Maturitas最新文献

{"title":"Exploring the influence of adenomyosis on endometrial cancer","authors":"Ran Matot ,&nbsp;Danna Englander ,&nbsp;Yarden Sela ,&nbsp;Nati Bor ,&nbsp;Yossi Geron ,&nbsp;Gil Zeevi ,&nbsp;Effi Yeoshoua ,&nbsp;Oded Raban ,&nbsp;Ram Eitan","doi":"10.1016/j.maturitas.2026.108872","DOIUrl":"10.1016/j.maturitas.2026.108872","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate whether coexisting adenomyosis is associated with distinct clinicopathological features in women with endometrial cancer.</div></div><div><h3>Study design</h3><div>This retrospective cohort included 399 women who had undergone hysterectomy for histologically confirmed endometrial carcinoma at a tertiary center between 2016 and 2024. Patients were stratified according to the presence or absence of adenomyosis on final pathology. Clinical and pathological characteristics were compared, and multivariable logistic regression was used to adjust for potential confounders.</div></div><div><h3>Main outcome measures</h3><div>Associations between adenomyosis and tumor invasiveness, stage at diagnosis, and other pathological features.</div></div><div><h3>Results</h3><div>The cohort consisted predominantly of postmenopausal women, with a median age of 67 years. Adenomyosis was identified in 94 patients (23.6%). Women with adenomyosis were more likely to have non-invasive tumors (1.1% vs. 6.8%; <em>p</em> = 0.037) and early-stage disease (Stage I–II: 91.3% vs. 80.8%; <em>p</em> = 0.029). After adjustment for age, adenomyosis was associated with lower odds of advanced-stage disease (adjusted odds ratio 0.40; 95% confidence interval 0.17–0.91). In a comprehensive model including age, histologic subtype, and peritoneal cytology, this association remained significant (adjusted odds ratio 0.20; 95% confidence interval 0.05–0.78). Endometrioid histology was independently protective (adjusted odds ratio 0.32; 95% confidence interval 0.13–0.75), while positive cytology was linked to advanced-stage disease (adjusted odds ratio 4.40; 95% confidence interval 1.86–10.40).</div></div><div><h3>Conclusions</h3><div>Coexisting adenomyosis is associated with less invasive tumors and a lower likelihood of advanced-stage endometrial cancer. These findings suggest adenomyosis may influence tumor progression, potentially through structural or biological mechanisms. Prospective studies are needed to clarify the underlying biology and long-term prognostic impact.</div><div><strong>Trial registration:</strong> This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Rabin Medical Center (Date 3 July 2025 /No RMC- 0037-25).</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108872"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168490","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":"Functional testosterone deficiency in aging men: Clinical impact, diagnostic pathways, and treatment strategies","authors":"Michael Zitzmann ,&nbsp;Armin Soave ,&nbsp;Simone Bier","doi":"10.1016/j.maturitas.2026.108870","DOIUrl":"10.1016/j.maturitas.2026.108870","url":null,"abstract":"<div><h3>Background</h3><div>Testosterone constitutes an indispensable determinant of male corporeal integrity, psychological resilience, and overall vitality across the life course. Testosterone deficiency (male hypogonadism) represents an endocrine disorder capable of engendering a broad spectrum of somatic derangements and psychosocial sequelae. Its origins may lie in testicular insufficiency, hypothalamic-pituitary dysfunction, or, more subtly, in functional hypogonadism arising from comorbid states such as obesity and type 2 diabetes mellitus.</div></div><div><h3>Methods</h3><div>This review distills contemporary evidence on the pathophysiology, clinical expression, diagnostic algorithms, and therapeutic armamentarium of male hypogonadism, with particular attention to functional hypogonadism and its repercussions for quality of life. Data from recent randomized trials and large-scale observational studies delineate both the efficacy and the safety of therapeutic strategies.