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L Dennerstein

Publications and source records attributed to L Dennerstein.

At least 19 recordsLinked to original sources

Intimate partner violence and health outcomes in mid-life women: a population-based cohort study.

AIM: To investigate the association between experience of intimate partner violence (IPV) and health outcomes measured prospectively. METHOD: Eleven-year prospective study of a population-based cohort of 438 Australian-born women aged 45-55 years at baseline (in 1991). Annual face-to-face interviews measured health status and quality of life; questionnaires on intimate partner physical, emotional and sexual violence and on experiences of childhood abuse completed in year 6 of follow-up. RESULTS: In year 11 of follow-up 233 women (mean age 59.9 SD 2.5 years) were interviewed of whom 62 (27%) reported experiencing physical and/or emotional and/or sexual IPV prior to the 6(th) year of follow-up. In bi-variate analysis a history of IPV was significantly associated with mental and sexual health variables and marital status at baseline and follow-up. Multivariate analysis found that at follow-up after allowing for baseline measures and other co-variates: Frequency of Sexual Activities was lower in women who had experienced IPV (p < 0.05); and negative mood was higher in women with the experience of IPV during the 12 months prior to completing the violence questionnaire (p < 0.05). CONCLUSION: IPV was a significant contributor to mental and sexual health status measured prospectively in this cohort of mid-aged Australian-born women.

Aged↗

Factors affecting the prevalence of osteoarthritis in healthy middle-aged women: data from the longitudinal Melbourne Women's Midlife Health Project.

The prevalence of osteoarthritis (OA) is greater in women then men. Weight, a factor strongly associated with osteoarthritis, is significantly increased over the menopausal transition. Despite the high prevalence of osteoarthritis, a disabling disease with limited treatment options, there is a paucity of studies in women. The longitudinal phase of the Melbourne Women's Midlife Health Project, is a population-based prospective study of 438 Australian born women who have been followed annually over 11 years. 257 (59%) of these women remained in longitudinal assessment at 11th year of follow-up and 224 of these women agreed to undergo X-rays of their knees and hands. In this study, X-rays were scored for evidence of osteoarthritis using a validated scale, by two investigators who were blinded to questionnaire results. Information on hormone therapy use, physical activity, smoking, BMI and age were obtained by both self-administered and face-to-face questionnaires. Results showed that one hundred and twenty-eight women (56%) had evidence of radiological OA. Forty-nine (21.6%) had evidence of radiological knee OA. One hundred and one (44.5%) had evidence of radiological hand OA. Compared to baseline, at 11th year of follow-up participants had put on weight (4 kg range -14 to 25 kg) and a larger proportion (25% vs. 40%) reported exercising frequently (P = 0.005). Physical activity and BMI were associated with higher prevalence of osteoarthritis in the final year of follow-up. Smoking was associated with a lower prevalence of radiological knee OA. The prevalence was 61% among never smokers compared to only 39% among those who smoked (P < 0.05). Total OA was associated with never having used hormone therapy (odds ratio 2.7; CI 1.1-6.9). There was a trend for increasing level of physical activity at ages 20-29 to be associated with an increased risk of knee OA (P value 0.03 for trend). In conclusion increasing age, BMI and history of more frequent physical activity in younger years were risk factors for radiological knee OA. In contrast, smoking appeared to be associated with less knee OA. Never having used hormone therapy was a risk factor for radiological hand and knee OA. Further work will be needed to determine whether modification of these factors can prevent the development of OA.

Absorptiometry, Photon↗

Factors associated with abnormal eating attitudes among female college students in Japan.

