Pub Date : 2026-03-01Epub Date: 2026-01-21DOI: 10.1016/j.maturitas.2026.108836
Amandine André , Olivier Brière , Léa Bourreau , Solène Tridon , Mathilde Petit , Cédric Annweiler , Mathieu Corvaisier
Background
Intravenous acyclovir is the recommended treatment for suspected viral meningoencephalitis, but it may induce acute kidney injury. Evidence in very old adults is limited, particularly regarding the role of frailty in renal vulnerability.
Methods
We conducted a retrospective cohort study of adults aged 75 years or more who received intravenous acyclovir for suspected meningoencephalitis at a single university hospital between November 2021 and December 2024. Frailty was assessed using the 9-point Clinical Frailty Scale, with frailty defined as a score of 4 or higher. The primary outcome was acute kidney injury occurring within seven days of acyclovir initiation, identified according to international consensus criteria based on changes in serum creatinine levels. Logistic regression models were used to examine factors associated with acute kidney injury.
Results
Among 139 included patients (median age 83 years; 38% women), 31% developed acute kidney injury within seven days. Frailty was present in 60% of the cohort and was more frequent among those who developed acute kidney injury (79% vs. 52%, p = 0.004). Age, sex, comorbidity burden, baseline renal impairment, excessive acyclovir dosing, prolonged treatment, and use of three or more nephrotoxic medications were not significantly associated with the outcome.
Conclusion
In adults aged 75 years or more treated with intravenous acyclovir for suspected meningoencephalitis, frailty was a strong and independent predictor of acute kidney injury, whereas chronological age and baseline renal function were not. Incorporating frailty assessment into clinical decision-making may help identify patients at higher risk and guide preventive strategies.
{"title":"Risk factors for acute kidney injury associated with intravenous acyclovir in older adults: ACICLOAGED study","authors":"Amandine André , Olivier Brière , Léa Bourreau , Solène Tridon , Mathilde Petit , Cédric Annweiler , Mathieu Corvaisier","doi":"10.1016/j.maturitas.2026.108836","DOIUrl":"10.1016/j.maturitas.2026.108836","url":null,"abstract":"<div><h3>Background</h3><div>Intravenous acyclovir is the recommended treatment for suspected viral meningoencephalitis, but it may induce acute kidney injury. Evidence in very old adults is limited, particularly regarding the role of frailty in renal vulnerability.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adults aged 75 years or more who received intravenous acyclovir for suspected meningoencephalitis at a single university hospital between November 2021 and December 2024. Frailty was assessed using the 9-point Clinical Frailty Scale, with frailty defined as a score of 4 or higher. The primary outcome was acute kidney injury occurring within seven days of acyclovir initiation, identified according to international consensus criteria based on changes in serum creatinine levels. Logistic regression models were used to examine factors associated with acute kidney injury.</div></div><div><h3>Results</h3><div>Among 139 included patients (median age 83 years; 38% women), 31% developed acute kidney injury within seven days. Frailty was present in 60% of the cohort and was more frequent among those who developed acute kidney injury (79% vs. 52%, <em>p</em> = 0.004). Age, sex, comorbidity burden, baseline renal impairment, excessive acyclovir dosing, prolonged treatment, and use of three or more nephrotoxic medications were not significantly associated with the outcome.</div></div><div><h3>Conclusion</h3><div>In adults aged 75 years or more treated with intravenous acyclovir for suspected meningoencephalitis, frailty was a strong and independent predictor of acute kidney injury, whereas chronological age and baseline renal function were not. Incorporating frailty assessment into clinical decision-making may help identify patients at higher risk and guide preventive strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108836"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079308","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}
Pub Date : 2026-03-01Epub Date: 2026-01-22DOI: 10.1016/j.maturitas.2026.108828
Taifeng Chen , Yaqin Su , Li Yang , Minqi Gu , Jinliang Liang , Kexin Li , Yihao Shu , Kaixin Chen , Jinyuan Pang , Dongsheng Hu , Fulan Hu , Ming Zhang
Objective
To investigate the independent and joint effects of leukocyte telomere length and score on the Life's Essential 8 scale on type 2 diabetes mellitus risk using UK Biobank data.