</div></div><div><h3>Results</h3><div>Hypogonadism—whether primary, secondary, or functional - commonly manifests through disturbances of mood and cognition (including depression, fatigue, and mental decline), sexual dysfunction (diminished libido and impaired erectile capacity), disproportionate visceral adiposity, sarcopenia, osteopenia or osteoporosis, and anemia. These cumulative impairments markedly degrade quality of life. Crucially, aging per se does not precipitate hypogonadism; rather, age-associated comorbidities catalyze the emergence of functional hypogonadism. Epidemiological data corroborate a bidirectional nexus between functional hypogonadism and the metabolic syndrome, both being harbingers of increased cardiovascular mortality. Guideline-directed testosterone therapy, when judiciously prescribed, can reverse many of these perturbations—ameliorating sexual function, mood, vitality, muscle mass, bone density, and anemia—while simultaneously mitigating metabolic derangement.</div></div><div><h3>Conclusions</h3><div>Converging evidence, including from recent large-scale randomized controlled trials, demonstrates that modern testosterone therapy does not augment cardiovascular risk or mortality. On the contrary, it confers tangible metabolic and quality-of-life advantages, even in advanced age, provided coexistent conditions are addressed concomitantly. Optimal outcomes hinge upon meticulous patient selection, exclusion of contraindications (e.g., active prostate carcinoma or current fertility intention), and vigilant monitoring of prostate health and hematocrit. When applied with discernment, testosterone therapy offers a safe and efficacious means of restoring androgen sufficiency, thereby enhancing male health and well-being in its fullest sense.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108870"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146145290","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":"Effects of resistance training on postmenopausal women's muscle strength, muscle volume and muscle fat infiltration: A secondary analysis of a randomised controlled trial","authors":"Sofia Thorell ,&nbsp;Janne West ,&nbsp;Hanna Lindblom ,&nbsp;Mats Hammar ,&nbsp;Magnus Borga ,&nbsp;Anna-Clara Spetz Holm","doi":"10.1016/j.maturitas.2026.108856","DOIUrl":"10.1016/j.maturitas.2026.108856","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate changes in muscle volume and muscular fat infiltration in postmenopausal women after 15 weeks of resistance training compared with a control group with an unchanged low level of physical activity. We also assessed whether the intervention group increased their muscle strength.</div></div><div><h3>Study design</h3><div>This study was a secondary analysis of a randomised controlled trial on the effects of resistance training in postmenopausal women. Women with hot flushes (<em>n</em> = 65) were randomised to supervised resistance training three times per week for 15 weeks or to a control group.</div></div><div><h3>Main outcome measures</h3><div>Muscle strength in the intervention group was measured with 8-repetition maximum tests. At baseline and after 15 weeks, 44 subjects were scanned with a 3.0 T magnetic resonance scanner using a whole-body Dixon protocol. A semi-automated method was used for calculation of muscle volume and muscle fat infiltration.</div></div><div><h3>Results</h3><div>Significant between-groups differences were seen in change of muscle volume (<em>p</em> &lt; 0.001–0.015) between the intervention and control group from baseline to 15 weeks. Muscle volume increased by about 4 % (p &lt; 0.001) for all muscles in the intervention group, whereas no change was seen in the control group. Muscle strength increased significantly in the intervention group for all tested muscles. Muscle fat infiltration did not change.</div></div><div><h3>Conclusion</h3><div>Postmenopausal women with hot flushes and a low level of physical activity could, in just 15 weeks, increase their muscle volume and strength through resistance training.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier: <span><span>NCT01987778</span><svg><path></path></svg></span></div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108856"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191462","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":"Dietary intake of live microbes is inversely associated with fatigue and modified by serum folate among adults aged 40 years or more","authors":"Galya Bigman ,&nbsp;Amber S. Kleckner ,&nbsp;Yuanyuan Li ,&nbsp;Elizabeth A. Dennis ,&nbsp;Alice S. Ryan ,&nbsp;John D. Sorkin","doi":"10.1016/j.maturitas.2026.108868","DOIUrl":"10.1016/j.maturitas.2026.108868","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the independent associations between dietary live-microbe intake, as well as circulating levels of folate metabolites, and fatigue, and to examine their interaction as a potential biological pathway underlying fatigue in aging adults.