Maturitas[JOURNAL]
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200 papers
Age-related differences in patient preferences for adjuvant chemotherapy for high-risk endometrial cancer.
Wakkerman FC, Post CCB, Mens JWM … +17 more , Jürgenliemk-Schulz IM, Koppe FLA, Haverkort MAD, Roeloffzen EMA, Snyers A, de Jong MAA, Schaake EE, Beukema JC, Cnossen J, Kiderlen M, Lutgens LCHW, Nijman HW, de Kroon CD, Kroep JR, Pieterse AH, Creutzberg CL, Horeweg N
Maturitas · 2026 Jan · PMID 41352064 · Publisher ↗
INTRODUCTION: Adjuvant chemotherapy in the treatment of endometrial cancer can be difficult to tolerate for older women. This study examined age-related differences in patient preferences for chemotherapy in women with h...
INTRODUCTION: Adjuvant chemotherapy in the treatment of endometrial cancer can be difficult to tolerate for older women. This study examined age-related differences in patient preferences for chemotherapy in women with high-risk endometrial cancer. METHODS: We re-analyzed data from the cross-sectional patient preference study PRETEC-2 to determine the difference between three age groups in minimally desired survival benefit of chemotherapy. For this, patients with high-risk endometrial cancer treated with adjuvant pelvic radiotherapy with or without chemotherapy completed a treatment trade-off questionnaire. Patients also rated the importance they attributed to treatment duration and acute and late side-effects for their decision on chemotherapy, which we analyzed by age group. RESULTS: A total of 171 patients (23% <60 years, 40% 60-69 years and 37% ≥70 years) were included in the analysis. Older patients had a significantly higher median minimally desired survival benefit for preferring chemoradiotherapy (5% for <60 years, 8% for 60-69 years and 15% for patients ≥70 years; (p<0.001)), and had the largest variability in minimally desired survival benefit. For a real-life five-year survival benefit of 5%, fewer older patients preferred the addition of chemotherapy to their treatment regimen (61.5% for <60 years, 45.6% for 60-69 years and 21.9% for ≥70 years; p<0.001). Furthermore, older patients rated both treatment duration (p=0.001) and long-term tingling or numbness (p=0.005) as significantly more important than their younger counterparts. CONCLUSION: There is more heterogeneity in the desired benefit of chemotherapy among patients aged 70 years or more compared to younger patients. This underlines the importance of recognizing individual differences and the need for shared decision-making.
Comment on the paper "Effect of duration of hormonal contraceptive use on breast cancer risk: a systematic review and meta-analysis of cohort studies".
Jiang W, Yu Q
Maturitas · 2026 Jan · PMID 41349282 · Publisher ↗
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Sexual assault referral centers for survivors of rape in Finland - A review of their development and support for survivors.
Krogell J, Kero K, Klami R … +2 more , Pelkonen S, Korjamo R
Maturitas · 2026 Jan · PMID 41343961 · Publisher ↗
In Finland, multidisciplinary sexual assault referral centers (SARCs) primarily serve victims of rape within one month of the incident. The services are offered at no cost and are available to individuals aged 16 and ove...
In Finland, multidisciplinary sexual assault referral centers (SARCs) primarily serve victims of rape within one month of the incident. The services are offered at no cost and are available to individuals aged 16 and over, irrespective of sex or gender, and regardless of whether they decide to report the assault to the authorities. Services consist of medical and forensic examinations, trauma support and counselling. Follow-up and treatment of sexually transmitted diseases and potential pregnancy are included. Specialized services and standardized examination and follow-up protocols have increased the quality of forensic medical examination and samples. Trauma-informed psychosocial support services are available from the outset. Sensitive but active follow-up from the same place have improved the rape survivor's recovery. This paper reviews the history of SARCs in Finland and the care they provide to survivors of sexual violence.
Socioeconomic inequality in lifestyle trajectories among middle-aged and older adults: A 10-year longitudinal analysis across the US, UK and China.
An C, Zhang Z, Zhang Y … +1 more , Xu X
Maturitas · 2026 Jan · PMID 41337793 · Publisher ↗
BACKGROUND: Health-related lifestyles may change throughout the life course and are often socially patterned. However, few studies have identified the association of socioeconomic status with the longitudinal patterns of...
