Early menopause in women with Down’s syndrome.

We used the AAMR’s Adaptive Behavior Scale to ascertain current menstrual status in a population-based sample of 157 women with Down’s syndrome (DS) and 187 women with other intellectual disability, all 40 years of age or older. The age-adjusted likelihood of menopause was twice as high in women with DS syndrome as in women with other intellectual disability (OR = 2.3; 95% CI = 1.1-4.9). Treated thyroid conditions did not influence menstrual status and did not modify the relationship between DS and menstrual status. These findings support the hypothesis that women with DS experience menopause at an earlier age and that this may be associated with accelerated aging.

Risk factors for falling in home-dwelling older women with stroke: the Women’s Health and Aging Study.
Lamb SE, Ferrucci L, Volapto S, Fried LP, Guralnik JM; Women’s Health and Aging Study
Interdisciplinary Research Centre in Health, School of Health and Social Sciences, Coventry University/Warwick West Midlands Primary Care Network, Coventry, UK. s.lamb@coventry.ac.uk
Stroke 2003 Feb;34(2):494-501
Comment in Stroke. 2003 Feb;34(2):494-501.

Purpose: Much of our knowledge of risk factors for falls comes from studies of the general population. The aim of this study was to estimate the risk of falling associated with commonly accepted and stroke-specific factors in a home-dwelling stroke population.

Methods: This study included an analysis of prospective fall reports in 124 women with confirmed stroke over 1 year. Variables relating to physical and mental health, history of falls, stroke symptoms, self-reported difficulties in activities of daily living, and physical performance tests were collected during home assessments.

Results: Risk factors for falling commonly reported in the general population, including performance tests of balance, incontinence, previous falls, and sedative/hypnotic medications, did not predict falls in multivariate analyses. Frequent balance problems while dressing were the strongest risk factor for falls (odds ratio, 7.0). Residual balance, dizziness, or spinning stroke symptoms were also a strong risk factor for falling (odds ratio, 5.2). Residual motor symptoms were not associated with an increased risk of falling.

Conclusion: Interventions to reduce the frequency of balance problems during complex tasks may play a significant role in reducing falls in stroke. Clinicians should be aware of the increased risk of falling in women with residual balance, dizziness, or spinning stroke symptoms and recognize that risk assessments developed for use in the general population may not be appropriate for stroke patients.