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AIM: This study aimed to compare the effects of Ballroom Dancing (BD) versus Walking Training (WT) on the physical fitness performance in physically independent older women with adequate or inadequate levels of vitamins B12 and D. METHODS: Forty-three sedentary women aged 68.5 ± 6.5 years, were allocated to the BD (n = 23) or WT (n = 20) groups. They took part in a 12-week intervention, performed 3 times a week, for about 50 minutes with moderate effort intensity. Data were collected through Short Physical Performance Battery (SPPB), 6 minutes Walk Test (6MWT), Hand Grip Test (HGT), Isokinetic tests for lower limbs and blood tests to detect serum levels of vitamins B12 and D. RESULTS: The BD group performed better after the intervention in relation to the WT in the Sit and Stand Test (SST) (BD pre = 3.1 score vs post = 3.8 score; WT pre = 2.8 score vs post = 3.4 score; P = .02) and in the Peak Torque 180° extension (PKTOQ 180° extension) (BD pre = 56.7 Nm vs post = 61.2 Nm, WT pre = 56.7 Nm vs post = 56.1; P < .01). CONCLUSION: A time effect was observed in all other variables, with the exception of HGT. Both interventions improved physical fitness performance, regardless of the adequacy of vitamins B12 and D, but the older women from BD obtained significant improvements in more variables than the WT.

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The objectives of this study were: 1) to estimate the prevalence of child abuse (CA), intimate partner violence (IPV), and elder abuse (EA) in a representative sample of older Mexican women by status, type, and cause of disability; and 2) to examine the associations of EA with CA, IPV, and disability status. We conducted a secondary data analysis of 21,718 women aged 60 years and older. Older women with disabilities had higher prevalences of CA, IPV, and EA than those with some difficulties or without disabilities. In older women whose disability was acquired at birth or due to aggression, this prevalence was especially high. Older women with disabilities and a history of CA and IPV were twice as likely to suffer EA. Policymakers and government leaders should incorporate the matter of violence against women with disabilities into their public agendas. This should be done while considering the women's various disabilities and causes of disability.

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BACKGROUND: Several factors have been found to defend against pathologic cognitive decline in aging (i.e., cognitive reserve [CR]); however, other factors, including subjective memory complaints (SMC) and decreased functionality are considered early indicators of underlying neurocognitive dysfunction. Despite these known associations, the relationship between the presence of CR and SMC remains equivocal. This study sought to determine the relationship between objectively measured CR and SMC in a sample of functionally independent older women. METHODS: This cross-sectional study recruited women aged ≥60 years who attended fitness or continuing education programs at the University for Seniors in Mexico City. Participants underwent a battery of physical and cognitive evaluations, including the Cognitive Reserve Questionnaire (CRQ), and were asked probing questions used to identify the presence of SMC. RESULTS: The 269 participants had a median age of 69 years; most were single (40.5 %), lived alone (32.7 %), retired (58.2 %), well-educated (≥12 years of education), and functionally independent (89.2 %). 62 % scored "high" on the CRQ, while 9.3 % scored "low". After adjusting for multiple covariates, an independent association between CRQ score and the probability to have SMC was found (adjusted OR = 0.87, 95% CI 0.80-0.95, p-value = 0.002). CONCLUSIONS: This study identified a relationship between low CR and the presence of SMC, independently of the cognitive function and motoric marker of muscle strength (i.e., low gait speed and handgrip strength) in functionally independent older women over 60y. This relationship remains independent of other variables such as age, symptoms of depression and instrumented activities of daily living.

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This interpretive qualitative study explores the lived experience of intimate partner violence (IPV) among 12 older Mexican-American women aged 55-85 with past experiences of IPV to understand how it shaped their lives. Sociocultural factors that influenced the IPV experience and sustained health amidst adversity were explored. Denzin's interpretive interactionism along with Antonovsky's salutogenic theory guided this study. These women survived IPV and discovered ways to foster health and thrive in later years. They all vowed to break the cycle of violence for future generations. Their wisdom offers hope and has implications for healthcare professionals, future research, and advocacy efforts.