OBJECTIVES: To determine the prevalence rates of abnormal eating attitudes and associated risk factors among female Japanese college students. SUBJECTS AND METHODS: The study population was 7812 female college students in Tokyo. They were asked to fill out the Japanese version of EAT-26 and lifestyle questionnaires. RESULTS: 5.1% of the subjects had a total EAT-26 score above the cutoff point (>20). Multiple regression analysis found the most important factors associated with abnormal eating attitudes were distorted body image, fewer sleeping hours, irregular meal habits, cigarette smoking and more exercise. DISCUSSION: The prevalence of abnormal eating attitudes among female college students in this study was lower than that of Japanese female high school students and lower than that reported for college students of both western and non-western countries. Our results suggest that body image dissatisfaction may be the most important factor associated with abnormal eating behavior.

Adolescent↗

Comparative study of attitudes to eating between male and female students in the People's Republic of China.

OBJECTIVE: This study was conducted to compare eating attitudes and lifestyles of male and female college students in China (Beijing). SUBJECTS AND METHODS: The subjects of this study consisted of 217 male and 177 female college students. They were asked to fill out the Eating Attitudes Test-26 (EAT-26) and a lifestyle questionnaire. RESULTS: The percentages of those above the cutoff point on the EAT-26 for abnormal eating attitudes were 4.7% of male and 6.2% of female students. Body perception of being fat (distorted body image) was the factor most associated with abnormal eating attitudes. DISCUSSION: Weight related concern was prevalent amongst the Chinese students. This suggests that the culture of the beauty of thinness is common among young students in Beijing, particularly female students.

Adult↗

Mental health treatments and associated factors amongst mid-aged Melbourne women.

The aim of this study was to describe lifetime treatment rate and the treatment modalities used for psychiatric problems and to identify variables associated with the history of psychiatric treatment among mid-aged Melbourne women.A longitudinal observational study was carried out using a population-based sample of 438 mid-aged women interviewed annually for eight years. The baseline data on sociodemographic profiles and premenstrual symptoms, and history of exposure to violence obtained at year 6 were included in this analysis. All other variables including psychiatric treatment history, psychosocial and lifestyle variables, chronic medical conditions and mood score were obtained at year 8. We found 22.2% of the women in this study had ever taken psychotropic medication. Antidepressants were the most used drugs. History of hospitalization for psychiatric problems was reported by 15 women (3.9%). 27 of 387 women (7%) reported they had received other types of treatment for psychiatric problems such as counseling or psychotherapy. Of all variables taken from the questionnaire about the treatment, only the history of psychotropic medication had a high enough frequency for regression analysis. History of psychotropic drug use was associated with interpersonal stresses, poor self-rated health, and prior history of depressive change during the premenstrual period. Socio-demographic variables, exposure to violence, lifestyle factors, and chronic physical conditions were not associated with psychotropic drug use.

Antidepressive Agents↗

Self-reported arthritis and the menopause.

OBJECTIVES: To determine the prevalence of self-reported arthritis in a population-based cohort of mid-aged women and to identify health, social and lifestyle factors associated with self-reported arthritis. DESIGN: Cross-sectional population-based survey. METHOD: Data were obtained from a telephone-administered questionnaire of 2001 Australian-born women between 45 and 55 years old and residing in Melbourne. Information was collected on demographics, lifestyle factors and health conditions. RESULTS: The most commonly reported symptom in this cohort was aches and stiff joints, reported by 51.7% of the women; 34.4% of participants reported they had been diagnosed with arthritis. More postmenopausal women (39%) reported that they were diagnosed with arthritis compared to premenopausal women (27%, p < 0.001). Women who reported arthritis were more likely to be older (odds radio (OR), 1.09; 95% confidence interval (CI), 1.05-1.13), have a higher body mass index (OR, 1.04; CI, 1.02-1.07), be postmenopausal (OR, 1.88; CI, 1.33-2.66), have a higher negative mood (OR, 1.80; CI, 1.13-2.87), and report a decreased interest in sex (OR, 1.58; CI, 1.26-1.97). CONCLUSIONS: Aches and stiff joints are the most frequently reported symptom of mid-aged women. Reported arthritis is associated with postmenopausal status, age, body mass index, less interest in sex and lowered mood. Further longitudinal research is needed to determine the role of these factors in the development and impact of arthritis.

