle in shallow water (1.2 m). Outcome measures were 30-s chair stand and 30-s arm curl tests, assessed at baseline and 24 weeks. Significant differences between groups were analyzed using Fisher’s exact test. At 24 weeks there was a significantly (p < 0.05) greater improvement in measure of upper-body strength in the water exercise group. Arm curling improved by 15.8 versus 14.3% in the water exercise and comparison groups, respectively.

Higher central and brachial systolic blood pressure is selectively associated with weaker cogntive performance in postmenopausal women but not older men

Higher central and brachial systolic blood pressure is selectively associated with weaker cogntive performance in postmenopausal women but not older men

Sarcopenia, Osteopenia and Functional Performance in Postmenopausal Women

Sarcopenia, Osteopenia and Functional Performance in Postmenopausal Women

Effects of calcifediol versus cholecalciferol on 25(OH)D3 serum levels, appendicular muscle strength, and physical performance in post-menopausal women

Effects of calcifediol versus cholecalciferol on 25(OH)D3 serum levels, appendicular muscle strength, and physical performance in post-menopausal women

Effects of calcifediol versus cholecalciferol on 25(OH)D3 serum levels, appendicular muscle strength, and physical performance in post-menopausal women

Effects of calcifediol versus cholecalciferol on 25(OH)D3 serum levels, appendicular muscle strength, and physical performance in post-menopausal women

Clinical Evaluation of Effects of Chronic Resveratrol Supplementation on Cerebrovascular Function, Cognition, Mood, Physical Function and General Well-Being in Postmenopausal Women-Rationale and Study Design.

Background: This methodological paper presents both a scientific rationale and a methodological approach for investigating the effects of resveratrol supplementation on mood and cognitive performance in postmenopausal women. Postmenopausal women have an increased risk of cognitive decline and dementia, which may be at least partly due to loss of beneficial effects of estrogen on the cerebrovasculature. We hypothesise that resveratrol, a phytoestrogen, may counteract this risk by enhancing cerebrovascular function and improving regional blood flow in response to cognitive demands. A clinical trial was designed to test this hypothesis. Method: Healthy postmenopausal women were recruited to participate in a randomised, double-blind, placebo-controlled (parallel comparison) dietary intervention trial to evaluate the effects of resveratrol supplementation (75 mg twice daily) on cognition, cerebrovascular responsiveness to cognitive tasks and overall well-being. They performed the following tests at baseline and after 14 weeks of supplementation: Rey Auditory Verbal Learning Test, Cambridge Semantic Memory Battery, the Double Span and the Trail Making Task. Cerebrovascular function was assessed simultaneously by monitoring blood flow velocity in the middle cerebral arteries using transcranial Doppler ultrasound. Conclusion: This trial provides a model approach to demonstrate that, by optimising circulatory function in the brain, resveratrol and other vasoactive nutrients may enhance mood and cognition and ameliorate the risk of developing dementia in postmenopausal women and other at-risk populations.

Poster Number: NR 35 - Chronic but Not Acute Estradiol Improves Cholinergic-Related Cognitive Performance in Postmenopausal Women

Poster Number: NR 35 - Chronic but Not Acute Estradiol Improves Cholinergic-Related Cognitive Performance in Postmenopausal Women

Hypovitaminosis D is associated with a reduction in upper and lower limb muscle strength and physical performance in post-menopausal women: a retrospective study.