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Background: A conservative physiotherapy service development addressed to treat urinary incontinence for older women was studied using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Design: We conducted a pragmatic case study design based on RE-AIM. Settings/participants: Included women ≥ 60 years of age, with self-reported UI symptoms. Results: A total of 34 older women were enrolled in the service with a mean age of 61.53 years. There was a significant improvement in the strength of the pelvic floor muscles, power, endurance, and fast contraction capacity after the intervention, however, it was observed a high dropout rate. Program implementation was supported by Physical Therapy teams who engaged in care coordination. The program has been maintained for over 4 years. Conclusion: Our findings demonstrate that UI patients would benefit from physiotherapy treatment and that this intervention is feasible. This RE-AIM evaluation provides lessons learned and strategies for future adoption, implementation, and maintenance of a Physical Therapy pelvic service.

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Background: Pre-diabetes precedes Diabetes Mellitus (DM) disease and is a critical period for hyperglycemia treatment, especially for menopausal women, considering all metabolic alterations due to hormonal changes. Recently, the literature has demonstrated the role of physical exercise in epigenetic reprogramming to modulate the gene expression patterns of metabolic conditions, such as hyperglycemia, and prevent DM development. In the present study, we hypothesized that physical exercise training could modify the epigenetic patterns of women with poor glycemic control. Methods: 48 post-menopause women aged 60.3 ± 4.5 years were divided according to their fasting blood glucose levels into two groups: Prediabetes Group, PG (n=24), and Normal Glucose Group, NGG (n=24). All participants performed 14 weeks of physical exercise three times a week. The Infinium Methylation EPIC BeadChip measured the participants' Different Methylated Regions (DMRs). Results: Before the intervention, the PG group had 12 DMRs compared to NGG. After the intervention, five DMRs remained different. Interestingly, when comparing the PG group before and after training, 118 DMRs were found. The enrichment analysis revealed that the genes were related to different biological functions such as energy metabolism, cell differentiation, and tumor suppression. Conclusion: Physical exercise is a relevant alternative in treating hyperglycemia and preventing DM in post-menopause women with poor glycemic control.

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Dietary inflammatory index has been associated with bone loss. In this longitudinal study, we reported that changes in dietary inflammatory index were associated with a reduction in bone mineral density of the total hip and femoral neck in males and females ≥ 45 years, but not in individuals < 45 years. PURPOSE: Previous studies have suggested that an inflammatory environment can affect bone mineral density (BMD). However, most of the studies have been done in postmenopausal women. Thus, longitudinal studies in different age groups and sex are necessary to evaluate the longitudinal association between dietary inflammatory index (DII) and BMD in Mexican adults. METHODS: A total of 1,486 participants of the Health Workers Cohort Study were included in this study. The DII was estimated with data retrieved through a semi-quantitative food frequency questionnaire. Total hip, femoral neck, and lumbar spine BMD were measured by dual-energy X-ray absorptiometry. Linear regression models for cross-sectional associations and fixed effects linear regression models for longitudinal association were estimated, and both models were stratified by sex and age groups (< 45 and ≥ 45 years). RESULTS: We did not observe cross-sectional associations between DII and the different BMD sites at baseline. In contrast, women and men ≥ 45 years in the 25th quartile of changes in DII were associated with a gain of 0.067 g/cm2 and 0.062 g/cm2 of total hip BMD, while those in the 75th quartile of DII was associated with a reduction of - 0.108 g/cm2 and - 0.100 g/cm2, respectively. These results were similar for femoral neck BMD in women. In contrast, we did not observe association with femoral neck BMD in men. We did not observe statistically significant changes for lumbar spine BMD. CONCLUSION: Our data suggest that changes in the DII score are associated with changes in total hip and femoral neck BMD among Mexican population.

