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Preventive health care for older women: Life-style recommendations and new directions

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Abstract

One of the key paradoxes in gerontology is that, despite a higher longevity, aging women experience worse health and longer disability than men. However, there is growing evidence that changes in life-style, medical interventions and systematic screening for certain diseases may substantially reduce the excess risk of major chronic conditions and disability in aging women, and therefore improve the quality of their late life. The potentials and public health implications of prevention in older women have been recently emphasized, not only by the scientific literature, but also by the media. More and more women are turning to their primary care physicians or other health professionals to seek counselling and help on how to reduce the burden of chronic disease and disability in old age by quitting smoking, eating a healthy diet, increasing physical activity, and coping with stress. Hormone replacement therapy also has a central role in this action of prevention. To maximize compliance, women should be provided a few guidelines that are easy to understand, and can be followed without interfering too much with their daily life activities. This article reviews the current literature on prevention in older women to select preventive strategies that are based on robust scientific evidence. This list of guidelines should be considered as a starting point for all those who are in charge of caring for middle-aged and older women.

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References

  1. Verbrugge L.M.: Gender and health: an update on hypotheses and evidence. J. Health Soc. Behav. 26: 156–182, 1985.

    CAS  PubMed  Google Scholar 

  2. Deiana L., Ferrucci L., Pes G.M., Carru C., Delitala G., Ganau A., Mariotti S., Nieddu A., Pettinato S., Putzu P., Franceschi C., Baggio G.: AKEntAnnos. The Sardinia Study of extreme longevity. Aging Clin.Exp.Res. 11: 142–149, 1999.

    CAS  Google Scholar 

  3. Menard A.M., Roger M., Dry J.: Centenarians in France. Rev. Infirm. 42: 28–30, 1992.

    CAS  PubMed  Google Scholar 

  4. The Italian Multicentric Study on Centenarians: Epidemiological and socioeconomic aspects of Italian centenarians. Arch. Gerontol. Geriatr. 25: 149–157, 1997.

    Google Scholar 

  5. Zheng Z.X., Wang Z.S., Zhu H.M., Yang J.Y., Peng H.Y., Wang L.X., Li J., Jiang X.W.Y.Y.F.: Survey of 160 centenarians in Shanghai. Age Ageing 22: 16–19, 1997.

    Google Scholar 

  6. Guralnik J.M., Land K.C., Blazer D., Fillenbaum G.G., Branch L.G.: Educational status and active life expectancy among older blacks and whites. N. Engl. J. Med. 329: 110–116, 1993.

    CAS  PubMed  Google Scholar 

  7. Land K.C., Guralnik J.M., Blazer D.G.: Estimating increment-decrement life tables with multiple covariates from panel data: the case of active life expectancy. Demography 31: 297–319, 1994.

    CAS  PubMed  Google Scholar 

  8. Strawbridge W.J., Cohen R.D., Shema S.J., Kaplan G.A.: Successful aging: Predictors and associated activities. Am. J. Epidemiol. 144: 135–141, 1996.

    CAS  PubMed  Google Scholar 

  9. Branch L.G., Guralnik J.M., Foley D.J., Kohout F.J., Wetle T.T., Ostfeld A., Katz S.: Active life expectancy for 10,000 Caucasian men and women in three communities. J. Gerontol. 46: M145–M150, 1991.

    CAS  PubMed  Google Scholar 

  10. Ferrucci L., Guralnik J.M., Simonsik E., Salive M.E., Corti M.C., Langlois J.: Progressive versus catastrophic disability: A longitudinal view of the disablement process. J. Gerontol. 51A: M123–M130, 1996.

    Google Scholar 

  11. Hazzard W.H.: The sex differential in longevity. In: Hazzard W.R., Bierman E.L., Blass J.P., Ettinger W.H., Halter J.B. (Eds.), Principles of Geriatric Medicine and Gerontology. McGraw-Hill, Inc., New York, 1994, pp. 37–47.

    Google Scholar 

  12. Colditz G.A., Willett W.C., Stampfer M.J., Rosner B., Speizer F.E., Hennekens C.H.: Menopause and risk of coronary heart disease in women. N. Engl. J. Med. 316: 1105–1110, 1987.

    CAS  PubMed  Google Scholar 

  13. Eaker E.D., Chesebro J.H., Sacks F.M., Wenger N.K., Whisnant J.P., Winston M., AHA Staff: Cardiovascular disease in women. Circulation 88: 1999–2009, 1993.

    CAS  PubMed  Google Scholar 

  14. German, P.S., Fried L.P.: Prevention and the elderly: public health issues and strategies. Annu. Rev. Public Health 10: 319–332, 1989.

    CAS  PubMed  Google Scholar 

  15. Fogel R.W., Costa D.L.: A theory of technophysioevolution, with some implications for forecasting population, health care costs, and pension costs. Demography 34: 49–66, 1997.

    CAS  PubMed  Google Scholar 

  16. Calle E.E., Thun M.J., Petrelli J.M., Rodriguez C., Heath C.W.: Body-mass index and mortality in a prospective cohort of U.S. adults. N. Engl. J. Med. 341: 1097–1105, 1999.

    CAS  PubMed  Google Scholar 

  17. Bruning P.F., Bonfrer J.M., Hart A.A., Van Noord P.A., van der Hoeven H., Collette H.J., Battermann J.J., de Jong-Bakker M., Noijen W.J., de Waard F.: Body measurements, estrogen availability and the risk of human breast cancer: a case-control study. Int. J. Cancer 51: 14–19, 1992.

    CAS  PubMed  Google Scholar 

  18. Azevedo A., Ramos E., von Hafe P., Barros H.: Upper-body adiposity and risk of myocardial infarction. J. Cardiovasc. Risk 6: 321–325, 1999.

