Maturitas最新文献

{"title":"Group-based pelvic floor telerehabilitation for urinary incontinence in older women: A six-month follow-up pilot study","authors":"Mélanie Le Berre ,&nbsp;Johanne Filiatrault ,&nbsp;Barbara Reichetzer ,&nbsp;Dahlia Kairy ,&nbsp;Caroline Lachance ,&nbsp;Chantale Dumoulin","doi":"10.1016/j.maturitas.2025.108621","DOIUrl":"10.1016/j.maturitas.2025.108621","url":null,"abstract":"<div><h3>Background</h3><div>Urinary incontinence is prevalent among older women. This pilot study evaluated the effects of an online group-based pelvic floor muscle training program in older women with urinary incontinence at a six-month follow-up.</div></div><div><h3>Methods</h3><div>Women aged 65 and over, with stress or mixed urinary incontinence, were recruited. Eligibility was established through in-person evaluations, during which pelvic floor physiotherapists taught and verified correct pelvic floor muscles contraction using digital palpation. The 12-week online pelvic floor muscle training program comprised weekly one-hour training sessions, followed by an unsupervised maintenance exercise regimen. Data were collected before the program (PRE), immediately after (POST), during an interim phone call three months after the end of the program (3MO) and at a follow-up six months after the end of the program (6MO). Participants reported symptoms of urinary incontinence using a 7-day bladder diary and standardized questionnaires at PRE, POST and 6MO. Adherence to maintenance exercises was recorded at 3MO and 6MO. At 6MO, participants provided feedback on their perceived improvement and overall satisfaction.</div></div><div><h3>Results</h3><div>Women experienced a median leakage reduction of 73 % (range 38–88 %) from PRE to 6MO. Improvements were maintained from POST to 6MO for leakage episodes, symptoms of urinary incontinence, quality of life, and urinary incontinence self-efficacy. Adherence to maintenance exercises was substantial at 3MO and 6MO. Participants expressed high satisfaction with symptom improvement and the program overall at 6MO.</div></div><div><h3>Conclusions</h3><div>A 12-week online group-based pelvic floor muscle training including an in-person pelvic floor muscle evaluation and an unsupervised maintenance exercise regimen demonstrated sustained clinical benefits. Further validation through a randomized controlled trial is needed to confirm these findings.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108621"},"PeriodicalIF":3.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205669","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":"Female sexual dysfunction as an adverse effect of drugs: a narrative review","authors":"Mikael O.W. Piha ,&nbsp;Katja Kero ,&nbsp;Aleksi Tornio","doi":"10.1016/j.maturitas.2025.108623","DOIUrl":"10.1016/j.maturitas.2025.108623","url":null,"abstract":"<div><div>Sexual adverse effects of drugs are common and can compromise adherence to pharmacotherapy. Drugs can disrupt any or all phases of the sexual response cycle, potentially causing significant distress, which can amount to clinically relevant sexual dysfunction. Psychotropic and neurotropic agents are the best-characterised culprits in drug-related sexual dysfunction in females, although sexual dysfunction has been defined in various ways in the relevant literature. Specifically, serotonergic antidepressants, prolactin-increasing antipsychotics, long-term opioid therapy, and enzyme-inducing antiepileptics are associated with decreased desire, arousal dysfunction, orgasmic dysfunction, and more. In addition, progestin-containing contraceptives, antioestrogenic drugs, and beta blockers appear to increase the risk of sexual dysfunction. Possible mechanisms by which drugs interfere with sexual functions include alterations in neurotransmitter systems, increases in prolactin levels, increased sedation, and inhibition of the hypothalamic-pituitary-ovarian axis. Many medical conditions themselves can also cause sexual symptoms, and these are difficult to distinguish from pharmacological sexual adverse effects. However, different drugs for the same diseases can have substantially different sexual safety profiles, which often allows the clinician to choose a less-offending alternative. In some cases, drugs can exert even long-term adverse effects on sexual function. Therefore, sexual adverse effects must be taken into consideration when weighing the benefits and risks of different treatment modalities.