Assessment of subjective sleep disturbance and related factors during female mid-life with the Jenkins Sleep Scale

Objective

To assess sleep disturbance and related factors among mid-aged women.

Methods

This was a cross-sectional study in which 288 women (40–59 years) were requested to complete the Jenkins Sleep Scale (JSS), the 12-item General Health Questionnaire (GHQ-12), the Menopause Rating Scale (MRS) and a general socio-demographic questionnaire containing female and partner data.

Results

Median [interquartile range] age of the whole sample was 47 [8] years. A 62.2% of women were rural residents, 21.2% were postmenopausal, 20.1% were receiving psychotropic drugs, 64.2% had abdominal obesity (waist ≥ 88 cm), and 9.7% reported intimate violence. A 12.8% had an abnormal GHQ-12 score (total score ≥ 3) whereas 14.2% had severe menopause-related symptoms (total MRS score ≥ 17). The prevalence of disturbed sleep (JSS score ≥ 12) was 37.5%. JSS scores displayed significant differences in relation to menopausal status, presence of stress urinary incontinence, use of psychiatric treatment, intimate partner violence, self-perception of healthiness, and partner factors (perception of healthiness, educational level, and regular exercise). Higher JSS scores (disturbed sleep) positively correlated with GHQ-12 and MRS scores, number of co-morbid conditions, body mass index, and female and partner age. Multiple linear regression analysis found that JSS scores correlated positively with somatic MRS scores and with intimate violence, and inversely with partner educational level (r² = 0.375, p < 0.05).

Conclusion

In this mid-aged female sample, disturbed sleep was related to somatic menopause-related symptoms, intimate violence and partner educational level.     

Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life

Objective

To use the Menopause-Specific Quality of Life Questionnaire (MENQOL) to assess the impact of menopausal symptoms on health-related quality of life in a large US population-based study.

Methods

Participants were recruited from the US population through random-digit-dialing and probability sampling. Analyses included 2703 postmenopausal women 40–65 years old in our Menopause Epidemiology Study. Respondents answered a 30-min questionnaire, including the MENQOL.

Results

Scores for each domain were: vasomotor: 3.2 ± 2.2; psycho-social: 3.3 ± 1.8; physical: 3.5 ± 1.5; sexual: 2.9 ± 2.1. There were significant differences in the MENQOL scores by age, smoking, exercise, education, employment status and BMI. Women aged 60–65 years (p < 0.0001), with a bachelor’s degree or higher level of education (p < 0.0001), who exercised at least 3 days a week (p < 0.0001), who had never smoked (p < 0.0001), with a body mass index ≤25 kg/m² (p < 0.0001), and who had significantly lower scores indicating better quality of life. Hot flashes affected work (46.0%), social activities (44.4%), leisure activities (47.6%), sleep (82.0%), mood (68.6%), concentration (69.0%), sexual activity (40.9%), total energy level (63.3%) and overall quality of life (69.3%).

Conclusion

Symptoms experienced during menopause and socio-demographic characteristics affect the quality of life in postmenopausal women. Hot flashes impact the daily activities of most postmenopausal women, especially those with more frequent/severe symptoms. Treatments that safely and effectively treat these symptoms could improve quality of life among postmenopausal women.     

Sexual function,satisfaction with life and menopausal symptoms in middle-aged women

Purpose

To assess sexual function, satisfaction with life (SWL), and menopause-related symptoms among mid-aged Spanish women.

Materials and methods

Cross-sectional study of 260 women, aged 40–59, attending the public gynecology consultations completed the 14-item Changes in Sexual Functioning Questionnaire (CSFQ-14), the SWL Scale (SWLS), the Menopause Rating Scale (MRS), and a socio-demographic questionnaire.