    CAS  PubMed  Google Scholar 

  19. Poehlman E.T., Toth M.J., Fishman P.S., Vaitkevicius P., Gottlieb S.S., Fisher M.L., Fonong T.: Sarcopenia in aging humans; the impact of menopause and disease. J. Gerontol. 50: 73–77, 1995.

    Google Scholar 

  20. Evans J.W., Campell W.W.: Sarcopenia and age-related changes in body composition and functional capacity. J. Nutr. 123: 465–468, 1993.

    CAS  PubMed  Google Scholar 

  21. Serrano Rios M.: Relationship between obesity and the increased risk of major complications in non-insulin-dependent diabetes mellitus. Eur. J. Clin. Invest. 28: 14–17, 1998.

    PubMed  Google Scholar 

  22. Smith S.R., Zachwija J.J.: Visceral adipose tissue: a critical review of intervention strategies. Int. J. Obes. Relat. Metab. Disord. 23: 329–335, 1999.

    CAS  PubMed  Google Scholar 

  23. Hegsted D.M., Kritchevsky D.: Diet and serum lipid concentrations: where are we? Am. J. Clin. Nutr. 65: 1893–1896, 1997.

    CAS  PubMed  Google Scholar 

  24. Schaefer E.J., Lichtenstein A.H., Lamon-Fava S., Contois J.H., Li Z., Goldin B.R., Rasmussen H., McNamara J.R., Ordovas J.M.: Effects of National Cholesterol Education Program Step 2 diets relatively high or relatively low in fish-derived fatty acids on plasma lipoproteins in middle-aged and elderly subjects. Am. J. Clin. Nutr. 63: 234–241, 1996.

    CAS  PubMed  Google Scholar 

  25. Nordin B.E., Need A.G., Steurer T., Morris H.A., Chatterton B.E., Horowitz M.: Nutrition, osteoporosis, and aging. Ann. N.Y. Acad. Sci. 20: 336–351, 1998.

    Google Scholar 

  26. Dawson-Hughes B.: Calcium and vitamin D nutritional needs of elderly women. J. Nutr. 126: 1165S–1167S, 1996.

    CAS  PubMed  Google Scholar 

  27. Kaufman K.R., An K.-N., Chao E.Y.S.: A comparison of intersegmental joint dynamics to isokinetic dynamometer measurements. J. Biomech. 28: 1243–1256, 1995.

    CAS  PubMed  Google Scholar 

  28. Joshipura K.J., Ascherio A., Manson J.E., Stampfer M.J., Rimm E.B., Speizer F.E., Hennekens C.H., Spiegelman D., Willett W.C.: Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA 282: 1233–1239, 1999.

    CAS  PubMed  Google Scholar 

  29. La Vecchia C., Tavani A.: Fruit and vegetables, and human cancer. EUR J. Cancer Prev. 7: 3–8, 1998.

    PubMed  Google Scholar 

  30. Messina M.J.: Legumes and soybeans: overview of their nutritional profiles and health effects. Am. J. Clin. Nutr. 70: 439S–450S, 1999.

    CAS  PubMed  Google Scholar 

  31. Bidlack W.R., Wang W.: Nutrition requirements of the elderly. In: Morley J.E., Glick Z., Rubenstein L.Z. (Eds.), Geriatric Nutrition. Raven Press Ltd, New York, 1995, pp. 25–49.

    Google Scholar 

  32. Baghurst P.A., Rohan T.E.: High-fiber diets and reduced risk of breast cancer. Int. J. Cancer 56: 173–176, 1994.

    CAS  PubMed  Google Scholar 

  33. Keil U., Liese A., Filipiak B., Swales J.D., Grobbee D.E.: Alcohol, blood pressure and hypertension. Novartis Found. Symp. 216: 125–144, 1998.

    CAS  PubMed  Google Scholar 

  34. Criqui M.H.: Do known cardiovascular risk factors mediate the effect of alcohol on cardiovascular disease? Novartis Found. Symp. 216: 159–167, 1998.

    CAS  PubMed  Google Scholar 

  35. Stampfer M.J., Colditz G.A., Willett W.C., Speizer F.E., Hennekens C.H.: A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N. Engl. J. Med. 319: 267–273, 1988.

    CAS  PubMed  Google Scholar 

  36. Pahor M., Guralnik J.M., Havlik R.J., Carbonin P.U., Salive M.E., Ferrucci L., Corti M.C., Hennekens C.H.: Alcohol consumption and risk of deep venous thrombosis and pulmonary embolism in older persons. J. Am. Geriatr. Soc. 44: 1030–1037, 1996.

    CAS  PubMed  Google Scholar 

  37. Scherr P.A., LaCroix A.Z., Wallace R.B., Berkman L., Curb J.D., Cornoni-Huntley J., Evans D.A., Hennekens C.H.: Light to moderate alcohol consumption and mortality in the elderly. J. Am. Geriatr. Soc. 40: 651–657, 1992.

    CAS  PubMed  Google Scholar 

  38. Enger S.M., Ross R.K., Paganini-Hill A., Longnecker M.P., Bernestein L.: Alcohol consumption and breast cancer oestrogen and progesteron receptor status. Br. J. Cancer. 79: 1308–1314, 1999.

    CAS  PubMed Central  PubMed  Google Scholar 

  39. Pierce J.P., Faerber S., Wright F.A., Newman W., Flatt S.W., Kealey S., Rock C.L., Hryniuk W., Greenberg E.R.: Feasibility of a randomized trial of a high vegetable diet to prevent breast cancer recurrence. Nutr. Cancer 28: 282–288, 1997.

    CAS  PubMed  Google Scholar 

  40. Buzzard I.M., Faucett C.L., Jeffery R.W., McBane L., McGovern P., Baxter J.S., Shapiro A.C., Blackburn G.L., Chlebowski R.T., Elashoff R.M., Wynder E.L.: Monitoring dietary change in a low-fat diet intervention study: Advantages of using 24-hour dietary recalls vs food records. J. Am. Diet. Assoc. 96: 574–579, 1996.