Methods
A total of 309,288 participants without type 2 diabetes mellitus at baseline were included. Leukocyte telomere length was categorized into quartiles (Q1-Q4), and Life's Essential 8 scores into three groups: low (< 50 points), intermediate (50–79 points) and high (≥ 80 points). Cox proportional-hazards models were used to estimate hazard ratios (HRs) for T2DM. Multiplicative and additive models assessed interactions between leukocyte telomere length and Life's Essential 8 score.
Results
Over a median follow-up of 13.33 years, 9830 participants developed T2DM. Compared with group Q1, the risk of T2DM was reduced by 7% (HR = 0.93, 95%CI: 0.88, 0.99) in the Q4 group. Compared with the low Life's Essential 8 score group, the risk of T2DM was reduced by 70% (HR = 0.30, 95%CI: 0.29, 0.31) and 93% (HR = 0.07, 95%CI: 0.06, 0.08) in the intermediate and high score groups, respectively. The group with long leukocyte telomere length and high Life's Essential 8 score had the most significant reduction in T2DM risk compared with the group with short leukocyte telomere length and low Life's Essential 8 score (HR = 0.07, 95%CI: 0.05, 0.08). Both multiplicative (Pinteraction < 0.001) and additive interactions (S = 1.12, 95%CI: 1.01, 1.25) were observed between the effects of leukocyte telomere length and Life's Essential 8 score on T2DM.
Conclusion
Elevated leukocyte telomere length and Life's Essential 8 scores synergistically reduce T2DM risk beyond their individual effects, underscoring the importance of integrated strategies that simultaneously target leukocyte telomere length maintenance and the optimization of cardiovascular-metabolic health in the prevention of T2DM.
{"title":"Independent and interaction effects of telomere length and life's essential 8 score on the risk of type 2 diabetes mellitus: Findings from a large prospective cohort study","authors":"Taifeng Chen , Yaqin Su , Li Yang , Minqi Gu , Jinliang Liang , Kexin Li , Yihao Shu , Kaixin Chen , Jinyuan Pang , Dongsheng Hu , Fulan Hu , Ming Zhang","doi":"10.1016/j.maturitas.2026.108828","DOIUrl":"10.1016/j.maturitas.2026.108828","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the independent and joint effects of leukocyte telomere length and score on the Life's Essential 8 scale on type 2 diabetes mellitus risk using UK Biobank data.</div></div><div><h3>Methods</h3><div>A total of 309,288 participants without type 2 diabetes mellitus at baseline were included. Leukocyte telomere length was categorized into quartiles (Q1-Q4), and Life's Essential 8 scores into three groups: low (< 50 points), intermediate (50–79 points) and high (≥ 80 points). Cox proportional-hazards models were used to estimate hazard ratios (HRs) for T2DM. Multiplicative and additive models assessed interactions between leukocyte telomere length and Life's Essential 8 score.</div></div><div><h3>Results</h3><div>Over a median follow-up of 13.33 years, 9830 participants developed T2DM. Compared with group Q1, the risk of T2DM was reduced by 7% (HR = 0.93, 95%CI: 0.88, 0.99) in the Q4 group. Compared with the low Life's Essential 8 score group, the risk of T2DM was reduced by 70% (HR = 0.30, 95%CI: 0.29, 0.31) and 93% (HR = 0.07, 95%CI: 0.06, 0.08) in the intermediate and high score groups, respectively. The group with long leukocyte telomere length and high Life's Essential 8 score had the most significant reduction in T2DM risk compared with the group with short leukocyte telomere length and low Life's Essential 8 score (HR = 0.07, 95%CI: 0.05, 0.08). Both multiplicative (<em>P</em><sub>interaction</sub> < 0.001) and additive interactions (S = 1.12, 95%CI: 1.01, 1.25) were observed between the effects of leukocyte telomere length and Life's Essential 8 score on T2DM.</div></div><div><h3>Conclusion</h3><div>Elevated leukocyte telomere length and Life's Essential 8 scores synergistically reduce T2DM risk beyond their individual effects, underscoring the importance of integrated strategies that simultaneously target leukocyte telomere length maintenance and the optimization of cardiovascular-metabolic health in the prevention of T2DM.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108828"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079259","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}
Pub Date : 2026-03-01Epub Date: 2026-01-24DOI: 10.1016/j.maturitas.2026.108855
Félix Ayala , Juan E. Blümel , María S. Vallejo , Peter Chedraui , Hugo Gutiérrez-Crespo , Marcela López , Juan Matzumura-Kasana , Paolo Meza , Álvaro Monterrosa-Castro , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Ana Lucia Ribeiro Valadares , Doris Rodríguez-Vidal , Marcio A.H. Rodrigues , Javier Saavedra , Carlos Salinas , Lida Sosa , Konstantinos Tserotas , Margot Acuña-San Martín , Gustavo Gómez-Tabares
Background
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.
