Sieu Gaen Chan

Menopausal symptoms and symptom clustering in Chinese women

OBJECTIVESnthis paper aims to report the prevalence of symptoms in the Hong Kong Chinese perimenopausal women; to construct reported symptoms into symptom groupings; and to clarify whether the symptom groups are associated with menopausal status.nnnMETHODSna random telephone survey of perimenopausal women aged 44-55 years was conducted in 1996. Eligible subjects were identified through telephone dialing of a random sample of the numbers listed in the residents telephone directory. Standardized questionnaire, including a 22-item symptom check list, was administered over the telephone. The principal component analysis method followed by varimax rotation was used to examine the relations among the symptoms.nnnRESULTSndifferences in the prevalence of menstrual problems across the menopausal status were noted with perimenopausal women having the most complaints. Musculoskeletal conditions were the top complaints reported by the respondents, followed by headaches and psychological symptoms. About 10% of the women complained of hot flushes, and less than 5% of cold sweats. Five symptom clusters, namely psychological, musculoskeletal/gastrointestinal, non-specific somatic, respiratory, and vasomotor, have been identified. After adjustment for age, the analysis of variance showed that psychological, non-specific somatic and vasomotor symptoms were significantly associated with menopausal status, while musculoskeletal and respiratory were of borderline statistical significance.nnnCONCLUSIONSncompared with pre- and post-menopausal women, perimenopausal women had the highest reports of symptom complaints. Musculoskeletal complaints were the most prevalent complaints, followed by psychological symptoms. While vasomotor symptoms were significantly associated with menopausal status, their prevalence was comparatively lower than that reported in Caucasian populations.

Soy Intake and the Maintenance of Peak Bone Mass in Hong Kong Chinese Women

Our previous study on bone health among premenopausal women showed that bone mass consolidation is attained by the early 30s, and small loss of spinal bone mineral density (SBMD) occurs soon after peak bone mass attainment. Recent interest has been shown in the potential beneficial effects of phytoestrogens on bone health. However, data are lacking, particularly in Asian women. This study aims to investigate the effect of soy isoflavones intake on the maintenance of peak bone mass in a cohort of 132 women aged 30‐40 years who were followed up for 3 years. Baseline measurements of SBMD (L2‐L4) were obtained using dual‐energy X‐ray densitometry, and dietary intake of soy foods and other key nutrients, including dietary calcium, were obtained through a quantitative food frequency method. Information on body measurements; physical activity (PA), weight‐bearing activity in particular; age of menarche; and number of pregnancies were obtained at baseline. Repeated measurements of SBMD were obtained yearly for a further 3 years with an average follow‐up time of 38 months. Analyses were performed on 116 subjects with at least three SBMD measurements (at baseline, 3‐year follow‐up, and at least one measurement during follow‐up). The individual SBMD regression slope was computed for each of the subjects. Soy isoflavones consumption was categorized as quartiles of intake. We observed a significant difference in the SBMD individual regression slopes between women belonging to the fourth and first soy isoflavones intake quartiles. The positive effect of soy isoflavones on SBMD remained after adjusting for age and body size (height, weight, and bone area). Multiple linear regression analysis including the other known covariates (lean body mass, PA, energy adjusted calcium, and follow‐up time) showed that soy isoflavones, together with these variables, accounted for 24% of the variances of the SBMD individual regression slope. This longitudinal study shows that soy intake had a significant effect on the maintenance of SBMD in women aged 30‐40 years. The effects of phytoestrogens on bone health should be explored further in a population with habitual dietary soy but low calcium intake.

Life Satisfaction and Associated Factors in Older Hong Kong Chinese

Life Satisfaction and Associated Factors in Older Hong Kong Chinese

Age-Associated Gait Changes in the Elderly: Pathological or Physiological?

AIMnTo examine the role of disease-related factors and age-related physiological changes in affecting gait speed and stride length in the elderly.nnnSUBJECTSn925 men and 890 women aged 70 years and above who were ambulant, recruited by random sampling stratified according to age and sex, from all recipients of Old Age and Disability Allowance in Hong Kong.nnnDESIGNnGait was assessed by measuring the time taken and the number of steps required to complete a 16-foot walk. Information on health and functional status, cognitive function, and depressive symptoms was collected, and anthropometric indices obtained. Factors affecting walking speed and stride were examined in the overall population and also after excluding those with physical disability or diseases.nnnRESULTSnResults were analyzed separately for men and women since mean walking speed was slower in women, who also took a larger number of steps. Age, coexisting disease, leg or back pain, poor vision, low level of physical activity, functional and cognitive impairment, high depressive symptom score, and anthropometric indices were all negatively associated with walking speed. Fallers also had slower speed. After excluding those with diseases or physical impairment, multivariate analysis showed that the only factors affecting speed were age in men, and age, height, and level of physical activity in women. Age and height were factors associated with stride length in men, and height only for women.nnnCONCLUSIONnBoth disease-related factors as well as age-related physiological changes contribute to the decline in walking speed and stride length.