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The study aimed to assess the association between body image perception and (dis)satisfaction and the anthropometric profile of older women. Data from 60 women attending a senior community center were analyzed. Body image perception and (dis)satisfaction were considered dependent variables and were assessed using a silhouette scale constructed for the Brazilian population. The independent variables were body mass (BM), body mass index (BMI), waist circumference (WC), and calf circumference (CC). The associations were performed by logistic and linear regression models. Half of the participants overestimated their body size and 61.7% were dissatisfied due to excess weight. Overweight older women had 3.6 times higher odds to overestimate body size and 14.4 higher odds to be dissatisfied due to excess weight compared to normal-weight women. The increase in BM, BMI, WC, and CC raised mean difference between perceived and desired BMI and the odds of dissatisfaction due to excess weight. The anthropometric profile was more important to explain (dis)satisfaction than body size perception. The stimulus to changes that provide the adequacy of the anthropometric profile may reduce dissatisfaction due to excess weight among older women.

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STUDY BACKGROUND: The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada. METHODS: A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada. RESULTS: Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well. CONCLUSION: This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.

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Resumen: La vejez de las mujeres mayores suele ser descrita como una etapa en la que se vivencian múltiples cambios y pérdidas, donde se acrecientan las discriminaciones de género. Sin embargo, poco se ha explorado la experiencia biográfica al envejecer. En este artículo, identificamos como construyen narrativamente trayectorias de acción política mujeres mayores activistas de la Agrupación Bordadoras por la Memoria de la ciudad de Valparaíso-Chile. Realizamos un estudio cualitativo con entrevistas biográficas siguiendo la propuesta de relatos de vida. Sus itinerarios biográficos dan cuenta de un continuum en su acción política y un cuestionamiento al sistema neoliberal. Por medio de sus bordados, contribuyen a la lucha por la memoria y la justicia social. Resignifican su activismo en la vejez, incluyendo nuevos repertorios de acción y proyectos, mediante prácticas de sororidad. Concluimos la importancia de disputar la vejez desde el ciclo vital convencional, dando cabida a trayectorias femeninas agencializadas.

Resumo: A velhice das mulheres idosas é muitas vezes descrita como uma época de múltiplas mudanças, perda e maior discriminação de género. No entanto, pouco tem sido explorado sobre a experiência biográfica do envelhecimento. Neste artigo, identificamos como as mulheres ativistas mais velhas da "Agrupación Bordadoras por la Memoria" na cidade de Valparaíso-Chile constroem trajetórias narrativas de ação política. Realizámos um estudo qualitativo com entrevistas biográficas na sequência da proposta de narrativas de vida. Os seus itinerários biográficos mostram uma continuidade na sua ação política e um questionamento do sistema neoliberal. Através dos seus bordados, elas contribuem para a luta pela memória e justiça social. Dão novo significado ao seu ativismo na velhice, incluindo novos repertórios de ação e projetos, através de práticas de irmandade. Concluímos que é importante contestar a velhice do ciclo de vida convencional, criando espaço para trajetórias femininas agencializadas.

Abstract: Old age among older women is usually described as a stage in which multiple changes, losses and gender discrimination are experienced. However, little has been explored about the biographical experience of aging. In this article, we identify how older women activists of the Agrupación Bordadoras por la Memoria in the city of Valparaíso, Chile, narratively construct trajectories of political action. We conducted a qualitative study with biographical interviews following proposal of life narratives. Their biographical itineraries show a continuum in their political action and a questioning of the neoliberal system. Through their embroideries, they contribute to the struggle for memory and social justice. They re-signify their activism in old age, including new repertoires of action and projects, through practices of sorority. We conclude the importance of disputing old age from the conventional life cycle, making room for agentialized feminine trajectories.

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Aging in women is characterized by extreme hormonal changes leading them to develop a chronic low-grade inflammation that is linked to the development of systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM). In this scenario, physical activity emerges as an interesting methodology, since it seems to be connected to a decrease in serum levels of some pro-inflammatory cytokines. Nevertheless, most studies evaluate these cytokines in an isolated manner not considering the influence of comorbidities on the responsiveness of participants to the benefits of physical activity. So, this study aimed to assess the influence of physical activity on body composition, anthropometric parameters, lipid profile, and inflammatory markers of diabetic and hypertensive older postmenopausal women. We evaluated 163 women aged from 60 to 80 years, diagnosed with T2DM and SAH that were assisted by the Family Health Units in Vitória da Conquista, Bahia, Brazil. The pratice of physical activity was measured by the International Physical Activity Questionnaire with the participants being classified as active or sedentary individuals. Active older women presented better body composition, lipid profile and inflammatory balance. This was connected to a better correlation profile between these factors in active older women, characteristics that were not noticed in sedentary older women. Moreover, IL-17A and the relationship between IL-10 and the other pro-inflammatory cytokines examined was greatly influenced by physical activity. Consequently, physical activity is linked to a global improvement in T2DM and SAH risk factors and with a positive inflammatory modulation in diabetic and hypertensive older women.