</div></div><div><h3>Study design</h3><div>Cross-sectional analysis of adults aged ≥40 years participating in the National Health and Nutrition Examination Survey 2011–2023.</div></div><div><h3>Main outcome measures</h3><div>Fatigue was assessed using the Patient Health Questionnaire fatigue item and categorized as none/low versus moderate/severe. Dietary intake of live-microbe foods was derived from two 24-h recalls and classified as low, medium, or high. Total serum concentrations folate and its metabolites, including 5-methyltetrahydrofolate, were quantified. Survey-weighted logistic regression, adjusted for sociodemographic, dietary, and clinical covariates, estimated main effects and interactions between the effects of 5-methyltetrahydrofolate and of live-microbe intake; sensitivity analyses additionally adjusted for depressive symptoms and sleep disturbance.</div></div><div><h3>Results</h3><div>Moderate/severe fatigue was reported by 16.3% of 14,376 participants and 15.0% reported no intake of live-microbe foods. High versus low live-microbe intake was associated with lower odds of moderate/severe fatigue (odds ratio [OR] 0.60; 95% confidence interval [CI] 0.46–0.79). Higher serum 5-methyltetrahydrofolate levels were also associated with lower odds of moderate/severe fatigue (OR 0.85; 95% CI 0.73–0.98). In stratified analyses, high live-microbe intake corresponded to 38–65% lower odds of moderate/severe fatigue only among adults with higher levels of 5-methyltetrahydrofolate, with no significant associations among those with lower levels.</div></div><div><h3>Conclusions</h3><div>Intake of microbe-rich foods and higher levels of circulating 5-methyltetrahydrofolate are both associated with lower levels of fatigue in midlife and older adults, and folate sufficiency appears to potentiate the fatigue-reducing benefits of live-microbe foods, supporting a nutrient–microbe pathway relevant to healthy aging.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108868"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137702","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":"Associations between BMI and menopausal symptoms among Danish nurses: A cross-sectional study","authors":"Louise Polano ,&nbsp;Tine Worm Thinggaard ,&nbsp;Mette Kildevæld Simonsen ,&nbsp;Maarten van Wijhe ,&nbsp;Marianne Vámosi","doi":"10.1016/j.maturitas.2026.108859","DOIUrl":"10.1016/j.maturitas.2026.108859","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between body mass index and the severity of menopausal symptoms among Danish nurses.</div></div><div><h3>Study design</h3><div>Cross-sectional analysis of the 2024 wave of the Danish Nurse Cohort.</div></div><div><h3>Main outcome measures</h3><div>Total score on the Menopause Rating Scale dichotomized as no-to-mild (&lt;9) versus moderate-to-severe (≥9), with domain cut-offs applied for somatic, psychological, and urogenital symptoms. Multiple logistic regression models were applied, adjusted for age, smoking, alcohol, physical activity, diet, cohabitation, and age at last menstrual period.</div></div><div><h3>Results</h3><div>Of 6078 women (mean age 63.5 (standard deviation 9.3) years), 55.8% reported moderate-to-severe symptoms. Each 5-unit increase in body mass index was associated with higher odds of moderate-to-severe symptoms (odds ratio 1.13, 95% confidence interval 1.06–1.20). Domain analyses showed associations for psychological (odds ratio 1.15, 95% confidence interval 1.08–1.23) and somato-vegetative (odds ratio 1.15, 95% confidence interval 1.08–1.22) domains, but not urogenital (odds ratio 0.96, 95% confidence interval 0.91–1.03). Participants with a body mass index of less than 18.5 kg/m² had lower associated odds (odds ratio 0.53, 95% confidence interval 0.34–0.83) and participants with a body mass index of 30 kg/m² or more had higher odds (odds ratio 1.24, 95% confidence interval 1.05–1.46) than women with an eutrophic body mass index.