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Transgender patients and gender-affirming hormone therapy through the mid-life 变性患者和性别确认激素疗法的中年时期
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-20 DOI: 10.1016/j.maturitas.2024.108093
Jaya M. Mehta , Sarah Kanell , Charlie E.A. Borowicz , Molly Ainsman Fisher
{"title":"Transgender patients and gender-affirming hormone therapy through the mid-life","authors":"Jaya M. Mehta ,&nbsp;Sarah Kanell ,&nbsp;Charlie E.A. Borowicz ,&nbsp;Molly Ainsman Fisher","doi":"10.1016/j.maturitas.2024.108093","DOIUrl":"10.1016/j.maturitas.2024.108093","url":null,"abstract":"<div><p>The menopause transition and post-menopause period marks a time of dynamic physiological and hormonal change. Cisgender women commonly experience vasomotor symptoms, genitourinary symptoms, and changes in bone health. The transgender population, including those assigned female at birth (AFAB) and those assigned male at birth (AMAB), has been understudied in terms of experiences through the menopause transition and midlife. Additionally, there is no formal recommendation or guidance on continuation of gender-affirming hormone therapy (GAHT) through midlife. While gender-affirming therapies for transgender patients are well defined and supported by organizational guidelines, including from the World Professional Association for TGD Health (WPATH) (Standards of Care 8, SOC8) and from the Endocrine Society (2017), evidence on continuation of therapy and dose adjustments into mid-life are lacking. Data from a few large cohort studies and small cross-sectional studies suggest increased risk of venous thromboembolism (VTE), stroke and myocardial infarction in those AMAB on GAHT. For those AFAB on testosterone therapy, risks of cardiovascular disease and stroke and to bone health are not well defined, given inconsistent findings from large cohort studies. Currently, the decision to continue GAHT for transgender patients is guided by patient preference along with clinician guidance. Further research is warranted regarding risks of continuing GAHT into mid-life for both AMAB and AFAB patients. Given the significant benefit of GAHT in this population, however, this data would be most helpful for counseling on risks along with appropriate monitoring and prevention for related morbidities during mid-life in the setting of GAHT use.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044748","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}
引用次数: 0
The impact of carnosine on biological ageing – A geroscience approach 肌肽对生物老化的影响 - 地球科学方法
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-10 DOI: 10.1016/j.maturitas.2024.108091
Qian Wang , Saeede Saadati , Robel Hussen Kabthymer , Laura Kate Gadanec , Amy Lawton , Nicholas Tripodi , Vasso Apostolopoulos , Barbora de Courten , Jack Feehan
{"title":"The impact of carnosine on biological ageing – A geroscience approach","authors":"Qian Wang ,&nbsp;Saeede Saadati ,&nbsp;Robel Hussen Kabthymer ,&nbsp;Laura Kate Gadanec ,&nbsp;Amy Lawton ,&nbsp;Nicholas Tripodi ,&nbsp;Vasso Apostolopoulos ,&nbsp;Barbora de Courten ,&nbsp;Jack Feehan","doi":"10.1016/j.maturitas.2024.108091","DOIUrl":"10.1016/j.maturitas.2024.108091","url":null,"abstract":"<div><p>Biological ageing involves a gradual decline in physiological function and resilience, marked by molecular, cellular, and systemic changes across organ systems. Geroscience, an interdisciplinary field, studies these mechanisms and their role in age-related diseases. Genomic instability, inflammation, telomere attrition, and other indicators contribute to conditions like cardiovascular disease and neurodegeneration. Geroscience identifies geroprotectors, such as resveratrol and metformin, targeting ageing pathways to extend the healthspan. Carnosine, a naturally occurring dipeptide (b-alanine and l-histidine), has emerged as a potential geroprotector with antioxidative, anti-inflammatory, and anti-glycating properties. Carnosine's benefits extend to muscle function, exercise performance, and cognitive health, making it a promising therapeutic intervention for healthy ageing and oxidative stress-related pathologies. In this review, we summarize the evidence describing carnosine's effects in promoting healthy ageing, providing new insights into improving geroscience.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992678","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}
引用次数: 0
Beyond breast cancer: An exploration of the experiences of middle-aged female breast cancer survivors in Australia 超越乳腺癌:澳大利亚中年女性乳腺癌幸存者的经历探索。
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-09 DOI: 10.1016/j.maturitas.2024.108089
Bridie Campbell, Lynette Mackenzie, Joanne Lewis