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Physical activity is a priority to improve health. However, a sedentary lifestyle is increasingly becoming the norm. For example, in Mexico, sedentarism has increased, especially among older women. This study evaluated the effects of aquafitness on the health of older women in Mexico. Healthy older women performed aquafitness exercise and were compared to a control group of comparable women. Outcome assessments performed at baseline and after 17-weeks included psychological and physical/anthropometric measures. Participants in aquafitness became more optimistic, lost more weight, body fat, and a subsequent decrease in BMI, compared to controls. The results suggest important avenues for future research.

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Women with triple negative breast cancer (TNBC) have a high prevalence of BRCA1 mutations, and current clinical guidelines recommend genetic testing for patients with TNBC aged ≤60 years. However, studies supporting this recommendation have included few older women with TNBC. METHODS: Genetic testing results from women aged >60 years with TNBC enrolled in the Clinical Cancer Genomics Community Research Network (CCGCRN) registry were included in this analysis. Prevalence of breast cancer-associated pathogenic variants (PVs) was compared across age groups. RESULTS: We identified 151 women with TNBC aged >60 years (median 65 years; SD 5.3). Of these, 130 (86%) underwent genetic testing, and a breast cancer-associated PV was identified in 16 (12.3%; 95% CI 7-19): BRCA1 (n = 6), BRCA2 (n = 5), PALB2 (n = 2), ATM (n = 1) and RAD51C (n = 2). We found no differences in the proportion of patients with close blood relatives with breast (≤50 years) or ovarian cancer (any age) between PV carriers (37.5%) and non-carriers (34.2%) (p = 0.79). Among PV's carriers, the proportion of older women with a BRCA1 PV was lower when compared to younger women (37.5% vs 77.2%; p < 0.01). CONCLUSION: Breast cancer-associated PVs were found in an important proportion of women aged >60 years with TNBC undergoing genetic testing, including greater representation of BRCA2. These results suggest that older women with TNBC should be offered genetic testing, and that their exclusion based on chronologic age alone may not be appropriate.

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Objective: It is not known if the intensity in which exergames are performed can change gait parameters at different walking speeds. This study was designed to determine if a training program based on exergame exercises performed at different intensities (moderate vs. vigorous) influences walking speed and gait parameters in older adult women. Methods: After applying the inclusion criteria, 20 participants (69.5 ± 5.4 years) were randomized into two groups: moderate (11-13 perceived exertion) and vigorous (14-16 perceived exertion). Walking speed and gait parameters at self-selected walking speed (SSWS) and maximal walking speed (MWS) were evaluated before and after 3 months of exergame training. The walking speed and gait parameters were measured with an instrumented walkway. The walking speed reserve (WSR) was calculated as a difference and ratio. Results: There was pre-to-post effect of walking speed at self-selected walking pace (pre = 112.1 ± 16.4 cm.s-1; post = 124.8 ± 16.4 cm.s-1), in WSR calculated as ratio (pre = 1.35 ± 0.08; post = 1.28 ± 0.09), in a number of gait parameters at SSWS (step length, stride length, stride velocity, step time, stride time, swing time, stance time, single support, double support, gait cycle time, and cadence) and at MWS (step time, stride time, swing time, single support, double support, gait cycle time, and cadence). Conclusion: Irrespective of the exercise intensity, exergame training improved walking speed only at a self-selected walking pace and some gait parameters at self-selected and MWS in older women.