Objective
To examine the association between physical activity, menopausal symptoms, and the use of menopausal hormone therapy in women with primary ovarian insufficiency.
Methods
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.
Results
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.
Conclusions
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.
研究背景：体育活动可以缓解45岁以后绝经的妇女的更年期症状；然而，它对40岁以前发生的原发性卵巢功能不全的影响尚不清楚。目的探讨原发性卵巢功能不全妇女体力活动、更年期症状和绝经期激素治疗的相关性。方法：我们分析了来自12个拉丁美洲国家的两项研究的4708名参与者的数据。应用资格标准后，纳入564名原发性卵巢功能不全妇女（351名特发性和213名手术性）。使用有效的量表评估更年期症状，根据确定的临界值定义严重症状。体育活动是根据国际上对中等强度活动的建议进行分类的。根据社会人口学、临床和生活方式变量调整逻辑回归模型。结果原发性卵巢功能不全和特发性卵巢功能不全的发生率为39.2%，差异无统计学意义。症状严重的妇女不太可能达到推荐的体力活动水平，也不太可能目前使用更年期激素治疗。在调整后的模型中，有规律的身体活动（OR 0.65; 95% CI 0.45-0.94）和目前使用更年期激素治疗（OR 0.27; 0.17-0.42）与较低的严重症状可能性相关，而肥胖和使用精神药物与较高的可能性相关。结论：原发性卵巢功能不全的妇女经常进行体育锻炼或正在接受更年期激素治疗，其更年期症状较轻。对于不能或不喜欢使用激素治疗的女性来说，定期锻炼可能是一个重要的非激素选择。
{"title":"Physical activity as an alternative or adjunct to menopausal hormone therapy for symptom management in women with primary ovarian insufficiency","authors":"Félix Ayala , Juan E. Blümel , María S. Vallejo , Peter Chedraui , Hugo Gutiérrez-Crespo , Marcela López , Juan Matzumura-Kasana , Paolo Meza , Álvaro Monterrosa-Castro , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Ana Lucia Ribeiro Valadares , Doris Rodríguez-Vidal , Marcio A.H. Rodrigues , Javier Saavedra , Carlos Salinas , Lida Sosa , Konstantinos Tserotas , Margot Acuña-San Martín , 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":"2026-03-01","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}
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.
Methods
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.
Results
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 MSH6 (OR = 1.46, 95% CrI 1.02–2.04) and reduced risk with PMS2, 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, PMS2 (OR = 1.52, 95% CI 1.02–2.25) and MSH6 (OR = 2.27, 95% CrI 1.08–2.49) were associated with higher risk, while MLH1 and MSH2 carried significantly lower risk.
Conclusions
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 MSH6 and PMS2 carriers, but conflicting evidence from large perspective databases prevents definitive conclusions about breast cancer as part of the Lynch syndrome spectrum.
{"title":"Gene-specific cancer risks in female Lynch syndrome carriers: A copula-based meta-analysis","authors":"Raheleh Karimi , Iraj Kazemi , Marjan Mansourian , Hamid Reza Marateb , 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":"2026-03-01","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}
As global aging accelerates, cognitive decline is a major public health concern. Natural menopause, characterized by a sharp decline in endogenous estrogen, is a hypothesized modulator of long-term cognitive health, yet epidemiological evidence remains inconsistent. This study aimed to clarify the cross-sectional and longitudinal associations between age at natural menopause and cognitive function using data from the English Longitudinal Study of Aging (ELSA).
