INTRODUCTION:Ovarian cancer is one of the most lethal malignancies in older adults. The Geriatric Vulnerability Score (GVS) may support treatment decisions in this population. We adapted this score, originally developed in clinical trials, for use with routinely collected geriatric oncology data. METHODS:Patients aged ≥70 years with FIGO stage III-IV ovarian cancer from the ELCAPA cohort were included. Two versions of the GVS were developed. The modified GVS (0-5 points) included an Activities of Daily Living score (ADL) <6 or an instrumental Activities of Daily Living score (iADL) <8) at diagnosis, a 4-item Geriatric Depression Scale score ≥ 1, lymphocyte count <1 G/L, and serum albumin <35 g/L. The adapted GVS incorporated dependency measures recorded 3 months before diagnosis. The primary endpoint was 2-year overall survival (OS). RESULTS:Eighty-nine patients were included (median age, 81 years). The 2-year OS rate was 51.6% (95% CI 40.3-61.8). Both scores were associated with OS: HR = 1.45 (95% CI 1.07-1.97; p = 0.016; c-index = 0.646) for the modified GVS and HR = 1.72 (95% CI 1.20-2.47; p = 0.004; c-index = 0.664) for the adapted GVS. In multivariable analysis, a Timed Get-Up-and-Go ≥20 s and the adapted GVS were independently associated with OS, improving discrimination (c-index = 0.7522). CONCLUSION:The GVS can be derived from routinely collected geriatric oncology data. Using dependency measures recorded 3 months before diagnosis slightly improved prognostic performance. Combining the adapted GVS with mobility measures resulted in modestly improved discrimination of mortality risk. Cancer-specific frailty tools may help refine risk stratification and guide treatment decisions in older patients with advanced ovarian cancer.
OBJECTIVES:Women with intellectual disabilities experience significantly poorer health outcomes than women from the general population, on average dying 15 years younger. Little is known about menopause in women with intellectual disabilities; therefore, this study explores the perceptions, experiences and knowledge of women with intellectual disabilities on the topic of menopause. STUDY DESIGN AND MAIN OUTCOME MEASURES:Semi-structured interviews were utilised to collect qualitative data on menopause from women with intellectual disabilities. A sample of 13 women with mild or moderate intellectual disabilities over the age of 35 were purposively recruited from a linked service provider. Reflexive thematic analysis was utilised to generate themes reflecting the perceptions and experiences of participants on the topic of menopause. Ethical approval was obtained for the current study, and Patient and Public Involvement was embedded throughout. RESULTS:Five overarching themes were developed: a) Menopause takes control; b) Difficult to understand; c) Knowledge is power; d) Dismissed due to intellectual disability; e) A tailored approach. The findings indicate a dearth of knowledge among women with intellectual disabilities on the topic of menopause. The lack of understanding is pervasive and influences perceptions of menopause which can negatively affect the severity of menopausal symptoms and help-seeking behaviour. CONCLUSIONS:Understanding obtained from an in-depth exploration of menopause highlights the inequities faced by women with intellectual disabilities and can help to inform the production of specialised educational materials, care pathways and tailored policy initiatives on menopause to improve the health outcomes of this population.
BACKGROUND:Exercise is increasingly recognized as a promising non-pharmacological strategy for supporting cognitive function in older adults. However, it remains unclear which exercise types are most beneficial for specific cognitive domains. This study compared the effects of different exercise types on cognitive function in cognitively healthy older adults. METHODS:From inception to March 23, 2025, we systematically searched the Web of Science, PubMed, Cochrane Library, SPORTDiscus, and PsycINFO databases, with an updated search performed on 26 June 2026. Eligible studies included healthy older adults without cognitive impairment (≥60 years). Risk of bias was assessed using the Risk of Bias 2 tool. Random-effects models were used to perform pairwise and Bayesian network meta-analyses. RESULTS:The network meta-analysis included 110 randomized controlled trials involving 8130 participants. Mind-body exercise was the most effective exercise type for executive function (SMD 0.54; 95% CrI 0.35, 0.73), processing speed (SMD 0.83; 95% CrI 0.45, 1.26), and attention (SMD 0.97; 95% CrI 0.40, 1.59). Aerobic exercise was most effective in improving global cognition (SMD 1.11; 95% CrI 0.58, 1.65) and language function (SMD 0.31; 95% CrI 0.10, 0.53). For memory function, high-intensity interval training ranked highest (SMD 0.58; 95% CrI 0.21, 0.96). CONCLUSIONS:The most effective exercise types varied across cognitive domains: aerobic exercise for global cognition and language function, mind-body exercise for executive function, processing speed, and attention, and high-intensity interval training for memory function. These findings may inform exercise-based strategies for cognitive health and healthy ageing.
