Maturitas最新文献

{"title":"Advanced paternal age at birth and risk of cyanotic congenital heart defects in the United States","authors":"Julie Sang ,&nbsp;Imo A. Ebong ,&nbsp;Duke Appiah","doi":"10.1016/j.maturitas.2026.108863","DOIUrl":"10.1016/j.maturitas.2026.108863","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited inconsistent evidence suggests a potential association between advanced paternal age (APA) and simple congenital heart defects, which often resolve without surgical interventions, in offspring. There is no reported potential relationship between APA with major cardiac defects like cyanotic congenital heart defects (CCHD). This study evaluated the association between APA (age at birth ≥40 years) and the occurrence of CCHD among livebirths in the USA, accounting for maternal and other potential confounding factors.</div></div><div><h3>Methods</h3><div>Data were from the National Vital Statistics System, comprising 9.9 million singleton first-time livebirths among mothers and fathers aged ≥15 years from 2016 to 2023. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>From 2016 to 2023, the proportion of births to fathers with APA increased from 7.5% to 7.9%. A greater proportion of fathers with APA had offspring with CCHD (62.0 vs. 53.1 per 100,000), used infertility treatment (9.5% vs. 2.3%), and their partners were also older (34.6 vs. 27.0 years). In models adjusted for paternal factors (age, race and ethnicity, and education), APA was associated with a modest elevated odds for CCHD (OR = 1.22, 95% CI 1.11–1.34) which remained significant after further control for maternal pre-pregnancy sociodemographic and health factors (OR = 1.12, 95% CI 1.01–1.25). However, additional adjustments for infertility treatment attenuated the observed association (OR = 1.08, 95% CI 0.98–1.20).</div></div><div><h3>Conclusions</h3><div>The findings of this large population-based study suggest no association between APA and CCHD after accounting for important confounders, including maternal factors and infertility treatment.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108863"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer genetics and risk assessment 101: What women's health care providers need to know","authors":"Barbara E. Ruddy ,&nbsp;Patress A. Persons ,&nbsp;Elizabeth R. Dacek","doi":"10.1016/j.maturitas.2026.108865","DOIUrl":"10.1016/j.maturitas.2026.108865","url":null,"abstract":"<div><div>Breast cancer affects the lives of many women and their loved ones. Women's health practitioners have an important role in identifying women at increased risk for breast cancer and guiding them toward appropriate counseling, imaging surveillance, and preventive care. Familial cancer syndromes account for a substantial proportion of breast cancer diagnoses. When family history or other clinical features suggest a hereditary predisposition, practitioners should consider recommending genetic testing and genetic counseling to help mitigate risk. The U.S. National Comprehensive Cancer Network offers evidence-based guidelines for identifying candidates for genetic testing and provides tools for surveillance and screening. Genetic counselors can help patients select appropriate tests and interpret results, facilitating informed decision-making. Additional risk factors for breast cancer include increasing age, lifestyle factors, prolonged exposure to endogenous or exogenous hormones, prior radiotherapy, high breast-tissue density, and a personal history of high-risk breast lesions such as atypical hyperplasia and lobular carcinoma in situ. Several validated risk-assessment tools for breast cancer are available for clinical use and incorporate patient-specific data to guide management. For individuals at increased risk of developing breast cancer, preventive and risk-reducing strategies include early-detection enhanced surveillance protocols, risk-reducing surgery, pharmacologic interventions, and lifestyle modifications.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108865"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of physical performance and associated factors in community-dwelling older adults","authors":"Laíza Rodrigues Mucenecki ,&nbsp;Karla Pereira Machado ,&nbsp;Thiago Gonzalez Barbosa-Silva ,&nbsp;Andréa D. Bertoldi ,&nbsp;Elaine Tomasi ,&nbsp;Flávio Fernando Demarco ,&nbsp;Maria Cristina Gonzalez ,&nbsp;Mariana Otero Xavier ,&nbsp;Renata Moraes Bielemann","doi":"10.1016/j.maturitas.2026.108877","DOIUrl":"10.1016/j.maturitas.2026.108877","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate 10-year trajectories of physical performance and identify associated socioeconomic, demographic, health-related, and behavioral factors among community-dwelling older adults.