Methods
This study included 3712 postmenopausal women aged ≥50 years from the English Longitudinal Study of Aging Wave 4 (2008–2009), with follow-up until Wave 9. The primary exposure was self-reported age at natural menopause. Cognitive function (memory, executive function, orientation) was synthesized into a global z-score. Multiple linear regression (cross-sectional) and linear mixed-effects models (longitudinal) were employed, with sequential adjustment for sociodemographic, lifestyle, and health-related covariates.
Results
In these 3712 postmenopausal women, later age at menopause was consistently associated with better global cognitive function. Cross-sectionally, each additional year was linked to higher cognitive scores (β = 0.058, P < 0.001). Longitudinally, each year was associated with improved cognitive performance (β = 0.008, 95% CI 0.002–0.015, P = 0.014), with the latest menopause quartile (Q4) significantly outperforming the earliest (Q1) (β = 0.100, 95% CI 0.010–0.189, P = 0.030). Subgroup and sensitivity analyses corroborated the robustness of the primary findings.
Conclusion
This study found that a later age at menopause correlates with improved cognitive abilities.
{"title":"Cognitive function in relation to age at menopause: Insights from the English longitudinal study of aging","authors":"Jiawei Zhai , Jinglei Huang , Yuou Chen , Ting Qiu , Huishu Liu","doi":"10.1016/j.maturitas.2026.108857","DOIUrl":"10.1016/j.maturitas.2026.108857","url":null,"abstract":"<div><h3>Background</h3><div>As global aging accelerates, cognitive decline is a major public health concern. Natural menopause, characterized by a sharp decline in endogenous estrogen, is a hypothesized modulator of long-term cognitive health, yet epidemiological evidence remains inconsistent. This study aimed to clarify the cross-sectional and longitudinal associations between age at natural menopause and cognitive function using data from the English Longitudinal Study of Aging (ELSA).</div></div><div><h3>Methods</h3><div>This study included 3712 postmenopausal women aged ≥50 years from the English Longitudinal Study of Aging Wave 4 (2008–2009), with follow-up until Wave 9. The primary exposure was self-reported age at natural menopause. Cognitive function (memory, executive function, orientation) was synthesized into a global z-score. Multiple linear regression (cross-sectional) and linear mixed-effects models (longitudinal) were employed, with sequential adjustment for sociodemographic, lifestyle, and health-related covariates.</div></div><div><h3>Results</h3><div>In these 3712 postmenopausal women, later age at menopause was consistently associated with better global cognitive function. Cross-sectionally, each additional year was linked to higher cognitive scores (β = 0.058, <em>P</em> < 0.001). Longitudinally, each year was associated with improved cognitive performance (β = 0.008, 95% CI 0.002–0.015, <em>P</em> = 0.014), with the latest menopause quartile (Q4) significantly outperforming the earliest (Q1) (β = 0.100, 95% CI 0.010–0.189, <em>P</em> = 0.030). Subgroup and sensitivity analyses corroborated the robustness of the primary findings.</div></div><div><h3>Conclusion</h3><div>This study found that a later age at menopause correlates with improved cognitive abilities.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108857"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121457","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}
Pub Date : 2026-03-01Epub Date: 2026-02-02DOI: 10.1016/j.maturitas.2026.108864
Jiao-Jiao Ren , Zhi-Hao Li , Wen-Fang Zhong , Jian Gao , Pei-Liang Chen , Xiao-Meng Wang , Fang-Fei You , Chen Mao
Objectives
Serum 25-hydroxyvitamin D concentrations have been associated with the risk of dementia, but the results are inconsistent. Previous studies have reported that vitamin D metabolism is related to sleep characteristics. We investigated the association between serum 25-hydroxyvitamin D concentrations and the risk of dementia, as well as whether sleep characteristics and sleep patterns modified this association.
Study design
In this prospective population-based cohort study, serum 25-hydroxyvitamin D concentrations were measured. Sleep characteristics, including sleep duration, chronotype, sleeplessness, snoring, and daytime sleepiness, were integrated to generate an overall sleep pattern. We used a multivariable adjusted Cox proportional hazards regression model to evaluate the association of serum 25-hydroxyvitamin D concentrations with the risk of incident dementia.
