Maturitas最新文献

{"title":"Evaluating the predictive validity of SARC-F cut-off scores for low muscle strength among older adults in a low-income community","authors":"Alex Barreto de Lima ,&nbsp;Reshma Aziz Merchant ,&nbsp;Myrian Abecassis Faber ,&nbsp;Duarte Henrinques-Neto","doi":"10.1016/j.maturitas.2026.108869","DOIUrl":"10.1016/j.maturitas.2026.108869","url":null,"abstract":"<div><h3>Background</h3><div>With an aging population, muscle health, encompassing locomotion and metabolic function, has become a public health priority. Handgrip strength is a validated surrogate measure of general muscle strength, but measurement may not be feasible in low-resource settings. The SARC-F questionnaire (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) provides a simple, low-cost, and practical tool for sarcopenia screening, though its optimal cut-off remains debated.</div></div><div><h3>Objective</h3><div>To evaluate the predictive validity of SARC-F cut-off scores in identifying low muscle strength among community-dwelling older adults in a low-income population.</div></div><div><h3>Methods</h3><div>We included 733 participants (221 men, 512 women; aged 60–95 years) from the Amazonas region of Brazil. All completed the SARC-F and underwent handgrip strength testing. Low handgrip strength was based on EWGSOP2 criteria (&lt;27 kg men, &lt;16 kg women). Agreement, sensitivity, specificity, predictive values, and ROC curves were calculated for cut-offs ≥4 and ≥ 2, stratified by sex.</div></div><div><h3>Results</h3><div>Low handgrip strength was highly prevalent (47.1% in men, 94.1% in women). Agreement between SARC-F and muscle weakness was generally poor (κ &lt;0.4), except for men at the ≥4 threshold (κ = 0.41). Sensitivity was higher in men than in women (≥4: 48% vs 37%; ≥2: 70% vs 69%). Lowering the cut-off to ≥2 improved sensitivity but reduced specificity (65.8% men, 56.7% women). ROC analysis identified ≥2 as the optimal threshold, with AUC 0.68 in men and 0.63 in women.</div></div><div><h3>Conclusion</h3><div>A SARC-F cut-off of ≥2 improves sensitivity for detecting probable sarcopenia and may be more suitable for screening in low-income settings. Longitudinal validation is warranted across diverse populations.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108869"},"PeriodicalIF":3.6,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116774","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":"Advanced paternal age at birth and risk of cyanotic congenital heart defects in the United States","authors":"Julie Sang ,&nbsp;Imo A. Ebong ,&nbsp;Duke Appiah","doi":"10.1016/j.maturitas.2026.108863","DOIUrl":"10.1016/j.maturitas.2026.108863","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited inconsistent evidence suggests a potential association between advanced paternal age (APA) and simple congenital heart defects, which often resolve without surgical interventions, in offspring. There is no reported potential relationship between APA with major cardiac defects like cyanotic congenital heart defects (CCHD). This study evaluated the association between APA (age at birth ≥40 years) and the occurrence of CCHD among livebirths in the USA, accounting for maternal and other potential confounding factors.</div></div><div><h3>Methods</h3><div>Data were from the National Vital Statistics System, comprising 9.9 million singleton first-time livebirths among mothers and fathers aged ≥15 years from 2016 to 2023. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>From 2016 to 2023, the proportion of births to fathers with APA increased from 7.5% to 7.9%. A greater proportion of fathers with APA had offspring with CCHD (62.0 vs. 53.1 per 100,000), used infertility treatment (9.5% vs. 2.3%), and their partners were also older (34.6 vs. 27.0 years). In models adjusted for paternal factors (age, race and ethnicity, and education), APA was associated with a modest elevated odds for CCHD (OR = 1.22, 95% CI 1.11–1.34) which remained significant after further control for maternal pre-pregnancy sociodemographic and health factors (OR = 1.12, 95% CI 1.01–1.25). However, additional adjustments for infertility treatment attenuated the observed association (OR = 1.08, 95% CI 0.98–1.20).</div></div><div><h3>Conclusions</h3><div>The findings of this large population-based study suggest no association between APA and CCHD after accounting for important confounders, including maternal factors and infertility treatment.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108863"},"PeriodicalIF":3.6,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116775","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 window of opportunity for treating vulvovaginal atrophy in menopause: Insights from oestrogen receptor distribution and age-related changes","authors":"Silvia P. González ,&nbsp;Laura Nieto-Pascual ,&nbsp;Diana López-Freire ,&nbsp;Santiago Palacios","doi":"10.1016/j.maturitas.2026.108858","DOIUrl":"10.1016/j.maturitas.2026.108858","url":null,"abstract":"<div><h3>Objective</h3><div>To review the biological basis of the “window of opportunity” hypothesis for the treatment of vulvovaginal atrophy (VVA), focusing on the distribution of oestrogen receptors (ERs) in vulvovaginal tissues, the impact of sustained oestrogen deficiency over time, and the rationale for a preventive or very early sequential therapeutic approach.