Systolic Blood Pressure and Survival to Very Old Age. Results from the Women's Health Initiative.

Background: The association between systolic blood pressure (SBP) and longevity is not fully understood. We aimed to determine survival probabilities to age 90 for various SBP levels among women aged ≥ 65 years with or without BP medication. Methods: We analyzed blood pressure data from participants in the Women's Health Initiative (n=16,570) who were aged 65 or older and without history of cardiovascular disease, diabetes or cancer. Blood pressure was measured at baseline (1993-1998) and then annually through 2005. The outcome was defined as survival to age 90 with follow-up until February 28, 2020. Results: During a follow-up of 18 years, 9,723 (59%) of 16,570 women survived to age 90. The SBP associated with the highest probability of survival was about 120mmHg regardless of age. Compared to an SBP between 110 and 130 mmHg, women with uncontrolled SBP had a lower survival probability across all age groups and with or without BP medication. A 65-year-old women on BP medication with an interpolated SBP between 110 and 130 mmHg in 80% of the first 5 years of follow-up had a 31% (95% confidence interval, 24%, 38%) absolute survival probability. For those with 20% time in range, the probability was 21% (95% confidence interval, 16%, 26%). Conclusions: An SBP level below 130 mmHg was found to be associated with longevity among older women. The longer SBP was controlled at a level between 110 and 130 mmHg, the higher the survival probability to age 90. Preventing age-related rises in SBP and increasing the time with controlled BP levels constitute important measures for achieving longevity.

Positive associations between menstrual lifespan, geriatric depression and healthy longevity in Chinese oldest-old and centenarian women.

OBJECTIVE: Menstrual lifespan (ML) is an important biological characteristic for women. Rare evidence has established the associations between menopause age (MI), geriatric depression and healthy longevity. This study aimed to address these associations in Chinese oldest-old and centenarian women, and explore their related factors in order to provide strategy support for healthy aging. METHODS: The China Hainan Centenarian Cohort Study provides a population-based sample in Hainan, China. A total of 723 women including 318 centenarian women and 405 oldest-old women aged 80-99 years were included in this study. Data on demographic information were collected using a structured questionnaire. Physical examination and blood samples were obtained following standard procedure. Geriatric Depression Scale (GDS-15) was used to evaluate depressive symptoms for all participants. RESULTS: The proportions of participants with depression and longevity were 19.78 % (143 older adults) and 43.98 % (318 older adults), respectively. After adjusting for a wide range of other covariates in multiple logistic regression analyses, ML was positively and significantly associated with depression and longevity [Exp(ß) 1.076 and 1.121; P < 0.05 for all]. In multiple linear regression analyses, there were significantly positive associations of ML with GDS-15 (ß = 0.061) and age (ß = 0.238, p < 0.05 for all) after adjusting for all covariates. CONCLUSIONS: This study provides epidemiological evidence that menstrual lifespan has positive associations with geriatric depression and healthy longevity in Chinese oldest-old and centenarian women. Future researches should focus on the effects of intervening MI on psychological health and successful longevity.

Mature cystic extragonadal teratoma in Douglas' pouch: Case report and literature review.

Teratomas often occur in the gonads, while Extragonadal mature cystic teratomas are reported occasionally, with the most common site being the omentum. Teratoma in the Douglas sac is extremely rare. we report a rare case of mature cystic Teratoma in the Douglas sac in a 71-year-old woman who underwent laparoscopic surgery. A cyst with a diameter of approximately 6 cm from Douglas was found during surgery, and the mass was separated from both ovaries. Microscopically, the cyst was a mature cystic teratoma that did not originate from the ovary.

The Efficacy and Safety of Bisphosphonates for Osteoporosis in Women Older Than 65 Years: A Meta-Analysis.

