Midlife - Caring for the Golden Period
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Midlife or the period from 35-59 years of a women's life is a golden period of her life. Quality of life in this period has a far reaching impact on her future life, her younger and older generation's life and also on the society as a whole. Here the ways & means and evidences that junk the concept of midlife crisis, and tell how the Quality of life can be improved. The accompanying talk is available at https://www.youtube.com/watch?v=AsB3xY6WgJg
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Midlife - Caring for the Golden Period
- 1. Quality of Life in Midlife Dr. Asha Jain This Photo by Unknown Author is licensed under CC BY-NC-ND
- 2. Dr. Asha Jain MD, DNB, MNAMS, MBA asha@drasha.in • Director – SMSA Raipur • Medical Director – CPRS Raipur • Elected Member – Chhattisgarh Medical Council 2020-24 • Secretary – IMA Raipur 2019-21 • President – ROGS 2018-20 2020-22 • President – Rotary Club Raipur North 2019-20 28/02/21 Dr. Asha Jain
- 3. What is QOL - WHO WHO defines Quality of Life as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, personal beliefs, social relationships and their relationship to salient features of their environment. 28/02/21 Dr. Asha Jain
- 4. What is Health - WHO Health is a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity. 28/02/21 Dr. Asha Jain
- 6. Midlife in the United Stated – MIDUS Study Physical Health Cognitive Functioning Well Being 28/02/21 Dr. Asha Jain
- 8. Study of Women’s health across the nations – SWAN Study Physical Component Summary - PCS Mental Component Summary - MCS N - 2614 28/02/21 Dr. Asha Jain
- 9. PCS and MCS 28/02/21 Dr. Asha Jain
- 10. Better PCS HIGHER BASELINE PHYSICAL ACTIVITY INCREASE IN ACTIVITY FROM BASELINE 28/02/21 Dr. Asha Jain
- 11. Decreased PCS • Time/Aging • Higher baseline BMI • Increase in BMI over time • Smoking • 2 or more medical conditions • Sleep Problems • Urinary Incontinence 28/02/21 Dr. Asha Jain
- 12. Increase in MCS • Early and Late Menopause increase the MCS • Premenopause has no effect 28/02/21 Dr. Asha Jain
- 13. Low MCS Less than very good health Sleep problems Stressful life events Higher perceived stress Anxiety trait 28/02/21 Dr. Asha Jain
- 14. Race and Ethnicity are related to MCS not PCS 28/02/21 Dr. Asha Jain
- 15. Conclusion of Study Increase the quality of life Potentially modifiable midlife factors like Improved sleep hygiene Physical Activity Body mass index 28/02/21 Dr. Asha Jain
- 17. Changes independent of Ovarian Aging Endocrine change OR Coincidental Bone loss Osteoarthritis Adverse Lipid Profiles Diabetes Metabolic Syndrome Sleep Disturbances 28/02/21 Dr. Asha Jain
- 18. Better Physical Health leads to Better mental health, Cognitive health 28/02/21 Dr. Asha Jain
- 19. Evidence 28/02/21 Dr. Asha Jain
- 20. Midlife (35-60y) is a critical window of opportunity to prevent Chronic Disease, and Optimize health and functioning
- 21. Symptoms that are Hallmark of Menopause • Vasomotor Symptoms or Hot flashes • Additionally, other conditions peak or are exacerbated at this time • Fibroids à Hysterectomy • Migraine • Systemic Lupus Erythematosus • Various precancers, and cancers • TODO – Care for Gynecological and Hormone Sensitive conditions 28/02/21 Dr. Asha Jain
- 22. Which period of life is defined as Midlife? Usual studies take 60 years and above Window of opportunity of primary prevention is missed 28/02/21 Dr. Asha Jain
- 23. Redefining Midlife • Here it is redefined as 35 to 60 years • This includes late reproductive phase to late menopause • Includes the menopausal transition up to a period when ovarian senescence has no longer any effect on aging 28/02/21 Dr. Asha Jain
- 24. 25% recently menopausal women report disability Health Midlife Transition Disability 28/02/21 Dr. Asha Jain
- 25. The hardest hit is mobility In one study upto 39% reported loss of mobility within 2 years of menopause 28/02/21 Dr. Asha Jain
- 26. Additional Factors • Metabolic Syndrome • Diabetes • Adverse Lipid Profiles • Hearing Loss • Diminished vision • Osteoarthritis • Body composition changes • 66% had pain due to osteoarthiritis 28/02/21 Dr. Asha Jain
- 27. Osteoporosis leading to fractures This chart shows bone mass in women as it relates to age. Reproduced from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003. 28/02/21 Dr. Asha Jain
- 28. Of all the boneloss that occurs in a women in her entire life, 50% occurs in just 7 years. 2 years before and 5 years after last menstrual period 28/02/21 Dr. Asha Jain
- 29. WHI Study and heart health • Within 2 years of menopause, there is • Increased LDL • Increased Cholesterol • Increased Apolipoprotein B • Therefore increased aortic calcification • Increased hot flashes have an increased CV risk 28/02/21 Dr. Asha Jain
- 30. Depression • 20% to 30% of midlife women have incidental or recurrent episodes of clinical depression • Causes • Hormonal • Sleep Disturbances 28/02/21 Dr. Asha Jain
- 31. Social Health • Infertility • Failed Contraception • Empty Nest Syndrome • Taking care of aging parents • Career issues in working women • Social Connect • Failed Marriages • Loss of partner • Retirement Anxiety 28/02/21 Dr. Asha Jain
- 32. Conclusion • Critical changes are occurring in midlife that need • Change into a healthy lifestyle • Behavioral Change • Social Engagement • Healthcare practices • Focus needs to be on modifiable critical factors in midlife to have healthy instead of unhealthy aging 28/02/21 Dr. Asha Jain
- 33. Future Research Requirement • Research in our country • Impact on midlife of • Early childbirth • Late childbirth • Lifelong under nutrition • Obesity • Racial and ethnic differences • Impact of environment • Impact of occupation 28/02/21 Dr. Asha Jain
- 34. Age Gracefully Be Beautiful, Be Alert Be Active, Be Self Reliant BE HAPPY! This Photo by Unknown Author is licensed under CC BY-SA 28/02/21 Dr. Asha Jain
- 35. Thank you This Photo by Unknown Author is licensed under CC BY-SA 28/02/21 Dr. Asha Jain
- 36. References and Acknowledgements • J Gerontol A Biol Sci Med Sci,2018, Vol. 73, No. 11, 1574– 1580doi:10.1093/gerona/gly062 • Harlow and DerbyWomen's Midlife Health (2015) 1:5 DOI 10.1186/s40695-015-0006-7 28/02/21 Dr. Asha Jain