The Effect of a Multicomponent Dual-Modality Exercise Program Targeting Osteoporosis on Bone Health Status and Physical Function Capacity of Postmenopausal Women

Purpose: Exercise is important for the prevention of osteoporosis and the reduction of fracture risk because it improves muscle mass and strength, besides improving balance. We evaluated the effect of a specific exercise program on bone mass and quality and physical function capacity in postmenopausal women with low bone mineral density. Methods: Participants (N = 125) underwent a bone mass (Dual X-ray Absorptiometry), bone quality (osteosonography), and physical functional capacity assessment. Fifty-eight of them took part in an 11-month exercise program (E), that included a multicomponent (strength, aerobic capacity, balance, joint mobility) dual-modality (on ground and in the water; alternating group and home-based exercise periods) exercise regimen. The others represented a control group (C) that did not exercise. After the exercise program all participants were reevaluated. Results: After the training program: femoral neck T-score significantly improved in E; C significantly decreased all bone quality (osteosonography) parameters, whereas E showed no differences; E significantly improved all the physical function capacity parameters, while most of them decreased or did not change in C. Conclusions: A specific exercise program targeting osteoporosis improves physical function capacity, reduces physiological bone loss, and maintains bone quality in low bone mineral density postmenopausal women.     

Chronic Musculoskeletal Pain:

Two diseases, osteoporosis and osteoarthritis, are responsible for a majority of the chronic musculoskeletal pain that older women experience. Osteoporosis is the metabolic bone disease most common in older women and is responsible for fractures, kyphosis, and chronic pain. Osteoarthritis, the most commonly diagnosed musculoskeletal problem in older women, causes degeneration of the weight-bearing joints in the body, resulting in limited function and chronic pain. In this paper, these and other common disorders are briefly described and typical coping strategies used by older women in pain are reviewed. In addition, potential multidisciplinary treatment regimens are discussed.     

Widowhood and spirituality: coping responses to bereavement

Nearly half of women age 65 or older are widows and nearly 70% of these women live alone. Because older women are three times more likely than their male counterparts to be widowed, widowhood has been labeled a primarily female phenomenon. This review article has two aims: (a) to discuss the impact of widowhood on the lives of older women and (b) to discuss how religion and spirituality may be used as coping methods for conjugal loss. After reviewing the literature the authors conclude that older women use religious coping as well as religious and spiritual beliefs and behaviors to facilitate positive adjustment to the loss of a spouse.     

Widowhood and Spirituality: Coping Responses to Bereavement

SUMMARY

Nearly half of women age 65 or older are widows and nearly 70% of these women live alone. Because older women are three times more likely than their male counterparts to be widowed, widowhood has been labeled a primarily female phenomenon. This review article has two aims: (a) to discuss the impact of widowhood on the lives of older women and (b) to discuss how religion and spirituality may be used as coping methods for conjugal loss. After reviewing the literature the authors conclude that older women use religious coping as well as religious and spiritual beliefs and behaviors to facilitate positive adjustment to the loss of a spouse.     

Prevalence of low bone health using quantitative ultrasound in Indian women aged 41–60 years: Its association with nutrition and other related risk factors

The purpose of this study was to find the prevalence of low bone health conditions and assess associated nutritional and other risk factors in Indian women aged 41–60 years. A total of 1,911 women participated in this cross-sectional study. Bone health was assessed using an Omnisense multisite quantitative ultrasound bone densitometer on two sites (radius and tibia). Crude prevalence of osteopenia and osteoporosis was found to be 30.09% and 19.89%, respectively. The Indian women were deficient in a majority of nutrients. Postmenopause, hysterectomy, hyperthyroid, hypothyroid, hypertension, low physical activity, low sun exposure, high stress levels, and low calcium levels were found to be independent risk factors of low bone health.     

Barriers to a healthy lifestyle post gestational-diabetes: An Australian qualitative study

Background

Overseas-born-women from certain ethnicities are at high risk of type-2 diabetes and related metabolic disorders. This study explored the barriers and facilitators to long-term healthy lifestyle recommendations among Australian-born and overseas-born-women who attended health promotion sessions at a tertiary Australian Hospital for gestational diabetes 3–4 years previously.

Posttraumatic stress disorder and older women

This article examines the literature related to the identification and treatment of post traumatic stress disorder in older women. From this review, several key findings emerge. Consistent in the research literature is the fact that American women are more at risk for PTSD than are men as a result of the high frequency of sexual and domestic physical abuse that women experience. Studies on older women and PTSD indicate that older women are underdiagnosed and are more typically perceived as suffering from depression, anxiety or poor physical health. It was found consistently that older women who present with age-related stressors may not be asked about earlier trauma history or it may not be understood within the context of trauma related variables. In several research studies, trauma history was often not identified either as a result of current assessment practice or because women from certain age cohorts did not disclose trauma-related data to health professionals. Key researchers emphasize the necessity of clinicians, staff and medical personnel to attend to the historical variables present in trauma histories of older women. Researchers underscore the importance of understanding the impact of early and repeated trauma, especially interpersonal trauma, on the physical health and social functioning of older women- even though a significant amount of time may have elapsed since exposure. These findings indicate that further study of PTSD in older women is warranted. The paper concludes with a discussion of assessment and treatment options.     