{"title":"Beyond breast cancer: An exploration of the experiences of middle-aged female breast cancer survivors in Australia","authors":"Bridie Campbell,&nbsp;Lynette Mackenzie,&nbsp;Joanne Lewis","doi":"10.1016/j.maturitas.2024.108089","DOIUrl":"10.1016/j.maturitas.2024.108089","url":null,"abstract":"<div><h3>Objectives</h3><p>Middle-aged women (i.e., aged 40–65 years) who live with, through and beyond breast cancer (survivors) are an under-researched population, particularly within an Australian context. The unmet needs reported within this population include fatigue, psychological distress, body image concerns, early-onset menopause, and a lack of information on these issues. This study explores how the experiences of breast cancer survivorship impact the lives of Australian middle-aged women.</p></div><div><h3>Study design</h3><p>Qualitative analysis of written comments in an open text field of a survey completed by 644 women reporting breast cancer in the middle-aged cohort of the Australian Longitudinal Study of Women's Health gathered between 1996 and 2013. Data was collected from any participants who reported breast cancer in any survey. Researchers conducted a thematic analysis using consensus coding on data and identified key themes.</p></div><div><h3>Main outcome measures</h3><p>Any data where participants described their experiences of breast cancer survivorship.</p></div><div><h3>Results</h3><p>This cohort reported a unique experience of breast cancer survivorship due to their age group. Analysis developed the following themes: the middle-aged context of breast cancer; care and support, body changes, overcoming fears and maintaining balance; and finding a ‘new normal’.</p></div><div><h3>Conclusions</h3><p>Breast cancer survivorship is a diverse experience. For many it involves chronic limitations and challenges. Investigation and application of survivorship care plans in Australia could benefit breast cancer survivors by including multidisciplinary health professionals in their care. Unmet needs and psychological distress were described by participants rather than biomedical concerns. Further recommendations include development of online support groups providing access to rehabilitation professionals, especially for otherwise isolated rural women.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001841/pdfft?md5=da008ef56343dde0a0b35b842b7f4ab7&pid=1-s2.0-S0378512224001841-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Age differences in the moderating effects of neighbourhood disadvantage on the relationship between physical activity and cognitive function: A longitudinal analysis of the Canadian Longitudinal Study on Aging 邻里劣势对体育锻炼和认知功能之间关系的调节作用的年龄差异:加拿大老龄化纵向研究纵向分析》。
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-08 DOI: 10.1016/j.maturitas.2024.108088
Ryan S. Falck , Theodore D. Cosco , Andrew V. Wister , John R. Best
{"title":"Age differences in the moderating effects of neighbourhood disadvantage on the relationship between physical activity and cognitive function: A longitudinal analysis of the Canadian Longitudinal Study on Aging","authors":"Ryan S. Falck ,&nbsp;Theodore D. Cosco ,&nbsp;Andrew V. Wister ,&nbsp;John R. Best","doi":"10.1016/j.maturitas.2024.108088","DOIUrl":"10.1016/j.maturitas.2024.108088","url":null,"abstract":"<div><h3>Objectives</h3><p>To explore whether the association between physical activity (PA) and cognition is moderated by neighbourhood disadvantage, and whether this relationship varies with age.</p></div><div><h3>Study design</h3><p>A longitudinal analysis of the Canadian Longitudinal Study on Aging, wherein we included participants (<em>N</em> = 41,599) from urban areas who did not change their residential postal code from baseline (2010–2015) to first follow-up (2015–2018).</p></div><div><h3>Main outcome measures</h3><p>At baseline, we measured PA using the Physical Activity Scale for the Elderly, and neighbourhood disadvantage using the Material and Social Deprivation Indices.</p></div><div><h3>Results</h3><p>Using latent change score regression models, we determined that higher PA at baseline was independently associated with greater maintenance in memory performance from baseline to first follow-up both for adults aged 45–64 (<em>B</em> = 0.04, SE = 0.01, <em>p</em> = 0.001) and for those aged 65+ years (<em>B</em> = 0.12, SE = 0.02, <em>p</em> &lt; 0.001). For participants aged 45–64 years, greater material deprivation was independently associated with declines in memory performance (<em>B</em> = −0.10, SE = 0.03, <em>p</em> &lt; 0.001). In addition, greater social deprivation was associated with a stronger effect of PA on changes in executive functions (<em>B</em> = 0.17, SE = 0.08, <em>p</em> = 0.025) for adults aged 45–64 years; greater material deprivation was associated with a stronger effect of PA on changes in memory performance (<em>B</em> = 0.07, SE = 0.03, <em>p</em> = 0.022). We failed to detect any interactions between PA and neighbourhood disadvantage among adults aged 65+ years (all <em>p</em> values &gt;0.05).