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108623"},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184841","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":"Intravaginal prasterone for urinary urgency in postmenopausal women without urodynamic detrusor overactivity","authors":"Stefano Pautasso ,&nbsp;Matteo Mancarella ,&nbsp;Lorenzo Novara ,&nbsp;Silvia Carignano ,&nbsp;Francesca Chiadò Piat ,&nbsp;Francesco Testa ,&nbsp;Francesca Luppi ,&nbsp;Valentina Elisabetta Bounous ,&nbsp;Annamaria Ferrero ,&nbsp;Luca Giuseppe Sgro","doi":"10.1016/j.maturitas.2025.108620","DOIUrl":"10.1016/j.maturitas.2025.108620","url":null,"abstract":"<div><h3>Objectives</h3><div>Symptoms of an overactive bladder are frequently reported in women with genitourinary syndrome of menopause. Despite a frequent association with detrusor overactivity, urodynamic assessment does not always reveal this condition, which suggests a leading role for increased bladder mucosal sensitivity due to hormone deprivation in producing urinary symptoms. The present study assessed the effects of intravaginal prasterone on urgency symptoms in those patients receiving treatment for concurrent vulvovaginal atrophy.</div></div><div><h3>Study design</h3><div>This was an observational cohort study on 21 women with genitourinary syndrome of menopause, including urgency symptoms, without detrusor overactivity on urodynamic assessment. Patients received intravaginal prasterone 6.5 mg daily and were reassessed at 12 weeks.</div></div><div><h3>Main outcome measures</h3><div>Urinary symptoms and their impact on the quality of life were evaluated through the Urogenital Distress Inventory (UDI-6) and Overactive Bladder short-form (OAB-Q SF) questionnaires; secondary outcomes included urinary frequency and prevalence of urgency or incontinence as recorded in a voiding diary, and scores on a visual analogue scale (VAS) for vaginal discomfort.</div></div><div><h3>Results</h3><div>A significant improvement in urinary symptoms was observed in the scores on both the UDI-6 (57.1 +/− 20.7 vs 30.2 +/− 22.7, <em>p</em> &lt; 0.001) and the OAB-Q SF (61.3 +/− 19.7 vs 35.7 +/− 22, p &lt; 0.001); a significant improvement was also reported in terms of better quality of life, diminished VAS scores, and a reduction in incontinence and daily and nocturnal frequency.</div></div><div><h3>Conclusions</h3><div>Women complaining of urgency related to genitourinary syndrome of menopause with no urodynamic evidence of detrusor overactivity may benefit from treatment with intravaginal prasterone.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108620"},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177502","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":"Menopause and arterial stiffness index: insights from the women's UK Biobank cohort","authors":"Alexandre Vallée","doi":"10.1016/j.maturitas.2025.108608","DOIUrl":"10.1016/j.maturitas.2025.108608","url":null,"abstract":"<div><h3>Background</h3><div>Menopause is a significant physiological transition characterized by hormonal changes that can influence cardiovascular health. One key concern is increased arterial stiffness, a predictor of cardiovascular disease and adverse cardiovascular events. However, the independent association between menopause and arterial stiffness, beyond traditional cardiovascular risk factors, remains unclear. This study investigates the relationship between menopause and arterial stiffness index in the women's UK Biobank cohort.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 52,891 women from the UK Biobank with measurements of arterial stiffness index. Arterial stiffness index was assessed using a non-invasive photoplethysmographic method. Multiple linear and logistic regression models were used to examine the association between menopause status and arterial stiffness index (continuous and cutoff&gt;10 m/s), adjusting for age, body mass index, antihypertensive medication use, income, education, dyslipidemia, alcohol consumption, chronic kidney disease, smoking, diabetes, heart rate, mean blood pressure, hormone therapy, and previous cardiovascular disease.</div></div><div><h3>Results</h3><div>Postmenopausal women had significantly higher values of arterial stiffness index (9.10 ± 4.61 m/s) than premenopausal women (7.76 ± 2.72 m/s, p &lt; 0.001). Menopause was independently associated with increased arterial stiffness index (B = 0.22, 95 % CI [0.16–0.28], p &lt; 0.001) and a higher odds ratio for arterial stiffness index &gt;10 m/s (OR = 1.41, 95 % CI [1.31–1.51], p &lt; 0.001), after adjusting for confounders.</div></div><div><h3>Conclusion</h3><div>Menopause is significantly associated with increased arterial stiffness, independent of traditional cardiovascular risk factors. These findings highlight menopause as a critical period for cardiovascular health assessment and prevention strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"198 ","pages":"Article 108608"},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123152","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":"Beyond estrogen: Mitochondrial dysfunction and sleep disruption in menopausal hair loss","authors":"Yu-Hsiang Lin ,&nbsp;Jau-Yuan Chen ,&nbsp;Chun-Te Wu","doi":"10.1016/j.maturitas.2025.108619","DOIUrl":"10.1016/j.maturitas.2025.108619","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108619"},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166819","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":"Reply to Lin et al., “Beyond estrogen: Mitochondrial dysfunction and sleep disruption