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BACKGROUND: Caregivers may have a higher risk of cardiovascular diseases and have high rates of anxiety and depression. AIMS: The objective of this study was to evaluate mood, lifestyle and the presence of cardiovascular risk factors in older women caregivers of patients with Alzheimer´s disease (AD) dementia compared to non-caregivers living in the neighborhood. METHODS: Paired case-control (1:1). Volunteers responded to a questionnaire with information about physical and leisure activities, smoking, alcohol use, and daily hours of care. Blood pressure (BP) was measured on 5 days with the Home Blood Pressure Monitoring (HBPM) system, and mood was assessed with the Geriatric Depression Scale (GDS) and Mini International Neuropsychiatric Interview (MINI). Laboratory testing for cardiovascular risk factors was performed. RESULTS: Sixty-two volunteers were evaluated. Total cholesterol levels were higher among caregivers, with an odds ratio (OR) of 3.57 (95% CI 1.2-11, p = 0.03). There was no difference in BP. A positive screening for depression was obtained for 58% of caregivers and for 16% of control subjects (OR = 6.62, 95% CI 1.9-22.6, p < 0.01). The MINI revealed that 38.7% of caregivers had an actual depressive episode as compared to 9.7% of controls (9.7%) (OR = 5.42, 95% CI 1.3-22.7, p = 0.02); 35.5% of caregivers and 6% of controls had a diagnosis of anxiety disorder (OR = 4.79, 95% CI 1.2-19.1, p = 0.03). DISCUSSION: The cardiovascular risk markers and lifestyle were similar in caregivers and non-caregivers, but there was a higher prevalence of depression and anxiety among caregivers. CONCLUSIONS: Older women caregivers of patients with AD have more mental health symptoms and disorders and need to be treated.

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BACKGROUND/OBJECTIVES: Women diagnosed with breast cancer (BC) at an older age are less likely to undergo genetic cancer risk assessment and genetic testing since the guidelines and referrals are biased toward earlier age at diagnosis. Thus, we determined the prevalence and type of pathogenic cancer predisposition variants among women with a history of BC diagnosed at the age of 65 years or older vs younger than 65 years. DESIGN: Prospective registration cohort. SETTING: The Clinical Cancer Genomics Community Research Network, including 40 community-based clinics in the United States and 5 in Latin America. PARTICIPANTS: Women with BC and genetic testing results. MEASUREMENTS: Sociodemographic characteristics, clinical variables, and genetic profiles were compared between women aged 65 years and older and those younger than 65 years at BC diagnosis. RESULTS: Among 588 women diagnosed with BC and aged 65 years and older and 9412 diagnosed at younger than 65 years, BC-associated pathogenic variants (PVs) were detected in 5.6% of those aged 65 years and older (n = 33) and 14.2% of those younger than 65 years (n = 1340) (P < .01). PVs in high-risk genes (eg, BRCA1 and BRCA2) represented 81.1% of carriers among women aged 65 years and older (n = 27) and 93.1% of those younger than 65 years (n = 1248) (P = .01). BRCA2 PVs represented 42.4% of high-risk gene findings for those aged 65 years and older, whereas BRCA1 PVs were most common among carriers younger than 65 years (49.7%). PVs (n = 7) in moderate-risk genes represented 21.2% for carriers aged 65 years and older and 7.3% of those younger than 65 years (n = 98; P < .01). CHEK2 PVs were the most common moderate-risk gene finding in both groups. CONCLUSION: Clinically actionable BC susceptibility PVs, particularly in BRCA2 and CHEK2, were relatively prevalent among older women undergoing genetic testing. The significant burden of PVs for older women with BC provides a critical reminder to recognize the full spectrum of eligibility and provide genetic testing for older women, rather than exclusion based on chronological age alone. J Am Geriatr Soc 67:884-888, 2019.