Results
Over a median follow-up of 13.7 years, there were 7030 cases of all-cause dementia, including 3089 of Alzheimer's disease and 1539 of vascular dementia in the cohort of 366,160 participants. Higher concentrations of serum 25-hydroxyvitamin D were associated with a lower risk of all-cause dementia, Alzheimer's disease and vascular dementia. We found a statistically significant interaction of modest magnitude between serum 25-hydroxyvitamin D concentrations and sleep patterns with the risk of vascular dementia (P interaction = 0.04). Among the sleep characteristics, an interaction was found between serum 25-hydroxyvitamin D concentrations and daytime sleepiness in their effect on the risk of vascular dementia (P interaction = 0.03). The protective hazard ratios for vascular dementia were more pronounced in individuals with low daytime sleepiness than in those with high daytime sleepiness.
Conclusions
Serum 25-hydroxyvitamin D concentrations were inversely associated with the risks of all-cause dementia, Alzheimer's disease and vascular dementia. Sleep characteristics, particularly daytime sleepiness, may modify the association between serum 25-hydroxyvitamin D concentrations and the risk of vascular dementia.
{"title":"Serum 25-hydroxyvitamin D concentrations, sleep characteristics and the risk of incident dementia","authors":"Jiao-Jiao Ren , Zhi-Hao Li , Wen-Fang Zhong , Jian Gao , Pei-Liang Chen , Xiao-Meng Wang , Fang-Fei You , Chen Mao","doi":"10.1016/j.maturitas.2026.108864","DOIUrl":"10.1016/j.maturitas.2026.108864","url":null,"abstract":"<div><h3>Objectives</h3><div>Serum 25-hydroxyvitamin D concentrations have been associated with the risk of dementia, but the results are inconsistent. Previous studies have reported that vitamin D metabolism is related to sleep characteristics. We investigated the association between serum 25-hydroxyvitamin D concentrations and the risk of dementia, as well as whether sleep characteristics and sleep patterns modified this association.</div></div><div><h3>Study design</h3><div>In this prospective population-based cohort study, serum 25-hydroxyvitamin D concentrations were measured. Sleep characteristics, including sleep duration, chronotype, sleeplessness, snoring, and daytime sleepiness, were integrated to generate an overall sleep pattern. We used a multivariable adjusted Cox proportional hazards regression model to evaluate the association of serum 25-hydroxyvitamin D concentrations with the risk of incident dementia.</div></div><div><h3>Results</h3><div>Over a median follow-up of 13.7 years, there were 7030 cases of all-cause dementia, including 3089 of Alzheimer's disease and 1539 of vascular dementia in the cohort of 366,160 participants. Higher concentrations of serum 25-hydroxyvitamin D were associated with a lower risk of all-cause dementia, Alzheimer's disease and vascular dementia. We found a statistically significant interaction of modest magnitude between serum 25-hydroxyvitamin D concentrations and sleep patterns with the risk of vascular dementia (P interaction = 0.04). Among the sleep characteristics, an interaction was found between serum 25-hydroxyvitamin D concentrations and daytime sleepiness in their effect on the risk of vascular dementia (P interaction = 0.03). The protective hazard ratios for vascular dementia were more pronounced in individuals with low daytime sleepiness than in those with high daytime sleepiness.</div></div><div><h3>Conclusions</h3><div>Serum 25-hydroxyvitamin D concentrations were inversely associated with the risks of all-cause dementia, Alzheimer's disease and vascular dementia. Sleep characteristics, particularly daytime sleepiness, may modify the association between serum 25-hydroxyvitamin D concentrations and the risk of vascular dementia.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108864"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121508","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}
Pub Date : 2026-03-01Epub Date: 2026-01-21DOI: 10.1016/j.maturitas.2026.108840
Melkamu Tamir Hunegnaw , Jakub Mesinovic , Paul Jansons , Elena S. George , Belinda De Ross , Nicole Kiss , Peter R. Ebeling , Robin M. Daly , Eugene Gvozdenko , David Scott
Objective
To determine the effects of a digital voice assistant-delivered self-management program on dietary behaviours for supporting musculoskeletal health in postmenopausal women with osteoporosis.