</div></div><div><h3>Study design</h3><div>Longitudinal cohort using data from three waves (2014, 2019, and 2024) of a population-based study of adults aged ≥60 in southern Brazil.</div></div><div><h3>Main outcome measures</h3><div>Physical performance was assessed using gait speed (GS, m/s) and the Timed Up and Go test (TUG, seconds). Trajectories were modeled using a group-based semiparametric approach. Associations with socioeconomic, demographic, health-related, and behavioral factors were examined using multinomial and binomial logistic regression.</div></div><div><h3>Results</h3><div>746 participants had their physical performance trajectories over 10 years modeled. Three GS trajectories (lower, 27.4%; intermediate, 60.8%; higher, 11.8%) and two TUG trajectories (gradual increase, 83.0%; rapid increase, 17.0%) were identified. Poorer physical performance trajectories were associated with sex, age, schooling, economic level, functional capacity, polypharmacy, low muscle strength, and self-rated health. The highest relative risk (RR) and odds ratio (OR) of being classified in the poorest GS and TUG trajectories were observed among women (RR 10.01, 95%CI 5.22–19.17; OR 2.26, 95%CI 1.40–3.63), individuals with &lt;8 years of schooling/no schooling (RR 6.82, 95%CI 3.24–14.38; OR 2.80, 95%CI 1.69–4.64), and those with low muscle strength (RR 7.60, 95%CI 1.95–29.65; OR 2.70, 95%CI 1.46–4.97). Conversely, being physically active was associated with a lower risk of belonging to the poorest GS trajectory (RR 0.36, 95%CI 0.18–0.74).</div></div><div><h3>Conclusions</h3><div>All trajectories demonstrated a decline in physical performance over time. The poorest trajectories were associated with socioeconomic, demographic, health-related, and behavioral factors, indicating that decline in physical performance is not solely attributable to chronological aging.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108877"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time since menopause and a circulating metabolomic signature for sarcopenia risk: Data from 68,064 women from the UK Biobank","authors":"Xiaoyu Zhang ,&nbsp;Bo Xie ,&nbsp;Chunying Fu ,&nbsp;Qi Wang ,&nbsp;Juan Li ,&nbsp;Dongshan Zhu","doi":"10.1016/j.maturitas.2026.108875","DOIUrl":"10.1016/j.maturitas.2026.108875","url":null,"abstract":"<div><h3>Background</h3><div>Menopause-related metabolic alterations may increase susceptibility to sarcopenia, yet the longitudinal dimension of reproductive ageing—namely time since menopause—has not been investigated using an innovative metabolomic strategy that captures dynamic, multi-pathway metabolic changes and constructs a validated metabolomic signature related to time since menopause. We aimed (1) to identify a plasma metabolomic profile related to time since menopause, (2) to evaluate the independent associations of time since menopause and the metabolomic signature with sarcopenia and its components, and (3) to quantify the mediation effect exerted by this profile.</div></div><div><h3>Methods</h3><div>We analyzed 68,064 naturally postmenopausal women (4406 with sarcopenia) from the UK Biobank and validated findings in 5971 women with repeat assessments. Time since menopause was defined as baseline age minus age at natural menopause. Nuclear magnetic resonance spectroscopy was used to quantify 251 plasma metabolites. Elastic net regression was applied to derive a metabolomic signature related to time since menopause, which was validated by correlation analysis. Multivariable logistic regression estimated odds ratios (ORs) for sarcopenia, low strength, mass, and performance; mediation was assessed via bootstrapping.</div></div><div><h3>Results</h3><div>Eighty-six metabolites spanning lipid, amino acid, and glycolytic pathways—closely linked to energy metabolism and protein homeostasis relevant to muscle physiology—comprised the signature related to time since menopause (baseline <em>r</em> = 0.27, <em>P</em> &lt; 0.001). Each 5-year increase in time since menopause was associated with higher odds of sarcopenia (OR 1.13, 95% CI 1.09–1.16), and each 1-SD higher signature score was independently associated with sarcopenia (1.06, 1.02–1.10). The metabolomic signature mediated 13.3% of the association between time since menopause and sarcopenia.