in menopausal hair loss”","authors":"Paradi Mirmirani ,&nbsp;Aditya K. Gupta ,&nbsp;Vasiliki Economopoulos","doi":"10.1016/j.maturitas.2025.108617","DOIUrl":"10.1016/j.maturitas.2025.108617","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108617"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166820","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":"Persistent gaps in menopause care: current recommendations of the POESIT group","authors":"Costantino Di Carlo ,&nbsp;Angelo Cagnacci ,&nbsp;Marco Gambacciani ,&nbsp;Santiago Palacios ,&nbsp;Cláudio Rebelo ,&nbsp;Pluvio Coronado ,&nbsp;Jesús Presa ,&nbsp;Sonia Sánchez ,&nbsp;Ana Fatela ,&nbsp;Mónica Gomes Ferreira ,&nbsp;Rossella E. Nappi","doi":"10.1016/j.maturitas.2025.108607","DOIUrl":"10.1016/j.maturitas.2025.108607","url":null,"abstract":"<div><div>In recent years, menopause awareness has been increasing in several European countries; however, gaps in menopause knowledge, attitudes and practices persist. This review provides an overview of the women's current menopausal experience in Italy, Spain and Portugal, and gives POESIT (Portugal + Spain + Italy) group recommendations to address persistent barriers in menopause care. The perception, occurrence and impact of menopause symptoms vary among countries, with genitourinary syndrome of menopause and vasomotor symptoms being the most frequent overall. Sexuality seems to be particularly affected by menopause, mostly due to genitourinary syndrome of menopause. Nonetheless, women's knowledge about the diverse range of menopause symptoms and their therapies is still poor. The importance of menopause hormone therapy for quality of life and prevention of chronic conditions, such as osteoporosis, is underestimated and its use remains generally low, likely due to women's view of menopause as a natural condition not requiring treatment, and common misconceptions and fears about side-effects (mostly cancer). The lack of knowledge and training about menopause symptoms and treatment indications among healthcare professionals represents another important barrier to providing suitable personalized care to women. The POESIT group highlights the need to raise public knowledge about menopause and its symptoms to improve care for women during and after menopausal transition. Policymakers and scientific societies should be actively involved to address treatment barriers. The POESIT group advocates the improvement of education among healthcare professionals to foster a personalized approach to menopause care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108607"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184842","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":"Welzijn.AI: Developing responsible conversational AI for the care of older people through stakeholder involvement","authors":"Bram M.A. van Dijk ,&nbsp;Armel E.J.L. Lefebvre ,&nbsp;Marco R. Spruit","doi":"10.1016/j.maturitas.2025.108616","DOIUrl":"10.1016/j.maturitas.2025.108616","url":null,"abstract":"<div><h3>Objectives</h3><div>We present Welzijn.AI, a new digital solution for monitoring (mental) well-being in older populations, and illustrate how the development of systems like Welzijn.AI can align with guidelines on responsible AI development.</div></div><div><h3>Study design</h3><div>Three different evaluations with various groups of stakeholders were designed to disclose new perspectives on the strengths, weaknesses, design characteristics, and value requirements of Welzijn.AI. Evaluations consisted of expert panels with patient representatives, general practitioners, researchers, and older people themselves. Panels were involved in interviews, a co-creation session, and an evaluation of a proof-of-concept implementation of Welzijn.AI.</div></div><div><h3>Main outcome measures</h3><div>Interview results were summarized in terms of Welzijn.AI's strengths, weaknesses, opportunities and threats. The co-creation session ranked a variety of value requirements of Welzijn.AI with the Hundred Dollar Method. The proof-of-concept evaluation entailed analysing proportions of (dis)agreement on statements targeting Welzijn.AI's design characteristics, and ranking desired social characteristics.</div></div><div><h3>Results</h3><div>Stakeholders in the interviews acknowledged Welzijn.AI's potential to combat loneliness and extract patterns from the linguistic behaviour of older people. The proof-of-concept evaluation complemented the design characteristics most appealing to older people to achieve empathetic and varying interactions. Stakeholders linked the technology to the implementation context: Welzijn.AI can unlock an individual's social network, but practice sessions and continuous support should also be available to empower users. Yet, stakeholders also disclosed challenges to a proper understanding of the application, and issues concerning privacy were also highlighted.