    CAS  PubMed  Google Scholar 

  41. Metz J.A., Kris-Etherton P.M., Morris C.D., Mustad V.A., Stern J.S., Oparil S., Chait A., Haynes R.B., Resnick L.M., Clark S., Hatton D.C., McMahon M., Holcomb S., Snyder G.W., Pi-Sunyer F.X., McCarron D.A.: Dietary compliance and cardiovascular risk reduction with a prepared meal plan compared with a self-selected diet. Am. J. Clin. Nutr. 66: 373–385, 1997.

    CAS  PubMed  Google Scholar 

  42. McGinnis J.M., Foege W.H.: Actual causes of death in the United States. JAMA 270: 2207–2212, 1993.

    CAS  PubMed  Google Scholar 

  43. Pearl R.: Tobacco smoking and longevity. Science 87: 216–217, 1938.

    CAS  PubMed  Google Scholar 

  44. Wald N.J., Hackshaw A.K.: Cigarette smoking. An epidemiological overview. Br. Med. Bull. 52: 3–11, 1996.

    CAS  PubMed  Google Scholar 

  45. Wingo P.A., Ries L.A., Giovino G.A., Miller D.S., Rosemberg H.M., Shopland D.R., Thun M-J., Edwards B.K.: Annual report to the nation on the status of cancer, 1973-1996, with special section on lung cancer and tobacco smoking. J. Natl. Cancer Inst. 91: 675–690, 1999.

    CAS  PubMed  Google Scholar 

  46. Qualters J.R., Lee N.C., Smith R.A., Aubert R.E.: Breast and cervical surveillance, United States, 1973–1987. Mor. Mortal Wkly Rep. CDC Surveil. Summ. 42: 1–7, 1999.

    Google Scholar 

  47. Szyfter K., Banaszewski J., Jaloszynsky P., Pabiszczak M., Szyfter W., Szmeja Z.: Carcinogen: DNA adducts in tobacco smoke-associated cancer of the upper respiratory tract. Acta Biochim. Pol. 46: 275–287, 1999.

    CAS  PubMed  Google Scholar 

  48. Chow W.H., Devessa S.S., Warren J.L., Fraumeni J.F.J.: Rising incidence of renal cell cancer in the United States. JAMA 281: 1628–1631, 1999.

    CAS  PubMed  Google Scholar 

  49. Talamini G., Bassi C., Falconi M., Sartoni N., Pasetto M., Salvia R., Di Francesco V., Frulloni L., Vaona B., Bovo P., Pederzoli P., Cavallini G.: Early detection of pancreatic cancer following the diagnosis of chronic pancreatitis. Digestion 60: 554–561, 1999.

    CAS  PubMed  Google Scholar 

  50. Pinsky J.L., Jette A.M., Branch L.G., Kannel W.B., Feinleib M.: The Framingham Disability Study: relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am. J. Public Health 80: 1363–1367, 1990.

    CAS  PubMed  Google Scholar 

  51. Denke M.A.: Primary prevention of coronary heart disease in postmenopausal women. Am. J. Med. 107: 48S–50S, 1999.

    CAS  PubMed  Google Scholar 

  52. Fruzzetti F.: Hemostatic effects of smoking and oral contraceptive use. Am. J. Obstet. Gynecol. 180: S369–S374, 1999.

    CAS  PubMed  Google Scholar 

  53. Cooper G.S., Sandler D.P., Bohlig M.: Active and passive smoking and the occurrence of natural menopause. Epidemiology 10: 771–773, 1999.

    CAS  PubMed  Google Scholar 

  54. Christen W.G., Manson J.E., Seddon J.M., Glynn R.J., Buring J.E., Rosner B., Hennekens C.H.: A prospective study of cigarette smoking and risk of cataract in men. JAMA 268: 989–993, 1992.

    CAS  PubMed  Google Scholar 

  55. Spangler J.G.: Smoking and hormone-related disorders. Prim. Care 26: 499–511, 1999.

    CAS  PubMed  Google Scholar 

  56. Sontag S., Graham D.Y., Belsito A., Weiss J., Farley A., Grunt R., Cohen N., Kinnear D., Davis W., Archambault A., Achord J., Thayer W., Gillies R., Sidov J., Sabesin S.M., Dyck W., Fleshler B., Cleator I., Wenger J., Opekun A. Jr: Cimetidine, cigarette smoking, and recurrence of duodenal ulcer. N. Engl. J. Med. 311: 689–693, 1984.

    CAS  PubMed  Google Scholar 

  57. Ferrucci L., Izmirlian G., Leveille S., Phillips C.L., Corti M.C., Brock D.B., Guralnik J.M.: Smoking, physical activity, and active life expectancy.Am. J. Epidemiol. 149: 645–653, 1999.

    CAS  PubMed  Google Scholar 

  58. Kumar P.R., Kumar N.V.: Effect of cigarette smoking on muscle strength of flexibility of athletes. Indian J. Exp. Biol. 36: 1144–1146, 1998.

    CAS  PubMed  Google Scholar 

  59. Vazquez F.L., Becona E.: Treatment of major depression associated with smoking cessation. Acta Psychiatr. Scand. 98: 507–508, 1998.

    CAS  PubMed  Google Scholar 

  60. Moller A.M., Tonnesen H.: Group therapy and smoking cessation. Ugeskr. Laeger 161: 4987–4988, 1999.

    CAS  PubMed  Google Scholar 

  61. Kunze U., Schmeiser-Rieder A., Schoberberger R.: European Medical Association smoking or Health (EMASH) consensus on smoking cessation: guidelines for physicians. Soz. Praventivmed. 43: 167–172, 1999.