BACKGROUND: Health-related lifestyles may change throughout the life course and are often socially patterned. However, few studies have identified the association of socioeconomic status with the longitudinal patterns of lifestyle trajectories. This study aimed to identify lifestyle trajectories among middle-aged and older adults across multiple regions, and examine whether these trajectories differed by socioeconomic status. METHODS: In this multi-cohort study, individual-level data were pooled from three longitudinal studies: the Health and Retirement Study in the US, the English Longitudinal Study on Ageing in the UK, and the China Health and Retirement Longitudinal Study in China. Lifestyle scores were constructed using smoking status, alcohol consumption, physical activities, and sleep quality. Socioeconomic status scores were based on education level and total household income. Group-based trajectory modeling was used to identify participants' lifestyle trajectories over 10 years. The associations between socioeconomic status and lifestyle trajectories were evaluated using multinomial logistic regression models. RESULTS: Of the 27,401 participants, 16,325 were from the US, 4683 from the UK, and 6393 from China. Three lifestyle trajectories over 10 years were identified: 'stable high', 'stable medium', and 'stable low'. Participants with low socioeconomic status were at higher odds of belonging to the 'stable low' group, with an odds ratio (OR) of 1.86 (95 % confidence interval [CI] 1.66-2.09), 1.38 (95 % CI 1.12-1.70) and 1.84 (95 % CI 1.45-2.34) in the US, UK and Chinese participants, respectively. Study-specific meta-analysis showed similar associations between socioeconomic status and lifestyle trajectories, with an OR of 1.69 (low vs high socioeconomic status; 95 % CI 1.40-2.05) and 1.18 (middle vs high socioeconomic status; 95 % CI 1.04-1.34). CONCLUSION: Lifestyle trajectories remained stable over 10 years, and lower socioeconomic status was associated with higher odds of belonging to the 'stable low' group. Early-life interventions to minimize socioeconomic inequality should be prioritized to promote sustainable healthier lifestyles in later life.
Are Hormones a risk or an opportunity? Strategies for managing women predisposed to gynecological cancers.
Caretto M, Casula E, Fidecicchi T … +1 more , Simoncini T
Maturitas · 2026 Jun · PMID 41330826 · Publisher ↗
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Reply to the letter titled "Comment on the paper Effect of duration of hormonal contraceptive use on breast cancer risk: a systematic review and meta-analysis of cohort studies".
Sayon-Orea C, Martínez-González MA
Maturitas · 2026 Jan · PMID 41330237 · Publisher ↗
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Correlation between anti-Müllerian hormone, hypertension and vascular age: the Generation R Study, a population-based prospective cohort study.
Dykgraaf RHM, Schalekamp-Timmermans S, van den Berg SAA … +4 more , Vinke EJ, Steegers EAP, Laven JSE, Louwers YV
Maturitas · 2026 Jan · PMID 41314127 · Publisher ↗
OBJECTIVE: The objective of this study was to explore the relationship between levels of anti-Müllerian hormone (AMH) and the risk of hypertension and vascular ageing in a population-based cohort. STUDY DESIGN: This stud...
OBJECTIVE: The objective of this study was to explore the relationship between levels of anti-Müllerian hormone (AMH) and the risk of hypertension and vascular ageing in a population-based cohort. STUDY DESIGN: This study was embedded in the Generation R Study, a prospective population-based cohort study of children and their parents in the City of Rotterdam, the Netherlands. The present study included all women at the first recall visit with available data on AMH and blood pressure (n = 4883) and analysed the association between AMH and hypertension. AMH levels (first recall visit) and carotid artery intima-medial thickness (CIMT) measurements (second recall visit) were used to analyse the association between AMH serum levels and CIMT as a proxy for vascular age (n = 3508). RESULTS: A higher age and lower AMH percentiles (adjusted for age) were associated with an increased risk of hypertension. Women with AMH percentiles <p10 had a 2.1 times higher risk of hypertension than women with AMH levels >p90 (P < .001). Vascular age, conducted from CIMT measurements (second recall visit), was on average 9.8 years older than chronological age in those with an AMH below p10 (first recall visit). This difference was 6.1 years in those with an AMH exceeding p90. Similarly, differences in medians between the groups were significant (p < 0,008). CONCLUSIONS: This large prospective cohort study shows that low AMH levels later in life, independent of age, are associated with hypertension. The results indicate that diminished ovarian reserve at a younger age is associated with indicators of vascular alterations. Women with low AMH levels should not only be counseled about potential fertility issues, but should also be informed about their increased risk of vascular damage in order to take appropriate preventive measures. In the future, AMH may serve as a prospective marker for the early detection of cardiovascular diseases.
Preoperative hyperglycemia and postoperative adverse events in geriatric hip fracture surgery: Glycemic thresholds and exposure persistence.
Liu Y, Yang Y, Li Y … +2 more , Yang Z, Yang X
Maturitas · 2026 Jan · PMID 41314126 · Publisher ↗
BACKGROUND: Preoperative blood glucose levels are closely related to the occurrence of postoperative adverse events for geriatric patients undergoing surgery for hip fracture. However, the specific association between pr...