Results

Median [inter quartile range] age was 47 [8.0] years, 87.7% had a stable partner, 27.0% were postmenopausal, and 53.9% had increased body mass index (BMI). The prevalence of sexual dysfunction was 46.5% (CSFQ-14 score ≤ 41). Postmenopausal status was associated with lower CSFQ-14 scores (worse sexual function) and severe menopausal symptoms whereas there were not significant differences in SWLS scores. CSFQ-14 scores correlated with SWLS (p < 0.04), and inversely correlated with menopausal symptoms (p < 0.02). Multiple linear regression analysis model predicted 26.6% of the total CSFQ-14 score variance, and higher scores (better sexual function) were correlated with better SWL, and inversely correlated to female age and worse menopausal symptoms. A second model predicted 38.4% of the SWLS score variance. The SWLS score correlated with the total CSFQ-14 score and BMI, and inversely correlated with economical problems, female tobacco use, lack of healthiness, menopausal symptoms, not having a partner, and partner's lack of healthiness.

Conclusions

Lower sexual function was related to low SWL, age and menopausal symptoms while low SWLS score was related with economical problems, smoking, menopausal symptoms, and partner factors.     

Beliefs regarding menopausal hot flushes among climacteric women as assessed with the Hot Flush Beliefs Scale

Background

Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Beliefs regarding these complaints may vary from one population to another.

Objective

To assess HF beliefs and factors related to negative beliefs in a climacteric Hispanic population using the Hot Flush Beliefs Scale (HFBS).

Methods

A total of 1154 healthy women (40–59 years) were assessed with the Menopause Rating Scale (MRS), those presenting HFs were requested to fill out the HFBS and a questionnaire containing socio-demographic data (female and partner).

Results

A total of 646 presented HFs (56%) graded according to the first item of the MRS as mild (28.6%), moderate (33.2%), severe (29.1%) and very severe (9.1%). Mean age of these women was 49.5 ± 5.2 years, with 51.9% having 12 or less years of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on HT, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. Women strongly disagreed in more negatively oriented items of those contained in subscale one (beliefs about self in social context). Contrary to this, women strongly agreed in more negative oriented items contained in subscale two which assesses beliefs about coping with HFs. Women presenting with severe–very severe HFs displayed higher HFBS total and subscale scores indicating a more negative belief regarding HFs. Logistic regression analysis determined that HF severity was related to higher HFBS scores for the total and subscales one and two. Current smoking, higher parity, lower female education, female psychiatric consultation, time since menopause and partner unhealthiness and alcohol consumption were also related to higher HFBS scorings. Postmenopausal status and church attendance were related to lower scores.

Conclusion

In this mid-aged Ecuadorian female series negative beliefs regarding HFs were related to the severity of HFs and individual female or partner characteristics. Data provided from clinical research using this tool, alone or in combination with other tests, is warranted.     

Factors related to increased daytime sleepiness during the menopausal transition as evaluated by the Epworth Sleepiness Scale

Background

Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning.

Objective

To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS).

Methods

In this cross-sectional study 149 women aged 40–59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data.

Results

Mean age of surveyed women was 47.6 ± 5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe–very severe in 42.8% of cases. Regarding the partner (n = 132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8 ± 4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score ≥10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51–17.23], p = 0.001), sedentarism (OR 3.43, CI 95% [1.14–10.26], p = 0.02) and hot flush presence (OR 2.61, CI 95% [1.02–6.65], p = 0.04) among women were risk factors for increased daytime sleepiness (ESS total score ≥10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24–0.90], p = 0.02).

Conclusion

Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention.     

Assessment of sexual function of mid-aged Ecuadorian women with the 6-item Female Sexual Function Index

Background

Assessing sexuality is a difficult task, hence used tools should be straight forward and easy to use.

Objective

To assess sexual function in mid-aged Ecuadorian women.

Method

In this cross sectional study, 904 otherwise healthy women 40–59 years completed the short 6-item Female Sexual Function Index (FSFI-6) and a general socio-demographic questionnaire containing personal/partner data. Internal consistency of the tool was also assessed.