    Google Scholar 

  62. Bouchard C., Shephard R.J., Stephens T., Sutton J.R., McPherson B.D.: Exercise, fitness, and health: the consensus statement. In: Exercise, fitness, and health: a consensus of current knowledge. Human Kinetics, Champaign, Ill., 1990, pp. 3–28.

    Google Scholar 

  63. Skelton D.A., Young A., Greig C.A.: Muscle function of women aged 65-89 years meeting two sets of health criteria. Aging Clin. Exp. Res. 9: 106–111, 1997.

    CAS  Google Scholar 

  64. Bennett K.M.: Gender and longitudinal changes in physical activities in later life. Age Ageing 27: 24–28, 1998.

    PubMed  Google Scholar 

  65. Rutherford O.M.: The role of exercise in prevention of osteoporosis. Physiotherapy 76: 522–526, 1990.

    Google Scholar 

  66. Kano K.: Relationship between exercise and bone mineral density among over 5000 women aged 40 years and above. J. Epidemiol. 8: 28–32, 1998.

    CAS  PubMed  Google Scholar 

  67. Bassey E.J., Hall M.R.P.: Exercise for elderly people. Exercise and Health 51–58, 1985.

    Google Scholar 

  68. Campbell A.J., Robertson M.C., Gardner M.M., Norton R.N., Tilyard M.W.: Randomised controlled trial of a general practice program of home based exercise to prevent falls in elderly women. BMJ 315: 1065–1067, 1997.

    CAS  PubMed  Google Scholar 

  69. Callaman L.E., Rao J., Boutaugh M.: Arthritis and women’s health: prevalence, impact, and prevention. Am. J. Prev. Med. 12: 401–409, 1996.

    Google Scholar 

  70. Seals D.R., Stevenson E.T., Jones P.P., DeSouza C.A., Tanaka H.: Lack of age-associated elevations in 24-h systolic and pulse pressures in women who exercise regularly. Am. J. Physiol. 277: H947–H955, 1999.

    CAS  PubMed  Google Scholar 

  71. Ishikawa K., Ohta T., Zhang J., Hashimoto S., Tanaka H.: Influence of age and gender on exercise training-induced blood pressure reduction in systemic hypertension. Am. J. Cardiol. 84: 192–196, 1999.

    CAS  PubMed  Google Scholar 

  72. Knight S., Bermingham M.A., Mahajan D.: Regular non-vigorous physical activity and cholesterol levels in the elderly. Gerontology 45: 213–219, 1999.

    CAS  PubMed  Google Scholar 

  73. Visser M., Launer L.J., Deurenberg P., Deeg D.J.H.: Total and sports activity in older men and women: relation with body fat distribution. Am. J. Epidemiol. 145: 752–761, 1997.

    CAS  PubMed  Google Scholar 

  74. Thompson R.F., Crist D.M., Marsh M., Rosenthal M.: Effects of physical exercise for elderly patients with physical impairments. J. Am. Geriatr. Soc. 36: 130–135, 1988.

    CAS  PubMed  Google Scholar 

  75. Krebs D.E., Jette A.M., Assermann S.F.: Moderate exercise improves gait stability in disabled elders. Arch. Phys. Med. Rehabil. 79: 1489–1495, 1998.

    CAS  PubMed  Google Scholar 

  76. Shephard R.J.: The scientific basis of exercise prescribing for the very old. J. Am. Geriatr. Soc. 38: 62–70, 1990.

    CAS  PubMed  Google Scholar 

  77. Leitzmann M.F., Rimm E.B., Willett W.C., Spiegelman D., Grodstein F., Syampfer M.J., Colditz G.A., Giovannucci E.: Recreational physical activity and the risk of cholecystectomy in women. N. Engl. J. Med. 341: 777–784, 1999.

    CAS  PubMed  Google Scholar 

  78. Colditz G.A., Manson J.E., Hankinson S.E.: The nurses’ health study: 20 year contribution to the understanding of health among women. J. Women’s Health 6: 49–62, 1997.

    CAS  Google Scholar 

  79. Martinez M.E., Giovannucci E., Spiegelman D., Hunter D.J., Willett W.C., Colditz G.A.: Leisure-time physical activity, body size, and colon cancer in women. J. Natl. Cancer Inst. 89: 948–955, 1997.

    CAS  PubMed  Google Scholar 

  80. Young A., Dinan S.: Fitness for older people. BMJ 309: 331–333, 1994.

    CAS  PubMed  Google Scholar 

  81. Skelton D.: Exercise for healthy ageing. Research into Ageing, London, 1994.

    Google Scholar 

  82. Nelson M.E., Wernick S.: Strong women stay young. Bantan Books, New York, 1997, pp. 1–276.

    Google Scholar 

  83. Westcott W.L., Baechle T.R.: Building an effective training program. In: Strength training past 50. Eds. USA, Human Kinetics, 1998, pp. 129–149.

    Google Scholar 

  84. Dinan S., Sharp C.: Fitness for life. Judy Piatkus Ltd, London, 1996.

    Google Scholar 

  85. Skelton D.A., Young A., Greig C.A., Malbut K.E.: Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older. J. Am. Geriatr. Soc. 43: 1081–1087, 1995.

    CAS  PubMed  Google Scholar 

  86. Barrett-Connor E.: Postmenopausal estrogen and prevention bias. Ann. Intern. Med. 115: 455–456, 1991.

    CAS  PubMed  Google Scholar 

  87. Harris R.B., Laws A., Reddy V.M., King A., Haskell W.L.: Are women using postmenopausal estrogens? A community survey. Am. J. Public Health 80: 1266–1268, 1990.