</p></div><div><h3>Conclusion</h3><p>For middle-aged adults, the benefits of PA on cognitive performance may be strongest among adults living with greater neighbourhood social and material disadvantages. For older adults, PA may be beneficial to cognitive performance irrespective of neighbourhood disadvantages.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S037851222400183X/pdfft?md5=7960f6ceae9c5539665fae84df559d14&pid=1-s2.0-S037851222400183X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk of pelvic organ prolapse after hysterectomy for benign conditions: A nationwide cohort study 良性疾病子宫切除术后盆腔器官脱垂的风险:全国性队列研究
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-08 DOI: 10.1016/j.maturitas.2024.108090
Jin-Sung Yuk
{"title":"Risk of pelvic organ prolapse after hysterectomy for benign conditions: A nationwide cohort study","authors":"Jin-Sung Yuk","doi":"10.1016/j.maturitas.2024.108090","DOIUrl":"10.1016/j.maturitas.2024.108090","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the risk of pelvic organ prolapse (POP) after hysterectomy for benign conditions.</p></div><div><h3>Study design</h3><p>This nationwide retrospective cohort study, utilizing data from the Korean National Health Insurance Service database, compared women aged 40 to 59 who underwent benign hysterectomy between 2002 and 2011 (hysterectomy group) with those who had national medical examinations during the same period (nonhysterectomy group). The analysis used a 1:1 propensity score matching method adjusted for variables.</p></div><div><h3>Main outcome measure</h3><p>Incident POP.</p></div><div><h3>Results</h3><p>The final sample of 32,984 participants (16,492 in each group) had a median age of 47 years [45–50] <strong>(</strong><em>p</em>-value 0.305) and a median follow-up of 11.4 years [10–13.3] (p-value 0.189). The incidence of POP was 0.5 % in the nonhysterectomy group and 0.6 % in the hysterectomy group. Hysterectomy was associated with an increased risk of POP that required surgery or pessary use (hazard ratio [HR] 1.403, 95 % confidence interval [CI] 1.026–1.919). Subtotal hysterectomy was not associated with an increased risk of POP (HR 1.868, 95 % CI, 0.624–5.593), while total hysterectomy was associated with an increased risk (HR 1.633, 95 % CI, 1.083–2.46). Laparoscopic surgery was not associated with an increased risk of POP (HR 0.611, 95 % CI 0.311–1.202)<strong>.</strong></p></div><div><h3>Conclusions</h3><p>The study found that, overall, hysterectomy is linked to a higher risk of POP, but subtotal hysterectomy and laparoscopy are not associated with increased risk, while total hysterectomy is associated with a higher risk.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040159","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}
引用次数: 0
Age-related differences in fluctuations in insulin resistance evaluated with HOMA-IR and triglyceride and glucose-based indices during the menstrual cycle, as determined using the NHANES cross-sectional dataset 利用 NHANES 横截面数据集确定,在月经周期中,用 HOMA-IR 以及甘油三酯和葡萄糖指数评估的胰岛素抵抗波动与年龄相关的差异。
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-04 DOI: 10.1016/j.maturitas.2024.108085
Leonardo M. Porchia , Renata Ochoa-Precoma , Yúvika Reyes-Albarracín , M. Elba Gonzalez-Mejia , Esther López-Bayghen
{"title":"Age-related differences in fluctuations in insulin resistance evaluated with HOMA-IR and triglyceride and glucose-based indices during the menstrual cycle, as determined using the NHANES cross-sectional dataset","authors":"Leonardo M. Porchia ,&nbsp;Renata Ochoa-Precoma ,&nbsp;Yúvika Reyes-Albarracín ,&nbsp;M. Elba Gonzalez-Mejia ,&nbsp;Esther López-Bayghen","doi":"10.1016/j.maturitas.2024.108085","DOIUrl":"10.1016/j.maturitas.2024.108085","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine how age affects insulin resistance during the menstrual cycle and insulin resistance-associated indices: the Triglyceride-glucose and Triglyceride-glucose-BMI indexes.</p></div><div><h3>Methods</h3><p>This prospective observational study used fasting plasma glucose, fasting insulin, triglycerides, body mass index (BMI), and days since the start of the menstrual period collected from the NHANES dataset (1999–2006). Insulin resistance was determined using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). The participants were categorized as young (16–34 years) or older (&gt;35 years). Rhythmicity during the menstrual cycle was analyzed using the Cosinor and Cosinor2 packages for R.