Maturitas最新文献

{"title":"Declined intrinsic capacity predicts long-term mortality in Chinese older adults: Beijing Longitudinal Study of Aging","authors":"","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}

{"title":"Establishing a risk score for prediction of intrapartum cesarean delivery among older women: A retrospective cohort study","authors":"","doi":"10.1016/j.maturitas.2024.108072","DOIUrl":"10.1016/j.maturitas.2024.108072","url":null,"abstract":"<div><h3>Objective</h3><p>To determine risk factors and to develop a risk prediction score for intrapartum cesarean delivery (CD) in women over 40 years old.</p></div><div><h3>Study design</h3><p>A retrospective cohort study, in a single university-affiliated tertiary medical center. All women aged 40 years or more who planned a trial of labor between 2012 and 2022. Women who opted for an elective CD and those with non-viable fetuses were excluded. Maternal and neonatal characteristics of women who delivered vaginally were compared to those who underwent an intrapartum CD. Risk factors were examined using univariate and multivariate analysis. A score was developed to predict the need for intrapartum CD. We assessed a receiver operating characteristic curve to evaluate the performance of our model.</p></div><div><h3>Main outcome measure</h3><p>An unplanned intrapartum cesarean section.</p></div><div><h3>Results</h3><p>During the study period, 122,583 women delivered at our center, of whom 6122 (4.9 %) aged 40 years or more attempted a trial of labor. Of them, 428 (7 %) underwent intrapartum CD. Several independent risk factors were identified, including nulliparity, regional anesthesia, induction of labor, use of antibiotics during labor, multiple gestation, previous cesarean delivery, and the presence of gestational diabetes or preeclampsia. A risk score model, employing a cut-off of 7, demonstrated successful prediction of intrapartum CD, with an area under the curve of 0.86.</p></div><div><h3>Conclusion</h3><p>The score model for intrapartum CD can be used by caregivers to offer a more informed consultation to women aged 40 years or more deciding on the mode of delivery.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790678","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":"Treatment utilization and non-drug interventions for vasomotor symptoms in breast cancer survivors taking endocrine therapy: Real-world findings from the United States and Europe","authors":"","doi":"10.1016/j.maturitas.2024.108071","DOIUrl":"10.1016/j.maturitas.2024.108071","url":null,"abstract":"<div><h3>Objectives</h3><p>Vasomotor symptoms induced by endocrine therapy are common in breast cancer survivors and a risk factor for therapy discontinuation and lower quality of life. The REALISE study evaluated the real-world treatment landscape in breast cancer survivors with vasomotor symptoms taking endocrine therapy, including pharmaceuticals, lifestyle changes, and over-the-counter products.</p></div><div><h3>Study design</h3><p>Secondary analysis of the Adelphi Vasomotor Disease Specific Programme™, a large cross-sectional point-in-time survey and chart review conducted in the US and five European countries (February–October 2020). Oncologists provided demographic, clinical, and treatment data for adult breast cancer survivors with induced vasomotor symptoms taking endocrine therapy (tamoxifen or aromatase inhibitors); patients voluntarily completed self-report surveys on their symptom severity, concomitant sleep and/or mood symptoms, lifestyle changes, and use of over-the-counter products.</p></div><div><h3>Main outcome measures</h3><p>Patient characteristics; vasomotor symptom severity; use of pharmaceuticals, lifestyle changes, and over-the-counter products (from pre-defined lists); lines of treatment.</p></div><div><h3>Results</h3><p>Overall, 77 oncologists reported data for 618 breast cancer survivors, of whom 183 (29.6 %) completed self-report forms. Physicians classified 420 (68.0 %) women as experiencing moderate-severe vasomotor symptoms, of whom 66.9 % were receiving treatment. In total, 15.2 % of all breast cancer survivors were prescribed systemic hormone therapy. Venlafaxine (24.7 %), citalopram (16.5 %), and paroxetine (13.6 %) were the most commonly prescribed nonhormonal medications. Lifestyle changes (77.8 %) and over-the-counter products (61.6 %) were common, especially in patients with concomitant sleep and/or mood symptoms.</p></div><div><h3>Conclusions</h3><p>Despite contraindications, a relatively large proportion of treatment-seeking breast cancer survivors with vasomotor symptoms were prescribed systemic hormone therapy. This, combined with high patient-reported use of lifestyle changes and over-the-counter products, suggests a need for symptomatic relief and demand for new nonhormonal alternatives with established safety profiles in this population.