Arthritis↗

Serum C-reactive protein and plasma homocysteine levels are associated with hormone therapy use and other factors: a population-based study of middle-aged Australian-born women.

OBJECTIVE: To investigate the associations between C-reactive protein (CRP), homocysteine levels, use of hormone therapy (HT) and other factors. METHODS: A 12-year prospective study of 438 Australian-born women (Melbourne Women's Midlife Health Project), who at baseline were aged 45-55 years, had menstruated in the previous 3 months and were not taking HT. Fasting blood was collected in the 11th follow-up year for CRP, homocysteine, estradiol and follicle stimulating hormone (FSH) levels. Physical measurements and face-to-face interviews obtained information on health and lifestyle variables. RESULTS: A total of 258 women (mean age 60 years) participated in the 11th follow-up year. Multiple regression analysis found that CRP levels were positively associated with body mass index (p < 0.001), HT use (p < 0.01), and negatively associated with statin use (p < 0.005) and exercising (p < 0.05). In postmenopausal women currently not using HT (n = 173) and after adjusting for body mass index, exercise and smoking, CRP was negatively associated with FSH levels (beta = -0.32, p < 0.05). Homocysteine levels were positively associated with smoking (p < 0.001) and negatively associated with HT use (p < 0.05). CONCLUSION: In middle-aged Australian-born women, HT use was associated with increased CRP and decreased homocysteine levels. High CRP levels were also associated with high relative weight, low exercise levels and no statin medication.

Australia↗

The menopausal transition: does it induce women's worries about aging?

OBJECTIVE: This study examines whether patterns of worries about aging change in women during the menopausal transition. DESIGN: A population-based sample of 261 Australian-born women aged 45-55 years at baseline participated in a longitudinal study. Data were collected at baseline and in the 5th year of annual follow-up interviews. Measures included the Attitudes to Aging Scale which is based on a scale developed by Kaufert and Syrotuik and contained the six-item version which examines worries about specific losses. Menopausal status was determined by menstrual status as follows: late reproductive, early menopausal transition, late menopausal transition, and postmenopause. RESULTS: Data analysis carried out by cross-tabulation found that 36% of participants did not change their attitudes over the 5-year follow-up period, 30% became more worried and 33% became less worried and there was no significant difference between those who had or had not experienced the menopausal transition. There was no significant association between the scores on the Attitudes to Aging Scale and changes in the self-rated health, work status and marital status. CONCLUSION: The menopausal transition does not induce an overall increase in worries about aging.

Aging↗

The menopausal transition: a 9-year prospective population-based study. The Melbourne Women's Midlife Health Project.

OBJECTIVES: To describe the natural history of the menopause in Australian-born women. To determine the hormonal changes relating to the menopausal transition (MT) and how these affect quality of life, bone mineral density, body composition, cardiovascular disease (CVD) risk and memory. DESIGN: A 9-year prospective, observational study of a population-based sample of 438 Australian-born women aged 45-55 years at baseline. By the 9th year, the retention rate was 88%. Interviews, blood sampling, menstrual calendars, quality of life and physical measures were taken annually, and bone mineral density was measured bi-annually. RESULTS: The late MT coincides with changes in estradiol, follicle stimulating hormone, and free testosterone index, decreases in bone density and mastalgia, and increases in central adiposity, vasomotor symptoms, insomnia and vaginal dryness. Levels of total testosterone and dehydroepiandrosterone sulfate are unchanged by the MT. An increase in CVD risk was associated with increases in weight and free testosterone index and a decrease in estradiol. Depressed mood is increased by symptoms and by stressors occurring in the MT. Sexual functioning significantly deteriorates with the MT and aging, but relational factors have major effects. Menstrual cycles became more variable and longer closer to the final menstrual period. CONCLUSIONS: As hormonal changes during the MT directly or indirectly adversely affect quality of life, body composition and CVD risk, maintenance of health parameters in the premenopausal years is crucial for a healthy postmenopause.