</div></div><div><h3>Methods</h3><div>Narrative review of experimental and clinical studies evaluating ER expression in vaginal and vulvar tissues, its modulation by age and menopause, and clinical response to local and systemic hormonal therapy, with emphasis on timing of initiation and management strategies.</div></div><div><h3>Main results</h3><div>ER distribution and expression vary with age and menopausal status, with ER-α predominating after menopause. Experimental models show that immediate hormonal intervention after oestrogen deprivation restores tissue trophism and ER expression, whereas delayed treatment is associated with attenuated responses and irreversible histological changes. Loss of collagen, reduced angiogenesis, altered innervation, and inflammatory infiltration contribute to VVA progression. Clinical data suggest that early initiation of vaginal oestrogens enhances therapeutic efficacy. No consistent differences have been observed among local formulations, although ER subtype profile and time since menopause may influence outcomes.</div></div><div><h3>Conclusions</h3><div>Early initiation of ER-directed therapies may optimise tissue responses and prevent irreversible changes. A sequential treatment framework is useful for long-term management—particularly in women who did not start therapy early—yet further studies incorporating time since menopause and evaluating the long-term safety of hormonal therapy for VVA are warranted.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"207 ","pages":"Article 108858"},"PeriodicalIF":3.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116773","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":"Male breast health and breast cancer risk","authors":"Lakshmi Khatri ,&nbsp;Jessica Fraker ,&nbsp;Sandhya Pruthi","doi":"10.1016/j.maturitas.2026.108850","DOIUrl":"10.1016/j.maturitas.2026.108850","url":null,"abstract":"<div><div>Males account for a small but clinically significant component of overall breast conditions, both benign and malignant. This review summarizes current evidence on epidemiology, male breast anatomy, clinical presentation, diagnosis, management, and identification of risk factors for male breast disease. Benign male breast disease, including gynecomastia, prompts clinical evaluation and requires understanding of hormonal and pharmacological causes to guide diagnostics and management. Although male breast cancer is rare, accounting for less than 1% of all breast cancers, it carries important hereditary and clinical implications. Pathogenic germline variants in <em>BRCA2</em> are the predominant genetic contributor, conferring a lifetime risk of ~7%, while <em>BRCA1</em>, <em>CHEK2</em> and <em>PALB2</em> variants confer lower risk. Males with breast cancer typically present with subareolar masses, nipple changes, or pain, often at older ages and later stages compared with females. Imaging evaluation, including mammography and ultrasound, is central to diagnosis and management. Screening recommendations for high-risk men remain limited due to sparse prospective data, with multigene panel testing and family history assessment guiding individualized risk assessment. Management strategies for male breast cancer generally parallel female protocols, despite unique biological features. By integrating considerations of benign and malignant conditions, this review underscores the importance of tailored evaluation, risk assessment, and individualized care for males, while identifying knowledge gaps to inform future research and improve outcomes in this under-recognized population.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108850"},"PeriodicalIF":3.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079306","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":"Prospective association of social frailty with incident motoric cognitive risk syndrome among middle-aged and older adults","authors":"Mingming Liu ,&nbsp;Shanshan Wang ,&nbsp;Mengmei E. Wang ,&nbsp;Yuxiao Li ,&nbsp;Qiaoye J. Wang ,&nbsp;Lingyao Meng","doi":"10.1016/j.maturitas.2026.108854","DOIUrl":"10.1016/j.maturitas.2026.108854","url":null,"abstract":"<div><h3>Background</h3><div>The prospective association between social frailty and motoric cognitive risk syndrome in China is understudied.</div></div><div><h3>Objective</h3><div>To investigate the prospective association between social frailty and motoric cognitive risk syndrome among Chinese middle-aged and older adults.