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768396","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":"Body image and eating issues in midlife: A narrative review with clinical question recommendations","authors":"","doi":"10.1016/j.maturitas.2024.108068","DOIUrl":"10.1016/j.maturitas.2024.108068","url":null,"abstract":"<div><p>Midlife is a period of transition that is influenced by multiple biopsychosocial and cultural factors. Eating and body image issues are common at this life stage. The purposes of this narrative review are to explore: 1) the aspects of midlife that make individuals vulnerable to eating issues and body image concerns and 2) how these factors may be influenced by weight, cultural background, and socioeconomic status. Within this review, we aim to explore nuances of how eating and body image issues present in some historically marginalized groups at midlife. The aim is to provide clinicians who care for midlife individuals with practical tools to initiate conversations regarding body image and eating issues. Ideally this will facilitate early intervention and assessment for individuals who are struggling with new, chronic, or relapse of symptoms of disordered eating.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853325","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":"Trends in breast density and other risk factors for breast cancer and associations with trends in the incidence of breast cancer in Korean women","authors":"","doi":"10.1016/j.maturitas.2024.108070","DOIUrl":"10.1016/j.maturitas.2024.108070","url":null,"abstract":"<div><h3>Introduction</h3><p>This study investigated the trends in breast density in Korean women and their association with the incidence of breast cancer, incorporating the trends in the known risk factors for breast cancer from an ecological perspective.</p></div><div><h3>Methods</h3><p>The prevalence of risk factors for breast cancer from the National Health and Nutrition Survey, breast density from Korea's national breast cancer screening program, and breast cancer incidence from the Korea Central Cancer Registry during 2010–2018 were applied after age-standardization to the population at the middle of the year 2000. The association between the prevalence of risk factors for breast cancer, the prevalence of dense breast, and the incidence rate of breast cancer was estimated using linear regression.</p></div><div><h3>Results</h3><p>The proportion of age-standardized dense breasts steadily increased from 45.8 % in 2010 to 51.5 % in 2018. The increased prevalence of dense breasts in women was positively related to the prevalence of smoking, drinking, lack of exercise, early menarche age (&lt;15 years old), premenopausal status, nulliparity, and no history of breastfeeding, and negatively related to the prevalence of obesity. The increased prevalence of the dense breast was associated with an increase in the incidence of breast cancer, and 96 % of the variation in breast cancer incidence could be explained by the variation in the prevalence of dense breast. The factors associated with dense breast and breast cancer incidence overlapped.</p></div><div><h3>Conclusions</h3><p>Trends in breast cancer risk factors were associated with an increased prevalence of dense breast, which, in turn, was associated with an increased incidence of breast cancer in Korea.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851061","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 association of menopause with cardiometabolic disease risk factors in women living with and without HIV in sub-Saharan Africa: Results from the AWI-Gen 1 study","authors":"","doi":"10.1016/j.maturitas.2024.108069","DOIUrl":"10.1016/j.maturitas.2024.108069","url":null,"abstract":"<div><h3>Background</h3><p>Menopause and HIV are associated with cardiometabolic disease. In sub-Saharan Africa there is a growing population of midlife women living with HIV and a high prevalence of cardiometabolic disease.</p></div><div><h3>Objectives</h3><p>The aim of this study was to determine whether menopause and HIV were associated with cardiometabolic disease risk factors in a population of midlife sub-Saharan African women.</p></div><div><h3>Study design</h3><p>This was a cross-sectional comparison of cardiometabolic disease risk factors between 944 premenopausal women (733 living without HIV and 211 living with HIV) and 1135 postmenopausal women (932 living without HIV and 203 living with HIV) in sub-Saharan Africa.</p></div><div><h3>Main outcome measures</h3><p>Anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women living without HIV and between pre- and postmenopausal women living with HIV and between women living without HIV and women living with HIV.</p></div><div><h3>Results</h3><p>The prevalence of HIV was 19.9 %. Age at menopause was lower in women living with HIV than in women living without HIV (48.1 ± 5.1 vs 50.9 ± 4.7 years, p &lt; 0.001).</p><p>Women living with HIV and receiving efavirenz-based antiretroviral therapy had a lower body mass index (BMI), hip circumference, blood pressure and carotid intima media thickness but higher triglyceride levels and insulin resistance than women living without HIV. Antiretroviral therapy-naïve women living with HIV had lower HDL-cholesterol than women living without HIV.