</div></div><div><h3>Conclusions</h3><div>Incorporating all stakeholder perspectives in system development remains challenging. Still, our results benefit researchers, policymakers, and health professionals who aim to improve the care for older people through the use of technology.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108616"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166640","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":"Global prevalence of anorexia of aging: A systematic review and meta-analysis","authors":"Shirley Steffany Muñoz Fernandez ,&nbsp;Gabriela Cabett Cipolli ,&nbsp;Reshma Aziz Merchant ,&nbsp;Virgílio Garcia Moreira ,&nbsp;Tatiana Klompenhouwer ,&nbsp;Andreia Pain ,&nbsp;Sandra Maria Lima Ribeiro ,&nbsp;Gustavo Duque ,&nbsp;Jürgen Bauer ,&nbsp;Francesco Landi ,&nbsp;Tommy Cederholm ,&nbsp;Ivan Aprahamian","doi":"10.1016/j.maturitas.2025.108603","DOIUrl":"10.1016/j.maturitas.2025.108603","url":null,"abstract":"<div><div>Anorexia of aging is a major geriatric syndrome that contributes to the development of malnutrition, frailty, and other adverse health outcomes, including death. However, its prevalence has not been clearly established. We examined the scientific literature to estimate the global prevalence and incidence of anorexia of aging, and its trends based on diagnostic tools, settings, and geographical location. A systematic search was conducted in PubMed, Scopus, Web of Science, and EMBASE from the date of database inception to July 2024. Observational cross-sectional and longitudinal studies in adults aged 60 years or more reporting the prevalence of anorexia of aging were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis was used to estimate the pooled effects. A total of 40 studies were included in the systematic review. Among these, 36 studies with a total sample size of 29,864,296 individuals were included in the meta-analysis. The overall pooled prevalence of anorexia of aging was 22.7 %, and its incidence was 3.78 %. This prevalence estimate remained relatively steady from 2011 to 2024. The highest prevalence was found in the inpatient population, at 34.7 %, and the most used tool was the Simplified Nutritional Appetite Questionnaire. A significantly higher prevalence was observed in South America, at 27.1 %. Our findings highlight that, globally, more than one-fifth of older populations had anorexia of aging, and they illustrate the need for a global consensus on its diagnosis.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"198 ","pages":"Article 108603"},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115285","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 mortality and the ratio of red blood cell distribution width to albumin concentration in pre-hypertension and hypertension: A population-based cohort study","authors":"Haobiao Liu ,&nbsp;Zhuohang Chen","doi":"10.1016/j.maturitas.2025.108604","DOIUrl":"10.1016/j.maturitas.2025.108604","url":null,"abstract":"<div><h3>Objectives</h3><div>The ratio of red blood cell distribution width to albumin concentration (RAR) is a novel indicator of systemic inflammation and nutritional status. Its association with mortality in pre-hypertensive and hypertensive individuals remains unexplored.</div></div><div><h3>Methods</h3><div>This study investigates the relationship between RAR and all-cause as well as cause-specific mortality in a pre-hypertensive and hypertensive population using data from the National Health and Nutrition Examination Survey. Cox proportional hazard models assessed the relationship between RAR and mortality, with results reported as hazard ratios (HRs) and corresponding confidence intervals (CIs). Kaplan-Meier survival curves illustrated survival probabilities across quartiles, while restricted cubic spline (RCS) analysis examined potential non-linear associations.</div></div><div><h3>Results</h3><div>Elevated RAR was significantly associated with an increased risk of mortality. Each one-unit increase in RAR corresponded to an adjusted HR of 2.03 (95 % CI: 1.85–2.23) for all-cause mortality, 2.21 (95 % CI: 1.99–2.45) for heart disease, 1.86 (95 % CI: 1.65–2.10) for cancer, and 2.03 (95 % CI: 1.83–2.24) for other-cause mortality (<em>P</em> &lt; 0.001). Participants in the highest RAR quartile had a 178 % increased risk of all-cause mortality (HR = 2.78, 95 % CI: 2.51–3.08). Kaplan-Meier curves depicting the survival probabilities of pre-hypertensive and hypertensive participants across RAR quartiles substantiated these associations. RCS analysis also confirmed a positive association, demonstrating distinct linear or non-linear patterns in the associations with all-cause and cause-specific mortality.</div></div><div><h3>Conclusions</h3><div>RAR is independently associated with all-cause and cause-specific mortality in adults with pre-hypertension and hypertension, warranting its consideration for clinical risk stratification.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"198 ","pages":"Article 108604"},"PeriodicalIF":3.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115286","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}