BACKGROUND: Preoperative blood glucose levels are closely related to the occurrence of postoperative adverse events for geriatric patients undergoing surgery for hip fracture. However, the specific association between preoperative blood glucose levels and postoperative pressure ulcers (PU), postoperative delirium (POD), and prolonged length of stay (LOS) requires further investigation. METHODS: This retrospective cohort study included hip fracture patients from 2017 to 2024. Preoperative blood glucose levels were analyzed both as a continuous variable and as a categorical variable to examine their association with postoperative PU, POD, and LOS. Statistical analyses were conducted using multivariable logistic regression, propensity score matching analysis and generalized linear models. RESULTS: The results showed that for each 1 mmol/L increase in preoperative blood glucose, the risk of developing postoperative pressure ulcers and delirium increased by 21 % and 28 %, respectively, while hospital stay was prolonged by 0.54 days. Notably, in subgroups of male patients, those aged 70-79 years, those with no prior history of hypertension or delirium, those with surgical time ≥ 1.6 h, and those with time from admission to surgery >5 days, the positive correlation between preoperative blood glucose levels and PU and POD was even stronger. When preoperative blood glucose levels exceeded 6.09 mmol/L (for PU and LOS) and 6.17 mmol/L (for POD), timely intervention became crucial. CONCLUSIONS: Preoperative hyperglycemia is significantly associated with postoperative PU, POD, and LOS in geriatric patients undergoing surgery for hip fracture. Early intervention, particularly glucose management for specific high-risk groups, may help reduce the incidence of adverse events.
Vaginal symptoms and sexual function in climacteric women experiencing stress urinary incontinence: a secondary analysis from a six-month follow-up of a randomised trial comparing microablative radiofrequency, pelvic floor muscle training, and combination treatments.
Lunardi ALB, Juliato CRT, Slongo H … +1 more , Riccetto CLZ
Maturitas · 2026 Jan · PMID 41308283 · Publisher ↗
OBJECTIVES: To compare microablative fractional radiofrequency (FMRF), pelvic floor muscle training (PFMT), and their combination (PFMT+FMRF) on vaginal symptoms, quality of life, and sexual function in incontinent clima...
OBJECTIVES: To compare microablative fractional radiofrequency (FMRF), pelvic floor muscle training (PFMT), and their combination (PFMT+FMRF) on vaginal symptoms, quality of life, and sexual function in incontinent climacteric women. METHODS: Secondary outcomes from a prospective, blinded, three-arm randomised controlled trial with 117 women (39 per group), assessed at pre-treatment, one month, and six months using: International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), Female Sexual Function Index (FSFI), cytology, Vaginal Health Index (VHI), and transabdominal ultrasound to measure vaginal wall thickness. RESULTS: All groups showed significant improvement over time in ICIQ-VS total score, laxity, dryness, impact on sex life, abdominal pain, vaginal soreness (p < 0.0001 for all questions), reduced sensation (p = 0.0004), and impairment of sex life (p = 0.0005). Only the FMRF group had sustained improvement in daily life interference at six months (p = 0.0419; CL pre vs post: -63.2 [-94.7;-31.8], pre vs 6 months: -45.7 [-79.4;-12.0]). FSFI improvements (total and domains) were not sustained at six months: total score (0.0102), desire (0.0134), lubrication (0.0093), satisfaction (0.0239), pain (0.0430). VHI showed significant, treatment-dependent differences: for moisture, FMRF improved pre- vs post-treatment (p = 0.0209; CL: 4.5 [2.4;26.6]), FMRF+PFMT improved over time (p = 0.0209; CL: 24.3 [10.6;38.0], 18.6 [4.2;32.9]); for fluid volume, FMRF+PFMT improved (p = 0.0004; CL: 27.6 [12.2;43], 24.7 [8.5;40.8]); for total score, FMRF improved pre- vs post-treatment (p = 0.0028; CL: 13.2 [4.4;22.1]), and FMRF+PFMT improved over time (p = 0.0028; CL: 21.6 [11.7;31.5], 18.9 [8.5;29.3]). All groups improved in pH (p < 0.0001) and epithelial integrity (p < 0.0001); however, the improvement in elasticity (p = 0.0001) was not sustained at six months. Vaginal wall thickness increased similarly across groups. CONCLUSION: At six-month follow-up, all groups had similar improvements in quality of life, vaginal health, and sexual function. TRIAL REGISTRATION: This trial is registered on REBEC (Registro Brasileiro de Ensaios Clínicos; Brazilian Registry of Clinical Trials) under number RBR-9v3q33.
Associations of socioeconomic position and depression with frailty among older adults: Cross-sectional evidence from 17 countries.