</div></div><div><h3>Conclusions</h3><div>In a large national representative cohort of Danish nurses, higher body mass index was significantly associated with greater severity of menopausal symptoms, particularly psychological and somato-vegetative. These findings highlight the importance of considering weight-related factors when addressing midlife women's health and menopause care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108859"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138262","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":"Novel proteomic subtypes of frailty with distinct molecular patterns and prognosis","authors":"Zhenyi Xu ,&nbsp;Ce Wang ,&nbsp;Jiaofeng Wang ,&nbsp;Jie Chen ,&nbsp;Xiaojun Wang ,&nbsp;Zhijun Bao ,&nbsp;Yan Zhang","doi":"10.1016/j.maturitas.2026.108851","DOIUrl":"10.1016/j.maturitas.2026.108851","url":null,"abstract":"<div><h3>Objectives</h3><div>The frailty phenotype has limitations in capturing the biological heterogeneity of the condition. Our study identified subtypes of frailty based on proteomics and examined their associations with several adverse outcomes.</div></div><div><h3>Method</h3><div>The study included 1513 frail individuals and 29,339 non-frail individuals from the UK Biobank and analyzed 2920 proteins. Unsupervised K-means clustering was applied to identify molecular subtypes of frailty and the Boruta algorithm was applied to identify the key proteins for distinguishing these subtypes.</div></div><div><h3>Results</h3><div>Four novel subtypes were identified among frail individuals: S1 (<em>n</em> = 403), S2 (<em>n</em> = 209), S3 (<em>n</em> = 587) and S4 (<em>n</em> = 314). In total, 567 key proteins for distinguishing subtypes were identified, in diverse biological pathways. Each subtype exhibited distinct molecular characteristics. S1 was characterized by elevated genomic instability, S2 by altered intercellular communication, S3 by broad upregulation of aging-related features, and S4 by loss of proteostasis and mitochondrial dysfunction. While the prognosis of S3 was similar to S1, S2 and S4 had a worse prognosis than S1. S2, in particular, presented a significantly increased risk of multiple adverse outcomes compared with S1, including all-cause mortality (hazard ratio 2.13; 95% confidence interval 1.60–2.85), cardiovascular disease (hazard ratio 1.78; 95% confidence interval 1.00–3.17), respiratory disease (hazard ratio 1.83; 95% confidence interval 1.24–2.70), kidney disease (hazard ratio 2.76; 95% confidence interval 1.57–4.85), liver disease (hazard ratio 6.19; 95% confidence interval 4.13–9.29), and cancer (hazard ratio 2.06; 95% confidence interval 1.43–2.96).</div></div><div><h3>Conclusion</h3><div>Our study identified four proteomic subtypes of frailty with distinct molecular signatures and differential prognostic implications, highlighting the biological heterogeneity of frailty and the need for personalized medicine and management strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108851"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079303","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":"Management during pregnancy and lactation of patients who are at high risk of breast cancer","authors":"Christine Q. Nguyen ,&nbsp;Samanthika D. Gunaratne ,&nbsp;Caroline G. Clune ,&nbsp;Nicole P. Sandhu ,&nbsp;Christine L. Klassen","doi":"10.1016/j.maturitas.2026.108860","DOIUrl":"10.1016/j.maturitas.2026.108860","url":null,"abstract":"<div><div>Breast cancer is the most common malignancy among women of reproductive age, with increasing incidence influenced by delayed childbearing, genetic predisposition, and lifestyle factors. Younger patients often present with more aggressive tumor biology, including hormone receptor negativity and HER2 positivity. Pregnancy exerts a complex effect on breast cancer risk: the risk initially increases postpartum, particularly in older first-time mothers and those with a family history, but pregnancy has a long-term protective effect, mainly for estrogen receptor positive cancers. Pregnancy-associated breast cancer often presents at later stages and with aggressive features as physiologic changes in pregnancy and lactation increase breast density and ductal and lobular proliferation, which can complicate clinical and radiologic evaluation. Because of this, early risk assessment and tailored imaging are crucial for timely diagnosis. This review defines high-risk factors for breast cancer, and the management of these individuals during pregnancy and lactation.