Risk In Elderly Women Research Articles

Effects of different resistance training programmings on the relative strength, body composition, anthropometric variables, and metabolic risk of elderly women

The purpose of this study was to analyze the effect of two different programming models of resistance training (RT) on metabolic risk, anthropometric variables, and relative strength in elderly women. The research was a prospective and comparative longitudinal study with a non-probabilistic random sample. Twenty-two elderly women (64 ± 3 years) was divided into two experimental groups being the Linear programming (LP, n = 12) and Daily undulatory programming (DUP, n = 10), with 3 sessions/week for 12 weeks. Submaximal strength (10RM) was evaluated in the horizontal leg press (HL), pulldown (PD), leg curl (LC), vertical bench press (BP), and leg extension (LE). Anthropometric variables, food intake (R24h) and submaximal strength (10RM) was analyzed. Participants were initially classified as overweight or obese evaluated by body mass index (BMI) and percentual of fat mass (%FM) and with moderate to high risk to develop metabolic diseases evaluated by hip-waist ratio (HWR), waist-height ratio (WHR) and waist circumference (WC). There is no change for metabolic risk and anthropometric variables after the intervention period. There was a significant improvement for relative strength accessed by 10RM and body weight (10RM/BW), and lean body mass (10RM/LBM) (p < 0.05), with large or medium effect size for most of variables after 12 weeks of RT. As a conclusion, both programmings increased relative strength after 12 weeks of RT with attenuated change in body composition and metabolic risk in elderly women in both programming groups and all those strategies can be used in elderly women to improve strength.

Cervical Cancer Screening in Women Aged Older Than 65 Years.

Considerable debate exists among guidelines regarding when cervical cancer screening can be safely stopped. The authors aimed to compare the efficiency of human papillomavirus (HPV) test, cytology, and previous screening history for the diagnosis of cervical intraepithelial neoplasia (CIN) 2+ lesions in women aged older than 65 years. This is a retrospective cohort study. Multiple logistic regressions were used to compare the efficiency of the HPV test, cytology, and previous screening history for the diagnosis of histologically proven CIN 2+ lesions. A total of 5,427 women were included in the study. A total of 2,143 women were tested with HPV and 52 (2.4%) of them were HPV-positive. Abnormal cytology was detected in 359 (6.6%) women. Most of the women (70.4%) had inadequate screening in the previous 10 years. According to regression analysis, an HPV-positive test increases the risk of probability of CIN 2+ 136.111 times [95% CI for odds ratio (OR) = 41.212-449.538] compared with an HPV-negative test ( p < .001). Abnormal cytology increases the probability of CIN 2+ 13.072 times (95% CI for OR = 3.878-44.062) compared with normal cytology ( p < .001). Inadequate or positive previous screening increases the likelihood of CIN 2+ 9.705 times (95% CI for OR = 1.603-58.756) compared with adequate and negative previous screening ( p = .013). Adequate previous screening is a valuable strategy, and abnormal cytology is an important screening test in women aged older than 65 years. However, the HPV test is the most determinant parameter for CIN 2+ risk in elderly women.