Ye Y, Shi L, Shi Z … +5 more , Jiang Q, Yan H, Ou C, Mao C, Wang D
Maturitas · 2026 Jan · PMID 41308282 · Publisher ↗
OBJECTIVES: This study describes the cross-national variation in socioeconomic disparities in frailty among older adults, assesses whether depression mediates the relationship between socioeconomic position and frailty,...
OBJECTIVES: This study describes the cross-national variation in socioeconomic disparities in frailty among older adults, assesses whether depression mediates the relationship between socioeconomic position and frailty, and examines the extent of the interactive or joint effects of depression and socioeconomic position on frailty. STUDY DESIGN: A cross-sectional analysis was conducted using population-based data from five aging cohorts across 17 countries. Frailty was assessed using the modified Fried Frailty Phenotype scale, which comprises five domains. Educational level and total household income were used to measure socioeconomic position. Multivariable logistic regression was used to calculate the odds ratios and 95 % confidence intervals for the associations, and pooled odds ratios were estimated using a random-effect meta-analysis. Mediation and interaction analyses explored the association between socioeconomic position, depression, and frailty. RESULTS: Among the 104,136 adults (mean age 64.29 years), 27,115 were frail. The prevalence of frailty varied widely across countries (Switzerland, 6.00 %; India, 46.51 %). Participants occupying a low socioeconomic position had a significantly higher risk of frailty than those in higher socioeconomic positions, with the association more pronounced in high-income countries. Depression mediated 30.9 % of the association between socioeconomic position and frailty. A significant additive interaction of low socioeconomic position and depression on frailty (1.98) was observed. Individuals occupying a low socioeconomic position who had depression had a markedly higher risk of frailty than those in a high socioeconomic position and no depression. CONCLUSIONS: Socioeconomic disparities in frailty vary across countries. The combined effects of socioeconomic position and depression highlight the need for integrated interventions to reduce frailty and promote healthy, equitable aging globally.
Handgrip strength in patients with subclinical hypothyroidism or subclinical hyperthyroidism compared with that in euthyroid individuals: A systematic review and meta-analysis.
Fernández-Alonso AM, García-Alfaro P, Pérez-López FR
Maturitas · 2026 Jan · PMID 41298180 · Publisher ↗
OBJECTIVE: This systematic review and meta-analysis assessed handgrip strength in patients with either subclinical hypothyroidism or subclinical hyperthyroidism as compared with euthyroid individuals. METHODS: We searche...
OBJECTIVE: This systematic review and meta-analysis assessed handgrip strength in patients with either subclinical hypothyroidism or subclinical hyperthyroidism as compared with euthyroid individuals. METHODS: We searched in Web of Science, Scopus, and PubMed databases for information about cross-sectional studies comparing subclinical hypothyroid or subclinical hyperthyroid patients and euthyroid control individuals. The quality of included studies was evaluated with the Newcastle-Ottawa Scale. Random-effect meta-analyses were conducted to minimize the effects of uncertainty associated with inter-study variability. Results are reported as mean differences, standardized mean differences, or odds ratios with 95 % confidence intervals. Heterogeneity between studies was assessed using I and τ statistics. RESULTS: Seven studies with low or moderate risk of bias were eligible for inclusion in the meta-analysis of patients with either subclinical hypothyroidism or hyperthyroidism compared with euthyroid individuals. The meta-analysis of five studies of patients with subclinical hypothyroidism showed they had lower handgrip strength (standardized mean difference: -0.61, 95 % confidence interval -1.15, -0.07; p = 0.03) and lower thyroxine levels (standardized mean difference: -0.52, 95 % confidence interval -0.87, -0.16; p = 0.004) than euthyroid individuals. They also had a higher body mass index (mean difference: 1.05, 95 % confidence interval: 0.17, 1.93, p = 0.02), higher total cholesterol (standardized mean difference 0.28, 95 % confidence interval 0.09, 0.46, p = 0.003) and lower thyroxine levels (standardized mean difference: -0.52, 95 % confidence interval -0.87, -0.16; p = 0.004), and a higher risk of sarcopenia (odds ratio: 2.12, 95 % confidence interval 1.40, 3.22, p = 0.0004) than euthyroid individuals. The meta-analyses of four studies of patients with subclinical hyperthyroidism did not show differences in measured outcomes compared with euthyroid individuals. CONCLUSIONS: Patients with subclinical hypothyroidism have lower handgrip strength than euthyroid individuals. There was no significant difference in handgrip strength between patients with subclinical hyperthyroidism and euthyroid individuals. PROSPERO registration: CRD420251004586.
Cross-national evidence on frailty-depression multi-trajectories and osteoporosis risk: Findings from the ELSA and HRS cohorts.