</p></div><div><h3>Main outcome measures</h3><p>Cosine fit curves for insulin resistance during the menstrual cycle and age-associated effects on rhythmicity.</p></div><div><h3>Results</h3><p>Using 1256 participants, rhythmicity was observed for fasting insulin and HOMA-IR (<em>p</em> &lt; 0.05) but not for fasting plasma glucose, the Triglyceride-glucose index, or the Triglyceride-glucose-BMI index. Significant amplitudes for fasting insulin and HOMA-IR were observed when age was considered. Acrophases for fasting insulin and HOMA-IR were significant only for the younger group, and the differences between these groups were significant, suggesting that the changes in scores for insulin resistance for the younger and older groups occur at different times of their menstrual cycle.</p></div><div><h3>Conclusions</h3><p>Insulin resistance does fluctuate during the menstrual cycle, and it is at a maximum at different times for younger and older women. Since these results are unadjusted, this study is preliminary and further investigation is required.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001804/pdfft?md5=ce0dc58a06cd473cdf3aad4effc9ed6d&pid=1-s2.0-S0378512224001804-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neuroendocrine mechanisms of mood disorders during menopause transition: A narrative review and future perspectives 更年期过渡期情绪失调的神经内分泌机制:叙述性综述与未来展望。
IF 3.9 2区 医学
Maturitas Pub Date : 2024-08-02 DOI: 10.1016/j.maturitas.2024.108087
Tiziana Fidecicchi , Andrea Giannini , Peter Chedraui , Stefano Luisi , Christian Battipaglia , Andrea R. Genazzani , Alessandro D. Genazzani , Tommaso Simoncini
{"title":"Neuroendocrine mechanisms of mood disorders during menopause transition: A narrative review and future perspectives","authors":"Tiziana Fidecicchi ,&nbsp;Andrea Giannini ,&nbsp;Peter Chedraui ,&nbsp;Stefano Luisi ,&nbsp;Christian Battipaglia ,&nbsp;Andrea R. Genazzani ,&nbsp;Alessandro D. Genazzani ,&nbsp;Tommaso Simoncini","doi":"10.1016/j.maturitas.2024.108087","DOIUrl":"10.1016/j.maturitas.2024.108087","url":null,"abstract":"<div><p>The menopause transition is an important period in a woman's life, during which she is at an increased risk of mood disorders. Estrogen and progesterone fluctuations during the menopausal transition and very low levels of estradiol after menopause have a profound effect on the central nervous system (CNS), causing an imbalance between excitatory and inhibitory inputs. Changes in neurotransmission and neuronal interactions that occur with estradiol withdrawal disrupt the normal neurological balance and may be associated with menopausal symptoms. Hot flushes, depressed mood and anxiety are all symptoms of menopause that are a consequence of the complex changes that occur in the CNS, involving many signaling pathways and neurotransmitters (i.e. γ-aminobutyric acid, serotonin, dopamine), neurosteroids (i.e. allopregnanolone), and neuropeptides (i.e. kisspeptin, neurokinin B). All these pathways are closely linked, and the complex interactions that exist are not yet fully understood. This review summarizes the neuroendocrine changes in the CNS during the menopausal transition, with particular emphasis on those that underlie mood changes.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904065","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}
引用次数: 0
Do emotional dysregulation and body image issues contribute to disordered eating and the onset of eating disorders during menopause? 情绪失调和身体形象问题是否会导致更年期饮食紊乱和饮食失调的发生?
IF 4.9 2区 医学
Maturitas Pub Date : 2024-07-31 DOI: 10.1016/j.maturitas.2024.108086
Jônatas de Oliveira, Bianca Medeiros
{"title":"Do emotional dysregulation and body image issues contribute to disordered eating and the onset of eating disorders during menopause?","authors":"Jônatas de Oliveira, Bianca Medeiros","doi":"10.1016/j.maturitas.2024.108086","DOIUrl":"https://doi.org/10.1016/j.maturitas.2024.108086","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141883354","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}
引用次数: 0
Association between tricyclic antidepressants and health outcomes among older people: A systematic review and meta-analysis 三环类抗抑郁药与老年人健康状况之间的关系:系统回顾和荟萃分析
IF 3.9 2区 医学
Maturitas Pub Date : 2024-07-27 DOI: 10.1016/j.maturitas.2024.108083
Javier Santandreu , Francisco Félix Caballero , M. Pilar Gómez-Serranillos , Elena González-Burgos