BACKGROUND: Osteoporosis presents a major threat to the health of women older than 65 years. Bisphosphonates (BPs) are now the principal class of medications for osteoporosis. OBJECTIVE: To evaluate the efficacy and safety of BPs in women older than 65 years. METHODS: A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane Central databases was undertaken for randomized controlled trials (RCTs) on the efficacy and safety of BPs in women older than 65 years. The primary outcome measures were the change in bone mass density (BMD), serum bone turnover marker levels, fracture rate and the adverse effect (AE) rate. The final search was performed in August 2019. RESULTS: Seven RCTs were included. A total of 23287 patients met the inclusion criteria. BPs significantly increased the BMD of the posteroanterior (PA) spine, lateral spine and femoral neck, and reduced the fracture, vertebrate fracture and hip fracture rates in women older than 65 years. In addition, BPs increased the risks for pyrexia, myalgia, arthralgia, headache and influenza-like symptoms and had no statistical effect on any AEs, any serious AEs, discontinuation due to AEs, oesophagitis, any upper gastrointestinal adverse event, atrial fibrillation and myocardial infarction occurrence in women older than 65 years. Finally, intravenous BPs reduced hip fracture risk but increased AEs in women older than 65 years. CONCLUSION: Despite the fact that AEs significantly increased after drug delivery, BPs are highly effective and safe for managing osteoporosis in women older than 65 years. Zoledronic acid caused an increased rate of AEs in women older than 65 years, but these AEs seemed to be mild to moderate. In addition, the hip fracture rate in women older than 80 years old treated with BPs was different than that in the other included patients. Therefore, doctors may prescribe BPs for women older than 65 years in order to increase BMD, and AEs and hip fractures in women older than 80 years should be given attention.

Effects of circuit training interventions on bone metabolism markers and bone density of old women with osteopenia.

The purpose of this study is to propose an effective exercise intervention program to prevent and control osteopenia and osteoporosis that result from aging. To the end of this study, a circuit training intervention was performed for 8 weeks among participants with osteopenia who resided in Gyeonggi Province and were aged 65 and whose T-score of dual energy X-ray absorptiometry was between -1.0 and -2.5. Based on the effect of this intervention on their bone metabolism markers and bone density, the following conclusions were derived: First, it turned out that the circuit training intervention had statistically significant interactive effects on bone metabolism markers (osteocalcin and deoxypyrid-inoline) of old women with osteopenia depending on the measuring timing and groups. Second, it turned out that the circuit training intervention had statistically significant interactive effects on the bone density (T-score) depending on the measuring timing and groups. The conclusions above indicate that the circuit training intervention showed positive effects on bone metabolism markers and bone density of old women with osteopenia, being viewed as an effective intervention program applicable in order to prevent and control osteopenia and osteoporosis in line with bone density decrease.

Mechanistic Links Underlying the Impact of C-Reactive Protein on Muscle Mass in Elderly.

BACKGROUND/AIMS: Mechanisms underlying the relationship between systemic inflammation and age-related decline in muscle mass are poorly defined. The purpose of this work was to investigate the relationship between the systemic inflammatory marker CRP and muscle mass in elderly and to identify mechanisms by which CRP mediates its effects on skeletal muscle, in-vitro. METHODS: Muscle mass and serum CRP level were determined in a cohort of 118 older women (67±1.7 years). Human muscle cells were differentiated into myotubes and were exposed to CRP. The size of myotubes was determined after immunofluorescent staining using troponin. Muscle protein synthesis was assessed using stable isotope tracers and key signalling pathways controlling protein synthesis were determined using western-blotting. RESULTS: We observed an inverse relationship between circulating CRP level and muscle mass (ß= -0.646 (95% CI: -0.888, -0.405) p<0.05) and demonstrated a reduction (p < 0.05) in the size of human myotubes exposed to CRP for 72 h. We next showed that this morphological change was accompanied by a CRP-mediated reduction (p < 0.05) in muscle protein fractional synthetic rate of human myotubes exposed to CRP for 24 h. We also identified a CRP-mediated increased phosphorylation (p<0.05) of regulators of cellular energy stress including AMPK and downstream targets, raptor and ACC-ß, together with decreased phosphorylation of Akt and rpS6, which are important factors controlling protein synthesis. CONCLUSION: This work established for the first time mechanistic links by which chronic elevation of CRP can contribute to age-related decline in muscle function.