Deng S, Xie R, Zhao W … +2 more , Chen Z, Chen Z
Maturitas · 2026 Jan · PMID 41297365 · Publisher ↗
BACKGROUND: Frailty and depression commonly co-occur in older adults and may jointly elevate the risk of osteoporosis. However, evidence on their long-term multi-trajectories and impact on osteoporosis is limited, partic...
BACKGROUND: Frailty and depression commonly co-occur in older adults and may jointly elevate the risk of osteoporosis. However, evidence on their long-term multi-trajectories and impact on osteoporosis is limited, particularly across different populations. METHODS: We analyzed data from 2971 participants aged ≥50 years without osteoporosis at baseline in the English Longitudinal Study of Ageing (ELSA) and 5199 participants from the U.S. Health and Retirement Study (HRS). Group-based multi-trajectories modeling identified frailty-depression trajectories, and incident osteoporosis was ascertained through self-reported physician diagnosis during follow-up. Cox proportional hazards models estimated associations of trajectory groups with osteoporosis risk, adjusting for demographics and lifestyle factors. RESULTS: Over a median follow-up of 10 years in ELSA and 7.9 years in HRS, three consistent frailty-depression trajectories were identified in both cohorts-stable low, increasing moderate, and persistent high-accompanied by 220 (7.4 %) and 867 (16.7 %) incident osteoporosis cases, respectively. Compared with the stable low frailty-low depression group, the risk of osteoporosis was significantly higher for the persistent high frailty-high depression group (ELSA: HR = 2.52, 95 % CI 1.50-4.24; HRS: HR = 2.66, 95 % CI 2.12-3.35) and for the increasing moderate frailty-moderate depression group (ELSA: HR = 1.47, 95 % CI 1.03-2.09; HRS: HR = 1.45, 95 % CI 1.24-1.70). CONCLUSION: Across both the UK and US cohorts, long-term multi-trajectories of frailty and depression were strongly associated with the incidence of osteoporosis. Individuals with persistent high frailty-high depression had the greatest risk, whereas those with increasing moderate frailty-moderate depression also experienced cumulative risk. Prevention should extend beyond skeletal targets to include early, integrated strategies addressing functional decline and mental health in older adults.
Sex differences in the relationship between dynapenic abdominal obesity and the risk of motoric cognitive risk syndrome in older Chinese adults: A national prospective cohort study.
Li Q, Song C, Zhou H … +2 more , Li J, Chen M
Maturitas · 2026 Jan · PMID 41297364 · Publisher ↗
OBJECTIVES: Dynapenic abdominal obesity is associated with adverse health outcomes in older adults. However, the longitudinal relationship between dynapenic abdominal obesity and motoric cognitive risk syndrome, a pre-de...
OBJECTIVES: Dynapenic abdominal obesity is associated with adverse health outcomes in older adults. However, the longitudinal relationship between dynapenic abdominal obesity and motoric cognitive risk syndrome, a pre-dementia condition, remains unclear. We aimed to elucidate this association in older males and females. METHODS: A total of 3309 individuals from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were enrolled. Individuals were categorized into 4 groups based on sex-specific thresholds for handgrip strength (< 28 kg for males and < 18 kg for females) and waist circumference (≥ 90 cm for males and ≥ 85 cm for females): non-dynapenic/non-abdominal obesity, non-dynapenic/abdominal obesity, dynapenic/non-abdominal obesity and dynapenic/abdominal obesity. Multivariable logistic regression analysis was performed to investigate the relationship between dynapenic abdominal obesity and motoric cognitive risk syndrome risk. RESULTS: Over a 4-year follow-up, 410 (12.4 %) individuals experienced motoric cognitive risk syndrome. Individuals in the dynapenic/abdominal obesity group exhibited a markedly elevated risk of motoric cognitive risk syndrome as compared with those in the non-dynapenic/non-abdominal obesity group (odds ratio = 2.56, 95 % confidence interval 1.74-3.78, P < 0.001). This association was pronounced among males but not females. Further analyses revealed that the association was primarily driven by dynapenia, whereas abdominal obesity made only a modest contribution in males and showed no effect in females. CONCLUSIONS: Dynapenic abdominal obesity was significantly associated with an increased risk of developing motoric cognitive risk syndrome, especially among older males.
Estetrol for the treatment of moderate to severe vasomotor symptoms in postmenopausal women: The design of the E4COMFORT I and II trials.
Panay N, Simoncini T, Taziaux M … +6 more , Bouchard C, Black A, Kapoor E, Utian W, Foidart JM, Lobo RA
Maturitas · 2026 Jan · PMID 41289787 · Publisher ↗
Estetrol is a natural estrogen with a favorable safety profile, showing minimal effects on liver proteins, blood clotting, and breast tissue, which may reduce the risks of blood clots and cardiovascular disease. This rev...