</p><p>In this study, menopause was associated with higher LDL-C levels, regardless of HIV status.</p></div><div><h3>Conclusion</h3><p>The high prevalence of obesity and related cardiometabolic disease risk factors in these midlife sub-Saharan African women is not related to the menopausal transition. The association of cardiometabolic disease risk factors with HIV and antiretroviral therapy is complex and requires further investigation in longitudinal studies, as does the negative association of age at final menstrual period with HIV.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001646/pdfft?md5=2e74ccb24b118c3b8c71312324d57b52&pid=1-s2.0-S0378512224001646-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141732349","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}

{"title":"Running on empty: Exploring stem cell exhaustion in geriatric musculoskeletal disease","authors":"","doi":"10.1016/j.maturitas.2024.108066","DOIUrl":"10.1016/j.maturitas.2024.108066","url":null,"abstract":"<div><p>Ageing populations globally are associated with increased musculoskeletal disease, including osteoporosis and sarcopenia. These conditions place a significant burden of disease on the individual, society and the economy. To address this, we need to understand the underpinning biological changes, including stem cell exhaustion, which plays a key role in the ageing of the musculoskeletal system. This review of the recent evidence provides an overview of the associated biological processes. The review utilised the PubMed/Medline, Science Direct, and Google Scholar databases. Mechanisms of ageing identified involve a reaction to the chronic inflammation and oxidative stress associated with ageing, resulting in progenitor cell senescence and adipogenic differentiation, leading to decreased mass and quality of both bone and muscle tissue. Although the mechanisms underpinning stem cell exhaustion are unclear, it remains a promising avenue through which to identify new strategies for prevention, detection and management.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001610/pdfft?md5=a337c527edb36dd5bb34383f19868f3f&pid=1-s2.0-S0378512224001610-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708715","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}

{"title":"The role of sex hormone binding globulin levels in the association of surgical and natural premature menopause with incident type 2 diabetes","authors":"Shuang Wu ,&nbsp;Qiong Zhong ,&nbsp;Qiying Song ,&nbsp;Mengying Wang","doi":"10.1016/j.maturitas.2024.108063","DOIUrl":"10.1016/j.maturitas.2024.108063","url":null,"abstract":"<div><h3>Objective</h3><p>To examine associations of surgical and natural menopause before the age of 40 years with the risk of type 2 diabetes (T2D) in women.</p></div><div><h3>Methods</h3><p>A total of 273,331 women from the United Kingdom were recruited between 2006 and 2010 in the UK Biobank (UKB) study, and 146,343 women aged 40 to 69 years who were postmenopausal at baseline were included in the analysis. Surgical menopause and natural premature menopause were defined as bilateral oophorectomy before the age of 40 and menopause before the age of 40 without oophorectomy, respectively. Multivariable Cox regression models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between premature menopause and the incidence of T2D.</p></div><div><h3>Results</h3><p>During a median follow-up of 10.4 years, 47 women with surgical premature menopause, 244 women with natural premature menopause, and 4724 women without premature menopause developed T2D. Compared with women without premature menopause, both surgical premature menopause (adjusted HR = 1.46, 95 % CI: 1.09–1.95; <em>P</em> = 0.01) and natural premature menopause (adjusted HR = 1.20, 95 % CI: 1.06–1.37; <em>P</em> &lt; 0.01) were associated with higher risks of incident T2D in the multivariable-adjusted models. Additionally, we observed a significant interaction between levels of sex hormone binding globulin (SHBG) (<em>P</em>_interaction &lt; 0.01) and the effects of premature menopause on incident T2D. The association between premature menopause and T2D risk appeared to be stronger in women with higher SHBG levels. Furthermore, a joint association was detected between premature menopause and the genetic risk score (GRS) of T2D, with a higher score indicating a higher risk of developingT2D. The highest risk of T2D was observed with higher T2D GRS and surgical premature menopause (adjusted HR = 2.61, 95 % CI: 1.65–4.12; <em>P</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Surgical menopause and natural menopause before the age of 40 years were associated with an increased risk of T2D among postmenopausal women. The findings also suggest potential interactions of premature menopause with SHBG levels, with the association appearing to be stronger in higher SHBG levels, as well as a joint association between menopause status and genetic risk factors on T2D incidence.