</div></div><div><h3>Conclusions</h3><div>A distinctive, multi-pathway metabolomic signature tracks time since menopause and partly mediates its association with sarcopenia. Reflecting coordinated dysregulation in lipid and amino acid metabolism, this signature may provide a molecular link between reproductive ageing and postmenopausal muscle decline and has potential utility as a non-invasive biomarker for early risk stratification.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108875"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Endometriosis and menopausal health: An EMAS clinical guide”","authors":"Tugba Akcaoglu","doi":"10.1016/j.maturitas.2026.108861","DOIUrl":"10.1016/j.maturitas.2026.108861","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108861"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the predictive validity of SARC-F cut-off scores for low muscle strength among older adults in a low-income community","authors":"Alex Barreto de Lima ,&nbsp;Reshma Aziz Merchant ,&nbsp;Myrian Abecassis Faber ,&nbsp;Duarte Henrinques-Neto","doi":"10.1016/j.maturitas.2026.108869","DOIUrl":"10.1016/j.maturitas.2026.108869","url":null,"abstract":"<div><h3>Background</h3><div>With an aging population, muscle health, encompassing locomotion and metabolic function, has become a public health priority. Handgrip strength is a validated surrogate measure of general muscle strength, but measurement may not be feasible in low-resource settings. The SARC-F questionnaire (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) provides a simple, low-cost, and practical tool for sarcopenia screening, though its optimal cut-off remains debated.</div></div><div><h3>Objective</h3><div>To evaluate the predictive validity of SARC-F cut-off scores in identifying low muscle strength among community-dwelling older adults in a low-income population.</div></div><div><h3>Methods</h3><div>We included 733 participants (221 men, 512 women; aged 60–95 years) from the Amazonas region of Brazil. All completed the SARC-F and underwent handgrip strength testing. Low handgrip strength was based on EWGSOP2 criteria (&lt;27 kg men, &lt;16 kg women). Agreement, sensitivity, specificity, predictive values, and ROC curves were calculated for cut-offs ≥4 and ≥ 2, stratified by sex.</div></div><div><h3>Results</h3><div>Low handgrip strength was highly prevalent (47.1% in men, 94.1% in women). Agreement between SARC-F and muscle weakness was generally poor (κ &lt;0.4), except for men at the ≥4 threshold (κ = 0.41). Sensitivity was higher in men than in women (≥4: 48% vs 37%; ≥2: 70% vs 69%). Lowering the cut-off to ≥2 improved sensitivity but reduced specificity (65.8% men, 56.7% women). ROC analysis identified ≥2 as the optimal threshold, with AUC 0.68 in men and 0.63 in women.</div></div><div><h3>Conclusion</h3><div>A SARC-F cut-off of ≥2 improves sensitivity for detecting probable sarcopenia and may be more suitable for screening in low-income settings. Longitudinal validation is warranted across diverse populations.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108869"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The window of opportunity for treating vulvovaginal atrophy in menopause: Insights from oestrogen receptor distribution and age-related changes","authors":"Silvia P. González ,&nbsp;Laura Nieto-Pascual ,&nbsp;Diana López-Freire ,&nbsp;Santiago Palacios","doi":"10.1016/j.maturitas.2026.108858","DOIUrl":"10.1016/j.maturitas.2026.108858","url":null,"abstract":"<div><h3>Objective</h3><div>To review the biological basis of the “window of opportunity” hypothesis for the treatment of vulvovaginal atrophy (VVA), focusing on the distribution of oestrogen receptors (ERs) in vulvovaginal tissues, the impact of sustained oestrogen deficiency over time, and the rationale for a preventive or very early sequential therapeutic approach.</div></div><div><h3>Methods</h3><div>Narrative review of experimental and clinical studies evaluating ER expression in vaginal and vulvar tissues, its modulation by age and menopause, and clinical response to local and systemic hormonal therapy, with emphasis on timing of initiation and management strategies.</div></div><div><h3>Main results</h3><div>ER distribution and expression vary with age and menopausal status, with ER-α predominating after menopause. Experimental models show that immediate hormonal intervention after oestrogen deprivation restores tissue trophism and ER expression, whereas delayed treatment is associated with attenuated responses and irreversible histological changes. Loss of collagen, reduced angiogenesis, altered innervation, and inflammatory infiltration contribute to VVA progression. Clinical data suggest that early initiation of vaginal oestrogens enhances therapeutic efficacy. No consistent differences have been observed among local formulations, although ER subtype profile and time since menopause may influence outcomes.