This study aimed to provide a comprehensive oncogeriatric characterization of older women with breast cancer treated in the Chilean public health system and to explore the association between geriatric domains, particularly frailty and nutritional status, treatment decision-making, and early treatment-related toxicity. We conducted a retrospective observational cohort study that included 177 women aged ≥60 years (median age 79 years; range 60-95 years) who underwent a comprehensive geriatric assessment at the Instituto Nacional del Cáncer. Frailty was highly prevalent, with 56% of patients classified as vulnerable or mildly frail (a score on the Clinical Frailty Scale of 4 or 5) and 20.4% as moderately or severely frail (score on the Clinical Frailty Scale of 6-9). Nutritional vulnerability was also common, with a mean Mini Nutritional Assessment-Short Form score of 11.1, low muscle strength (mean handgrip 14.7 kg), and reduced calf circumference in 75.7% of patients, despite a mean body mass index in the overweight range (28.1 kg/m2). Most tumours were early stage and hormone receptor-positive; however, frailty, oncogeriatric cluster classification, and nutritional status were significantly associated with therapeutic intent and early treatment-related toxicity (all p < 0.05). Performance status underestimated multidimensional vulnerability compared with geriatric assessment. Treatment plans were modified following geriatric assessment in 40.1% of the cases. Overall, older women with breast cancer treated in the Chilean public health system exhibit a high burden of multidimensional vulnerability that is significantly associated with oncological decision-making and treatment-related outcomes. Comprehensive geriatric assessment provides clinically relevant information beyond traditional oncological metrics and should be systematically integrated into breast cancer care.
Earlier onset of type 2 diabetes could impact the age-related decline of the female reproductive system. Reproductive aging is characterized by decreases in oocyte quality and follicle numbers, and marked by declining fertility, endocrine shifts, and menopause. To better understand how type 2 diabetes might affect this process, we conducted a scoping review of studies that measured reproductive aging-related traits in participants diagnosed with type 2 diabetes before menopause. Systematic searches on MEDLINE, CINAHL, and Web of Science identified studies evaluating type 2 diabetes and traits such as menopause timing, ovarian reserve, and fertility-related outcomes. Exclusion criteria in two-step screening included no control group, post-menopausal diabetes diagnosis, or inclusion of type 1 diabetes in the diabetes group.We identified 16 studies, highlighting a need for more research. Six of seven studies that evaluated menopause timing reported at least one finding that indicated earlier menopause with premenopausal type 2 diabetes, although several associations were confined to specific subgroups and one study reported bidirectional findings depending on age at diabetes diagnosis. Thus, young-onset (before ~40 years) type 2 diabetes may be associated with earlier menopause. Type 2 diabetes conferred increased infertility risks and reduced odds of successful pregnancy outcomes, compared with age-matched controls. Impaired oocyte quality and reduced ovarian reserve may exacerbate these outcomes. Reproductive hormone patterns were not consistent, although some cross-sectional observations suggested an earlier drop in estradiol with type 2 diabetes. Together, these findings demonstrate associations between premenopausal type 2 diabetes and earlier and/or pronounced features of female reproductive decline.
This position statement provides a focused framework for integrating incretin-based therapies into the care of peri- and postmenopausal women with overweight or obesity, with emphasis on body composition, cardiometabolic risk, musculoskeletal health, monitoring, and menopause hormone therapy. MenoYoung Spain, the Young Investigators Group of the Spanish Menopause Society, coordinated a structured literature review and iterative expert review process with senior Spanish Menopause Society experts. MEDLINE, Embase, and the Cochrane Library were searched through April 30, 2026 for studies evaluating glucagon-like peptide-1 receptor agonists and dual incretin therapies in peri- or postmenopausal women, menopause-stratified populations, and clinically relevant broader obesity populations. Evidence was synthesized narratively across predefined clinical domains, and 20 position statements were developed and reviewed by all authors. Semaglutide currently provides the largest amount of direct menopause-specific evidence among incretin-based therapies, although this evidence remains limited and largely observational. Tirzepatide and other dual incretin therapies are clinically promising, particularly for cardiometabolic disease and obstructive sleep apnea, but require menopause-specific evaluation. The association between concomitant use of menopause hormone therapy and greater semaglutide-related weight loss remains hypothesis-generating and should not justify initiating hormone therapy solely to augment weight loss. Incretin-based therapy in menopause should be considered within a cardiometabolic and functional framework that incorporates visceral adiposity, skeletal muscle health, fracture risk, cardiovascular prevention, individualized hormone therapy decision-making, resistance exercise, adequate protein intake, and structured monitoring of functional and metabolic outcomes.