Affect↗

Estrogen exposures and memory at midlife: a population-based study of women.

Estrogen loss after natural menopause is hypothesized to impair episodic memory. A total of 326 women aged 52 to 63 years participating in the Melbourne Women's Midlife Health Project completed a word list memory task. Estrogen exposures were inferred from menopausal status, time from final menstrual period, use of hormone therapy, serum estradiol concentration, and other indices. Memory did not vary significantly with most exposures. The authors conclude that episodic verbal memory assessed by word list learning is not substantially affected during the menopausal transition or in the years immediately after natural menopause.

Body Mass Index↗

Serum lipids and memory in a population based cohort of middle age women.

OBJECTIVE: To assess the relation between serum lipids and memory in a healthy middle age cohort of women. METHODS: For 326 women in the Melbourne Women's Midlife Health Project aged 52-63 years, serum lipids were measured annually, and memory was assessed during the eighth annual visit. RESULTS: There was a small but significant association between current low density lipoprotein cholesterol (LDL-C) concentrations and memory; for total cholesterol (TC) the association approached significance. Better memory was associated with positive changes in TC and LDL-C based on lipid measurements three years, but not six years, earlier. Memory performance was lowest among women in the lowest quartile of current LDL-C values and among women whose LDL-C levels declined over the previous three years. High density lipoprotein cholesterol (HDL-C) and triglyceride concentrations were unassociated with memory. The association between memory and TC and LDL-C was primarily related to immediate recall and not delayed recall performance on the word list task. Low cholesterol has been linked with depression, but lipid measures and self-rated mood were unrelated. CONCLUSIONS: Higher serum concentrations of LDL-C, and relatively recent increases in TC and LDL-C concentrations, are associated with better memory in healthy middle age women. Possible cognitive effects of cholesterol reduction should be considered in future studies of lipid lowering agents.

Cholesterol, HDL↗

Health care-seeking for menopausal problems.

OBJECTIVES: To determine the rate and timing of medical consultations for menopausal problems during the menopausal transition and to identify baseline and prospective variables associated with these consultations. METHODS: This was a 9-year community-based study with annual interviews of 438 Australian-born women who at baseline were aged 45-55 years, had menstruated in the previous 3 months and were not using hormone therapy. RESULTS: In total, 387 women completed the 9-year study, of whom 86% consulted a doctor about menopausal problems, with an annual mean of 31%. Of the women, 212 experienced a natural menopause. The prevalence of consultations regarding menopausal problems was a maximum about 2.5 years before the final menstrual period (FMP). The time of greatest prevalence of reporting bothersome hot flushes was 2.1 years after the FMP. There was no significant relationship between number of symptoms reported and time to/from the FMP. Multiple regression analysis found that an increased number of consultations for menopausal problems was associated with the baseline variables: vasomotor symptoms (p < 0.005), rating one's health as 'worse than most' (p < 0.005) and taking two or more non-prescription medications (p < 0.05); and the follow-up variables: dysphoric symptoms (p < 0.05), vasomotor symptoms (p < 0.005) and hormone therapy use (p < 0.001). CONCLUSION: Nearly one-third of women will consult a doctor annually during the years of the menopausal transition. Those who are more symptomatic with mood or vasomotor symptoms consult doctors more often and are more likely to use hormone replacement therapy.

Estrogen Replacement Therapy↗

Studying the menopausal transition: methodological considerations.