Methods
This was a secondary analysis of a 12-month randomised controlled feasibility trial evaluating the feasibility and effectiveness of a digital voice assistant intervention to support osteoporosis-related health behaviours, with 50 participants randomly assigned to a digital voice assistant intervention (N = 25) or control group (N = 25) for a 6-month intervention and an additional 6-month maintenance period. During the intervention period, the digital voice assistant group received videos focused on dairy foods, dairy alternatives, protein, calcium and vitamin D, via a digital voice assistant device located in their home. The control group received six emails with weblinks to osteoporosis information. Dietary intakes were assessed at baseline, 6 and 12 months via three-day food records.
Results
Participants (mean age 64.3 ± 6.1 years) accessed approximately 80% of prescribed videos during the intervention. There were no significant within- or between-group changes in protein or calcium intakes at 6 or 12 months. Daily low-fat milk and egg servings increased in the digital voice assistant group compared with controls from baseline to 12 months (P = 0.02).
Conclusions
A digital voice assistant-delivered intervention, including osteoporosis-related nutrition information, resulted in small increases in the consumption of low-fat milk and eggs, but did not increase habitual protein or calcium intake in women with osteoporosis. Adequately powered trials are required to determine whether similar digital health interventions are effective for improving dietary behaviours in this population.
{"title":"Effects of a digital voice assistant-delivered osteoporosis self-management program on diet in postmenopausal women with osteoporosis: A secondary analysis of a 12-month feasibility randomised controlled trial","authors":"Melkamu Tamir Hunegnaw , Jakub Mesinovic , Paul Jansons , Elena S. George , Belinda De Ross , Nicole Kiss , Peter R. Ebeling , Robin M. Daly , Eugene Gvozdenko , David Scott","doi":"10.1016/j.maturitas.2026.108840","DOIUrl":"10.1016/j.maturitas.2026.108840","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effects of a digital voice assistant-delivered self-management program on dietary behaviours for supporting musculoskeletal health in postmenopausal women with osteoporosis.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of a 12-month randomised controlled feasibility trial evaluating the feasibility and effectiveness of a digital voice assistant intervention to support osteoporosis-related health behaviours, with 50 participants randomly assigned to a digital voice assistant intervention (<em>N</em> = 25) or control group (N = 25) for a 6-month intervention and an additional 6-month maintenance period. During the intervention period, the digital voice assistant group received videos focused on dairy foods, dairy alternatives, protein, calcium and vitamin D, via a digital voice assistant device located in their home. The control group received six emails with weblinks to osteoporosis information. Dietary intakes were assessed at baseline, 6 and 12 months via three-day food records.</div></div><div><h3>Results</h3><div>Participants (mean age 64.3 ± 6.1 years) accessed approximately 80% of prescribed videos during the intervention. There were no significant within- or between-group changes in protein or calcium intakes at 6 or 12 months. Daily low-fat milk and egg servings increased in the digital voice assistant group compared with controls from baseline to 12 months (<em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>A digital voice assistant-delivered intervention, including osteoporosis-related nutrition information, resulted in small increases in the consumption of low-fat milk and eggs, but did not increase habitual protein or calcium intake in women with osteoporosis. Adequately powered trials are required to determine whether similar digital health interventions are effective for improving dietary behaviours in this population.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108840"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038952","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}
Pub Date : 2026-03-01Epub Date: 2026-01-10DOI: 10.1016/j.maturitas.2026.108825
Jinzhu Yang , Mingyue Gao , Linjun Jiang , Yue Li , Lingxiao He
Background
Frailty is an ageing-related health condition, but it is not restricted to older adults. Understanding the characteristics of frailty transitions and relevant factors in midlife would benefit frailty prevention and management later in life.
Methods
Data on 3405 participants aged between 50 and 64 were selected from the English Longitudinal Study of Ageing (ELSA) across six waves (2008–2018). Frailty status at each wave was evaluated by a 52-item frailty index (FI), defining frailty as FI ≥ 0.25, pre-frailty as FI ≥ 0.12 and robustness as FI < 0.12. Multi-state Markov models were constructed to explore frailty transitions, and socioeconomic, behavioral and nutritional factors related to changes in frailty status.
