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Background: Intimate partner violence affects about a third of women in their lifetimes and can result in short- and long-term health consequences, including less favorable performance on measures of cognitive function. Objectives: We assess whether experiencing physical intimate partner violence in midlife was associated with steeper declines in subsequent tests of cognitive performance. Design: This study used data from 1713 women in the longitudinal cohort Study of Women's Health Across the Nation to relate baseline information on physical intimate partner violence to declines in scores from the Symbol Digit Modalities Test, the East Boston Memory Test and the Digit Span Backwards spanning follow-up visits 7 through 15. Methods: Separate linear mixed models were constructed for each cognitive test outcome. Analyses were adjusted for race-ethnicity, education, financial strain, depressive symptoms, trouble sleeping, and bodily pain. Results: At Study of Women's Health Across the Nation baseline, 3.1% of participants reported experiencing physical intimate partner violence in the prior year. In adjusted models, women who reported violence evidenced a statistically significant greater annualized decline (−0.17 points, 95% CI: −0.28, −0.06) in working memory (Digit Span Backwards test), compared to women who had not reported prior-year violence at baseline. Conclusion: Midlife women with a history of physical intimate partner violence exhibited a persistent decrease in the trajectory of working memory. These longitudinal findings extend previous cross-sectional reports which found that physical intimate partner violence had detrimental effects on working memory. These findings provide additional evidence that intimate partner violence is associated with decreases in working memory performance. They underscore the importance of further research into intimate partner violence and cognition during middle age, a particularly understudied life stage. Plain language summary: Physical intimate partner violence is associated with declines in test of working memory Introduction: Approximately a third of women in the United States experience intimate partner violence (IPV) during their lifetimes. Physical IPV is one form of partner violence characterized by physical harm perpetrated by a current or former intimate partner. Physical IPV has previously been linked to poorer cognitive performance, indicated by lower scores on tests of working memory and concentration. Few studies have examined the cognitive performance of women in midlife who have experienced physical IPV. Methods: This study included 1,713 women in the Study of Women's Health Across the Nation. Participants are from seven sites in the United States and were in midlife and premenopausal at study enrollment. This study includes data spanning the baseline study visit (1996-1997) through Study Visit 15 (2015-2016). Surveys captured experience of physical IPV, health conditions, and sociodemographic factors at the initial study visit. Participants completed several cognitive tests at multiple subsequent study visits. Statistical analysis examined the relationship between reported physical IPV at the initial visit and later changes in cognitive performance. Results: About 3% of participants had experienced physical IPV in the year before their first SWAN study visit. Women who experienced physical IPV showed greater decreases on a test of working memory than women who had not experienced IPV. Conclusion: Over time, physical IPV may be associated with greater declines in working memory in women moving from midlife into older adulthood. Future studies should investigate potential mechanisms for this greater decline. This study offers additional evidence of the harms of physical IPV. [ABSTRACT FROM AUTHOR]

Background: Pelvic organ prolapse (POP) affects a considerable proportion of women. Limited information exists regarding the incidence of POP as women transition through menopause. Using data from the Study of Women's Health Across the Nation (SWAN), this diverse community-based longitudinal cohort study assessed the incidence of symptomatic POP and risk by race/ethnicity. Methods: Self-reported POP was ascertained by questionnaire at 11 approximately annual SWAN visits over a median of 13.3 years of follow-up. We estimated probabilities for reporting POP using interval-censored Kaplan–Meier survival plots. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using interval-censored Cox proportional hazards models. Results: The estimated cumulative probability of POP increased linearly from 2.1% at age 45 to 10.1% by age 65 (4.0% per decade). At age 65, the probability was 4.2%, 4.8%, 8.9%, 9.7%, and 33.9% for Japanese, Chinese, Black, White, and Hispanic women, respectively. Compared with White women, the unadjusted HR for POP was 3.09 (95% CI = 2.18–4.39), 0.96 (0.71–1.31), 0.43 (0.22–0.85), and 0.48 (0.26–0.88) for Hispanic, Black, Chinese, and Japanese women, respectively. After adjustment for financial strain and vaginal birth, the low hazards among Chinese and Japanese women and the high hazard for Hispanic women remained significant. Conclusion: Incidence of symptomatic POP increased as women aged through midlife. Risks varied by race and ethnicity and were not accounted for by population differences in socioeconomic life contexts or the probability of having had a vaginal birth. Although not associated with menopause, health providers should incorporate screening for and information about POP when treating menopausal symptoms and health needs of midlife women. Research on pathophysiological factors associated with increasing POP in midlife is warranted. [ABSTRACT FROM AUTHOR]