    CAS  PubMed  Google Scholar 

  88. Matthews K.A., Kuller L.H., Wing R.R., Meilahn E.N., Plantinga P.: Prior use of estrogen replacement therapy: are users healthier than nonusers. Am. J. Epidemiol. 143: 971–978, 1996.

    CAS  PubMed  Google Scholar 

  89. Colditz G.A.: Relationship between estrogen levels, use of hormone replacement therapy, and breast cancer. J. Natl. Cancer Inst. 90: 814–823, 1998.

    CAS  PubMed  Google Scholar 

  90. Trichopoulis D., MacMahon B., Cole P.: Menopause and breast cancer risk. J. Natl. Cancer Inst. 48: 605–613, 1972.

    Google Scholar 

  91. Thomas H.V., Reeves G.K., Key T.J.: Endogenous estrogen and postmenopausal breast cancer: a quantitative review. Cancer Causes Control 8: 922–928, 1997.

    CAS  PubMed  Google Scholar 

  92. Collaborative Group on Hormonal Factors in Breast Cancer: Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,702 women with breast cancer and 108,411 women without breast cancer. Lancet 350: 1047–1059, 1997.

    Google Scholar 

  93. Rose P.G.: Endometrial carcinoma. N. Engl. J. Med. 335: 640–649, 1996.

    CAS  PubMed  Google Scholar 

  94. Grady D., Ernster V.L.: Hormone replacement therapy and endometrial cancer: are current regimens safe? J. Natl. Cancer Inst. 89: 1088–1089, 1997.

    CAS  PubMed  Google Scholar 

  95. Hebert-Croteau N.: A meta-analysis of hormone replacement therapy and colon cancer in women. Cancer Epidemiol. Biomarkers Prev. 7: 653–659, 1998.

    CAS  PubMed  Google Scholar 

  96. Marcantonio E.R., Goldman L., Mangione C.M., Ludwig L.E., Muraca B., Haslauer C.M., Donaldson M.C., Whitte more A.D., Sugarbaker D.J., Poss R., Haas S., Cook E.F., Orav E.J., Lee T.H.: A clinical predition rule for delirium after elective noncardiac surger. JAMA 271: 134–139, 1994.

    CAS  PubMed  Google Scholar 

  97. Rodriguez C., Calle E.E., Coates R.J., Miracle-McMahill H.L., Thun M.J., Healt C.W.: Estrogen replacement therapy and fatal ovarian cancer. Am. J. Epidemiol. 141: 828–835, 1995.

    CAS  PubMed  Google Scholar 

  98. Stampfer M.J., Colditz G.A.: Estrogen replacement therapy and coronary heart disease: A quantitative assessment of the epidemiologic evidence. Prev. Med. 20: 47–63, 1991.

    CAS  PubMed  Google Scholar 

  99. Grady D., Rubin S.M., Petitti D.B., Fox C.S., Black D., Ettinger B., Ernster V.L., Cummings S.R.: Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann. Intern. Med. 117: 1016–1037, 1992.

    CAS  PubMed  Google Scholar 

  100. Grodstein F., Stampfer M.J., Manson J.A., Colditz G.A., Willett W.C., Rosner B., Speizer F.E., Hennekens C.H.: Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N. Engl. J. Med. 335: 453–461, 1996.

    CAS  PubMed  Google Scholar 

  101. Ettinger B., Friedman G.D., Bush T., Quesenberry C.P. Jr.: Reduced mortality associated with long-term postmenopausal estrogen therapy. Obstet. Gynecol. 87: 6–12, 1996.

    CAS  PubMed  Google Scholar 

  102. Criqui M.H., Suarez L., Barrrett-Connor E., McPhillips J., Wingard D.L., Garland C.: Postmenopausal estrogen use and mortality: results from a prospective study in a defined, homogeneous community. Am. J. Epidemiol. 128: 606–614, 1988.

    CAS  PubMed  Google Scholar 

  103. Walsh B.W., Shiff I., Rosner B., Greenberg L., Ravnihar V., Sacks F.M.: Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins. N. Engl. J. Med. 17: 1196–1204, 1991.

    Google Scholar 

  104. Lobo R.A., Pickar J.H., Wild R.A., Walsh B., Hirvonen E.: Metabolic impact of adding medroxyprogesterone acetate to conjugated estrogen therapy in postmenopausal women. Obstet. Gynecol. 84: 987–995, 1994.

    CAS  PubMed  Google Scholar 

  105. Medical Research Council’s General Practice Research Framework. Randomized comparison of estrogen vs estrogen plus progestogen hormone replacement therapy in women with hysterectomy. BMJ 312: 473–478, 1996.

    Google Scholar 

  106. Lieberman E.H., Gerhard M.D., Uehata A., Walsh B.W., Selwyn A.P., Ganz P., Yeung A.C., Creager M.A.: Estrogen improves endothelium-dependent flow-mediated vasodilation in postmenopausal women. Ann. Intern. Med. 121: 936–941, 1994.

    CAS  PubMed  Google Scholar 

  107. Giraud G.D., Morton M.J., Wilson R.A., Burry K.A., Speroff L.: Effects of estrogen and progestin on aortic size and compliance in postmenopausal women. Am. J. Obstet. Gynecol. 174: 1708–1717, 1996.

    CAS  PubMed  Google Scholar 

  108. Sullivan J.M.: Coronary arteriography in estrogen-treated postmenopausal women. Prog. Cardiovasc. Dis. 38: 211–222, 1995.

    CAS  PubMed  Google Scholar 

  109. Rosano G.M.C., Sarrel P.M., Poole-Wilson P.A., Collins P.: Beneficial effect of estrogen on exercise-induced myocardial ischaemia in women with coronary artery disease. Lancet 342: 133–136, 1993.

    CAS  PubMed  Google Scholar 

  110. Holvoet P., Collen D.: Oxidation of low density lipoprotein in the pathogenesis of atherosclerosis. Atherosclerosis 137: S33–S38, 1998.