Estetrol is a natural estrogen with a favorable safety profile, showing minimal effects on liver proteins, blood clotting, and breast tissue, which may reduce the risks of blood clots and cardiovascular disease. This review presents the profile of estetrol in support of the rationale of two pivotal phase 3 clinical trials, E4COMFORT I and E4COMFORT II, as well as the design of those. E4COMFORT I and II are aimed at assessing the efficacy and safety of estetrol in the treatment of moderate to severe vasomotor symptoms in postmenopausal women. The E4COMFORT I and II trials were divided into an efficacy part (arms 1-3) and a safety part (arm 4). Efficacy was evaluated through a randomized, double-blind, placebo-controlled study examining two doses of estetrol (15 mg and 20 mg) in postmenopausal participants, both hysterectomized and non-hysterectomized, who experienced 7 or more moderate to severe vasomotor symptoms per day (or 50 or more per week). To comply with Food and Drug Administration and European Medicines Agency guidelines for long-term safety assessments in both groups, these trials evaluated the overall and endometrial safety of unopposed estetrol and of estetrol combined with natural progesterone. The total enrolment across the E4COMFORT I and II trials was 2576 participants. The results of these trials are expected to give a thorough understanding of estetrol 's potential as a new, distinctive treatment option for women with postmenopausal symptoms. CLINICALTRIALS REGISTRATION: NCT04209543 and NCT04090957.
Association between social determinants of health and intrinsic capacity trajectories: A population-based longitudinal study.
Zhang Y, Wu S, Xie F … +6 more , Xue E, Quan L, Zhu B, Qi Z, Zhu K, Wang W
Maturitas · 2026 Jan · PMID 41274137 · Publisher ↗
BACKGROUND: Global aging is a significant public health challenge. Social determinants of health are crucial in shaping healthy aging trajectories by influencing intrinsic capacity, a key indicator of functional ability...
BACKGROUND: Global aging is a significant public health challenge. Social determinants of health are crucial in shaping healthy aging trajectories by influencing intrinsic capacity, a key indicator of functional ability and well-being in older adults. However, the association between social determinants of health and intrinsic capacity trajectories remains underexplored. This study examines the associations between social determinants of health and intrinsic capacity trajectories among Chinese community-dwelling older adults. PARTICIPANTS AND SETTING: Community-dwelling adults aged ≥60 years from the China Health and Retirement Longitudinal Study (2011-2015). METHODS: Bifactor models of intrinsic capacity were constructed. Multigroup confirmatory factor analysis was used to test the longitudinal measurement invariance of intrinsic capacity. Growth mixture modeling was performed to identify distinct intrinsic capacity trajectory classes, and multivariate logistic regression was employed to determine the social determinants of health associated with these classes. RESULTS: A total of 5798 community-dwelling older adults were included. Four distinct intrinsic capacity trajectory classes were identified: high-increasing (20.6 %), medium-maintaining (37.1 %), medium-decreasing (29.0 %), and low-decreasing (13.3 %). Compared with the high-increasing trajectory, illiteracy, low-middle income, no social activities, being separated/divorced/widowed/never married, smoking, non-drinking, low physical activity, rural residence, non-age-friendly home environment, and no health insurance were associated with a higher likelihood of belonging to the low-decreasing trajectory. CONCLUSIONS: These findings provide evidence for the early identification of heterogeneous intrinsic capacity trajectories and support the implementation of stratified intervention strategies.
Women using menopausal hormone therapy who suicide have multiple risk factors.
Lappin JM, Darke S, Grattan S … +1 more , Havard A
Maturitas · 2026 Jan · PMID 41265236 · Publisher ↗
OBJECTIVES: To describe the characteristics, clinical presentation, documented risk factors for suicide, circumstances of death and toxicology of deaths by suicide in Australia, 2000-2024, among people known to be receiv...
OBJECTIVES: To describe the characteristics, clinical presentation, documented risk factors for suicide, circumstances of death and toxicology of deaths by suicide in Australia, 2000-2024, among people known to be receiving menopause hormonal therapy. DESIGN: A retrospective descriptive study. SETTING: National population-level data retrieved from the National Coronial Information System. MAIN OUTCOME MEASURES: Characteristics, clinical presentation, circumstances of death, documented risk factors for suicide and toxicology in all cases of death by suicide among people known to be receiving menopause hormonal therapy at their time of death in Australia, 2000-2024. RESULTS: 63 cases were identified with a mean age of 54 years (range 50-59). Mental health diagnoses were present in almost all cases (93.7 %), with a preponderance of anxiety and depression. Prior suicidal behaviours were present in over half (52.4 %) and chronic pain in one-third (30.2 %). Almost all of these women (96.8 %) had at least one risk factor for suicide and 79.3 % had two or more risk factors. The most common circumstances of death were drug toxicity (39.7 %) or hanging (36.5 %). Psychoactive drugs were present in blood in the majority (93.5 %), most commonly antidepressants (53.2 %), hypnosedatives (50.0 %) and opioids (29.0 %). CONCLUSIONS: Menopause hormonal therapy remains the most effective treatment for management of vasomotor symptoms and this study does not demonstrate any causal risk for suicide. Rather, it highlights that women prescribed menopause hormonal therapy who suicide have multiple risk factors for suicide including psychiatric complexity, prior suicidal behaviours, physical health comorbidity and concomitant psychoactive substance use.