Results
The incidence and improvement rates of frailty were 5.23 and 1.15 per 100 person-years, respectively. Among socioeconomic factors, high gross wealth (HR = 1.61, 95%CI [1.12, 2.33]) increased the likelihood of transition from frailty to pre-frailty. Among behavioral factors, using the internet (HR = 0.65, 95%CI [0.53, 0.80]) inhibited the progression from robustness to pre-frailty. Regular alcohol consumption (HR = 1.55, 95%CI [1.14, 2.11]) promoted a shift from pre-frailty to robustness. Living with others (HR = 0.52, 95%CI [0.39, 0.69]) and participating in voluntary activities (HR = 0.86, 95%CI [0.80, 0.94]) lessened progression from pre-frailty to frailty. Moderate (HR = 2.49, 95%CI [1.50, 4.14]) and vigorous (HR = 2.93, 95%CI [1.42, 6.07]) physical activity promoted the transition from frailty to pre-frailty. Among nutrition-related factors, high hemoglobin concentration (HR = 0.15, 95%CI [0.05, 0.47]) inhibited the development from robustness to frailty.
Conclusion
Encouraging healthy lifestyle, active social participation, and balanced nutrition may be beneficial to middle-aged people in diminishing the development of frailty.
{"title":"Frailty transitions and relevant factors in midlife: A longitudinal analysis of the ELSA cohort with multi-state Markov models","authors":"Jinzhu Yang , Mingyue Gao , Linjun Jiang , Yue Li , Lingxiao He","doi":"10.1016/j.maturitas.2026.108825","DOIUrl":"10.1016/j.maturitas.2026.108825","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is an ageing-related health condition, but it is not restricted to older adults. Understanding the characteristics of frailty transitions and relevant factors in midlife would benefit frailty prevention and management later in life.</div></div><div><h3>Methods</h3><div>Data on 3405 participants aged between 50 and 64 were selected from the English Longitudinal Study of Ageing (ELSA) across six waves (2008–2018). Frailty status at each wave was evaluated by a 52-item frailty index (FI), defining frailty as FI ≥ 0.25, pre-frailty as FI ≥ 0.12 and robustness as FI < 0.12. Multi-state Markov models were constructed to explore frailty transitions, and socioeconomic, behavioral and nutritional factors related to changes in frailty status.</div></div><div><h3>Results</h3><div>The incidence and improvement rates of frailty were 5.23 and 1.15 per 100 person-years, respectively. Among socioeconomic factors, high gross wealth (HR = 1.61, 95%CI [1.12, 2.33]) increased the likelihood of transition from frailty to pre-frailty. Among behavioral factors, using the internet (HR = 0.65, 95%CI [0.53, 0.80]) inhibited the progression from robustness to pre-frailty. Regular alcohol consumption (HR = 1.55, 95%CI [1.14, 2.11]) promoted a shift from pre-frailty to robustness. Living with others (HR = 0.52, 95%CI [0.39, 0.69]) and participating in voluntary activities (HR = 0.86, 95%CI [0.80, 0.94]) lessened progression from pre-frailty to frailty. Moderate (HR = 2.49, 95%CI [1.50, 4.14]) and vigorous (HR = 2.93, 95%CI [1.42, 6.07]) physical activity promoted the transition from frailty to pre-frailty. Among nutrition-related factors, high hemoglobin concentration (HR = 0.15, 95%CI [0.05, 0.47]) inhibited the development from robustness to frailty.</div></div><div><h3>Conclusion</h3><div>Encouraging healthy lifestyle, active social participation, and balanced nutrition may be beneficial to middle-aged people in diminishing the development of frailty.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108825"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928782","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}
Pub Date : 2026-03-01Epub Date: 2025-09-15DOI: 10.1016/j.maturitas.2025.108729
Y. Celik , A. Godfrey
{"title":"Ubiquitous monitoring of the environment and menopause","authors":"Y. Celik , A. Godfrey","doi":"10.1016/j.maturitas.2025.108729","DOIUrl":"10.1016/j.maturitas.2025.108729","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108729"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088691","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}
Pub Date : 2026-03-01Epub Date: 2026-01-18DOI: 10.1016/j.maturitas.2026.108835
Log Young Kim , Jin-Sung Yuk
Objective
To examine associations between reproductive factors and the risk of pelvic organ prolapse in postmenopausal women.