Results

Median age of the whole sample was 49 years, 51.1% were postmenopausal, 43.8% lived at high altitude, 12.6% used hormone therapy (HT), 58.5% presented hot flushes, 43.5% were abdominally obese and 80.8% had a partner. Overall, 72.4% of surveyed women reported sexual activity (n = 655/904) with 65% of these presenting total FSFI-6 scores equal or below 20 the calculated median (lower sexual function). A 10.2% of those having a partner were sexually inactive. Internal consistency of tool was high (Cronbach's alpha = 0.91). Total FSFI-6 scores positively correlated with coital frequency and female and partner educational level and inversely with female age, waist circumference, hot flush intensity and partner age (bivariate analysis). Multiple linear regression analysis determined that lower scores (lower sexual function) were related to high altitude, history of sexual abuse, sedentarism, hot flush intensity, partner age and sexual dysfunction whereas partner educational level, coital frequency and female parity were significantly related to higher scores (better sexual function).

Conclusion

As assessed with a consistent, short, and easy to use tool lower sexual function of this mid-aged series was related to several female and partner factors. More research with this tool is warranted.     

Application of the 10-item Cervantes Scale among mid-aged Ecuadorian women for the assessment of menopausal symptoms

Background

The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture.

Objective

To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10).

Method

This was a cross sectional study in which a total of 451 Ecuadorian women (40–59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data.

Results

Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88 cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores.

Conclusion

In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.     

Resilience and related factors during female Ecuadorian mid-life

Background

Studies reporting on resilience (capacity to overcome life adversity) and the menopausal transition are scarce.

Objective

To assess resilience and related factors in mid-aged Ecuadorian women.

Method

This was a cross sectional study in which 904 women aged 40–59 completed the 14-item Wagnild and Young Resilience Scale (WYRS) and a general socio-demographic questionnaire containing personal and partner data. Lower total WYRS scores indicate less resilience. Internal consistency of the tool was also assessed.

Results

Median age of all surveyed women was 49 years. A 51.1% were postmenopausal, 43.8% lived high altitude, 43.5% were abdominally obese, 12.6% used hormone therapy and 80.8% had a partner. Internal consistency was high for the WYRS tool (Cronbach's alpha: 0.94). Multiple linear regression analysis determined that lower total WYRS scores (less resilience) correlated with high altitude residency, more severe hot flushes, sedentarism, higher abdominal circumferences and having a partner with erectile dysfunction. Contrary to this, higher WYRS scores correlated with higher parity and sexual activity.

Conclusion

As assessed with the WYRS tool, lower resilience of this mid-aged Ecuadorian female sample was related to various female and partner lifestyle and health issues, not necessarily related per se to the ageing process. More research using the tool is warranted.     

Health-related and socio-demographic correlates of physical activity level amongst urban menopausal women in Nigeria

Objectives

To investigate the physical activity (PA) level of Nigerian women aged 40–60 years and examine possible association between the PA level and some health-related and socio-demographic variables.

Methods

This is a cross-sectional study of 547 women in which a purposive sampling method was used to recruit participants in urban centers of three states from three geopolitical zones in Nigeria. The International Physical Activity Questionnaire (IPAQ)-short form, was used to assess PA level. A self-administered 13-item semi-structured questionnaire was used to obtain health-related (menopausal status, perceived health status, health problems, menopausal symptoms) and socio-demographic (age, marital status, educational level, occupation, personal income) information from participants. Chi-square and logistic-regression analysis were used to assess association between PA level and these variables.

Results

The mean age of participants was 49.21 ± 5.2 years, comprising 184 (33.6%) premenopausal, 129 (23.6%) perimenopausal and 234 (42.8%) postmenopausal women. Most of the women in the three menopausal groups reported moderate PA level. No significant association was observed between PA level and menopausal status (P = 0.348), health problems (P = 0.079) or any of the menopausal symptoms and age-group (P = 0.381) of the women. PA level had a direct significant association with perceived health status (P = 0.001) and educational level (P = 0.000).

Conclusion

Menopausal women in Nigeria reported a moderate PA level. Self-perception of good health, having secondary/post-secondary education, were directly associated with not being of a low PA level.     