Early onset, maintenance of effect, and day-/night-time findings following fezolinetant treatment for moderate to severe vasomotor symptoms associated with menopause: A pooled phase 3 analysis.
Shapiro C M M, Neal-Perry G, Stute P … +5 more , Thurston RC, Wolfman W, English M, Wu X, Ottery FD
Maturitas · 2025 Dec · PMID 41259888 · Publisher ↗
OBJECTIVES: To evaluate onset of action, maintenance of effect, day-/night-time efficacy, and treatment response with fezolinetant for the treatment of vasomotor symptoms (VMS) using phase 3 data. STUDY DESIGN: SKYLIGHT...
OBJECTIVES: To evaluate onset of action, maintenance of effect, day-/night-time efficacy, and treatment response with fezolinetant for the treatment of vasomotor symptoms (VMS) using phase 3 data. STUDY DESIGN: SKYLIGHT 1 and 2 enrolled individuals (≥40-≤65 years) assigned female at birth who were seeking treatment/relief from moderate to severe VMS. Participants were randomised to placebo, or fezolinetant 30 or 45 mg for 12 weeks. Subsequently, fezolinetant-treated participants continued their dose and placebo participants were re-randomised to fezolinetant 30 or 45 mg for 40 weeks. MAIN OUTCOME MEASURES: Daily frequency and severity of VMS during week 1, up to week 12, over 52 weeks, during the day and night; and proportion of responders. RESULTS: Improvements in VMS frequency and severity with fezolinetant versus placebo were observed from day 1 (1022 participants). At weeks 1 and 12, least squares mean (95 % confidence interval [CI]) reductions in VMS frequency for fezolinetant 45 mg versus placebo were - 1.46 (-2.01, -0.92) and - 2.51 (-3.20, -1.82). VMS frequency and severity improvements were maintained throughout 52 weeks and for both the day- and night-time assessments. A greater proportion of fezolinetant-treated participants had a reduction of ≥50 % in VMS frequency from baseline to week 12 versus placebo (58.7 % versus 36.0 %, odds ratio [95 % CI]: 2.542 [1.868-3.472]). Similar trends were noted with 30 mg. CONCLUSIONS: The onset of action for fezolinetant was observed from day 1 for VMS frequency and severity and was maintained for 52 weeks. Fezolinetant can provide rapid and prolonged relief from VMS. CLINICAL TRIAL REGISTRATION: SKYLIGHT 1 ClinicalTrials.gov: NCT04003155 (https://clinicaltrials.gov/ct2/show/NCT04003155). SKYLIGHT 2 ClinicalTrials.gov: NCT04003142 (https://clinicaltrials.gov/ct2/show/NCT04003142).
Self-efficacy, quality of life, physical activity and educational interventions in menopausal women: A cross-sectional and pre-post study using Bayesian structural equation modelling.
Magistro D, Vagnetti R, Ansdell P … +1 more , Piasecki J
Maturitas · 2025 Dec · PMID 41252865 · Publisher ↗
OBJECTIVES: This two-part study aimed to confirm a theoretical model that integrates self-efficacy with menopause symptoms, quality of life and physical activity; and to determine the associations between self-efficacy a...
OBJECTIVES: This two-part study aimed to confirm a theoretical model that integrates self-efficacy with menopause symptoms, quality of life and physical activity; and to determine the associations between self-efficacy and menopause knowledge following an education intervention. STUDY DESIGN: The cross-sectional study involved 86 menopausal women (mean age = 55.57, SD = 7.44). Additionally, a pre-post design was employed after a half-day educational intervention (presentations, interactive polls and open discussions) with 51 women (mean age = 52.81, SD = 4.62). MAIN OUTCOME MEASURES: The impact of menopausal symptoms on quality of life (QoL) was assessed via the Peri-menopausal Depression Scale and the Utian Quality of Life Scale. Physical activity was measured with the International Physical Activity Questionnaire. Self-efficacy was assessed with the General Self-Efficacy Scale. An ad hoc questionnaire pre- and post-events determined level of knowledge regarding menopause. RESULTS: Bayesian structural equation modelling confirmed the model. Physical activity exhibited a negative association with menopause symptoms (mean estimate = -1.69, 95 % CI [-3.08, -0.28]), and its relationship with quality of life (mean estimate = 1.35, 95 % CI [-0.24, 2.93]) was mediated by symptoms (mean estimate = 0.75, 95 % CIs [0.12, 1.51]). The detrimental impact of symptoms on quality of life (mean estimate = 4.42, 95 % CIs [2.22, 6.59]) was partially mediated by self-efficacy (mean estimate = -0.24, 95 % CIs [-0.38, -0.11]). Self-efficacy (r = 0.47, p < .001) was significantly correlated with improvements in knowledge. CONCLUSIONS: Increased physical activity could reduce menopausal symptoms and thereby enhance quality of life during the menopause. Higher levels of self-efficacy support better symptom management via improvements in menopause-related knowledge.