    CAS  PubMed  Google Scholar 

  111. Hulley S., Grady D., Bush T., Furberg C., Herrington D., Riggs B., Vittinghoff E.: Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA 280: 605–613, 1998.

    CAS  PubMed  Google Scholar 

  112. Jick H., Derby L.E., Myers M.J., Vasilakis C., Newton K.M.: Risk of hospital admission of idiopathic venous thromboembolism among users of postmenopausal oestrogen. Lancet 348: 981–983, 1996.

    CAS  PubMed  Google Scholar 

  113. Daly E., Vesey M.P., Hawkins M.M., Carson J.L., Giugh P., Marsh S.: Risk of venous thromboembolism in users of hormone replacement therapy. Lancet 348: 977–980, 1996.

    CAS  PubMed  Google Scholar 

  114. The Writing Group for the PEPI Trial: Effects of hormone therapy on bone mineral density: results from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 276: 1389–1396, 1996.

    Google Scholar 

  115. Speroff L., Rowan J., Symons J., Genent H., Wilborb W., Clements K.M.: The comparative effect on bone density, endometrium, and lipids of continous hormones as replacement therapy (CHART study). A randomized controlled trial. JAMA 276: 1397–1403, 1996.

    CAS  PubMed  Google Scholar 

  116. Cauley J.A., Seeley D.G., Ensrud K., Ettinger B., Black D., Cummings S.R.: Estrogen replacement therapy and fractures in older women: Study of Osteoporotic Fractures Research Group. Ann. Intern. Med. 122: 9–16, 1995.

    CAS  PubMed  Google Scholar 

  117. Felson D.T., Zhang Y., Hannan M.T., Kiel D.P., Wilson P.W., Anderson J.J.: The effect of postmenopausal estrogen therapy on bone density in elderly women. N. Engl. J. Med. 329: 1141–1146, 1993.

    CAS  PubMed  Google Scholar 

  118. Schnitzer T., Bone H.G., Crepaldi G., Adami S., McClung M., Kiel D., Felsenberg D., Recker R.R., Tonino R.P., Roux C., Pinchera A., Foldes A.J., Greenspan S.L., Levine M.A., Emkey R., Santora II A.C., Kaur A., Thompson D.E., Yates J., and Orloff J.J. for the Alendronate Once-Weekly Study Group: Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Aging Clin. Exp. Res. 12: 1–12, 2000.

    CAS  Google Scholar 

  119. Reis S.E., Gloth S.T., Blumenthal R.S., Resar J.R., Zacur H.A., Gerstenblith G., Brinker J.A., Clements K.M.: Ethinyl estradiol acutely attenuates abnormal coronary vasomotor responses to acetylcholine in postmenopausal women. Circulation 89: 52–60, 1994.

    CAS  PubMed  Google Scholar 

  120. Sherwin B.B.: The impact of different doses of estrogen and progestin on mood and sexual behavior in postmenopausal women. J. Clin. Endocrinol. Metab. 72: 336–343, 1997.

    Google Scholar 

  121. Hahn R.: Compliance considerations with estrogen replacement: Withdrawal bleeding and other factors. Am. J. Obstet. Gynecol. 161: 1854–1858, 1989.

    CAS  PubMed  Google Scholar 

  122. Newton K.M., LaCroix A.Z., Leveille S.G., Rutter C., Keenan N.L., Anderson L.A.: Women’s beliefs and decision about hormone replacement therapy. J. Women’s Health 6: 459–465, 1997.

    CAS  Google Scholar 

  123. O’Sullivan A.J., Crampton L.J., Freund J., Ho K.K.Y.: The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women. J. Clin. Invest. 102: 1035–1040, 1998.

    PubMed Central  PubMed  Google Scholar 

  124. Paganini-Hill A., Henderson V.W.: Estrogen deficiency and risk of Alzheimer’s disease in women. Am. J. Epidemiol. 140: 256–261, 1999.

    Google Scholar 

  125. Henderson V.W., Paganini-Hill A., Emanual C.K., Dunn M.E., Buckwalter J.G.: Estrogen replacement therapy in older women: comparison between Alzheimer’s disease cases and nondemented control subjects. Arch. Neurol. 51: 896–900, 1994.

    CAS  PubMed  Google Scholar 

  126. Tang M-X., Jacobs D., Stern Y., Marder K., Schofield P., Gurland B., Andrews H., Mayeux R.: Effect of oestrogen during menopause on risk and age at onset of Alzheimer’s disease. Lancet 348: 429–432, 1996.

    CAS  PubMed  Google Scholar 

  127. Barrett-Connor E., Kirtz-Silverstein D.: Estrogen replacement therapy and cognitive function in older women. JAMA 269: 2637–2641, 1993.

    CAS  PubMed  Google Scholar 

  128. Phillips S.M., Sherwin B.B.: Effects of estrogen on memory function in surgically menopausal women. Psychoneuroendocrinology 17: 485–495, 1992.

    CAS  PubMed  Google Scholar 

  129. Parker M.G., Arbuckle N., Dauvois S., Danielian P., White R.: Structure and function of the estrogen receptor. Ann. N.Y. Acad. Sci. 684: 119–126, 1993.

    CAS  PubMed  Google Scholar 

  130. Jordan V.C.: Antiestrogenic action of Raloxifene and Tamoxifen: today and tomorrow. J. Natl. Cancer Inst. 90: 967–971, 1998.

    CAS  PubMed  Google Scholar 

  131. Fisher B., Powles T.J., Pritchard K.J.: Tamoxifen for prevention of breast cancer. Eur. J. Cancer 36: 142–150, 2000.