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592471","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":"Development and psychometric properties of the Balance in Daily Life (BDL) scale in a population of frail older people","authors":"","doi":"10.1016/j.maturitas.2024.108064","DOIUrl":"10.1016/j.maturitas.2024.108064","url":null,"abstract":"<div><h3>Background</h3><p>Balance disorders in older people cause falls, which can have serious functional and economic consequences. No existing scale relates fall risk to daily life situations. This study describes the development, psychometric properties and construct validity of the Balance in Daily Life (BDL) scale, comprising seven routine tasks including answering a phone, carrying a heavy bag, and sitting down and getting up from a chair.</p></div><div><h3>Methods</h3><p>Frail patients aged 65 years or more were prospectively recruited from the geriatric rehabilitation department of a French university hospital. Inclusion criteria included autonomous walking over 20 m and modified Short Emergency Geriatric Assessment score 8–11. Patients with motor skills disorders and comprehension or major memory difficulties were excluded. Patients were assessed on Day 3 and Day 30 with the Balance in Daily Life scale, Timed Up and Go, one-leg stance time, sternal nudge and walking-while-talking tests. The scale was assessed for acceptability, quality, unidimensionality, internal consistency, reliability, temporal stability, responsiveness and construct validity.</p></div><div><h3>Results</h3><p>140 patients (83 ± 6 years) were recruited, of whom 139 were assessed at Day 0 and 133 at Day 30. Acceptability was satisfactory (134/139 patients completed the test), quality assessment showed a slight floor effect (6 % of patients with minimal score) and evaluation of item redundancy found no strong correlation (Spearman &lt;0.7). Unidimensionality was verified (Loevinger H coefficient &gt; 0.5 for all items except item 6 = 0.4728). Internal consistency was good (Cronbach alpha = 0.86). Reliability and temporal stability were excellent (ICC = 0.97 and ICC = 0.92). Responsiveness was verified by significant score change <em>p</em> &lt; 0.0001 between Day 0 and Day 30 (decreased by 1 [0; 2] point), in line with other score changes. Construct validity revealed that the Balance in Daily Life scale was convergent with results of the timed up-and-go and one-leg stance time (<em>p</em> &lt; 0.0001 for both) and tended to be higher for participants who had not fallen in the previous 6 months (<em>p</em> = 0.0528). The new questionnaire was divergent to sternal nudge tests (<em>p</em> = 0.0002) and not related to the walking-while-talking test (<em>p</em> = 0.5969).</p></div><div><h3>Conclusion</h3><p>The Balance in Daily Life scale has good psychometric properties for this population. Its simplicity and innovative nature mean that it can be applied in institutions while being easily modifiable to domestic settings.</p><p>Study registration on <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>: NCT0334382.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001592/pdfft?md5=bfa03f7a81d96989b391d1f1659544be&pid=1-s2.0-S0378512224001592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728410","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}

{"title":"Evidence-based strategies to prevent cognitive decline in older people","authors":"Leon Flicker","doi":"10.1016/j.maturitas.2024.108062","DOIUrl":"10.1016/j.maturitas.2024.108062","url":null,"abstract":"<div><p>A helpful method to understand cognitive decline in older people is to consider this entity as increasing cognitive frailty caused by a number of interacting pathological processes. Over the last 20 years, multiple lifestyle, environmental and constitutional factors have been linked to the development of cognitive decline. For two interventions based on these factors, increasing physical activity and the control of hypertension, there is class 1 evidence for benefit. Other interventions based on these factors do not have the support of high-level evidence for the alteration of cognitive decline, but their other benefits would argue for their implementation. These interventions include increasing education, smoking cessation, avoiding head injuries, decreasing exposure to air pollution and increased social connections. As cognitive decline is experienced almost universally with ageing, and serious cognitive decline is experienced by substantial numbers of low-risk individuals, whole-of-population intervention strategies are the most effective and efficient. For other interventions to help prevent cognitive decline there is not sufficient evidence for their implementation to be recommended. These include alteration of alcohol ingestion, correction of hearing loss, treatment of depression, dietary interventions, menopausal hormone treatment and monoclonal antibodies directed against amyloid-β.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224001579/pdfft?md5=447dcc0f05d987d95ceaf21ad01e8b86&pid=1-s2.0-S0378512224001579-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474077","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}