Falls assessment and prevention in the nursing home and community

British Journal of Community NursingVol. 28, No. 2 Care of the Older PersonFalls assessment and prevention in the nursing home and communityTiago Horta Reis da SilvaTiago Horta Reis da SilvaE-mail Address: [email protected]Lecturer in Nursing Education AEP, Department of Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College LondonSearch for more papers by this authorTiago Horta Reis da SilvaPublished Online:3 Feb 2023https://doi.org/10.12968/bjcn.2023.28.2.68AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Almeida LMDS, Meucci RD, Dumith SC. Prevalence of falls in elderly people: a population based study. Rev Assoc Med Bras (1992). 2019;65(11):1397-1403. https://doi.org/10.1590/1806-9282.65.11.1397 Crossref, Medline, Google ScholarCare Inspectorate and NHS Scotland. managing fall and fractures in care homes for older people - good practise resource. 2016. http://www.careinspectorate.com/index.php/publications-statistics/76-professionals-registration/resources/2712-managing-falls-and-fractures-in-care-homes-for-older-people (accessed 9 January 2023) Google ScholarCooper R. Reducing falls in a care home. BMJ Open Quality. 2017;6:u214186.w5626. https://doi.org/10.1136/bmjquality.u214186.w5626 Google ScholarCraig J, Murray A, Mitchell S, Clark S, Saunders L, Burleigh L. The high cost to health and social care of managing falls in older adults living in the community in Scotland. Scott Med J. 2013;58(4):198-203. https://doi.org/10.1177/0036933013507848 Crossref, Medline, Google ScholarDemura S, Yamada T, Kasuga K. Severity of injuries associated with falls in the community dwelling elderly are not affected by fall characteristics and physical function level. Arch Gerontol Geriatr. 2012;55(1):186-189. https://doi.org/10.1016/j.archger.2011.06.033 Crossref, Medline, Google ScholarDepartment of Health. Best Practise Guidance. Falls and fractures - effective interventions in health and social care. 2009. http://www.laterlifetraining.co.uk/wp-content/uploads/2011/12/FF_Effective-Interventions-in-health-and-social-care.pdf (accessed 9 January 2023) Google ScholarDhargave P, Sendhilkumar R. Prevalence of risk factors for falls among older people people living in long-term care homes. J Clin Gerontol Geriatr. 2016;7(3):99–103. https://doi.org/10.1016/j.jcgg.2016.03.004 Crossref, Google ScholarJohansson J, Nordström A, Nordström P. Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking. J Am Med Dir Assoc. 2016;17(6):535-540. https://doi.org/10.1016/j.jamda.2016.02.009 Crossref, Medline, Google ScholarLamb SE, Jørstad-Stein EC, Hauer K, Becker C; Prevention of Falls Network Europe and Outcomes Consensus Group. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc. 2005; 53(9):1618-1622. https://doi.org/10.1111/j.1532-5415.2005.53455.x Crossref, Medline, Google ScholarNational Institute for Health and Care Excellence. Falls in older people. 2017. https://www.nice.org.uk/guidance/qs86/chapter/Quality-statements (accessed 9 January 2023) Google ScholarNational Institute for Health and Care Excellence. Falls. assessment and prevention of falls in older people (full NICE guideline). 2013. https://www.nice.org.uk/guidance/CG161/Guidance (accessed 9 January 2023) Google ScholarRubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35 Suppl 2:ii37-ii41. https://doi.org/10.1093/ageing/afl084 Crossref, Medline, Google ScholarSalari N, Darvishi N, Ahmadipanah M, Shohaimi S, Mohammadi M. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2022;17(1):334. https://doi.org/10.1186/s13018-022-03222-1 Crossref, Medline, Google ScholarSantos FD, Lange C, Llano PMP, Lemões MAM, Pastore CA, Paskulin LMG, Costa AEKD, Raymundo JLP. Falls of elderly people living in rural areas: prevalence and associated factors. Rev Bras Enferm. 2019;72(suppl 2):177-183. https://doi.org/10.1590/0034-7167-2018-0460 Crossref, Medline, Google ScholarSherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1(1):CD012424. https://doi.org/10.1002/14651858.cd012424.pub2 Medline, Google ScholarTinetti ME, Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci. 1998;53(2):M112-119. https://doi.org/10.1093/gerona/53a.2.m112 Crossref, Medline, Google ScholarUdell JE, Drahota A, Mackenzie H. Psychological and educational interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;2019(11):CD013480. https://doi.org/10.1002%2F14651858.CD013480 Google ScholarWorld Health Organization. WHO global report on falls prevention in older age. 2008. https://extranet.who.int/agefriendlyworld/wp-content/uploads/2014/06/WHo-Global-report-on-falls-prevention-in-older-age.pdf (accessed 9 January 2023) Google Scholar FiguresReferencesRelatedDetails 2 February 2023Volume 28Issue 2ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 3 February 2023 Published in print 2 February 2023 Information© MA Healthcare LimitedPDF download

The Relationship Between Lower Limb Muscle Strength With Fall Risk In Elderly Women With And Without Type 2 Diabetes

The Relationship Between Lower Limb Muscle Strength With Fall Risk In Elderly Women With And Without Type 2 Diabetes

12 Weeks of Physical Exercise Attenuates Oxidative Stress, Improves Functional Tests Performance, and Reduces Fall Risk in Elderly Women Independently on Serum 25(OH)D Concentration.