Posttraumatic Stress Disorder and Older Women

SUMMARY

This article examines the literature related to the identification and treatment of posttraumatic stress disorder in older women. From this review, several key findings emerge. Consistent in the research literature is the fact that American women are more at risk for PTSD than are men as a result of the high frequency of sexual and domestic physical abuse that women experience. Studies on older women and PTSD indicate that older women are under-diagnosed and are more typically perceived as suffering from depression, anxiety or poor physical health. It was found consistently that older women who present with age-related stressors may not be asked about earlier trauma history or it may not be understood within the context of trauma-related variables. In several research studies, trauma history was often not identified either as a result of current assessment practice or because women from certain age cohorts did not disclose trauma-related data to health professionals. Key researchers emphasize the necessity of clinicians, staff and medical personnel to attend to the historical variables present in trauma histories of older women. Researchers underscore the importance of understanding the impact of early and repeated trauma, especially interpersonal trauma, on the physical health and social functioning of older women–even though a significant amount of time may have elapsed since exposure. These findings indicate that further study of PTSD in older women is warranted. The paper concludes with a discussion of assessment and treatment options.     

Gender differences in physical activity and walking among older adults

Older women are generally more sedentary and less active than older men, but little is known about the specific factors underlying the differences between the genders in physical activity (PA). The purpose of this study was to compare men and women regarding their household leisure time PA, walking activity, and personal and environmental factors related to physical activity. Self-administered questionnaires were completed by 276 older adults recruited from senior centers. Findings revealed that women were less active overall but more involved in household activities. The women's personal and environmental factors represented poor conditions for PA, and as a result they engaged in lower levels of PA than men.     

Care arrangement choices for older widows: decision participants' perspectives

This research examines how a wide range of care arrangement decisions for frail older women are made. Interviews were conducted with 11 older women (ten of whom are widows), nine of their family members, and six professional service providers. Maintaining the older woman's independence was identified as a major theme. While all decision participants identified it as an explicit or implicit decision-making goal, their meanings of independence were different. The older women's meanings were flexible, changing in response to changes in their physical condition and need for assistance. Adult children tended to identify their mothers as independent when they did not actually need assistance, or when they received help from other sources (e.g., home health care). Professional service providers were inclined to define independence narrowly, as avoiding nursing home placement. Minor themes associated with independence include responsibility, reciprocity, and the family's importance in maintaining independence. These themes help to clarify the complex dynamics that take place during care arrangement decisions and explain how care arrangement choices are made.     

Long-term effects of back extensor strengthening exercises on quality of life in women with osteoporosis

The aim of the present study was to evaluate the long-term effect of back extensor strengthening exercises on health-related quality of life (QOL) in women with osteoporosis. In this randomized clinical trial, 183 women with osteoporosis were treated with pharmacotherapy and weight-bearing and balance-training exercises. The case group additionally performed back extensor exercises at home. Patients filled out the Persian version of the Short Form (SF-36) QOL questionnaire at baseline and 6 months post treatment. At the end, all physical and mental parameters of the SF-36 questionnaire improved significantly in the case group, except for one subscale of mental health, compared to the control group. In the control group, only some physical health dimensions (bodily pain, role limitation, physical function, vitality), and mental health status as a mental health subscale improved. In conclusion, considering a major impact of back extensor exercises on improving QOL in women with osteoporosis over the long term, these exercises should be prescribed in routine management of these patients.     

Stressors,Coping Resources,Functioning, and Role Limitations Among Older Korean Immigrants: Gender Differences

This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.     

Care Arrangement Choices for Older Widows: Decision Participants' Perspectives

SUMMARY

This research examines how a wide range of care arrangement decisions for frail older women are made. Interviews were conducted with 11 older women (ten of whom are widows), nine of their family members, and six professional service providers. Maintaining the older woman's independence was identified as a major theme. While all decision participants identified it as an explicit or implicit decision-making goal, their meanings of independence were different. The older women's meanings were flexible, changing in response to changes in their physical condition and need for assistance. Adult children tended to identify their mothers as independent when they did not actually need assistance, or when they received help from other sources (e.g., home health care). Professional service providers were inclined to define independence narrowly, as avoiding nursing home placement. Minor themes associated with independence include responsibility, reciprocity, and the family's importance in maintaining independence. These themes help to clarify the complex dynamics that take place during care arrangement decisions and explain how care arrangement choices are made.     

The Gendered Double Standard of Aging in US Marriage Markets

Using data on marriages collected in most US states between 1970 and 1988, we show that the older men are when they marry, the more years senior to their brides they are, whether it is a first or higher‐order marriage. While older men with more education marry down in age slightly more than less educated older men, the pattern of men marrying further down if they marry later holds strongly for all education groups. We consider several possible explanations for the tendency of men to marry further down in age if they are older at marriage. While we have no direct measure of physical attractiveness, we argue that the most compelling interpretation is that men, more than women, evaluate potential spouses on the basis of appearance. Because the prevailing standard of beauty favors young women, the older men are when they marry, the less they find women their own age attractive relative to younger women, leading them to marry further down in age if they are older at marriage. The consequence for women of men's preference for youth is more often that they remain unmarried than that they end up married to much older or less educated men.     

The Psychosocial Context of Bereavement for Older Women Who Were Caregivers for a Spouse With Advanced Cancer

The psychosocial context of bereavement for older women who were caregivers for a spouse with advanced cancer was explored qualitatively with 13 older women. Interviews and diaries were analyzed using constant comparison. The psychosocial context emerged as the intrapersonal : exhaustion, loneliness, pain, and recovering physical health; the interpersonal: finding a new way through both supportive and difficult relationships; and the community/societal: a loss of identity, pressure to move on, financial concerns, and relying on formal supports. The psychosocial context of bereavement for older women who were caregivers is uniquely challenging and must be considered when providing care and programs of support.