Study design
This nationwide retrospective cohort study included postmenopausal women aged 40 to 79 years who participated in a national health screening program in the period 2009–2012 in Korea. Participants were followed until 2022.
Main outcome measures
Clinically treated pelvic organ prolapse, defined by concurrent diagnosis and procedure codes (surgery or pessary).
Results
Among 3,743,520 women, 34,792 (0.9%) developed pelvic organ prolapse during a median follow-up of 10 years, corresponding to an incidence rate of 938 per 100,000 person-years. In fully adjusted models, having two or more births was the strongest predictor of pelvic organ prolapse (hazard ratio 1.751; 95% confidence interval 1.561–1.963). Breastfeeding ≥12 months (hazard ratio 1.297; 95% confidence interval 1.228–1.369), oral contraceptive use ≥1 year (hazard ratio 1.067; 95% confidence interval 1.024–1.112), menopausal hormone therapy for 2–4 years (hazard ratio 1.083; 95% confidence interval 1.022–1.147), age at menopause ≥55 years (hazard ratio 1.064; 95% confidence interval 1.031–1.098), and reproductive span ≥40 years (hazard ratio 1.169; 95% confidence interval 1.112–1.229) were each modestly associated with increased risk of pelvic organ prolapse. Age at menarche showed no association. Trends across exposure categories were significant for all factors except menarche. In women with parity 0 or 1, most reproductive factors were unrelated to pelvic organ prolapse, but prolonged breastfeeding (≥12 months) had a significant association (hazard ratio 1.348; 95% confidence interval 1.164–1.561).
Conclusion
Having multiple births and prolonged breastfeeding are key independent risk factors for pelvic organ prolapse in postmenopausal women. Other reproductive and hormonal factors have only minor effects.
{"title":"Reproductive factors and the risk of pelvic organ prolapse in postmenopausal women: A nationwide cohort study","authors":"Log Young Kim , Jin-Sung Yuk","doi":"10.1016/j.maturitas.2026.108835","DOIUrl":"10.1016/j.maturitas.2026.108835","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations between reproductive factors and the risk of pelvic organ prolapse in postmenopausal women.</div></div><div><h3>Study design</h3><div>This nationwide retrospective cohort study included postmenopausal women aged 40 to 79 years who participated in a national health screening program in the period 2009–2012 in Korea. Participants were followed until 2022.</div></div><div><h3>Main outcome measures</h3><div>Clinically treated pelvic organ prolapse, defined by concurrent diagnosis and procedure codes (surgery or pessary).</div></div><div><h3>Results</h3><div>Among 3,743,520 women, 34,792 (0.9%) developed pelvic organ prolapse during a median follow-up of 10 years, corresponding to an incidence rate of 938 per 100,000 person-years. In fully adjusted models, having two or more births was the strongest predictor of pelvic organ prolapse (hazard ratio 1.751; 95% confidence interval 1.561–1.963). Breastfeeding ≥12 months (hazard ratio 1.297; 95% confidence interval 1.228–1.369), oral contraceptive use ≥1 year (hazard ratio 1.067; 95% confidence interval 1.024–1.112), menopausal hormone therapy for 2–4 years (hazard ratio 1.083; 95% confidence interval 1.022–1.147), age at menopause ≥55 years (hazard ratio 1.064; 95% confidence interval 1.031–1.098), and reproductive span ≥40 years (hazard ratio 1.169; 95% confidence interval 1.112–1.229) were each modestly associated with increased risk of pelvic organ prolapse. Age at menarche showed no association. Trends across exposure categories were significant for all factors except menarche. In women with parity 0 or 1, most reproductive factors were unrelated to pelvic organ prolapse, but prolonged breastfeeding (≥12 months) had a significant association (hazard ratio 1.348; 95% confidence interval 1.164–1.561).</div></div><div><h3>Conclusion</h3><div>Having multiple births and prolonged breastfeeding are key independent risk factors for pelvic organ prolapse in postmenopausal women. Other reproductive and hormonal factors have only minor effects.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108835"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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