Chemotherapy in Old Women with Breast Cancer: Is Age Still a Predictor for Under Treatment?

Breast cancer affects mostly older women but there are no guidelines especially devoted to adjuvant chemotherapy for this population. In this context, this study was carried out in a population-based cohort of French elderly women with breast cancer, to check adherence to the existing national guidelines according to the women's age, taking into account the evolution of the situation over time for women requiring chemotherapy. Between October 2006 and December 2008, all consecutive women included in the French Health registry for a biopsy-proven primary nonmetastatic breast cancer, aged 65-80 years at diagnosis, and living in South Eastern France, were asked to participate in a cohort study. Medical information was collected from physicians. The study population was restricted to the 223 women who were recommended adjuvant chemotherapy according to national guidelines. Those who received chemotherapy were compared to those who did not receive this treatment. Among these 223 women 55% had received chemotherapy. Only three women refused the treatment. Less than 8% have had a geriatric assessment before treatment decision and only two were proposed to participate in a clinical trial. After adjustment for comorbidity score, tumor characteristics, socio-demographic characteristics, and year of diagnosis, increasing patient age was independently associated with decreased guideline concordance for adjuvant chemotherapy. Women aged 75-80 years received chemotherapy more than four times less often than women aged 65-74 years. However, the percentage of women who received chemotherapy increased from 33% to 58% between 2006 and 2008, in parallel with the setting up of Onco-Geriatric Coordination Units in the area. In France, chronological age remains a barrier to receive chemotherapy for older breast cancer women but the establishment of a formal collaboration between oncologists and geriatricians seems to be an effective way to improve care delivery in this population.

Effectiveness of HPV vaccination in women reaching screening age in Italy.

BACKGROUND AND OBJECTIVES: A randomized trial was conducted in Tuscany, Italy, to evaluate the effectiveness of HPV vaccination for 25year old (yo) women who attend at the first time cervical cancer screening. The trial also evaluated immune response after vaccination, reductions of cytological abnormalities and the impact of vaccination on screening activity. STUDY DESIGN: During 2010-2011, all 25 yo women who were invited to the Florence cervical cancer screening programme were also asked to participate in the trial. Enrolled women were randomized into study and control groups. Those in the study group were offered HPV vaccination after the usual Pap test. The cytology distribution and prevalence for any high risk (hr) HPV type were compared at the subsequent screening round in an intention-to-treat analysis. The impact of HPV vaccination was evaluated per protocol comparing vaccinated women with the control group. RESULTS: Our results showed a reduction in HPV prevalence at recall for any hr-HPV type but it was not statistically significant, being 17.1% vs 21.4%, p=0.20 in the study and control groups, respectively. If we restricted the analysis to vaccinated women, strong reductions of the HPV 16,18,31,33,45 and HPV 31,33,45 infections were observed, being 5.3% vs 12.8%, p<0.01 and 2.1% vs 6.5%, p=0.02, respectively. Significant reductions for any hr-HPV infection and for HPV 16 infection were also observed in women HPV 16/18 negative at enrolment, being 12% vs 21.4%, p<0.01 and 0.6% vs 6.7%, p-value<0.01, respectively. In women hr-HPV negative at enrolment no infections due to HPV 16 or HPV 18 were observed and there was a big reduction for any hr-HPV infection (7.1% vs 21.4% p<0.01). A strong antibody response was observed not only for HPV 16 & 18 but also for their related types. CONCLUSIONS: Our findings suggest that HPV vaccination at the age 25 is beneficial if it is offered to hr-HPV negative women. Our data will assist in developing a cost effectiveness model for choosing the best strategy to integrate screening and vaccination for the coming years. Clinical trial registration number is NCT02296255.

Comfortable and leisurely: Old women on style and dress.