Risk factors related to the presence and severity of hot flushes in mid-aged Ecuadorian women

Background

Several studies drawn from the Ecuadorian population have previously reported that more than half of mid-aged women present hot flushes, which can impair their quality of life. However up-to-date risk factors for their presence and severity have not been assessed.

Objective

To assess hot flush frequency and intensity and related risk factors among middle-aged Ecuadorian women.

Methods

In this cross-sectional study, 1154 healthy women aged 40–59 years, visiting healthcare centers of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the first item of the Menopause Rating Scale (MRS) and a questionnaire containing female and partner socio-demographic data.

Results

Mean age of the entire sample was 48.8 ± 5.6 years (median 48), a 48.7% had 12 or less years of schooling, 52.8% were postmenopausal, 43.6% lived at high altitude, 56.8% were married and 10% were on hormonal therapy (HT). Hot flushes accounted for 56% (n = 646) of the whole sample, of which 29.1% and 9.1% were respectively graded as severe and very severe. Logistic regression determined that female sedentarism (OR: 2.42, CI 95% [1.63–3.59]), accessing a free healthcare system (OR: 1.96, CI 95% [1.30–2.96]), living at high altitude (OR: 1.82, CI 95% [1.14–2.90]) and having a partner abusing alcohol (OR: 1.92, CI 95% [1.09–3.35]) were significant risk factors related to the presence of hot flushes. The regression model also determined that among women with hot flushes (n = 646), sedentarism (OR: 1.73, CI 95% [1.14–2.62]) and having a partner with erectile dysfunction (OR: 2.57, CI 95% [1.44–4.59]) were significant risk factors related to severe/very severe hot flushes whereas married status (OR: 0.53, CI 95% [0.32–0.86]), living at high altitude (OR: 0.46, CI 95% [0.26–0.78]) and partner healthiness (OR: 0.59, CI 95% [0.36–0.95]) were not.

Conclusion

To the best of our knowledge this is the first and largest study assessing hot flushes in a mid-aged Ecuadorian population. We found that the presence and severity were not significantly related to age and hormonal status yet to other individual female/male characteristics and the demography of the studied population.     

Serum cathepsin K as a marker of bone metabolism in postmenopausal women treated with alendronate

Context

Cathepsin K is a member of the cysteine protease family that cleaves both helical and telopeptide regions of collagen I, the major type of collagen in bone. Measurement of circulating levels of cathepsin K may be useful to assay the number or function of osteoclasts.

Objective

The aim of the study was to evaluate the role of serum cathepsin K as a biochemical marker of bone metabolism in patients with postmenopausal osteoporosis before and after treatment with alendronate.

Design, setting and participants

The study was a case–control and prospective study with postmenopausal osteoporotic women including a total number of 86 subjects. Serum cathepsin K was determined in 46 women with postmenopausal osteoporosis before and after 3, 6 and 12 months of treatment with alendronate. Basal serum cathepsin K levels were also compared between premenopausal healthy women (n = 20), postmenopausal women without osteoporosis (n = 20) and osteoporotic women. In addition, serum carboxyterminal cross-linked telopeptide of type I collagen (CTX), osteocalcin (OC) and bone-specific alkaline phosphatase (bALP) were measured.

Main outcome measure

Changes in cathepsin K serum levels after alendronate treatment.

Results

Serum cathepsin K levels were higher in postmenopausal women with osteoporosis (9.4 ± 11 pmol/L) compared with healthy postmenopausal women (6.8 ± 8.1 pmol/L; p < 0.01) and premenopausal women (6.3 ± 5.0 pmol/L, p < 0.01). Serum cathepsin K decreases gradually after alendronate treatment (17% at 3 months, 22% at 6 months and 41% at 12 months, p < 0.01). In contrast, the treatment resulted in early and sustained reductions in serum CTX.

Conclusion

We conclude that serum cathepsin K seems to provide additional information on bone metabolism in postmenopausal women treated with alendronate.     