BACKGROUND:Obesity and depression are independently associated with liver disease, yet to our knowledge, no prior study has specifically examined their joint longitudinal trajectories or the mediating role of frailty in this association. OBJECTIVES:To identify joint trajectories of body mass index and depressive symptoms, examine their associations with incident liver disease, and evaluate frailty as a potential mediator. METHODS:This multicohort prospective study included 17,582 participants aged 45 years or more from the China Health and Retirement Longitudinal Study (2011-2015; n = 10,487) and the Korean Longitudinal Study of Aging (2014-2018; n = 7095). Joint body mass index-depressive symptom trajectories were identified using group-based multi-trajectory modeling in the Chinese cohort and replicated in the Korean cohort via trajectory mean squared error matching. Associations with incident liver disease were estimated using Cox proportional hazards models with progressive covariate adjustment. Mediation analysis assessed the mediating role of mid-wave frailty index with 1000 bootstrap iterations. RESULTS:Four joint trajectory groups were identified: Normal Weight-Low Depression (25.3%), Overweight-Low Depression (31.8%), Normal Weight-High Depression (22.3%), and Obese-Moderate Depression (20.6%). During follow-up, 925 incident liver disease events occurred (5.3%). In fully adjusted models, compared with Normal Weight-Low Depression, hazard ratios for Obese-Moderate Depression were 3.53 (95% confidence interval 2.59-4.79; p < 0.001) in the Chinese cohort and 3.14 (95% confidence interval 2.21-4.47; p < 0.001) in the Korean cohort. Normal Weight-High Depression was associated with hazard ratios of 2.45 (95% confidence interval 1.80-3.35; p < 0.001) and 2.33 (95% confidence interval 1.62-3.33; p < 0.001), respectively. Frailty index mediated 8.5%-15.3% of these associations in the Chinese cohort and 6.8%-12.7% in the Korean cohort. Results remained robust across subgroup and sensitivity analyses, although marginal attenuation was observed for the Overweight-Low Depression group in the Korean cohort. CONCLUSIONS:Joint body mass index-depressive symptom trajectories are differentially associated with incident self-reported physician-diagnosed liver disease, partially mediated through frailty accumulation. Integrated metabolic, psychological, and frailty assessment may inform liver disease risk stratification, although further research with objective outcome ascertainment is needed.
OBJECTIVES:To investigate associations between the use of dietary supplements and diabetes status, and to examine whether epigenetic aging biomarkers derived from DNA methylation statistically mediates these associations. STUDY DESIGN:Cross-sectional analysis of adults participating in the National Health and Nutrition Examination Survey 1999-2002 with available data on use of dietary supplements, diabetes, and DNA methylation. MAIN OUTCOME MEASURES:Diabetes status was defined using self-reported diagnosis, use of glucose-lowering medication, fasting glucose, or hemoglobin A1c. Use of particular dietary supplements during the previous 30 days was analyzed as use versus non-use. Twelve epigenetic aging biomarkers derived from DNA methylation were evaluated. Survey-weighted logistic regression estimated associations with diabetes prevalence, and mediation analyses assessed indirect effects. Subgroup analyses were conducted across demographic, lifestyle, and clinical strata. RESULTS:Among 2381 participants, lycopene was the only supplement that remained associated with lower diabetes prevalence after full covariate adjustment and false discovery rate correction (odds ratio 0.092; 95% confidence interval 0.033-0.256; false discovery rate-adjusted P value = 0.003). Calcium, iodine, and molybdenum showed inverse associations before false discovery rate correction, but these associations were no longer significant after correction. Epigenetic aging biomarkers explained only a small proportion of the lycopene-diabetes association, with the largest mediation signals observed for GrimAgeMort, DunedinPoAm, and HorvathTelo. Several corrected indirect effects were also observed for calcium, iodine, and molybdenum, particularly through GrimAgeMort, but these findings were exploratory. CONCLUSIONS:The most robust supplement-related finding was that concerning the use of lycopene. Longitudinal studies with detailed exposure assessment and repeated DNA methylation measurements are needed.