Elderly people experience a gradual loss of muscle strength and a reduction of serum levels of vitamin D and of vitamin D receptor expression in skeletal muscle cells. The aim of our study was to evaluate the association among serum levels of 25-hydroxy-vitamin D [25(OH)D3], muscle strength, and physical performance in post-menopausal women. In our retrospective case-control study, we analyzed data from medical records of post-menopausal women aged ≥ 50 years. We compared subjects with hypovitaminosis D [25(OH)D3 <30 ng/ml] vs. those with normal levels [25(OH)D3 ≥ 30 ng/ml]. Outcome measures were: Hand Grip Strength Test (HGS) and Knee Extension Strength Test (KES) to evaluate upper and lower limb muscle strength, respectively; Short Physical Performance Battery (SPPB) and usual 4-m gait speed (4 MGS) to evaluate physical performance. We examined 80 patients (mean aged 65.92 ± 7.69 years): forty-six subjects with hypovitaminosis D (mean aged 66.09 ± 7.71 years) and 34 with normal levels of vitamin D (mean aged 65.71 ± 7.78 years). There was a statistically significant difference between hypovitaminosis D group and subjects with normal levels of vitamin D in HGS (12.13 ± 4.34 vs. 19.14 ± 5.59; p < 0.001), KES (11.99 ± 4.04 vs. 16.98 ± 8.43; p = 0.003), SPPB score [8 (5.75-10.25) vs. 12 (10-12); p < 0.001], and proportion of patients with usual 4 MGS ≤ 0.8 m/s [29 (63.0%) vs. 9 (26.5%); p = 0.002]. In literature, there is no agreement on the association among serum vitamin D levels and muscle function. Our data showed that post-menopausal women with hypovitaminosis D had worse upper and lower limb muscle strength and physical performance than subjects with normal levels of 25(OH)D3. Our results support the hypothesis that there is a significant positive association among serum 25(OH)D3 levels and upper and lower limb muscle functioning.

Hippocampal Gene Expression Is Highly Responsive to Estradiol Replacement in Middle-Aged Female Rats.

In the hippocampus, estrogens are powerful modulators of neurotransmission, synaptic plasticity and neurogenesis. In women, menopause is associated with increased risk of memory disturbances, which can be attenuated by timely estrogen therapy. In animal models of menopause, 17β-estradiol (E2) replacement improves hippocampus-dependent spatial memory. Here, we explored the effect of E2 replacement on hippocampal gene expression in a rat menopause model. Middle-aged ovariectomized female rats were treated continuously for 29 days with E2, and then, the hippocampal transcriptome was investigated with Affymetrix expression arrays. Microarray data were analyzed by Bioconductor packages and web-based softwares, and verified with quantitative PCR. At standard fold change selection criterion, 156 genes responded to E2. All alterations but 4 were transcriptional activation. Robust activation (fold change > 10) occurred in the case of transthyretin, klotho, claudin 2, prolactin receptor, ectodin, coagulation factor V, Igf2, Igfbp2, and sodium/sulfate symporter. Classification of the 156 genes revealed major groups, including signaling (35 genes), metabolism (31 genes), extracellular matrix (17 genes), and transcription (16 genes). We selected 33 genes for further studies, and all changes were confirmed by real-time PCR. The results suggest that E2 promotes retinoid, growth factor, homeoprotein, neurohormone, and neurotransmitter signaling, changes metabolism, extracellular matrix composition, and transcription, and induces protective mechanisms via genomic effects. We propose that these mechanisms contribute to effects of E2 on neurogenesis, neural plasticity, and memory functions. Our findings provide further support for the rationale to develop safe estrogen receptor ligands for the maintenance of cognitive performance in postmenopausal women.

Total body and trunk fat mass and the gait performance in postmenopausal women

To determine the relationship between total body and trunk fat mass and gait performance in postmenopausal women. Thirty-nine postmenopausal women aged 50 years or more were studied. The following items were determined: weight and height to calculate body mass index (BMI), body composition using the technique of Dual-Energy X-ray Absorptiometry (DXA), and gait using baropodometry. The body composition variables used were total body fat, percent body fat and trunk fat, while the gait variables were percent double stance time and single stance time and gait speed. The women were divided into two groups according to the median for each body composition variable: less and more body fat, less and more percent body fat and less and more trunk fat. To compare the gait variables between groups, we used the Mann-Whitney test. To evaluate the possible relationships between body composition variables and gait variables, we used the Spearman correlation test. All analyses were performed with the level of significance set at 5%. The group with more trunk fat showed longer double stance time (p=0.007) and lower values of single stance time (0.033) than the group with less trunk fat. We found significant and positive correlations between trunk fat and double stance time (R=0.40) and negative correlations between trunk fat and single stance time (R=-0.32). Postmenopausal women with a greater amount of trunk fat tended to have impaired gait performance.