Vitamin D deficiency and bone mineral density in postmenopausal women receiving aromatase inhibitors for early breast cancer

Objective

Aromatase inhibitors (AI) treatment leads to an increased risk of bone loss and fractures. In a group of women with early breast cancer (EBC) and baseline Vitamin D deficiency (<30 ng/ml) who are treated with AI, we aim to describe: serum levels of Vitamin D, bone mineral density (BMD), calcium intake, and the increase of serum 25(OH)D accomplished in 3 months of treatment with Vitamin D supplements.

Study design

Prospective, non-randomized clinical trial.

Methods

In 232 consecutively included women with EBC in treatment with AI, we assessed baseline calcium intake, serum levels of 25(OH)D, BMD and, spine X-ray. All received Calcium and Vitamin D supplements, and those with vitamin deficiency received 16,000 IU Vitamin D every 2 weeks. Serum levels of 25(OH)D were newly assessed after treatment. All the baseline evaluation was performed before starting AI treatment.

Results

Mean age at baseline (±SD) was 63.2 ± 8.8 years. In 150 (64.9%) cases, the women had been treated previously with tamoxifen; 101 (43.7%) started exemestane, 119 (51.5%) letrozole, and 11 (4.8%) anastrozole. The AI were initiated within 6 weeks after surgery or after the last cycle of chemotherapy.At baseline, 88.1% had 25(OH)D levels <30 ng/ml, 21.2% had severe deficiency (<10 ng/ml), and 25% of the participants had osteoporosis. Mean daily calcium intake was low (841 ± 338).We found a significant association between 25(OH)D levels and BMD at baseline, which remained significant in femoral neck BMD after multivariate adjustment.Plasma 25(OH)D levels improved significantly at 3 months follow-up in those treated with high dose Vitamin D supplements: mean increase 32.55 ng/ml (95%CI 28.06–37.03).

Conclusions

Our study suggests a high prevalence of commonly unrecognized Vitamin D deficiency in women with EBC treated with AI, a known osteopenic agent. Our results support the need for a routine assessment of 25(OH)D levels and, when necessary, supplementation in these patients.     

Effects of raloxifene and hormone replacement therapy on forearm skin elasticity in postmenopausal women

Objectives

Hormone replacement therapy (HRT) increases skin elasticity in postmenopausal women. However, the effects of raloxifene, a selective estrogen receptor modulator (SERM), on skin degenerative changes in postmenopausal women remain unknown. We investigated whether raloxifene increases skin elasticity, similar to HRT, in postmenopausal women.

Methods

In a 12-month trial, 17 postmenopausal women (mean age, 66.4 ± 7.8 years) received continuous raloxifene treatment (60 mg/day), 19 women (56.2 ± 6.4 years) received continuous 17-β estradiol treatment using a patch (0.72 mg/2 days) plus cyclic medroxyprogesterone acetate (2.5 mg/day, for 12 days/month), and 11 women (58.1 ± 7.3 years) did not receive either therapy. In each subject, the skin elasticity of the forearm was measured using a suction device at baseline and at 12 months after the start of the study.

Results

Raloxifene and HRT significantly increased skin elasticity from 52.4 ± 3.8% and 64.1 ± 7.2% at baseline to 55.1 ± 4.7% and 67.4 ± 7.4% after 12 months, respectively (P < 0.05, each), but the untreated subjects did not exhibit any significant change in skin elasticity during the study. The delta value for skin elasticity was significantly higher among the raloxifene and HRT subjects than among the untreated subjects (P < 0.05, each).

Conclusions

These findings suggest that raloxifene may have a beneficial effect on skin elasticity, which undergoes degenerative changes in postmenopausal women, in addition to its effects on bone metabolism.     

Treatment for premenstrual syndrome with Vitex agnus castus: A prospective,randomized, multi-center placebo controlled study in China

Objectives

To investigate the efficacy and safety of VAC BNO 1095 extract in Chinese women suffering from moderate to severe premenstrual syndrome (PMS).