The study aimed to evaluate if the 25(OH)D concentration is related to physical training responses. Moreover, to determine the association between serum 25(OH)D concentration and older women’s physical performance, oxidative stress markers, inflammation, and bone metabolism. 37 older women (age 72.9 ± 5.2 years) were assigned into two groups: supplemented (SG) and non-supplemented (NSG). Then, the participants from SG and NSG were randomly assigned into exercised and non-exercised groups: exercise sufficient vitamin D group (ESD; n = 10), exercise insufficient vitamin D group (EID; n = 9), control sufficient vitamin D group (CSD; n = 9), and control insufficient vitamin D group (CID; n = 9). To assess the study aims time up and go test (TUG), 6 min walk test (6MWT), fall risk test (FRT), blood osteocalcin (OC), parathormone (PTH), calcium (Ca2+), sulfhydryl groups (SH), malondialdehyde (MDA), and interleukin-6 (IL-6) were performed. The results showed that a higher 25(OH)D concentration was in line with better physical performance and bone metabolism as well as lower inflammation. After 12 weeks of training we noted an improvement in 6MWT (from 374.0 ± 17.3 to 415.0 ± 18.8; p = 0.001 and from 364.8 ± 32.8 to 419.4 ± 32.3; p = 0.001 for EID and ESD, respectively), TUG (from 7.9 ± 0.5 to 6.8 ± 0.8; p = 0.001 and from 7.3 ± 1.5 to 6.4 ± 0.9; p = 0.002, for EID and ESD, respectively), reduction of fall risk (from 2.8 ± 0.8 to 1.9 ± 0.4; p = 0.003 and from 2.1 ± 1.1 to 1.6 ± 0.5; p = 0.047, for EID and ESD, respectively) and increase in SH groups (from 0.53 ± 0.06 to 0.58 ± 0.08; p = 0.012 and from 0.54 ± 0.03 to 0.59 ± 0.04; p = 0.005, for EID and ESD, respectively), regardless of the baseline 25(OH)D concentration. A decrease in PTH and OC concentration was observed only in EID group (from 57.7 ± 15.7 to 49.4 ± 12.6; p = 0.013 for PTH and from 27.9 ± 17.2 to 18.0 ± 6.2; p = 0.004 for OC). To conclude, vitamin D concentration among older women is associated with physical performance, fall risk, inflammation, and bone metabolism markers. Moreover, 12 weeks of training improved physical performance and antioxidant protection, regardless of baseline vitamin D concentration.

The Effect of Otago Exercise Program on Walking Speed and Fall Risk in Elderly Women

Introduction: Elderly has a slower walking speed and an increased risk of falling. Decreased muscle mass and strength contribute to decreasing the ability to produce strength and accuracy responses to maintain balance and reduce walking speed. The Otago exercise program is a fall prevention exercise program for the elderly consist of lower limb strengthening exercises and balance exercises. This study aims to find the effects of eight weeks Otago exercise program on walking speed and risk of falling. Methods: This research is pre and post-test randomized control group design. Twenty-six elderly women in nursing homes age 60 years old or more who meet inclusion criteria, divide into 2 groups, with thirteen subjects in each group. The intervention group performed the Otago exercise program 3 times a week for 8 weeks and the control group had no intervention. Ten meters walking test (10-mWT) is used to assess the walking speed and a timed up and go test (TUG) is used to assess fall risk. Walking speed and fall risk were assessed before and after the intervention. Results: The results of this study showed that 8 weeks Otago exercise program significantly increase walking speed as assessed by the 10-mWT test from 0.67?0.16 m/sec to 0.79?0.19 m/sec (p<0.05) and significantly decreased the risk of falling by TUG test 14.99+2.82 sec to 14.00+2.93 (p<0.05) but not in the control group. Conclusion: The Otago exercise program for 8 weeks increased walking speed and decreased the risk of falling in elderly women.