Background: To assess whether Healing in Harmony (HiH), a form of music therapy, improved women's mental health following conflict-related trauma and sexual violence in the Democratic Republic of Congo. Methods: This study used a step-wedged design and included 167 women, who completed up to two pre-tests, a post-test, and up to two follow-up interviews at 3 and 6 months after completing the program. The Hopkins Symptoms Checklist was used to measure anxiety and depression. The Harvard Trauma Questionnaire was used to measure post-traumatic stress disorder (PTSD). Generalized estimating equations with unstructured covariance were used to estimate mean change in mental health scores and relative risks (RRs) for screening positive. Results: Prior to starting the HiH program, 73.9, 84.2, and 68.5% screened positive with median scores being 2.20, 2.70, and 2.06 for depression, anxiety, and PTSD, respectively. The RR for screening positive declined significantly (RR = 0.49 for depression, 0.61 for anxiety, and 0.54 for PTSD) and mean scores declined significantly by −0.54, −0.67, and −0.53 points, respectively, from the pre- to the post-test, declines that were sustained at the 3-month and 6-month follow-up interviews. Conclusion: The HiH program was associated with significant improvement in women's mental health that was sustained up to 6 months post completion of the program despite instability in the region and evidence of continued experience of conflict-related trauma during the study. These data support the value of providing psychological care in the context of ongoing humanitarian crises. [ABSTRACT FROM AUTHOR]

We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify novel genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets. We collected data from 55 cohorts with a combined sample size of 732,564 participants (87% European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) total sleep time were defined by the extreme 20% of the age- and sex-standardized values within each cohort. Based on cohort-level summary statistics data, we performed meta-analyses for the one-degree of freedom tests of interaction and two-degree of freedom joint tests of the main and interaction effect. In the cross-population meta-analyses, the one-degree of freedom variant-sleep interaction test identified 10 loci (P int <5.0e-9) not previously observed for lipids. Of interest, the ASPH locus (TG, LTST) is a target for aspartic and succinic acid metabolism previously shown to improve sleep and cardiovascular risk. The two-degree of freedom analyses identified an additional 7 loci that showed evidence for variant-sleep interaction (P joint <5.0e-9 in combination with P int <6.6e-6). Of these, the SLC8A1 locus (TG, STST) has been considered a potential treatment target for reduction of ischemic damage after acute myocardial infarction. Collectively, the 17 (9 with STST; 8 with LTST) loci identified in this large-scale initiative provides evidence into the biomolecular mechanisms underpinning sleep-duration-associated changes in lipid levels. The identified druggable targets may contribute to the development of novel therapies for dyslipidemia in people with sleep disturbances.

Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to genes involved in neurological, thyroidal, bone metabolism, and hematopoietic pathways. Non-overlap between short sleep (12) and long sleep (10) interactions underscores the plausibility of distinct influences of both sleep duration extremes in cardiovascular health. With several of our loci reflecting specificity towards population background or sex, our discovery sheds light on the importance of embracing granularity when addressing heterogeneity entangled in gene-environment interactions, and in therapeutic design approaches for blood pressure management., Competing Interests: Conflict of Interest/Disclosures: C.L.M. has received funding from AstraZeneca not related to the current study. B.M.P. serves on the steering committee of the Yale Open Data Access Project funded by Johnson & Johnson. D.C. receives consultancy fees from Roche Diagnostics and Trimedics and speaker fees from Servier. D.A.L. has received support from Medtronic LTD and Roche Diagnostics for biomarker research not related to the current study. The remaining authors declare no competing interests.