Methods

Prospective, double-blind, placebo controlled, parallel-group, multi-center clinical trial design was employed. After screening and preparation phase lasting three cycles, Eligible patients were randomly assigned into treatment or placebo groups and had treatment with VAC extract or placebo for up to three cycles. Efficacy was assessed using the Chinese version PMS-diary (PMSD) and PMTS.

Results

Two hundred and seventeen women were eligible to enter the treatment phase (TP) and were randomly assigned into the treatment group (108) or the placebo group (109), 208 provided the efficacy data (treatment 104, placebo 104), and 202 completed the treatment phase (treatment 101, placebo 101). The mean total PMSD score decreased from 29.23 at baseline (0 cycle) to 6.41 at the termination (3rd cycle) for the treatment group and from 28.14 at baseline (0 cycle) to 12.64 at the termination (3rd cycle) for the placebo group. The total PMSD score of 3rd cycle was significantly lower than the baseline in both groups (p < 0.0001). The difference in the mean scores from the baseline to the 3rd cycle in the treatment group (22.71 ± 10.33) was significantly lower than the difference in the placebo group (15.50 ± 12.94, p < 0.0001). Results of PMTS were similar, the total scores for PMTS were significantly lower between the two groups (p < 0.01) and within each group (p < 0.01). The score was decreased from 26.17 ± 4.79 to 9.92 ± 9.01 for the treatment group, and from 27.10 ± 4.76 to 14.59 ± 10.69 for the placebo group. A placebo effect of 50% was found in the present study. No serious adverse event (SAE) occurred in both groups.

Conclusion

Vitex agnus castus (VAC BNO 1095 corresponding to 40 mg herbal drug) is a safe, well tolerated and effective drug of the treatment for Chinese women with the moderate to severe PMS.     

Mortality and profiles of community-dwelling fallers. Results from the EPIDOS cohort

Objectives

To assess long-term survival of community-dwelling elderly women after a fall according to various characteristics of whom four falling profiles.

Methods

The study included 329 women (mean age ± SD: 84 ± 3.5 years). Phone interviews were conducted every four months over four years to investigate the occurrence of falls and fill out a specific questionnaire. The vital status was checked up to 13 years after these four years. An accelerated failure-time model was used to estimate the effect of the falling profiles on women survival.

Results

During the four-year follow-up, 86 women (26%) belonged to the “outside falls” profile, 63 (19%) to “environmental falls”, 140 (43%) to “inside falls”, and 40 (12%) to “falls from height”. At 13 years, the survival probability was estimated at 20.8% [95% CI: 16.4–25.2%]. On average, women with “inside falls” had shorter survivals in comparison with each of the other falling profiles. Kaplan–Meier survival curves showed also shorter survivals of these women vs. all other women grouped together (HR = 1.33 [1.02–1.73], p = 0.03).

Conclusion

Elderly women with inside falls had shorter survivals than others. Indoor falls could be markers of an underlying frailty and should trigger adequate prevention and protection measures.     

Vertebral fracture assessment in Moroccan women: Prevalence and risk factors

Introduction

Vertebral fracture assessment (VFA) is a fast, low-radiation technique which produces images that are of sufficient quality to be used to diagnose the presence of vertebral deformity consistent with fracture.

Objective

To study prevalence and risk factors of vertebral fractures using VFA in asymptomatic Moroccan women.

Methods

The study cohort consists of a population of 328 consecutive women aged over 50 (mean age, weight and BMI of 65 ± 6.5 (50–84) years, 72.0 ± 12.8 (42–125) and 29.4 ± 5.0 (17.1–45.8) kg/m², respectively). Lateral VFA images and scans of the lumbar spine and proximal femur were obtained by two technologists using a GE Healthcare Lunar Prodigy densitometer. Vertebral fractures were defined using a combination of Genant semiquantitative (SQ) approach and morphometry.