Abstract P188: Blood Pressure Control And Glaucoma Risk In Older Women

Objective: Individuals with elevated systolic blood pressure (BP) or low diastolic BP, whether or not on antihypertensive treatment, may be at higher risk for developing glaucoma. We aimed to investigate BP levels in relation to risk of incident glaucoma in a large cohort of elderly women. Methods: Prospective follow-up of 101,447 postmenopausal women without prior history of glaucoma enrolled in the Women’s Health Initiative Study (WHI). Blood pressure was measured in-clinic at baseline and after 3 years using standardized procedures and average BP was calculated. Antihypertensive medication use was determined by drug inventory at baseline and year 3. Women self-reported incident newly diagnosed glaucoma annually. Hazard ratios (HRs) and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards analyses adjusting for demographic, medical history, and lifestyle covariates. Results: During a mean follow-up of 4.7 years, we documented 7,514 glaucoma cases. Among women not on antihypertensive treatment, those with systolic BP ≥140 mmHg or diastolic BP ≥80 mmHg were not at higher risk of developing glaucoma (HR 0.97, 95% CI 0.88-1.08 and HR 1.00 [0.93-1.08], respectively), compared to women with a systolic BP &lt;120 mmHg or a diastolic BP 60-&lt;80 mmHg. Among women on antihypertensive treatment, neither systolic BP ≥140 mmHg nor diastolic BP ≥80 mmHg was associated with an increased risk of glaucoma (HR 0.91 [0.82-1.01] and HR 0.97 [0.90-1.05], respectively). A diastolic BP &lt;60 mmHg was not associated with a higher risk compared to a diastolic BP 60-&lt;80 mmHg. Conclusions: BP control is not associated with an increased or decreased glaucoma risk in elderly women.

Sex disparities in dialysis initiation, access to waitlist, transplantation and transplant outcome in German patients with renal disease-A population based analysis.

BackgroundRenal transplantation access and outcome differ between men and women, but no analysis has considered all transition phases and transplant outcome using the same data set. We analyzed sex disparities in all phases of patients’ clinical path (progression to dialysis, waitlisting, transplantation, graft failure/death).MethodsIn a population based approach using health insurance data (2005–2013) we examined patients’ risk of changing from one phase to another applying Cox Proportional Hazards model.ResultsAfter adjusting for age and comorbidities, women had a 16% lower risk of progression to ESRD (HR/95%-CI: 0.84/0.79–0.88). Access to the waitlist was lowered by 18% in women compared to men (HR/95%-CI: 0.82/0.70–0.96). An age stratified analysis did not reveal differences in any age group. Once waitlisted, the chance to receive a transplant was identical (HR/95%-CI: 0.96/0.81–1.15). The risk of transplant failure/death was identical for both sexes (HR/95%-CI: 0.99/0.73–1.35), but the effect was modified by age: in younger women (18–45 years) the risk was twice as high compared to men (HR/95%-CI: 2.08/1.04–4.14), whereas the risk in elderly women (> 65 years) was only half the risk of men (HR/95%-CI: 0.47/0.24–0.93).ConclusionSex disparities occurred at different steps in the history of patients with renal disease and affected progression to dialysis, waitlisting and transplantation outcome in a population with equal access to medical treatment.

Abdominal aorta diameter as a novel marker of diabetes incidence risk in elderly women

The prevalence of diabetes mellitus is increasing worldwide, including the nation of Poland. The aim of this prospective and observational study was to determine risk factors and the predictors of diabetes incidence in elderly women, and to calculate the diabetes incidence ratio in this population. Two-hundred women, aged 65–74, who were non-diabetic at baseline in 2012 were followed for 6.5 years. All women were checked for incident diabetes. In non-diabetic subjects, diagnostic procedures for diabetes were performed according to Poland’s Diabetes recommendations. Between April 2012 and September 2018, 25 women developed diabetes and the next 11 cases were diagnosed based on FPG or oral glucose tolerance test. Women with incident diabetes had significantly higher baseline FPG, triglycerides (TG), TG/HDL cholesterol ratio and visceral adiposity index (VAI) score, and lower abdominal aorta diameter (AAD), HDL cholesterol and eGFR. In the Cox proportional hazard regression analysis, only AAD < 18 mm and VAI score ≥ 3.8 were independently associated with diabetes risk, hazard ratio (HR) 2.47 (95% confidence interval 1.21–5.02), P = 0.013 and HR 2.83 (1.35–5.94), P = 0.006 respectively. In the backward stepwise regression analysis including all variables, diabetes incidence could be predicted from a linear combination of the independent variables: AAD < 18 mm (P = 0.002), VAI score ≥ 3.8 (P < 0.001) and FPG ≥ 5.6 mmol/L (P = 0.011). The calculated incidence of diabetes was 2769.2 new cases/100,000 persons per year. AAD below 18 mm seem to be a novel, independent marker of diabetes risk in elderly women, and AAD assessment during routine abdomen ultrasound may be helpful in identifying females at early elderliness with high risk of diabetes incidence.