</div></div><div><h3>Methods</h3><div>Data were derived from the China Health and Retirement Longitudinal Study, 2011–2015. The sample comprised 3373 adults aged ≥45 years without motoric cognitive risk syndrome at baseline (2011). Social frailty was constructed from five indicators and categorized into three levels: robust, pre-frail, and frail. Motoric cognitive risk syndrome was defined as concurrent slow gait and subjective cognitive complaint at the 2013 and/or 2015 follow-ups. Associations were estimated using Cox proportional hazards models with sequential adjustment.</div></div><div><h3>Results</h3><div>After multivariate adjustment, compared with the robust group, pre-frailty (HR 1.63; 95% CI 1.12–2.36) and frailty (HR 2.02; 95% CI 1.38–2.96) were associated with a higher risk of incident motoric cognitive risk syndrome. In sex-stratified analyses, associations were stronger in males, whereas among females only frailty was significantly associated with a higher risk.</div></div><div><h3>Conclusions</h3><div>Social frailty was associated with subsequent motoric cognitive risk syndrome in Chinese middle-aged and older adults, supporting social-risk screening and interventions.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108854"},"PeriodicalIF":3.6,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel proteomic subtypes of frailty with distinct molecular patterns and prognosis","authors":"Zhenyi Xu ,&nbsp;Ce Wang ,&nbsp;Jiaofeng Wang ,&nbsp;Jie Chen ,&nbsp;Xiaojun Wang ,&nbsp;Zhijun Bao ,&nbsp;Yan Zhang","doi":"10.1016/j.maturitas.2026.108851","DOIUrl":"10.1016/j.maturitas.2026.108851","url":null,"abstract":"<div><h3>Objectives</h3><div>The frailty phenotype has limitations in capturing the biological heterogeneity of the condition. Our study identified subtypes of frailty based on proteomics and examined their associations with several adverse outcomes.</div></div><div><h3>Method</h3><div>The study included 1513 frail individuals and 29,339 non-frail individuals from the UK Biobank and analyzed 2920 proteins. Unsupervised K-means clustering was applied to identify molecular subtypes of frailty and the Boruta algorithm was applied to identify the key proteins for distinguishing these subtypes.</div></div><div><h3>Results</h3><div>Four novel subtypes were identified among frail individuals: S1 (<em>n</em> = 403), S2 (<em>n</em> = 209), S3 (<em>n</em> = 587) and S4 (<em>n</em> = 314). In total, 567 key proteins for distinguishing subtypes were identified, in diverse biological pathways. Each subtype exhibited distinct molecular characteristics. S1 was characterized by elevated genomic instability, S2 by altered intercellular communication, S3 by broad upregulation of aging-related features, and S4 by loss of proteostasis and mitochondrial dysfunction. While the prognosis of S3 was similar to S1, S2 and S4 had a worse prognosis than S1. S2, in particular, presented a significantly increased risk of multiple adverse outcomes compared with S1, including all-cause mortality (hazard ratio 2.13; 95% confidence interval 1.60–2.85), cardiovascular disease (hazard ratio 1.78; 95% confidence interval 1.00–3.17), respiratory disease (hazard ratio 1.83; 95% confidence interval 1.24–2.70), kidney disease (hazard ratio 2.76; 95% confidence interval 1.57–4.85), liver disease (hazard ratio 6.19; 95% confidence interval 4.13–9.29), and cancer (hazard ratio 2.06; 95% confidence interval 1.43–2.96).</div></div><div><h3>Conclusion</h3><div>Our study identified four proteomic subtypes of frailty with distinct molecular signatures and differential prognostic implications, highlighting the biological heterogeneity of frailty and the need for personalized medicine and management strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108851"},"PeriodicalIF":3.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene-specific cancer risks in female Lynch syndrome carriers: A copula-based meta-analysis","authors":"Raheleh Karimi ,&nbsp;Iraj Kazemi ,&nbsp;Marjan Mansourian ,&nbsp;Hamid Reza Marateb ,&nbsp;Miquel Angel Mañanas","doi":"10.1016/j.maturitas.2026.108829","DOIUrl":"10.1016/j.maturitas.2026.108829","url":null,"abstract":"<div><h3>Background</h3><div>Lynch syndrome, caused by germline pathogenic variants in mismatch repair genes, markedly increases risks of endometrial, ovarian, and possibly breast cancer in women. We aimed to establish gene-specific risk profiles for these cancers using a unified multivariate model accounting for correlated outcomes.</div></div><div><h3>Methods</h3><div>Eligible studies reported frequencies of endometrial, ovarian, and breast cancer in female with Lynch syndrome carriers, for at least two mismatch repair genes. We applied a Bayesian multivariate random-effects meta-analysis with a copula model to jointly model prevalence and odds ratios across cancers, accounting for between-study heterogeneity and inter-cancer correlation.