Unveiling the association between dietary metals and prostate health: Identifying benign prostatic hyperplasia using a SHAP-based interpretable machine learning model in US adults.
Wang Y, Chen J, Chen W … +3 more , Jiang X, Ding C, Zhu J
Maturitas · 2025 Dec · PMID 41252864 · Publisher ↗
BACKGROUND: Benign prostatic hyperplasia affects roughly 50 % of men aged 51-60 and 70 % of those aged 61-70. While heavy metals have been linked to prostate cancer and inflammation, little is known about how the dietary...
BACKGROUND: Benign prostatic hyperplasia affects roughly 50 % of men aged 51-60 and 70 % of those aged 61-70. While heavy metals have been linked to prostate cancer and inflammation, little is known about how the dietary intake of trace metals influences BPH risk. This study aimed to establish an interpretable, machine-learning-based framework using U.S. NHANES data to identify key dietary metals associated with BPH risk. METHODS: We analyzed adult male participants from NHANES cycles 2005-2008, extracting daily intake estimates for six trace metals. This study compared six algorithms to elucidate the relationship between dietary metal intake and BPH risk, assessing their performance in associating BPH risk across seven evaluation metrics to identify the optimal model and enhance interpretability through analysis with SHapley Additive exPlanations (SHAP). Subgroup analyses explored nonlinear intake-risk relationships. RESULTS: LightGBM demonstrated superior performance (AUC = 0.668). SHAP ranking identified zinc, iron, and selenium as the top protective nutrients. The most pronounced protective effect against BPH was observed within the moderate zinc and selenium intake strata. Iron demonstrated a consistent protective association, with risk reduction observed across its intake range. Copper intake demonstrated a shift from risk reduction for BPH at low to moderate levels to an increased risk at high intake levels. CONCLUSIONS: These findings suggest that calibrated intake of these key micronutrients may attenuate BPH susceptibility, providing a data-driven foundation for targeted nutritional interventions and public-health strategies.
Impact of menopausal hormone therapy and physical activity on sexual function among postmenopausal women.
Feng P, Lin L, Xie Z … +6 more , Lin X, Huang J, Lin S, Luo M, Yu Q, Chen R
Maturitas · 2025 Dec · PMID 41252863 · Publisher ↗
OBJECTIVES: This study investigated the association between sexual function and both menopausal hormone therapy and physical activity among postmenopausal women. METHODS: In this cross-sectional study, postmenopausal wom...
OBJECTIVES: This study investigated the association between sexual function and both menopausal hormone therapy and physical activity among postmenopausal women. METHODS: In this cross-sectional study, postmenopausal women who had used menopausal hormone therapy for at least three years were recruited as the intervention group, and those who had never used menopausal hormone therapy served as controls. Additionally, women were further categorized based on physical activity levels. All women were requested to complete the Female Sexual Function Index and the International Physical Activity Short Questionnaire for the Elderly surveys to evaluate their sexual function and physical activity levels. RESULTS: Application of the inclusion and exclusion criteria led to a sample size of 260 for the two study groups combined, 109 in the intervention group (who had used menopausal hormone therapy) and 151 in the control group (who had never used it). Our study revealed that menopausal hormone therapy was effective in alleviating sexual discomfort, with higher scores on the Female Sexual Function Index in the menopausal hormone therapy group compared with the control group (43.73 vs. 37.46, P < 0.05). Specifically, users of menopausal hormone therapy experienced notable improvements in lubrication, orgasm, and overall satisfaction. Intriguingly, increased physical activity was associated with reduced sexual discomfort. Improved lubrication and pain relief were observed in the moderate- and high-exercise group receiving hormone therapy compared with controls. CONCLUSIONS: Both menopausal hormone therapy and physical exercise were related to less sexual discomfort among women in this demographic. Additionally, menopausal hormone therapy appears to enhance the benefits of exercise in addressing sexual discomfort.
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