This article uses wardrobe interviews with women in the ages of 62-94 to explore transitions and continuities during the life course. During interviews the women have defined their style preferences. One categorization favored by several of them was comfortable. Different meanings were attached to this concept. Practical and convenient outfits were described as increasingly important when aging. Garments that did not expose the body-and its changes with aging-were preferred. The informants talked about the importance of feeling at ease, appropriately dressed for the occasion and situation. They were concerned with feeling nice in their outfits but also stressed becoming more laid-back and prioritizing convenience in their later years. All of these examples had to do with comfort and being comfortable. Uncomfortable clothes were too tight, deemed wrong for the occasion, and unwanted sources of self-consciousness and visibility. Transitions in their style of dress had been gradual, slowly adapting to changes in everyday life as well as in their bodies.

Performance of the Osteoporosis Self-Assessment Tool for Asians (OSTA) in Screening Osteoporosis Among Middle-Aged and Old Women in the Chengdu Region of China.

The purpose of this study was to assess the performance of an osteoporosis self-assessment tool for Asians (OSTA) for screening middle-aged and old healthy women in the Chengdu region of China. OSTA scores were used to evaluate the effect of age on the development of osteoporosis. A total of 15,752 healthy women older than 40 yr, who reside in the Chengdu region, were assigned to 9 age groups divided by 5-yr intervals. Bone mineral density of the lumbar vertebrae, L1-L4, and the left hip was measured with a GE Lunar Prodigy advance dual-energy X-ray absorptiometry system (GE Healthcare, Cincinnati, OH). All subjects were classified into 3 categories according to OSTA cutoff values. The OSTA values used to define the categories were ≥-1, >-4 and <-1, and ≤-4. The accuracy of the OSTA index was compared with T-scores measured by dual-energy X-ray absorptiometry at various skeletal sites. All statistical analyses were performed using SPSS, version 17.0 (SPSS, Inc., Chicago, IL). The detection rate of osteoporosis and osteopenia at the lumbar vertebrae and the femur was found to increase with age. Furthermore, the sensitivity of OSTA value for detection of osteoporosis also gradually enhanced with subject age. In contrast, the specificity gradually decreased with age. The sensitivity and negative predictive value of the OSTA index for detecting osteoporosis gradually increased with higher OSTA cutoff values, and the specificity and positive predictive value appeared to gradually decline. It was concluded that the OSTA is a useful screening tool to detect osteoporosis in middle-aged and old women in the Chengdu region of China. Furthermore, specific OSTA cutoff values should be selected for screening individuals who belong to different age groups.

A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology.

The introduction of organized cervical cancer (CC) screening programs has drastically reduced the prevalence of CC. However the incidence is still too high, especially among elderly women. All guidelines strongly recommend a regular Papanicolaou (Pap) testing for young and middle-aged patients. On the other hand, many international professional societies no longer advise screening in women who have undergone hysterectomy, and in women aged 65 years and above, who have a previous history of regular Pap smears. Here we report the case of poorly differentiated CC, involving the pelvic lymph nodes and urinary bladder, occurring in a 79-year-old woman who regularly underwent Pap tests, with no reported cytological abnormalities. In this very rare case, the CC cells, as well as cells from metastatic lymph nodes and cells from urinary specimens, molecularly showed human papilloma virus (HPV)-53. With the limitations of a single case, this report brings important information to prevent CC in elderly patients: the utility of molecular tests to increase sensitivity of Pap smears in postmenopausal women; the importance of HPV-53 as one of the four "emergent" genotypes having a possible role in oncogenesis; and the presence of HPV-53 in lymph node metastases from cervical carcinoma, which would support the role of this virus in the maintenance of malignant status.