OBJECTIVES:Primary ovarian insufficiency (POI) is a fertility disorder with a well-established genetic component, but many cases still remain idiopathic. Approximately 1.5-12% of patients with POI can carry a variant in the BMP15 gene, depending on the population and the diagnostic criteria. We hypothesize that genetic variations within pathways downstream of BMP15 activity in ovarian granulosa cells (GCs) may contribute to unexplained cases of POI. The main goal of this study is to identify novel variants associated with POI in genes induced by BMP15 in GCs. STUDY DESIGN:Primary cultures of human GCs were stimulated with recombinant human BMP15. Microarray analysis profiled the BMP15-induced transcriptome in GCs. Validation was achieved by qPCR and immunoblot. Further, target exome sequencing of the differentially expressed genes was performed on 64 women with early POI onset in search of novel variants. MAIN OUTCOME MEASURES:Transcriptome profiling of human GCs stimulated with BMP15 and target exome sequencing in women with early onset of POI. RESULTS:Transcriptome analysis revealed significant upregulation of 19 genes (p < 0.05). Ontology analysis of these genes converged towards two main pathways: TGF-beta signaling and regulation of stem cell pluripotency. Target exome sequencing identified six novel rare variants in five BMP15-induced genes (SAMD11, SMAD6, ID1, USP35, GPCR137C) in 9 of the 64 women with early POI (14%). CONCLUSIONS:BMP15 action in human ovarian GCs defines TGF-beta signaling and pluripotency fate in ovarian follicles. In addition, this study uncovers new potential candidate genes for the pathogenesis of POI.
BACKGROUND:Although research has focused on metabolomic profiles linked to individual cardiometabolic diseases, there is a lack of studies on metabolomic signatures associated with cardiometabolic multimorbidity. METHODS:We included 79,712 participants without cardiometabolic disease from the UK Biobank, randomly divided at a 70:30 training:testing ratio. Cox proportional hazards regression models were used to identify 249 metabolic biomarkers associated with cardiometabolic multimorbidity. Two-sample Mendelian randomization analyses were applied to explore the causal relationships between the identified metabolites and cardiometabolic outcomes. The association between the metabolic risk score and the risk of transitioning from disease-free status to cardiometabolic multimorbidity was evaluated using multi-state models. RESULTS:Of the 249 metabolites, 183 were associated with cardiometabolic multimorbidity. Very low-density lipoprotein cholesterol levels were positively associated, whereas high-density lipoprotein cholesterol levels were inversely associated. Mendelian randomization identified the apolipoprotein B to A1 ratio as causally associated with ischemic heart disease, cardiometabolic multimorbidity, and stroke. Metabolite risk scores demonstrated a positive association with the risk of cardiometabolic multimorbidity (hazard ratio 2.67; 95% confidence interval 2.05-3.49) in the testing set. In multi-state models, those with a higher metabolite risk score had an increased risk of progressing from disease-free status to first cardiometabolic disease (hazard ratio 1.71, 95% confidence interval 1.51-1.93) and from first cardiometabolic disease to cardiometabolic multimorbidity (hazard ratio 1.89, 95% confidence interval 1.45-2.47) in the testing set. CONCLUSIONS:Our findings indicate that metabolomic signatures can significantly aid risk stratification, underscoring the need to explore metabolic biomarkers in cardiometabolic multimorbidity to inform preventive strategies.
OBJECTIVES:To estimate the 12-week effect of an individual, self-guided digital cognitive behavioral therapy application added to usual care for bothersome menopausal vasomotor symptoms. STUDY DESIGN:Fully decentralized, open-label, parallel-group pilot randomized controlled trial. MAIN OUTCOME MEASURES:The primary outcome was change in hot flush problem rating from baseline to week 12. Secondary outcomes included hot flush frequency, menopausal symptom burden (Menopause Rating Scale II), insomnia severity (Insomnia Severity Index), and perceived stress. Clinically meaningful improvement was assessed using prespecified thresholds. RESULTS:One hundred participants were randomized (51 intervention, 49 control); 92 completed week 12. Adjusted mean change in the primary intention-to-treat analysis was -2.68 versus -1.21, a between-group difference of -1.47 points (95% confidence interval -2.29 to -0.65; p < 0.001; standardized mean difference 0.74). A reduction of at least two points occurred in 70.8% versus 29.5% of participants with responder data. Per-protocol analysis included 28 intervention participants. No serious adverse events occurred; 5.9% reported device-related events. CONCLUSIONS:In this open-label pilot trial, digital cognitive behavioral therapy produced clinically meaningful improvements in bothersome vasomotor symptoms and related menopausal symptoms over 12 weeks compared with usual care, with excellent safety and tolerability. These findings support digital cognitive behavioral therapy as an effective non-pharmacological option for managing menopausal symptoms, though further confirmation is warranted given the moderate level of participant engagement and the use of self-reported outcomes. TRIAL REGISTRATION:German Clinical Trials Register (DRKS) DRKS00036152.