Decline in Muscle Strength and Performance Predicts Fracture Risk in Elderly Women and Men.

Muscle strength and performance are associated with fractures. However, the contribution of their rate of decline is unclear. To assess the independent contribution of the rate of decline in muscle strength and performance to fracture risk. Community-dwelling women (n = 811) and men (n = 440) aged 60 years or older from the prospective Dubbo Osteoporosis Epidemiology Study followed from 2000 to 2018 for incident fracture. Clinical data, appendicular lean mass/height2 (ht)2, bone mineral density, quadricep strength/ht (QS), timed get-up-and-go (TGUG), 5 times repeated sit-to-stand (5xSTS), and gait speed (GS) measured biennially. Rates of decline in muscle parameters were calculated using ordinary least squares regression and fracture risk was assessed using Cox's models. Incident low-trauma fracture ascertained by x-ray report. Apart from lean mass in women, all muscle parameters declined over time. Greater rates of decline in physical performance were associated with increased fracture risk in women (Hazard ratios [HRs] ranging from 2.1 (95% CI: 1.5-2.9) for GS to 2.7 (95% CI: 1.9-3.6) for 5xSTS, while in men only the decline in GS was associated with fracture risk (HR: 3.4 [95% CI: 1.8-6.3]). Baseline performance and strength were also associated with increased fracture risk in men (HRs ranging from 1.8 (95% CI: 1.1-3.0) for QS to 2.5 (95% CI: 1.5-4.1) for TGUG, but not in women. Rate of decline in physical performance in both genders, and baseline strength and performance in men, contributed independently to fracture risk. Sit-to-stand and GS were the tests most consistently associated with fractures. Further studies are required to determine whether muscle strength and/or performance improve the predictive accuracy of fracture prediction models.

Testing a theoretical model of imminent fracture risk in elderly women: an observational cohort analysis of the Canadian Multicentre Osteoporosis Study.

This study aimed to examine direct and indirect effects of several factors on imminent (1year) fracture risk. Data from women age 65 and older from population-based Canadian Multicentre Osteoporosis Study were used. Predictors were identified from study years 5 and 10, and imminent fracture data (1-year fracture) came from years 6 and 11 (year 5 predicts year 6, year 10 predicts year 11). A structural equation model (SEM) was used to test the theoretical construct. General health and physical functioning were measured as latent variables using items from the 36-Item Short Form Health Survey (SF-36) and bone mineral density (BMD) T-score was a latent variable based on observed site-specific BMD data (spine L1-L4, femoral neck, total hip). Observed variables were fractures and falls. Model fit was evaluated using root mean square error of approximation (RMSEA), Tucker Lewis index (TLI), and comparative fit index (CFI). The analysis included 3298 women. Model fit tests showed that the SEM fit the data well; χ2(172) = 1122.10 < .001, RMSEA = .03, TLI = .99, CFI = .99. Results suggested that having past year fracture, worse past year general health, worse past year physical functioning, and lower past year BMD T-score directly predicted higher risk of fracture in the subsequent year (p < .001). Past year falls had a statistically significant but indirect effect on imminent fracture risk through physical functioning and general health (p < .001). We found several direct and indirect pathways that predicted imminent fracture risk in elderly women. Future studies should extend this work by developing risk scoring methods and defining imminent risk thresholds.

Abstract TMP52: The Hidden Burden of Ischemic Stroke, Transient Ischemic Attack, and Atrial Fibrillation Hospitalizations Among Elderly Women