The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study

OBJECTIVES: The aim of this study was to investigate the impact of asymptomatic vertebral fractures on the quality of life in older women as part of the Sao Paulo Ageing & Health Study. METHODS: This study was a cross-sectional study with a random sample of 180 women 65 years of age or older with or without vertebral fractures. The Quality of Life Questionnaire of the European Foundation for Osteoporosis was administered to all subjects. Anthropometric data were obtained by physical examination, and the body mass index was calculated. Lateral thoracic and lumbar spine X-ray scans were obtained to identify asymptomatic vertebral fractures using a semi-quantitative method. RESULTS: Women with asymptomatic vertebral fractures had lower total scores [61.4(15.3) vs. 67.1(14.2), p = 0.03] and worse physical function domain scores [69.5(20.1) vs. 77.3(17.1), p = 0.02] for the Quality of Life Questionnaire of the European Foundation for Osteoporosis compared with women without fractures. The total score of this questionnaire was also worse in women classified as obese than in women classified as overweight or normal. High physical activity was related to a better total score for this questionnaire (p = 0.01). Likewise, lower physical function scores were observed in women with higher body mass index values (p<0.05) and lower physical activity levels (p,0.05). Generalized linear models with gamma distributions and logarithmic link functions, adjusted for age, showed that lower total scores and physical function domain scores for the Quality of Life Questionnaire of the European Foundation for Osteoporosis were related to a high body mass index, lower physical activity, and the presence of vertebral fractures (p<0.05). CONCLUSION: Vertebral fractures are associated with decreased quality of life mainly physical functioning in older community-dwelling women regardless of age, body mass index, and physical activity. Therefore, the results highlight the importance of preventing and controlling asymptomatic vertebral fractures to reduce their impact on quality of life among older women.

Satisfação da imagem corporal e visão de idosas ativas sob a influência do exercício físico na sua autoimagem / Body image satisfaction and the view of active old women about the influence of physical exercise in their self-image

Objetivou-se analisar a satisfação com a imagem corporal de 24 idosas ativas, e compreender a visão destas sobre a relação do exercício físico com sua imagem corporal. Todas responderam à escala proposta por Stunkard, Sorenson e Schlusinger (1983) e a uma entrevista semiestruturada. Estavam insatisfeitas com sua imagem corporal, 87,50%. A partir da leitura e análise dos discursos, formaram-se 2 categorias principais e 4 subcategorias. Assim, a maioria das idosas está insatisfeita com sua imagem corporal; porém, são reconhecidos os benefícios proporcionados pelo exercício físico...

The aim of this paper was to analyze the body image satisfaction with 24 active elderly women, and to understand the view of these people about the connection between physical exercise and their body image. All of them answered to the scale proposed by Stunkard, Sorenson and Schlusinger, 1983 and to a semi-structured interview. 87.50% of the women were unsatisfied about the body image. From the reading and analysis of the speeches, it was formed two major categories and four subcategories. Thus, most of the elderly women are unsatisfied about their body image, but the proportionate benefits by the exercises are recognized...

Satisfação da imagem corporal e visão de idosas ativas sob a influência do exercício físico na sua autoimagem / Body image satisfaction and the view of active old women about the influence of physical exercise in their self-image

Objetivou-se analisar a satisfação com a imagem corporal de 24 idosas ativas, e compreender a visão destas sobre a relação do exercício físico com sua imagem corporal. Todas responderam à escala proposta por Stunkard, Sorenson e Schlusinger (1983) e a uma entrevista semiestruturada. Estavam insatisfeitas com sua imagem corporal, 87,50%. A partir da leitura e análise dos discursos, formaram-se 2 categorias principais e 4 subcategorias. Assim, a maioria das idosas está insatisfeita com sua imagem corporal; porém, são reconhecidos os benefícios proporcionados pelo exercício físico.(AU)

The aim of this paper was to analyze the body image satisfaction with 24 active elderly women, and to understand the view of these people about the connection between physical exercise and their body image. All of them answered to the scale proposed by Stunkard, Sorenson and Schlusinger, 1983 and to a semi-structured interview. 87.50% of the women were unsatisfied about the body image. From the reading and analysis of the speeches, it was formed two major categories and four subcategories. Thus, most of the elderly women are unsatisfied about their body image, but the proportionate benefits by the exercises are recognized.(AU)