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108860"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121460","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":"Efficacy and safety of daridorexant for the treatment of insomnia disorder in women of menopausal transition age: Insights from a randomized controlled trial","authors":"Zoe Schaedel ,&nbsp;Talitha R. Bakker ,&nbsp;Claudio Bassetti ,&nbsp;Orestis Briasoulis ,&nbsp;Petra Cassel ,&nbsp;Scott Pain ,&nbsp;Santiago Palacios ,&nbsp;Christine Palmay ,&nbsp;Rosalia Silvestri ,&nbsp;Petra Stute ,&nbsp;Florence Trémollieres ,&nbsp;Suzanne M. Bertisch","doi":"10.1016/j.maturitas.2025.108821","DOIUrl":"10.1016/j.maturitas.2025.108821","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the efficacy and safety of daridorexant in women aged 47–55 years with insomnia disorder, an age group representative of the menopause transition.</div></div><div><h3>Study design</h3><div>In this randomized, double-blind, placebo-controlled study (<span><span>NCT03545191</span><svg><path></path></svg></span>), conducted in 10 countries between May 2018 and May 2020, 930 patients with insomnia disorder were randomized using interactive response technology (1:1:1) to receive a single film-coated tablet of daridorexant 25 mg, 50 mg, or placebo every evening for 3 months. Subgroup analyses were performed among the 117 women aged 47–55 (25 mg <em>n</em> = 43; 50 mg <em>n</em> = 35; placebo <em>n</em> = 39).</div></div><div><h3>Main outcome measures</h3><div>Efficacy endpoints included change from baseline to Month 3 of treatment in polysomnography-measured wake after sleep onset (WASO) and latency to persistent sleep (LPS), self-reported total sleep time (sTST), and insomnia-related daytime impairment, as recorded on the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ). Safety endpoints included adverse events and score on a visual analog scale for morning sleepiness. Efficacy was analyzed in all randomized subjects, and safety in all who received at least one treatment dose.</div></div><div><h3>Results</h3><div>At Month 3, daridorexant 50 mg vs placebo decreased WASO and LPS by a least-squares mean (LSM) of 13.8 min (95 % CI -29.0, 1.4) and 14.7 min (−30.0, 0.6) respectively, increased sTST by an LSM of 21.8 min (−3.9, 47.4) and decreased (improved) IDSIQ total score by an LSM of 4.1 (−14.4, 6.3). No marked deviations from the effect in the overall population were observed. The incidence of somnolence/fatigue was low and comparable across groups. Morning sleepiness improved in all groups.</div></div><div><h3>Conclusions</h3><div>These analyses suggest that daridorexant 50 mg provides benefit in sleep outcomes and daytime functioning in women aged 47–55 with insomnia disorder. Daridorexant 50 mg is well tolerated in this population, with no increased risk of next-morning sleepiness or somnolence.</div></div><div><h3>ClinicalTrials.gov identifier</h3><div><span><span>NCT03545191</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108821"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908891","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":"Home-based exercise reduces fall risk in older adults with mild cognitive impairment who have sustained a hip fracture: A 6-month randomized controlled trial","authors":"Jordyn Rice ,&nbsp;Ryan S. Falck ,&nbsp;Yeon Soo Seo ,&nbsp;Larry Dian ,&nbsp;Jennifer C. Davis ,&nbsp;Deborah A. Jehu ,&nbsp;Naaz Parmar ,&nbsp;Kenneth Madden ,&nbsp;Pierre Guy ,&nbsp;Darren Roffey ,&nbsp;Teresa Liu-Ambrose","doi":"10.1016/j.maturitas.2026.108832","DOIUrl":"10.1016/j.maturitas.2026.108832","url":null,"abstract":"<div><h3>Objectives</h3><div>Falls cause more than 85% of hip fractures in older adults. Older adults with cognitive impairment have been largely excluded from research on people who have sustained a hip fracture. As a consequence, whether exercise reduces fall risk in this high-risk population is unknown. We address this gap by examining the effect of a home-based exercise program on fall risk in older adults with mild cognitive impairment after hip fracture.