{"title":"Association between tricyclic antidepressants and health outcomes among older people: A systematic review and meta-analysis","authors":"Javier Santandreu ,&nbsp;Francisco Félix Caballero ,&nbsp;M. Pilar Gómez-Serranillos ,&nbsp;Elena González-Burgos","doi":"10.1016/j.maturitas.2024.108083","DOIUrl":"10.1016/j.maturitas.2024.108083","url":null,"abstract":"<div><p>Tricyclic antidepressants are effective for managing depression and other disorders. However, they can cause adverse reactions due to their anticholinergic properties, with the risk of such events increasing with age.</p><p>This study identifies and describes clinical studies that evaluate associations between the use of tricyclic antidepressants and adverse health outcomes (falls, fractures, and mortality) among older people.</p><p>A systematic search of the literature in English, Spanish, and French was conducted using the electronic databases PubMed, ISI Web of Science, PsycINFO, and Cochrane. The systematic review included a total of 18 studies. The meta-analysis examined the 14 studies that investigated the association between the use of tricyclic antidepressants and the risk of falls and fractures (4 of the 18 studies focused on mortality and so were excluded from the meta-analysis). The odds ratio (OR) was 1.40 (95 % CI = 1.27–1.53, <em>p</em> &lt; 0.001). The Cochran Q test was significant (<em>X</em><sup><em>2</em></sup> = 79.72, p &lt; 0.001), indicating high heterogeneity (<em>I</em><sup><em>2</em></sup> = 84.9 %). An additional meta-analysis was conducted on studies reporting hazard ratios (HRs), yielding an HR of 1.21 (95 % CI = 0.93–1.58, <em>p</em> = 0.16). Meta-regression analysis indicated that the years of follow-up could have a significant effect on the association studied (<em>p</em> = 0.008).</p><p>In conclusion, enhancing our understanding of the use of antidepressants and the associated risk of adverse events in older adults will enable the identification of the most appropriate type of antidepressant for each clinical situation.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001786/pdfft?md5=c1bef07f6ac3169e4a343ef9d53c3f83&pid=1-s2.0-S0378512224001786-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Declined intrinsic capacity predicts long-term mortality in Chinese older adults: Beijing Longitudinal Study of Aging 内在能力下降可预测中国老年人的长期死亡率北京老龄化纵向研究
IF 3.9 2区 医学
Maturitas Pub Date : 2024-07-27 DOI: 10.1016/j.maturitas.2024.108082
Yiming Pan , Xiaxia Li , Li Zhang , Yun Li , Zhe Tang , Lina Ma
{"title":"Declined intrinsic capacity predicts long-term mortality in Chinese older adults: Beijing Longitudinal Study of Aging","authors":"Yiming Pan ,&nbsp;Xiaxia Li ,&nbsp;Li Zhang ,&nbsp;Yun Li ,&nbsp;Zhe Tang ,&nbsp;Lina Ma","doi":"10.1016/j.maturitas.2024.108082","DOIUrl":"10.1016/j.maturitas.2024.108082","url":null,"abstract":"<div><h3>Background</h3><p>Intrinsic capacity reflects an individual's functions and capacities across their lifetime. There are few studies on whether the level of intrinsic capacity can predict long-term mortality in Chinese populations.</p></div><div><h3>Objective</h3><p>To explore the effects of intrinsic capacity on long-term outcomes in older Chinese adults.</p></div><div><h3>Methods</h3><p>Data were obtained from the Beijing Longitudinal Study of Aging. Overall, 1699 community-dwelling adults aged ≥60 years were included and followed up for 8 years. Intrinsic capacity was determined according to the World Health Organization definition. The predictive ability for adverse outcomes was assessed using the age- and sex-adjusted Cox proportional hazards model.</p></div><div><h3>Results</h3><p>A decline in intrinsic capacity domains was observed in 729 (42.9 %) participants. Declines in the mobility, cognition, vitality, sensory and psychology domains were observed in 21.8 %, 15.1 %, 11.4 %, 9.10 %, and 14.2 % of the participants, respectively. Low intrinsic capacity was associated with worse physical performance, frailty, social frailty, chronic diseases, fracture, and falls. A greater decline in intrinsic capacity predicted an elevated 8-year mortality rate (decline in overall intrinsic capacity hazard ratio 2.91, 95 % confidence interval 2.44–3.47, <em>P</em> &lt; 0.001; decline in one domain hazard ratio 2.11, 95 % confidence interval 1.71–2.61, <em>P</em> &lt; 0.001; decline in two domains hazard ratio 3.54, 95 % confidence interval 2.81–4.45, <em>P</em> &lt; 0.001; decline in three or more domains hazard ratio 5.30, 95 % confidence interval 4.09–6.87, P &lt; 0.001); adjusted models did not affect prediction performance. Among the five domains of intrinsic capacity, cognition was the strongest predictor of mortality (hazard ratio 3.17, 95 % confidence interval 2.63–3.81, <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Intrinsic capacity is useful in identifying older adults at higher risk of adverse outcomes, presenting significant implications for healthcare policies in China.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839600","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}
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