Background: US women have a greater lifetime risk of stroke than men. Risk factors such as pregnancy and hormones influence sex differences in stroke at younger ages, but less is known about hospitalization rates and the proportion of hospitalizations for ischemic stroke (IS), transient ischemic attack (TIA), and atrial fibrillation (AF) by sex in different age groups. We assessed IS, TIA, and AF hospitalizations by sex and age. Methods: IS (ICD-9 433, 434, 436), TIA (435), and AF (427.31) hospitalizations were identified in the 2014 National Inpatient Sample (NIS). Hospitalization rates per 100,000 population aged ≥18y were calculated using age- and sex-specific Census population denominators and NIS sampling weights to obtain national estimates. We also determined the proportions of condition-specific hospitalizations by sex. Results: There were 338,654 (49.8% women) patients hospitalized for IS, 90,812 (58.0% women) for TIA, and 284,770 (49.9% women) for AF. For IS, TIA, and AF, respectively, the mean ages for women were 72.7y, 71.4y, and 74.0y vs 68.8y, 69.1y, and 66.2y for men. Hospitalization rates were higher for men than women at most ages for IS and AF; however, AF rates were higher in women beginning with age 80-84y (figure). Women represented a greater proportion of hospitalizations among those aged ≥75y for all 3 conditions (58% of IS, 62.5% of TIA, and 64.7% of AF events). The proportion of women hospitalized for TIA was higher in most age groups, but for IS and AF, the proportions of women exceeded those of men beginning at ages 75-80y and 70-75y, respectively. Conclusion: Women were older when hospitalized for IS, TIA, and AF, and women aged ≥75y comprised the majority of these hospitalizations. This highlights the need for early detection of AF and IS risk in elderly women and underscores the importance of treating modifiable conditions to decrease the burden of vascular illness in women. This is critical given the overrepresentation of women among the very elderly.

Executive functions and bone health: a focus on cognitive impulsivity and bone mineral density

Background : It is known that cognitive impairment is associated with low bone mineral density (BMD) and that low BMD is also observed in elderly people with neurodegenerative diseases, in which executive functions (EF) could be decreased. A limited number of studies investigated the association between EF with BMD and fracture risk in elderly women. Aims : The aim of this study was to explore the association between cognitive impulsivity, BMD and fall risk in a sample of postmenopausal women evaluated for osteoporosis. Methods : We consecutively recruited women who obtained a score ≥ 24 at the Mini Mental State Examination (MMSE). Cognitive impulsivity was evaluated by the Stroop Colour and Word Test (SCWT). BMD was detected by dual-energy X-ray absorptiometry at lumbar spine and femoral neck. Results: Cognitive impulsivity, as evidenced by the greater number of errors at the SCWT, was significantly related with BMD values at lumbar spine and femoral neck (r= -0.39, p= 0.01 and r= -0.43, p= 0.008; respectively), suggesting a neuropsychological impairment in patients assessed for osteoporosis. Moreover, interference effect on response time was significantly associated with higher prevalence of falls (r= 0.342; p= 0.031). Discussion and Conclusions : Our findings suggested a potential involvement of cognitive impulsivity on BMD and risk of fall. This is a relevant issue in clinical practice for both clinical psychologists and physicians who evaluate postmenopausal women, to eventually predict risk of fracture.

209-LB: Is the Abdominal Aorta Diameter a Novel Marker of Diabetes Risk in Elderly Women?

Diabetes mellitus (DM) prevalence increases worldwide. Elevated BMI, waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG) and triglycerides (TGs), as well as low HDL cholesterol level are known risk factors of DM incidence. We analyzed the association of these parameters, with the addition of abdominal aorta diameter (AAD) and estimated glomerular filtration rate (eGFR) using CKD-EPI equation, with DM incidence among 200 women aged 65-74, nondiabetic at baseline assessment in 2012. After 6.5 years of follow-up 36 new DM cases occurred. Women with incident DM had significantly higher baseline FPG, 108.6±18.0 vs. 97.2±10,9 mg/dL, P&amp;lt;0.001 and TGs, 142.2±54,6 vs. 115,6±49,7 mg/dL, P=0.002, while they had lower AAD, 18.1±4,7 vs. 18.4±2,5 mm, P=0.019; HDL cholesterol 58.7±12.7 vs. 68.9±17.3 mg/dL, P&amp;lt;0.001 and eGFR, 77.4±14.5 vs. 83.1±17.2 mL/min/1.73 m2, P=0.045. WC, BP and BMI were not significantly different between groups. Relative risk (RR) of DM incidence was significantly higher for AAD &amp;lt;18 mm, RR (95% CI) 2.66 (1.41-5.01), P=0.003; FPG ≥100 mg/dL, RR 2.89 (1.51-5.55), P&amp;lt;0.001; TGs ≥150 mg/dL, RR 2.26 (1.26-4.03), P=0.013 and eGFR &amp;lt;75,0 ml/min/1,73 m2, RR 2.11 (1.18-3.77), P=0.020. Other variables did not attain statistical significance limit. In the multiple logistic regression analysis including all variables, only AAD &amp;lt;18 mm, FPG ≥100 mg/dL, and eGFR &amp;lt;75,0 ml/min/1,73 m2 were independently associated with DM risk (P=0.005, P=0.010 and P=0.018 respectively). In the backward stepwise regression analysis DM incidence could be predicted from a linear combination of the independent variables: AAD &amp;lt;18 mm (P=0.005), FPG ≥100 mg/dL (P=0.009), eGFR &amp;lt;75,0 ml/min/1,73 m2 (P=0.017) and TGs ≥150 mg/dL (P=0.034). Thus, AAD &amp;lt;18 mm seem to be a novel, independent marker of DM risk in elderly women, and AAD assessment during routine abdomen ultrasound may be helpful, together with other DM risk factors, in identifying elderly females at very high risk of DM incidence. Disclosure M. D?browski: Other Relationship; Self; Ascensia Diabetes Care, AstraZeneca, Eli Lilly and Company, Mundipharma, Novo Nordisk Inc., Sanofi-Aventis, Servier, WöRWAG Pharma. T. Derezinski: None. A. Uruska: None. D. Zozulinska-Ziolkiewicz: Advisory Panel; Self; Roche Diabetes Care. Other Relationship; Self; Ascensia Diabetes Care, AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk Inc., Sanofi-Aventis, Servier, WöRWAG Pharma.