</div></div><div><h3>Methods</h3><div>This was a 6-month randomized controlled trial comparing the effect of the Otago Exercise Program (OEP) versus standard care (SC) on fall risk measured with the Physiological Profile Assessment. Participants with mild cognitive impairment (Montreal Cognitive Assessment score &lt;26/30 and no dementia) who sustained a hip fracture were included. Secondary outcomes included the Short Physical Performance Battery, gait speed, Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test immediate and delayed recall, and Clinical Frailty Scale.</div></div><div><h3>Results</h3><div>Sixty participants, mean age 80 years (SD 7 years), were randomized (OEP, <em>n</em> = 30; SC, n = 30). At 6 months, compared with SC participants, OEP participants had significantly better Physiological Profile Assessment performance (estimated mean difference −0.73; 95% CI [−1.45, −0.11]; <em>p</em> = 0.048), delayed recall performance (estimated mean difference 1.11; 95% CI [0.14, 2.09]; <em>p</em> <em>=</em> 0.025), and Clinical Frailty scores (estimated mean difference −0.71; 95% CI [−1.40, −0.01]; <em>p</em> = 0.046). There were no effects of the intervention on other secondary outcomes at 6 months.</div></div><div><h3>Conclusions</h3><div>The Otago Exercise Program was efficacious at reducing fall risk in older adults with mild cognitive impairment after hip fracture. Exercise also improved cognitive function and frailty, highlighting its critical role in recovery after hip fracture in this high-risk population.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108832"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980199","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":"Associations of DNA methylation algorithm measures of aging with type 2 diabetes and mortality risk among US older adults","authors":"Xuetong Zhao ,&nbsp;Chongyu Ding ,&nbsp;Hui Zhang ,&nbsp;Yaqian Xu ,&nbsp;Yulu Gong ,&nbsp;Darong Hao ,&nbsp;Zhaojun Wang ,&nbsp;Xiangwei Li","doi":"10.1016/j.maturitas.2026.108827","DOIUrl":"10.1016/j.maturitas.2026.108827","url":null,"abstract":"<div><h3>Background</h3><div>DNA methylation algorithm values show promise as biomarkers for aging and adverse health outcomes, However, their comparative predictive utility for type 2 diabetes mellitus and its related mortality remains inadequately characterized. This study systematically evaluated twelve established epigenetic algorithms to address this knowledge gap.</div></div><div><h3>Methods</h3><div>Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, we assessed twelve DNA methylation algorithms (e.g., PhenoAgeAcc, GrimAgeMortAcc, GrimAge2MortAcc) in relation to type 2 diabetes mellitus risk and mortality among 2532 participants aged 50 years or more. DNA methylation was measured using the Infinium Methylation EPIC BeadChip kit. Statistical models quantified effect estimates as odds ratios for type 2 diabetes mellitus risk and subdistribution hazard ratios for mortality, with 95% confidence intervals expressed per one-standard deviation increment in epigenetic age Acceleration metrics.</div></div><div><h3>Results</h3><div>Significant associations were observed for PhenoAgeAcc, GrimAgeMortAcc, and GrimAge2MortAcc with type 2 diabetes mellitus risk, with multivariable-adjusted odds ratios (95% confidence interval) per standard deviation increase of 1.24 (1.04–1.49), 2.08 (1.39–3.13), and 2.95 (1.97–4.43), respectively. These associations remained consistent across biological sex and age subgroups (50–64 vs. ≥65 years). For mortality risk, eight algorithm measures were positively associated with type 2 diabetes mellitus mortality, with GrimAgeMortAcc and GrimAge2MortAcc showing the strongest predictive performance, with adjusted subdistribution hazard ratios (95% confidence interval) per standard deviation increase of 1.61 (1.39–1.87) and 1.69 (1.48–1.93), respectively.</div></div><div><h3>Conclusions</h3><div>DNA methylation algorithm values, particularly GrimAgeMortAcc and GrimAge2MortAcc, are strongly associated with prevalent type 2 diabetes mellitus and show significant utility for mortality risk stratification, highlighting the potential of these algorithms as tools for identifying high-risk populations. These findings highlight the potential of epigenetic biomarkers in guiding targeted prevention strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108827"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980198","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}