</div></div><div><h3>Results</h3><div>Using a copula-based multivariate meta-analysis to account for outcome interdependence, the estimated prevalence was 20% for endometrial cancer, 5.7% for ovarian cancer, and 11% for breast cancer. Gene-specific analyses showed increased endometrial cancer risk with <em>MSH6</em> (OR = 1.46, 95% CrI 1.02–2.04) and reduced risk with <em>PMS2</em>, relative to other Lynch genes (OR = 0.36, 95% CrI 0.14–0.95). Ovarian cancer risk did not differ significantly by gene. For breast cancer, <em>PMS2</em> (OR = 1.52, 95% CI 1.02–2.25) and <em>MSH6</em> (OR = 2.27, 95% CrI 1.08–2.49) were associated with higher risk, while <em>MLH1</em> and <em>MSH2</em> carried significantly lower risk.</div></div><div><h3>Conclusions</h3><div>This copula-based meta-analysis identifies gene-specific risks of endometrial and ovarian cancer in female Lynch syndrome carriers, supporting personalized gynecologic surveillance. It also notes higher breast cancer risks in <em>MSH6</em> and <em>PMS2</em> carriers, but conflicting evidence from large perspective databases prevents definitive conclusions about breast cancer as part of the Lynch syndrome spectrum.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108829"},"PeriodicalIF":3.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079302","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 of social frailty and cognitive domain trajectories in middle-aged and older adults in China: A population-based cohort study from a network perspective","authors":"Xue Wang ,&nbsp;Huaxin Si ,&nbsp;Yanyan Li ,&nbsp;Jiaqi Yu ,&nbsp;Wendie Zhou ,&nbsp;Hejing Chen ,&nbsp;Cuili Wang","doi":"10.1016/j.maturitas.2026.108852","DOIUrl":"10.1016/j.maturitas.2026.108852","url":null,"abstract":"<div><h3>Objective</h3><div>The association between social frailty and the long-term trajectories of cognitive domains remains understudied in Chinese middle-aged and older adults. This study explores this association using data from a nationwide longitudinal study.</div></div><div><h3>Methods</h3><div>This study analyzed data obtained from the 2011–2020 waves of the China Health and Retirement Longitudinal Study. Trajectories in the three cognitive domains of global cognition, episodic memory, and executive function were determined through group-based trajectory modeling. Logistic regression models were employed to assess the associations between social frailty (classified as social frailty, pre-social frailty or robust) and the identified trajectories of global cognition, episodic memory, and executive function. In addition, network analysis was conducted to detect central nodes.</div></div><div><h3>Results</h3><div>A total of 7961 participants were included. The group-based trajectory modeling identified two distinct trajectories for global cognition, episodic memory, and executive function: a persistently low trajectory and a persistently high trajectory. Compared with the robust group, the pre-social frailty and social frailty groups were associated with higher odds of having a persistently low trajectory for global cognition, episodic memory, and executive function (pre-social frailty: odds ratio (OR) = 1.37, 95% confidence interval (CI) 1.22, 1.54, for global cognition; OR = 1.31, 95% CI 1.17, 1.46, for episodic memory; OR = 1.40, 95% CI 1.25, 1.58, for executive function; social frailty: OR = 1.86, 95% CI 1.45, 2.40, for global cognition; OR = 1.74, 95% CI 1.34, 2.27, for episodic memory; OR = 1.89, 95% CI 1.47, 2.44, for executive function). Moreover, network analysis revealed “loneliness” to be the most influential node in the network.</div></div><div><h3>Conclusions</h3><div>These findings underscore the relevance of social frailty and loneliness to cognitive trajectories and support further research to evaluate whether interventions that enhance social support and reduce loneliness can improve cognitive outcomes in at-risk populations.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108852"},"PeriodicalIF":3.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079304","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":"Physical activity as an alternative or adjunct to menopausal hormone therapy for symptom management in women with primary ovarian insufficiency","authors":"Félix Ayala ,&nbsp;Juan E. Blümel ,&nbsp;María S. Vallejo ,&nbsp;Peter Chedraui ,&nbsp;Hugo Gutiérrez-Crespo ,&nbsp;Marcela López ,&nbsp;Juan Matzumura-Kasana ,&nbsp;Paolo Meza ,&nbsp;Álvaro Monterrosa-Castro ,&nbsp;Mónica Ñañez ,&nbsp;Eliana Ojeda ,&nbsp;Claudia Rey ,&nbsp;Ana Lucia Ribeiro Valadares ,&nbsp;Doris Rodríguez-Vidal ,&nbsp;Marcio A.H. Rodrigues ,&nbsp;Javier Saavedra ,&nbsp;Carlos Salinas ,&nbsp;Lida Sosa ,&nbsp;Konstantinos Tserotas ,&nbsp;Margot Acuña-San Martín ,&nbsp;Gustavo Gómez-Tabares","doi":"10.1016/j.maturitas.2026.108855","DOIUrl":"10.1016/j.maturitas.2026.108855","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity alleviates menopausal symptoms in women whose menopause occurs after the age of 45; however, its effect in primary ovarian insufficiency, which occurs before the age of 40, remains unknown.