Determinants of peak bone mass in Chinese women aged 21-40 years. III. Physical activity and bone mineral density

Previous studies on the relation between moderate physical activity and bone mass have observed conflicting results. Many of these studies have not dissociated the role of physical activity by age groups and in relation to the period of peak bone mass formation. Our cross‐sectional analysis of the baseline data of a longitudinal study of 273 women aged 21–40 attempted to evaluate the role of moderate physical activity on bone mass around the period of peak bone mass attainment. The analyses were carried out separately for the two age groups—21–30 and 31–40—and had also taken into account the effects of age, dietary calcium intake, and lean body mass on bone mineral density (BMD). The total metabolic equivalent values (MET) of leisure time physical activity was based on the MET values for each activity and the reported time spent on each activity in the past year. The results indicated that among the younger group of women, high level of leisure time physical activity was associated with higher bone mass at both the spine and the hip. Additive effects of physical activity and dietary calcium intake on the spine and the hip BMD were observed. Together with age and lean body mass, physical activity and dietary calcium intake accounted for 19% of the variances of bone mineral at the spine and 9–11% at the hip. Among women aged 31–40, presumably after the peak bone mass formation, lean body mass as well as fat mass have independent strong association with BMD. Physical activity was not associated with bone mass in this age group.

Factors associated with menopausal symptom reporting in Chinese midlife women.

OBJECTIVESnthis paper examines whether menopausal status, sociodemographic factors, self-perceived health, and social stress are related to symptom reporting in a community-based sample of Chinese women in midlife.nnnMETHODSna random telephone survey of perimenopausal women aged 44-55 years was conducted in 1996. Eligible subjects were identified through telephone dialing of a random sample of the numbers listed in the residents telephone directory. Standardized questionnaire on social and health information, as well as a 21-item symptom checklist, were administered over the telephone. Logistic regress analyses were performed to find out if menopausal status and other social and health factors were independently associated with overall symptom reporting as well as high prevalence of reporting of each of the five symptom groups - psychological, musculoskeletal, non-specific somatic, respiratory and vasomotor.nnnRESULTSnwe observed that compared with premenopausal women, women going through menopausal transition had a 2.3- to threefold increased risk of reporting more symptoms. The prevalence of symptom reporting was lower in postmenopausal women, but remained slightly elevated compared with premenopausal women. Factors including currently not working, decreased household income in the past year, worry over friends/relatives, and health affecting daily activities were also independently associated with symptom reporting. Among these factors, reporting health affecting daily activities had the strongest association with symptom reporting.nnnCONCLUSIONSncompared with pre and postmenopausal women, perimenopausal women had the highest reports of symptom complaints. Social, psychological and health factors were also independently associated with symptom reporting.

Change in bone mineral density and its determinants in pre- and perimenopausal Chinese women: the Hong Kong perimenopausal women osteoporosis study

SummaryThis 30-month study investigating bone change and its determinants in 438 perimenopausal Chinese women revealed that the fastest bone loss occurred in women undergoing menopausal transition but maintenance of body weight and physical fitness were beneficial for bone health. Soy protein intake also seemed to exert a protective effect.IntroductionThis 30-month follow-up study aims to investigate change in bone mineral density and its determinants in Hong Kong Chinese perimenopausal women.MethodsFour hundred and thirty-eight women aged 45 to 55xa0years were recruited through random telephone dialing and primary care clinic. Bone mass, body composition, lifestyle measurements were obtained at baseline and at 9-, 18- and 30-month follow-ups. Univariate and stepwise multiple regression analyses were performed with the regression coefficients of BMD/C (derived from baseline and follow-up measurements) as the outcome variables. Menopausal status was classified as pre- or postmenopausal or transitional.ResultsMenopausal status was the strongest determinant of bone changes. An annual bone loss of about 0.5% was observed among premenopausal, 2% to 2.5% among transitional, and about 1.5% in postmenopausal women. Multiple regression analyses, revealed that a positive regression slope of body weight was protective for follow-up bone loss at all sites. Number of pregnancy, soy protein intake and walking were protective for total body BMC. Higher baseline LM was also protective for neck of femur BMD.ConclusionMaintenance of body weight and physical fitness were observed to have a protective effect on for bone loss in Chinese perimenopausal women.

An estimate of chronic disease burden and some economic consequences among the elderly Hong Kong population.

OBJECTIVES: To estimate the burden of chronic disease for an elderly Chinese population aged 70 years and over, and to illustrate the use of this information in estimating the economic consequences of disease burden using stroke as an example. PARTICIPANTS: A total of 1902 subjects recruited by random sampling of the old age and disability allowance schemes, which cover over 90% of the Hong Kong elderly population, stratified by sex and five year age groups from age 70 years onwards. METHOD: Information was collected on 10 medical conditions at baseline: arthritis, hypertension, cardiac disease, stroke, chronic obstructive airways disease, peptic ulcer, diabetes mellitus, osteoporotic fracture, malignancy, and dementia. A follow up survey was carried out after 18 months to determine the occurrence of new disease and the number with disease who had died. Disease burden is calculated as the number with disease at baseline plus the number developing new disease minus the number who had died. RESULTS: Disease burden figures were highest for arthritis, hypertension, cardiac disease, and peptic ulcer, and were higher in the 70-79 age group than the 80+ age group for some diseases. For stroke, the economic cost based on a population projection for 2001 was estimated to be around HK

Smoking and mortality in an older Chinese cohort.

1,900,000,000, or US

Influence of Age, Disease and Disability on Anthropometric Indices in Elderly Chinese Aged 70 Years and Above

250 million. CONCLUSION: Information on the burden of chronic disease is important. It enables the economic consequences to be estimated so that strategies can be developed to prevent diseases with high costs and known effective preventive methods.