0493 Associations of Obstructive Sleep Apnea with Total and Site-specific Cancer Risk in Elderly Women: A Prospective Study

0493 Associations of Obstructive Sleep Apnea with Total and Site-specific Cancer Risk in Elderly Women: A Prospective Study

Visceral adiposity index as a useful tool for the assessment of cardiometabolic disease risk in women aged 65 to 74.

The visceral adiposity index (VAI) is considered to be a reliable indicator of adipose tissue dysfunction and cardiometabolic disease risk. The aim of this study was to evaluate its usefulness in assessing cardiometabolic risk in a sample of elderly women living in a rural-urban community in central Poland. A total of 365 women aged 65 to 74years were included in this cross-sectional study. All patients were interviewed to obtain their history of diabetes mellitus, myocardial infarction, stroke, and revascularization. For all participants, anthropometric measurements were performed, then body mass index (BMI) and waist/hip ratio were calculated. Blood pressure was measured on the arm and on both ankles, and the ankle/brachial index was calculated. Blood samples were collected for the assessment of glycemia, lipid profile, and creatinine level. In patients with elevated fasting glucose, the test was repeated, or an oral glucose tolerance test was performed where appropriate. Finally, carotid intima-media thickness was measured in all women. The VAI of participants was significantly correlated with a history of myocardial infarction, higher carotid intima-media thickness, diabetes, prediabetes, and impaired kidney function. Furthermore, VAI demonstrated a better correlation with these endpoints than BMI or waist circumference. The VAI can be considered a useful tool for the assessment of cardiometabolic disease risk in elderly women, with a score of ≥2.71 representing the cut-off point for identifying females at high risk. In such patients, screening for cardiovascular disease, abnormal glucose metabolism, and impaired kidney function should be routine practice.

Letter re: Calcium supplementation and risk of dementia in women with cerebrovascular disease.

Kern et al.1 conducted a small, observational, retrospective, longitudinal, population-based cohort study of calcium supplementation and increased dementia risk in elderly women. Women who took calcium supplementation had higher odds of dementia. However, the number of individuals taking calcium supplements without vitamin D was low and compromised the reliability of the results. The sample size (n = 98) in the calcium supplements group included women taking calcium supplements with 85.7% (84 of 98) also taking vitamin D.1 The authors, recognizing vitamin D as a confounding variable, included it in regression models and stated that vitamin D did not affect the “main results.”1 However, controlling for vitamin D would not improve statistical power. Women taking calcium supplements with vitamin D should have been excluded at baseline because the dependent variable in the hypothesis was calcium supplementation alone.1 The calcium supplement group was described as “women treated with calcium supplements,”1 but they were actually women treated with calcium supplements, most of whom took vitamin D. Thus, the study hypothesis of calcium supplementation association with an increased risk of dementia was tested with a small sample size of 98 where only 14 individuals were relevant to the research question.

Aspirin use and the incidence of breast, colon, ovarian, and pancreatic cancers in elderly women in the Iowa Women's Health Study.