</div></div><div><h3>Objective</h3><div>To examine the association between physical activity, menopausal symptoms, and the use of menopausal hormone therapy in women with primary ovarian insufficiency.</div></div><div><h3>Methods</h3><div>We analysed data from 4708 participants from two studies conducted in 12 Latin American countries. After applying eligibility criteria, 564 women with primary ovarian insufficiency (351 idiopathic and 213 surgical) were included. Menopausal symptoms were assessed using a validated scale, and severe symptoms were defined according to established cut-offs. Physical activity was classified according to international recommendations for moderate-intensity activity. Logistic regression models were adjusted for sociodemographic, clinical, and lifestyle variables.</div></div><div><h3>Results</h3><div>The prevalence of severe menopausal symptoms was 39.2%, with no significant difference between idiopathic and surgical primary ovarian insufficiency. Women with severe symptoms were less likely to meet recommended levels of physical activity or to be current users of menopausal hormone therapy. In adjusted models, regular physical activity (OR 0.65; 95% CI 0.45–0.94) and current use of menopausal hormone therapy (OR 0.27; 0.17–0.42) were associated with a lower likelihood of severe symptoms, whereas obesity and use of psychotropic medication were associated with a higher likelihood.</div></div><div><h3>Conclusions</h3><div>Women with primary ovarian insufficiency who engage in regular physical activity or currently use menopausal hormone therapy report less severe menopausal symptoms. Regular exercise may be an important non-hormonal option for women who cannot or prefer not to use hormone therapy.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108855"},"PeriodicalIF":3.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079257","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":"Frequency and factors related to very early return of older persons to the emergency department: A separate analysis of men and women (EDEN-26 study)","authors":"Òscar Miró ,&nbsp;Natalia Miota ,&nbsp;Andrea Bellido ,&nbsp;Carolina Rangel ,&nbsp;Anette Arce ,&nbsp;Sira Aguiló ,&nbsp;Ana García-Martínez ,&nbsp;Effie Polyzogopoulou ,&nbsp;John Parissis ,&nbsp;Juan González del Castillo ,&nbsp;Blanca Coll-Vinent ,&nbsp;on behalf of the SIESTA Research Network","doi":"10.1016/j.maturitas.2026.108853","DOIUrl":"10.1016/j.maturitas.2026.108853","url":null,"abstract":"<div><h3>Objectives</h3><div>Discharge from acute care assumes adequate medical and social conditions. Very early return to the emergency department (i.e. within 72 h) may reflect a failure to ensure a safe discharge. Older persons are particularly vulnerable, yet sex-related disparities remain underexplored. We assessed the incidence and sex-specific predictors of very early returns to the emergency department.</div></div><div><h3>Methods</h3><div>We analyzed 23,962 consecutive individuals aged 65 years or more from the multicenter Spanish EDEN registry, including patients discharged home alive from 52 emergency departments, with post-discharge follow-up. The outcome was any emergency department return within 72 h after discharge either from the emergency department or following hospitalization. Candidate predictors included age, living arrangements, comorbidity, functional status, walking ability, previous falls, and prior diagnoses of depression, dementia, or delirium. Multivariable logistic regression models were stratified by sex, adjusted for all candidate predictors, and included interaction terms to assess sex-specific effects.</div></div><div><h3>Results</h3><div>The overall incidence of very early emergency department return was 6.6% (7.1% in men and 6.2% in women). In men, comorbidity was independently associated with return. In women, comorbidity, functional dependence, previous falls, and depression were independent predictors. Significant sex-by-predictor interactions indicated a stronger association for previous falls in women in the overall cohort, for depression in women discharged directly from the emergency department, and for prior delirium in women discharged after hospitalization. Male sex was independently associated with a higher adjusted risk of very early emergency department return (adjusted odds ratio 1.12).</div></div><div><h3>Conclusions</h3><div>Predictors of very early emergency department return differ by sex in older persons. Previous falls and depression have a stronger impact in women, while male sex is independently associated with a higher baseline risk. Sex-sensitive discharge planning may help reduce avoidable early revisits and improve transitional care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108853"},"PeriodicalIF":3.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079258","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}