OBJECTIVE: To document prospectively the menopausal status of a population-based cohort of women. METHODS: A 11-year community-based study with annual interviews of 438 Australian-born women who at baseline were aged 45-55 years, had menstruated in the previous 3 months and were not using hormone therapy or the oral contraceptive pill. Women were interviewed annually in their own homes. Each woman's menstrual history during her transition to menopause was documented prospectively using menstrual calendars. RESULTS: After 11 years of follow-up, the retention rate was 83%. The percentages of the cohort who had experienced a natural menopause at the 3rd, 6th, 9th and 11th years of follow-up were 13%, 36%, 51% and 52%, respectively. After 11 years of follow-up, 3% of the cohort had menstruated in the previous 12 months and 18% had used hormone therapy prior to their final menstrual period. CONCLUSION: In studying the normal transition to menopause, the baseline age of the cohort, the length of time available for follow-up, the intervention rate (hormone therapy and hysterectomy) and the number of participants all need to be considered to ensure there is sufficient power for analyses.

Climacteric↗

The effects of the menopausal transition and biopsychosocial factors on well-being.

OBJECTIVE: The aim of this study was to determine whether women's well-being changed with the menopausal transition, and the effect on well-being of other biological, psychosocial and lifestyle factors. METHOD: A longitudinal observational study was carried out utilising a population-based sample of 438 mid-aged, Australian- born women. A total of 9 assessments were made at annual intervals. Mood was measured using the Affectometer 2. Mood, menopausal status, psychosocial and lifestyle variables and hormone levels were determined annually. 226 subjects who transited the natural menopausal transition were included in the analysis. RESULTS: As women pass from early in the menopausal transition to later in the transition, reporting at least 3 months of amenorrhoea, negative mood declines significantly, positive mood does not change and well-being significantly improves. Well-being scores are highly correlated over time, with early scores having a major effect on later scores. Well-being is also significantly affected by changes in marital status, work satisfaction, daily hassles and life events. CONCLUSIONS: Well-being improves as women enter the later stages of the menopausal transition and is also influenced significantly by psychosocial factors.

Affect↗

Empty nest or revolving door? A prospective study of women's quality of life in midlife during the phase of children leaving and re-entering the home.

BACKGROUND: This study documents changes in household composition and effects on women's quality of life of children leaving and returning home. METHODS: A 9-year annual prospective study of a population-based sample of mid-aged Australian-born women who were premenopausal at baseline (N = 438) was conducted. Documentation was made of household composition and change, well-being, bothersome symptoms, daily hassles, feelings for partner and frequency of sexual activities. RESULTS: There was an increase in the number of women living alone, and a reduction in number of households in which there were children or parents. Each year > 25% of women reported a change in household composition. In the first year after the last child departed (N = 155), there was an improvement in women's positive mood and total well-being and a reduction in negative mood and the number of daily hassles. This improvement in mood was confined to those women who at baseline were not worried about children leaving home. In the first year after children return home there was a trend towards reduced frequency of sexual activities but no mood changes. CONCLUSIONS: For the majority of women, the departure of the last child from the household leads to positive changes in women's mood state and a reduced number of daily hassles. Return of offspring may have an adverse effect on sexual relating of the parents.

Adult↗

Statistical techniques for the analysis of change in longitudinal studies of the menopause.

OBJECTIVE: Critical review of statistical techniques used to analyze data from longitudinal studies. METHOD: Literature search and classification of statistical methods and their utilization evaluated against known underlying assumptions. RESULTS: One hundred and twenty-three papers found: 1. cross-sectional reduction of data (56%); 2. multifactorial techniques (26%); 3. repeated measurement analysis of variance (14%); 4. other (time series and structural equation modelling) (4%). CONCLUSIONS: Cross-sectional reduction violates underlying statistical assumptions. A simple and powerful technique is to mean values prior to and following an event such as the final menstrual period. To allow for the influence of multiple factors, linear regression is preferred to logistic regression where continuous data are available. For more information about evolution in time, more complex techniques are needed. A suitable technique is repeated measurement multivariate analysis of variance using a number of contrasts to estimate various effects. Split plot or randomized block designs cannot be recommended as they violate compound symmetry assumptions. For series involving more than 100 observations for each subject, time series and spectral analysis techniques should be considered. Structural equation modelling is recommended for examination in detail of a range of factors that may influence the studied end-point, the presence of feedback and of latent or non-measurable variables.

Adult↗