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BACKGROUND: Osteoarthritis (OA) is a common condition in older adults, with high epidemiological, clinical, and economic burden worldwide. In clinical practice, patients with knee OA often walk with abnormal gait patterns because of pain, stiffness and/or mobility dysfunctions. Therefore, assessing the symmetry of the lower limbs might improve the rehabilitation treatment and prescription of walking devices. AIMS: To compare the symmetry of step length and single support phase between lower limbs during gait of older women with bilateral knee OA and asymptomatic controls, and to verify if there is difference between these two groups in relation to velocity, cadence, step length and single support phase. METHODS: This cross-sectional study included a convenience sample of 66 community-dwelling older women aged ≥ 65 years with a medical diagnosis of symptomatic bilateral knee OA (n = 33) and asymptomatic controls (n = 33), matched by age and body mass index. All gait parameters were obtained using the GAITRite® system. RESULTS: Mean age of the sample was 72.6 ± 4.0 years. Participants with OA walked with lower velocity (p = 0.001), cadence (p = 0.009) and step length bilaterally (both p = 0.001). No significant difference was found between groups in the symmetry of step length between lower limbs, single support phase and symmetry of single support phase between lower limbs. CONCLUSION: Older women with bilateral knee OA walk with lower velocity, cadence and step length, but have the same symmetry in the step length and single support phase between lower limbs as asymptomatic older women.

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BACKGROUND: The maximal one-repetition test (1-RM) is widely used in scientific research; however, there are conflicting results regarding its reproducibility in elderly populations. The present study aimed to analyze the reproducibility of the test both before and after a 12-week training period by using the bench press and leg press 45° 1-RM tests in the elderly, taking into consideration the training experience and strength level of the women. METHODS: Elderly women (n = 376; age, 68.5 ± 14.1 years; height, 162.7 ± 5.5 cm; body mass, 71.2 ± 16.0 kg) who underwent ≥3 months of resistance training performed an initial week of familiarization and a second week of testing and retest, with a 48⁻72 h interval. RESULTS: The results showed that Kappa indices ranged from 0.93 to 0.95, and the intraclass correlation coefficients were 0.99 for both the lower and upper limbs. In addition, minimal detectable changes were found that ranged between 1 and 3%, which means that changes lower than 1 kg could be detected. CONCLUSION: The present study confirms that the 1-RM test has high reliability and reproducibility in the elderly, for both upper and lower limbs.

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OBJECTIVE: This study aims to evaluate whether body image satisfaction improves with practice in resistance training in elderly women. METHODS: Forty women were selected and randomly divided into an untrained group (UN) group and a group trained in resistance exercises (RT). To evaluate body image satisfaction, the silhouette matching task was used. RESULTS: No differences were found between current (5.45±0.24) and ideal (4.7±0.12) silhouettes in the RT group. However, the UN group showed a significant difference (p<0.01) between current (10.4±0.43) and ideal (5.6±0.26) silhouettes. The current silhouette was significantly different between the UN and RT groups (p<0.002). However, the ideal silhouette value did not differ between them. Body satisfaction was present in 90% of the participants in the RT group, and the difference was 15% less than that in the UN group (x2 test, p<0.001). CONCLUSION: Resistance training in elderly women can promote satisfaction with their body image.

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BACKGROUND: Older women with low back pain (LBP) constitute a special subpopulation at risk of severe and permanent disability. It is important to identify factors limiting functionality in this population in order to reduce costs and improve both prevention and intervention. Handgrip strength (HGS) is a biomarker of aging associated with several adverse health outcomes, but long-term associations with disability in older patients with LBP are not known. OBJECTIVE: To examine whether HGS predicts disability in older women with acute low back pain (LBP). METHODS: Longitudinal analyses were conducted with a sample of 135 older women from the international multicenter study Back Complaints in the Elders (BACE-Brazil). Women aged 60 years and over with a new episode of acute LBP were included. HGS was assessed with Jamar® dynamometer, and disability was assessed using the Roland Morris questionnaire and gait speed test. Variables were assessed at baseline and at 12-month follow-up. Linear regression models explored associations between HGS and disability measures. RESULTS: Significant association was found between HGS at baseline and gait speed at 12-month follow-up (r=-0.24; p=0.004). A multivariable-adjusted model showed that this association was independent of age, body mass index, and pain intensity (adjusted R2=0.13; p<0.001). A final prediction model showed an incremental difference of only 2.1% in gait speed after inclusion of HGS as an independent variable. No association was found between HGS and score on the Roland Morris questionnaire. CONCLUSION: Caution is needed regarding the use of HGS as a predictive measure of disability in older women with acute LBP. Changes in gait speed were very small and unlikely to be of clinical relevance.

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