Few studies have evaluated the chemopreventive effect of aspirin on the cancer risk in elderly women. We examined associations between frequency, dose, and duration of aspirin use with incidence of 719 aspirin-sensitive cancers (cancers of colon, pancreas, breast, and ovaries) in the Iowa Women's Health Study (IWHS), a prospective cohort of women over 70years old. Aspirin frequency, dose, and duration were self-reported in the 2004 IWHS questionnaire. Women were followed-up to 2011. Cancer cases were ascertained by linkage to the Iowa State Health Registry. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). Among the 14,386 women, 30% were nonusers of aspirin; 34% used low-dose aspirin, and 36% used regular- or high-dose aspirin. Compared with nonuse of aspirin, the HRs (95% CI) for incidence of aspirin-sensitive cancers were 0.87 (0.72-1.06) for regular to high doses of aspirin use, 0.95 (0.80-1.13) for aspirin use 6+ times per week, and 0.93 (0.74-1.17) for aspirin use for 10+ years. For cumulative aspirin use, HR (95% CI) was 0.87 (0.70-1.09) for >60,000mg of aspirin per year and 0.95 (0.75-1.21) for >280,000mg of aspirin in their lifetime, versus nonuse of aspirin. Results were similar for the all-cause cancer death as an endpoint, with a significant inverse association observed between lifetime aspirin dose and cancer mortality [<95,000mg vs nonuser HR 0.76 (0.61-0.95)]. These findings suggest that aspirin use may prevent incident breast, colon, pancreatic, and ovarian cancer in elderly women.

Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking

ObjectiveAs 90% of fractures are caused by falls, and as fractures are more common in elderly women than in elderly men, a better understanding of potential sex differences in fall rates and underlying mechanisms is needed. The purpose of this study was to determine whether women are more prone than men to falling, and to evaluate whether the risk of falling is associated with variations in gait patterns. Design, setting, and participantsThe cohort for this prospective observational study consisted of 1390 community-dwelling men and women aged 70 years, examined in a health survey between July 2012 and November 2014. MeasurementsGait patterns were measured using a computerized walkway system during normal-speed, fast-speed, and dual-task trials. Triaxial accelerometers were used to collect objective data on physical activity, and self-reported fall data were collected by telephone 6 and 12 months after examination. Incident low-energy falls were defined as unexpected events in which participants came to rest on the ground. ResultsDuring the follow-up period, 148 study participants (88 women, 60 men; P = .01) reported falls. After adjusting for multiple confounders, including objective measures of physical activity, socioeconomic factors, cardiovascular disease, and cognitive function, the odds ratio for falling in women was 1.49 (95% confidence interval [CI] 1.02–2.19). Variations in gait pattern were significantly (20%–40%) increased in fallers compared with nonfallers during the dual-task trial for step width, step length, stride length, step time, stance time, stride velocity, and single support time (all P < .05). Furthermore, women showed 15% to 35% increased variability in all of these gait parameters during the dual-task trial compared with men (all P < .01). ConclusionIn the present cohort, 70-year-old women were at greater risk of falls compared with their male counterparts. This increased risk was associated with increased variation in gait pattern during dual-task activities, and may contribute to women's greater fracture risk compared with men.

여성노인에게 적용한 12주간 복합하지근력 운동프로그램이 낙상위험도에 미치는 영향

Abstract The purpose of this study was to investigate the effects of 12weeks complexed lower body muscle-strengthening exercise program on fall risk in elderly women. Twenty subjects volunteered to participate who use a welfare center in W city For the study we divided into two groups: exercise group (EC, n=10, mean age:69.6±2.2), comparative group(CG, n=10, mean age:71.3±4.6). In order to investigate the effect of lower body muscle-strengthening program on the degree of risk of fall. It reached a conclusion as follows after having applied BBS (Berg Balance Scale) and OLST (One -Leg Stance Test) to examine the degree of risk of fall. As a result of changes in BBS and OLST, there were significant differences between EG and CG for each test(p<.00). Therefore, it confirmed that the application of complexed lower body muscle-strengthening program to the elderly who have a high risk of fall influences the risk of fall positively. Key Words : Complexed Lower Body Muscle-Strengthening, Elderly Women, Fall, Berg Balance Scale, One -Leg Stance Test, Convergence