    CAS  PubMed  Google Scholar 

  132. Powles T., Eeles R., Ashley S., Easton D., Chang J., Dowsett M., Tidy A., Viggers J., Davey J.: Interim analyses of the incidence of breast cancer in the Royal Marsden Hospital. Tamoxifen randomized chemoprevention trial. Lancet 352: 98–101, 1998.

    CAS  PubMed  Google Scholar 

  133. Love R.R., Mazess R., Tormey D.C., Barden H.S., Newcomb P.A., Jordan V.C.: Bone mineral density in women with breast cancer treated with adjuvant tamoxifen for a least two years. Breast Cancer Res. Treat. 12: 297–302, 1998.

    Google Scholar 

  134. Turken S., Siris E., Selden D., Flaster E., Hyman G., Linday R.: Effects of tamoxifen on spinal bone density in women with breast cancer. J. Natl. Cancer Inst. 81: 1086–1088, 1989.

    CAS  PubMed  Google Scholar 

  135. MacMahon B.: Overview of studies on endometrial cancer and other types of cancer in humans: perspectives of an epidemiologist. Semin. Oncol. 24: 122–139, 1999.

    Google Scholar 

  136. Delmas P.D., Bjarnason N.H., Mitlak B.H., Ravou A.C., Shah A.S., Huster W.J., Draper M., Christiansen C.: Effects of Raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women. N. Engl. J. Med. 337: 1641–1647, 1997.

    CAS  PubMed  Google Scholar 

  137. McNeil C.: In search of the perfect SERM: beyond Tamoxifen and Raloxifene. J. Natl. Cancer Inst. 90: 956–957, 1998.

    CAS  PubMed  Google Scholar 

  138. The Women’s Health Initiative Study Group: Design of the Women’s Health Initiative Clinical Trial and Observational Study. Control. Clin. Trials 19: 61–109, 1998.

    Google Scholar 

  139. Van Dijck J.A., Broeders M.J., Verbeek A.L.: Mammographic screening in older women. Is it worthwhile? Drugs Aging 10: 69–79, 1997.

    PubMed  Google Scholar 

  140. Hansen J.: Common cancer in the elderly. Drugs Aging 13: 467–478, 1998.

    CAS  PubMed  Google Scholar 

  141. Landis S.H., Murray T., Bolden S., Wingo P.A.: Cancer statistics. CA Cancer J. Clin. 49: 8–31, 1999.

    CAS  PubMed  Google Scholar 

  142. Feuer E.J., Wun L.M., Boring C.C.: The lifetime risk of developing breast cancer. J. Natl. Cancer Inst. 85: 892–897, 1993.

    CAS  PubMed  Google Scholar 

  143. Tabar L., Fageberg G., Duffy S.W.: Update of the Swedish two-county program of mammographic screening for breast cancer. Radiol. Clin. North Am. 30: 187–210, 1992.

    CAS  PubMed  Google Scholar 

  144. Tabar L., Fageberg G., Day N.E.: What is the optimum interval between mammographic screening examination? An analysis based on the latest results of the Swedish two-county breast cancer screening trial. Br. J. Cancer 55: 547–551, 1987.

    CAS  PubMed Central  PubMed  Google Scholar 

  145. Miller A.B., Baines C.J., To T.: Canadian National Breast Screening Study 2: Breast cancer detection and death rates among women aged 50 to 59 years. Can. Med. Assoc. J. 147: 1477–1488, 1992.

    CAS  Google Scholar 

  146. Kerlikowske K., Grady D., Barclay J.: Effect of age, breast density, and family history on the sensitivity of first screening mammographic. JAMA 276: 33–38, 1996.

    CAS  PubMed  Google Scholar 

  147. Costanza M.E.: Breast cancer screening in older women: overview. J. Gerontol. 47(Special Issue): 1–3, 1992.

    Google Scholar 

  148. Screening recommendations of the forum panel. J. Gerontol. 47(Special Issue): 5, 1992.

    Google Scholar 

  149. Katz A.: Cervical cancer screening. Can. Fam. Physician 44P: 1661–1665, 1998.

    Google Scholar 

  150. Burk J.R., Lehman H.F., Wolf F.S.: Inadequacy of Papanicolau smears in the detection of endometrial cancer. N. Engl. J. Med. 291: 191–192, 1974.

    CAS  PubMed  Google Scholar 

  151. Koss L.G., Schreiber K., Oberlander S.G., Moussoris N.F., Lesser M.: Detection of endometrial carcinoma and hyperplasia in asymptomatic women. Obstet. Gynecol. 64: 1–11, 1984.

    CAS  PubMed  Google Scholar 

  152. Smith L.H., Oi R.H.: Detection of malignant ovarian neoplasms: a review of a literature: I. Detection of the patient at risk; clinical radiological and cytological detection. Obstet. Gynecol. Surv. 39: 313–328, 1984.

    CAS  Google Scholar 

  153. Campbell S., Bhan V.: Transabdominal ultrasound screening for early ovarian cancer. BMJ 299: 1363–1367, 1989.

    CAS  PubMed  Google Scholar 

  154. Niloff J.M., Knapp R.C., Schaetzl E., Reynolds C., Bast R.C. Jr.: CA125 antigen levels in obstetric and gynecologic patients. Obstet. Gynecol. 64: 703–707, 1984.

    CAS  PubMed  Google Scholar 

  155. Ries L.A.G., Kosary C.L., Hankey B.F., Miller B.A., Edwards B.K.: SEER cancer statistics Review, 1973–1994. National Cancer Institute, NIH PUB. NO. 97-2789. Bethesda, MD, 1997.

    Google Scholar 

  156. Ahsan H., Neugut A.I., Garbowsi G.C.: Family history of colorectal adenomatous polyps and increased risk for colorectal cancer. Ann. Intern. Med. 128: 900–905, 1998.

    CAS  PubMed  Google Scholar 

  157. Kewenter J., Bjork S., Haglind E.: Screening and rescreening of colorectal cancer: controlled trial of fecal occult blood testing in 27,700 subjects. Cancer 62: 645–651, 1999.

