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How well do different measurement modalities estimate the number of vasomotor symptoms? Findings from the Study of Women's Health Across the Nation FLASHES Study.

ABSTRACT: Studies of vasomotor symptoms (VMS) typically measure VMS via daily diaries completed at the end of the day. VMS can also be measured via diaries completed throughout the day or via physiological monitors-modalities with lower recall demands. We examined the degree of correspondence between three VMS measurement modalities: retrospective end-of-day/morning diaries, prospective reporting, and physiological monitoring. We determined whether discrepancies between measurement modalities varied by participant characteristics.Twenty-five African-American women and 27 white women from the Pittsburgh site of the Study of Women's Health Across the Nation who were experiencing VMS, had intact uterus and ovaries, and were free of medications affecting VMS underwent 4 days of ambulatory VMS and Actiwatch monitoring. VMS were recalled in end-of-day and morning diaries, reported prospectively during the day, and measured physiologically via a hot flash monitor. Associations between anxiety, sleep, or race/ethnicity and VMS measurement modality difference scores were examined using generalized estimating equations.Women underestimated the number of daytime VMS at the end of the day as compared with VMS that were prospectively reported or physiologically measured throughout the day. This pattern was particularly pronounced among African-American women (b [SE] = -3.01 [0.93], P = 0.001) and women with higher anxiety (b [SE] = -3.13 [1.53], P = 0.04). For nighttime VMS, women overestimated the number of VMS in the morning upon waking as compared with prospective measures, particularly if they had poorer sleep (higher wakening after sleep onset: b [SE] = 0.03 [0.008], P = 0.001).Different measurement modalities yield different VMS estimates. Negative affect, sleep, and race/ethnicity may affect the recall of VMS.

SUBMITTER: Fu P

PROVIDER: S-EPMC3812392 | biostudies-other | 2014 Feb

REPOSITORIES: biostudies-other

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Project description:Small clinical studies suggest depression is associated with alterations in adiponectin and leptin, adipocyte-derived secretory proteins involved in metabolic regulation; however, longitudinal data on these association are lacking. This study examined cross-sectional and longitudinal associations of depressive symptoms and major depressive disorder (MDD) with adiponectin and leptin in healthy middle-aged women (mean (SD) age, 45.6 (2.5) years). Cross-sectional analyses included 575 women with baseline adipokine data; longitudinal analyses included 262 women with 2-4 adipokine measurements over 5 years. The 20-item Center for Epidemiologic Studies Depression scale (CES-D) was used to assess depressive symptoms; history of MDD was determined by the Structured Clinical Interview for DSM-IV. Adipokines were assayed from stored serum specimens; values were log-transformed for analyses. Linear and repeated measure random effects regression models evaluated associations of baseline CES-D scores with baseline adipokine concentrations and changes over time, respectively. Secondary analyses evaluated the relation of MDD history with adipokine concentrations. Mean (SD) baseline concentrations of adiponectin and leptin were 9.90 (4.92) ?g/mL and 27.02 (20.06) ng/mL; both increased over time (p?<?.0001). CES-D scores were associated with lower adiponectin at baseline (per 1-SD: estimate=-0.04, SE=.02, p=.03) and over time (per 1-SD: estimate=-0.055, SE?=?.024, p=.02). Associations were unchanged in risk factor-adjusted models. Women with elevated CES-D scores (?16) had 6.9% (95% CI: -1.1%, 14.3%; p?=?.089) lower median adiponectin at baseline and 11.5% (95% CI: 1.5%, 20.4%, p?=?.025) lower median adiponectin over time in adjusted models, compared to women with CES-D<16. Rate of change in adipokines did not vary by baseline depressive symptoms or MDD history. Depressive symptoms and MDD history were unrelated to leptin. In women at midlife, depressive symptoms are associated with lower adiponectin, a critical anti-inflammatory biomarker involved in metabolic and cardiovascular conditions.

Project description:BackgroundWomen commonly seek medical advice about menopausal symptoms. Although menopausal hormone therapy is the most effective treatment, many women prefer non-pharmacological treatments, such as physical activity. The effectiveness of physical activity has been inconclusive when assessed by randomised controlled trials, and it remains unclear how women feel about it as a possible treatment approach. The aim of the study was to explore symptomatic menopausal women's views and experiences of physical activity as a treatment for vasomotor and other menopausal symptoms.MethodsAn in-depth qualitative study was embedded within a randomised controlled trial that assessed the effectiveness of physical activity as a treatment for vasomotor menopausal symptoms in previously inactive vasomotor symptomatic women. Participants were randomised to one of two physical activity interventions or a usual care group. Both physical activity interventions involved two one-to-one consultations, plus either supporting materials or access to physical activity support groups, over 6 months. Semi-structured interviews were conducted with 17 purposively selected participants from all three trial groups after they had completed trial follow-up. Interviews were audio recorded, transcribed verbatim, and analysed by constant comparison.ResultsAll participants talked positively about physical activity as a treatment for their menopausal symptoms, with most reporting participation had improved their hot flushes and night sweats. They reported that they had experienced improved sleep, physical health and psychological well-being. Those who received the physical activity plus social-support intervention reported their ability to cope with their menopausal symptoms had improved. Many participants commented that they would prefer doctors to discuss physical activity as a possible treatment for their hot flushes and night sweats, before offering medication.ConclusionsBased on the views and experiences of the women who participated in this study, healthcare professionals should continue discussing physical activity as a potential first treatment option with menopausal women. Furthermore, healthcare professionals should ensure they prepare, support, and encourage these women both physically and emotionally.Trial registrationISRCTN ISRCTN06495625 Registered 10/11/2010.

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How well do different measurement modalities estimate the number of vasomotor symptoms? Findings from the Study of Women's Health Across the Nation FLASHES Study.

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