O gênero (in)visível da terceira idade no saber da enfermagem / The (in)visible gender of old age in the knowledge of Nursing / El Género (in) visible de la Tercera Edad en el Saber de Enfermería

Trata-se de um estudo bibliográfico, no qual realizou-se um levantamento da produção científica de enfermagem referente à Mulher na Terceira Idade no Catálogo de Dissertações e Teses do CD-room do Centro de Estudos e Pesquisas em Enfermagem(CEPEn) da Associação Brasileira de Enfermagem - ABEn no período de 1979 a 1999. Objetivou conhecer os afastamentos e/ou aproximações no saber de enfermagem com o objeto de estudo da tese de doutorado: os saberes e práticas de saúde das mulheres idosas, na perspectiva de gênero. Concluiu-se que a mulher na terceira idade foi investigada em poucos estudos, além do mais, os objetos destas investigações se afastaram fortemente das questões de gênero, demonstrando-se o aspecto assexuado da velhice, e negação dos papéis sociais da mulher.

It is a bibliographical study in which the scientific production of Nursing regarding Women in Old Age was surveyed. The study was based on the Catalog of Dissertations and Theses from the CD-ROM of the Center for Studies and Research on Nursing (CEPEn) of the Brazilian Nursing Association (ABEn), from 1979 to 1999. It was aimed at getting to know the deviations and/or approximations in the knowledge of Nursing by way of the object of study of the Ph.D. thesis 'Health practice and knowledge of old women in the gender perspective'. It was found out that old women have been investigated in few studies. In addition, the objects of these investigations have strongly deviated from gender issues, demonstrating the sexless aspect of old age and the denial of women's social roles.

Se trata de un estudio bibliográfico en el cual se realizó un levantamiento de la producción científica de enfermería referente a la Mujer en la Tercera Edad, en el Catálogo de Disertaciones y Tesis del CD - room del Centro de Estudios e Investigaciones en Enfermería (CEPEn) de la Asociación Brasileña de Enfermería - ABEn en el período de 1979 a 1999. El objetivo es conocer los alejamientos y aproximaciones en el saber de enfermería con el objeto de estudio de la tesis de doctorado: los saberes y prácticas de salud de las mujeres ancianas, en la perspectiva de género. Se concluye que la mujer en la tercera edad, fue objeto de estudio en pocas investigaciones y aquellas investigadas se alejaron mucho de las cuestiones de género, demostrándose el aspecto asexuado de la vejez y negación de los papeles sociales de la mujer.

Sexuality and its influential factors in old women

BACKGROUND: Although sexuality in old women is important for the quality of life, that has been overlooked due to social indifference. Because the studies for sexuality in old women were lack in Korea, we surveyed sexuality and its influential factors in old women. METHODS: From March to July 2000, we surveyed 115 old women over 60 years with 22 items of questionnaire. Data was gathered through written responses to the questionnaire and one to one interview between doctor and subject. Statistical analysis was done with SPSS ver10.0/PC and its significance was tested by chi square(p<0.05). RESULTS: Mean age of 115 women is 64.84+/-4.54year. There are 80 cases(69.6%) that thought sexuality is important in old women. Sexuality and sexual interest get gradually decreased by aging. Marital state, age of husband, family structure, economic state, sexual interest are statistically significant as the influential factors of sexuality(p<0.05). Sexual satisfaction comes out 35.7%. Age, marital state, family structure, job, economic state, subjective health state, current medication, sexual interest are statistically signifiant as the influential factors of sexual satisfaction(p<0.05). The reasons of decreased sexuality is due to aging process(47.8%), no partner(17.4%), partner problem(14.8%), physical illness(10.4%) and decreased libido. CONCLUSION: We conclude that sexuality in old women is important. Its influential factors are marital state, age of husband, family structure, economic state, sexual interest. Age, marital state, family structure, job, economic state, subjective health state, current medication, sexual interest are statistically signifiant as the influential factors of sexual satisfaction.