    Google Scholar 

  158. Hardcastle J.D., Thomas W.M., Chamberlain J.: Randomized, controlled trial of faecal occult blood screening for colorectal cancer, results for first 107,349 subjects. Lancet 1: 1160–1164, 1989.

    CAS  PubMed  Google Scholar 

  159. Kronborg O., Fenger C., Sondergaard O.: Initial mass screening for colorectal cancer with fecal occult blood test: a prospective randomized study at Funen in Denmark. J. Gastroenterol. 22: 677–686, 1987.

    CAS  Google Scholar 

  160. Kronborg O., Fenger C., Olsen J.: Repeated screening for colorectal cancer with fecal occult blood test: a prospective randomized study at Funen Denmark. Scand. J. Gastroenterol. 24: 599–606, 1989.

    CAS  PubMed  Google Scholar 

  161. Polo-Kantola P., Erkkola R., Helenius H., Irjala K., Polo O.: L. Ferrucci, E. Benvenuti, B. Bartali, et al. replacement therapy improve sleep quality? Am. J. Obstet. Gynecol. 178: 1002–1009, 1998.

    CAS  PubMed  Google Scholar 

  162. Keefe D.L., Watson R., Naftolin F.: Hormone replacement therapy may alleviate sleep apnea in menopausal women: a pilot study. Menopause 6: 196–200, 1999.

    CAS  PubMed  Google Scholar 

  163. Wright K.P., Badia P.: Effects of menstrual cycle phase and oral contraceptives on alertness, cognitive performance, and circadian rhythms during sleep deprivation. Behav. Brain Res. 103: 185–194, 1999.

    CAS  PubMed  Google Scholar 

  164. Brzezinski A. “Melatonin replacement therapy” for postmenopausal women: is it justified? Menopause 5: 60–64, 1998.

    CAS  PubMed  Google Scholar 

  165. Gentili A., Edinger J.D.: Sleep disorder in older people. Aging Clin. Exp. Res. 11: 137–141, 1999.

    CAS  Google Scholar 

  166. Morin C.M., Colecchi C., Stone J., Sood R., Brink D.: Behavioral and pharmacological therapies for late-life insomnia. JAMA 281: 991–999, 1999.

    CAS  PubMed  Google Scholar 

  167. Lewis-Hall F.C., Wilson M.G., Tepner R.G., Koke S.C.: Fluoxetine vs tricyclic antidepressant in women with major depressive disorder. J. Women’s Health 6: 337–343, 1997.

    CAS  Google Scholar 

  168. Prigerson H.G., Maciejewski P.K., Rosenheck R.A.: The effects of marital dissolution and marital quality on health and health service use among women. Med. Care 37: 858–873, 1999.

    CAS  PubMed  Google Scholar 

  169. Cochran D.L., Brown D.R., McGregor K.C.: Racial differences in the multiple social roles of older women: implications for depressive symptoms Gerontologist 39: 465–472, 1999.

    CAS  PubMed  Google Scholar 

  170. Bhatia S.C., Bhatia S.K.: Depression in women: diagnostic and treatment considerations. Am. Fam. Physician 60: 234, 1999.

    Google Scholar 

  171. Whooley M.A., Kip K.E., Cauley J.A., Ensrud K.E., Nevitt M.C., Browner W.S.: Depression, falls, and risk of fracture in older women. Study of Osteoporotic Fractures Research Group. Arch. Intern. Med. 8: 484–490, 1999.

    Google Scholar 

  172. Penninx B.W.J.H., Guralnik J.M., Ferrucci L., Simonsick E.M., Deeg D., Wallace R.B.: Depressive symptoms and physical decline in community-dwelling older persons. JAMA 279: 1720–1726, 1999.

    Google Scholar 

  173. Carranza-Lira S., Valentino-Figueroa M.L.: Estrogen therapy for depression in postmenopausal women. Int. J. Gynaecol. Obstet. 65: 35–38, 1999.

    CAS  PubMed  Google Scholar 

  174. Burt V.K., Altshuler L.L., Rasgon N.: Depressive symptoms in the perimenopause: prevalence, assessment, and guidelines for treatment. Harv. Rev. Psychiatry 6: 121–132, 1998.

    CAS  PubMed  Google Scholar 

  175. Coope J.: Hormonal and non-hormonal interventions for menopausal symptoms. Maturitas 23: 159–168, 1996.

    CAS  PubMed  Google Scholar 

  176. Reynolds C.F. III, Kupfer D.J.: Depression and aging: a look to the future. Psychiatr. Serv. 50: 1167–1172, 1999.

    PubMed  Google Scholar 

  177. Koening H.G.: Late-life depression: how to treat patients with comorbid chronic illness. Geriatrics 54: 56–61, 1999.

    Google Scholar 

  178. Doris A., Ebmeier K., Shajahan P.: Depressive illness. Lancet 354: 1369–1375, 1999.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Geriatria, INRCA, Viale Michelangelo 41, 50127, Firenze, Italy

    L. Ferrucci M.D., Ph.D., E. Benvenuti, B. Bartali & S. Bandinelli

  2. Institute of Gerontology, University of Chieti, Chieti, Italy

    A. Di Iorio

  3. Ospedale S. Giovanni di Dio, Firenze, Italy

    C. R. Russo

  4. Institute of Gerontology, University of Firenze, Firenze, Italy

    F. Lauretani

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  1. L. Ferrucci M.D., Ph.D.
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  2. E. Benvenuti
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Ferrucci, L., Benvenuti, E., Bartali, B. et al. Preventive health care for older women: Life-style recommendations and new directions. Aging Clin Exp Res 12, 113–131 (2000). https://doi.org/10.1007/BF03339898

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