Results

68% of vertebrae from T4–L4 and 75% from T8–L4 were adequately visualized on VFA. Vertebral fractures (grades 2 or 3) were detected in 25.6% (84/328) of these women. Thirty-two of women with VFA-identified fracture (38.0%) had only a single vertebral fracture, while the other 61.9% had two or more. Fractures were most common in the mid-thoracic spine and at the thoraco-lumbar junction. As would be expected, the prevalence of VFA-detected fractures increased with age and as BMD declined. Stepwise regression analysis showed that presence of vertebral fracture was mainly related to the spine osteoporotic status, age older than 65, history of peripheral fracture and more than six parities.

Conclusion

Vertebral fractures are common in asymptomatic Moroccan women and are related to age, low BMD, history of fracture and multiparity.     

Psychological factors and subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong

Background

Substantial evidence shows that psychological factors are associated with cardiovascular diseases. However, data on the association between psychological factors and subclinical atherosclerosis is lacking in postmenopausal Chinese women.

Objectives

To examine the associations of perceived stress and trait anxiety with subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong. Their relationships with biological and behavioral risk factors were also examined.

Methods

Between 2002 and 2004, we recruited 518 postmenopausal women aged 50–64 years. Perceived stress and trait anxiety were evaluated by the perceived stress scale and the state-trait anxiety inventory, respectively. Subclinical atherosclerosis was determined by measuring carotid intima-media thickness (IMT) and plaque using B-mode ultrasonography.

Results

Perceived stress and trait anxiety showed no significant association with IMT or plaque. Multivariate analyses showed high perceived stress scores were associated with an increased risk of elevated total cholesterol (OR = 2.10; 95% CI = 1.17–3.77) and elevated low-density lipoprotein cholesterol (LDL-C) (OR = 2.39; 95% CI = 1.36–4.21). High trait anxiety scores were associated with a 2.7-fold risk of elevated LDL-C (OR = 2.74; 95% CI = 1.56–4.80). Women with high perceived stress or trait anxiety scores were more likely to be physically inactive.

Conclusions

Perceived stress and trait anxiety were associated with atherogenic lipid levels, but not subclinical atherosclerosis. Maintaining high physical activity may help alleviate psychological stress and anxiety.     

Genetic associations with acute stress-related changes in eating in the absence of hunger

Background

Acute psychological stress is associated with eating in the absence of hunger.

Objective

To investigate if BclI and FTO polymorphisms are associated with eating in the absence of hunger as a result of acute psychological stress.

Methods

FTO (rs9939609) and BclI were genotyped in 98 subjects (BMI = 23.9 ± 3.3 kg/m²). In a randomized crossover design, the ‘eating in absence of hunger’ protocol was measured as a function of acute stress vs. a control task and of STAI (State Trait Anxiety Index) state scores.

Results

In comparison with the FTO T allele, the A allele was associated with an increased feelings of hunger after food intake in the stress (11 ± 10 vs. 18 ± 15, p < 0.01) and control condition (12 ± 9 vs. 16 ± 12, p < 0.05), even though food intake was not different. For the first time, it was observed that in comparison to the BclI C/C genotype, the BclI G/G genotype was associated with higher STAI states scores at 0, 10, and 20 min after the stress condition (30.8 ± 6.4 vs. 36.3 ± 8.2; 28.3 ± 5.5 vs. 32.3 ± 7.5; 27.7 ± 6.1 vs. 31.2 ± 7.5, p < 0.05). Additionally, the BclI G/G genotype was associated with a larger difference in energy intake between the stress and control condition, in comparison with the BclI C/C genotype (136.6 ± 220.4 vs. 29.4 ± 176.3 kJ, p < 0.04).

Conclusion

In concordance with previous studies, the FTO A allele is related to a lower feeling of hunger after a standardized meal. For the first time, the BclI G/G genotype is shown to be associated with increased sensitivity to psychological stress, and increased eating in the absence of hunger after stress.

Practice implications

Interventions to reduce body weight should consider the subjects’ genetic background.