</div></div><div><h3>Conclusions</h3><div>Early initiation of ER-directed therapies may optimise tissue responses and prevent irreversible changes. A sequential treatment framework is useful for long-term management—particularly in women who did not start therapy early—yet further studies incorporating time since menopause and evaluating the long-term safety of hormonal therapy for VVA are warranted.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108858"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomization to hormone therapy and changes in plasma biomarkers of Alzheimer's pathology: The women's health initiative memory study","authors":"Aladdin H. Shadyab ,&nbsp;Bowei Zhang ,&nbsp;Andrea Z. LaCroix ,&nbsp;Linda K. McEvoy","doi":"10.1016/j.maturitas.2026.108873","DOIUrl":"10.1016/j.maturitas.2026.108873","url":null,"abstract":"<div><div>The association of hormone therapy with Alzheimer's pathology among postmenopausal women is not well understood. We examined the association of randomized assignment to hormone therapy with changes in plasma biomarkers of Alzheimer's pathology in the Women's Health Initiative Memory Study. Rates of change in the biomarkers (p-tau217, p-tau181, Aβ42:Aβ40, GFAP, and NfL) over an average 15-year follow-up did not significantly differ for estrogen alone vs placebo or estrogen plus progestin vs placebo. These null associations do not support either a protective or a detrimental association of hormone therapy of the types tested in the Women's Health Initiative with long-term changes in plasma Alzheimer's biomarkers.</div></div><div><h3>Clinicaltrials.gov</h3><div><span><span>NCT00685009</span><svg><path></path></svg></span></div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108873"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between intrinsic capacity and urinary incontinence in community-dwelling octogenarians: Results from the ilSIRENTE study","authors":"Stefano Cacciatore ,&nbsp;Mathias Schlögl ,&nbsp;Riccardo Calvani ,&nbsp;Andrea Russo ,&nbsp;Matteo Tosato ,&nbsp;Adrian Wagg ,&nbsp;Emanuele Marzetti ,&nbsp;Francesco Landi","doi":"10.1016/j.maturitas.2026.108871","DOIUrl":"10.1016/j.maturitas.2026.108871","url":null,"abstract":"<div><h3>Background</h3><div>Urinary incontinence (UI) is common in older adults. The construct of intrinsic capacity (IC) provides a multidimensional framework to assess functional reserves. This cross-sectional study examined the association between IC and UI in community-dwelling octogenarians from the Ageing and Longevity in the Sirente (ilSIRENTE) study.</div></div><div><h3>Methods</h3><div>IC was computed as the mean of standardized (0−100) scores across five domains (locomotion, cognition, vitality, psychological well-being, and sensory function) derived from Minimum Data Set for Home Care (MDS-HC) instruments and supplementary tests. UI was defined as a score of 3 or more on MDS-HC item I1. Associations between IC and UI were examined using logistic regression models adjusted for sociodemographic and clinical covariates. Restricted cubic splines tested linearity.</div></div><div><h3>Results</h3><div>Among 320 participants (median age 83.9 years [81.7–88.5]; 67.2% women), 35 (10.9%) had UI. Incontinent individuals had a lower total IC score (60.2 [51.5–69.7] vs. 85.2 [76.1–92.7]; <em>p</em> &lt; 0.001) and lower scores in the locomotion, cognition, vitality, psychological well-being, and sensory domains. In fully adjusted models, higher IC score was associated with lower odds of UI (per 10-point increase: OR 0.34, 95% CI 0.24–0.48). High IC score was associated with markedly lower odds of UI compared with low IC score (OR 0.07, 95% CI 0.02–0.20). Restricted cubic spline analyses supported linearity (p for non-linearity = 0.701).</div></div><div><h3>Conclusions</h3><div>Lower IC scores were associated with higher odds of UI, particularly in locomotion, cognition, vitality, and sensory domains. These findings support UI as a marker of multidimensional vulnerability and highlight the value of IC-oriented assessment to guide multidomain interventions in geriatric care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108871"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply to Tugba Akcaoglu","authors":"Tamer Erel ,&nbsp;Margaret Rees ,&nbsp;Irene Lambrinoudaki","doi":"10.1016/j.maturitas.2026.108867","DOIUrl":"10.1016/j.maturitas.2026.108867","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108867"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}