OBJECTIVES:Vasomotor symptoms are experienced by up to 80% of postmenopausal women. Women were surveyed to evaluate the impact of vasomotor symptoms in the workplace, support from employers/colleagues, and perceptions of workplace accommodations. STUDY DESIGN:Participants aged 40-65 years were recruited from Dynata panels for an electronic survey. Women were experiencing vasomotor symptoms for ≥1 month with ≥2 hot flash/night sweat episodes per day in the preceding 2 weeks and were currently employed or had stopped working/retired within the last year. MAIN OUTCOME MEASURES:Demographic characteristics and Work Productivity and Activity Impairment. RESULTS:Respondents (N = 1011) were mostly White (72.9%), with a mean (standard deviation) age 49.6 (6.4) years, reporting a mean of 7.5 (11.1) hot flashes or night sweats per day in the preceding 2 weeks. The majority (81.3%) had never received treatment. Activity impairment, absenteeism, and presenteeism were reported by 36%, 6%, and 32%, respectively, and increased with increasing vasomotor symptom severity. Almost 80% of respondents had not discussed vasomotor symptoms with their employer; only 18.1% indicated employer support for vasomotor symptoms. Top coping mechanisms at work were temperature control (71.0%) and wearing layered, breathable clothing (46.0%). Respondents suggested some work accommodations for vasomotor symptoms: changes to benefit packages (27.9%), creating more workplace awareness (25.7%), and more flexible working arrangements (23.2%). CONCLUSIONS:Despite demonstrable adverse effects of vasomotor symptoms on United States women in the workplace, treatment rates were very low. Enhanced awareness regarding treatment options alongside potential workplace accommodations may improve work productivity, employee satisfaction, and retention.
BACKGROUND:Waist-to-height ratio (WHtR) is a simple marker of central obesity, but whether long-term target attainment is associated with incident cardiovascular disease (CVD) independent of baseline WHtR remains unclear. This study examined the association of WHtR time in target range (WHtR-TTR) with incident CVD and evaluated its consistency across glycemic status. METHODS:We included 5550 CVD-free participants from the China Health and Retirement Longitudinal Study (CHARLS). WHtR-TTR was defined as the percentage of visits with WHtR <0.5 across three waves and was categorized as 0%, 33.3%, 66.7%, and 100% of visits within the target range. Multivariable Cox proportional hazards models assessed the association with incident CVD. Stratified analyses were performed across normal glucose regulation (NGR), prediabetes (Pre-DM), and diabetes mellitus (DM) groups. RESULTS:During follow-up, 1375 incident CVD events occurred. CVD incidence decreased from 28.14% in the 0% WHtR-TTR group to 17.88% in the 100% group (P < 0.001). In Model 3, hazard ratios (HRs) for 33.3%, 66.7%, and 100% WHtR-TTR versus 0% were 0.88 (95% CI 0.74-0.96), 0.83 (95% CI 0.71-0.94), and 0.76 (95% CI 0.63-0.92), respectively. After additional adjustment for baseline WHtR, the corresponding HRs were 0.89, 0.84, and 0.79. Each 33.3-percentage-point increase in WHtR-TTR was associated with lower incident CVD risk (HR 0.92; 95% CI 0.87-0.98). No significant interaction with glycemic status was observed. CONCLUSIONS:A higher percentage of visits within the WHtR target range was associated with a lower risk of incident CVD independent of baseline WHtR and traditional cardiometabolic risk factors.
BACKGROUND:Intrinsic capacity (IC) reflects multidimensional functional reserve, but its joint role with hypertension in cardiovascular risk stratification remains unclear. We examined the independent and combined associations of IC impairment and hypertension with incident cardiovascular disease (CVD), and explored the contribution of specific IC domains. METHODS:We pooled data from three prospective aging cohorts in China, England, and the United States. IC was assessed across cognition, locomotion, vitality, psychological function, and sensory function. Participants were classified according to IC impairment and hypertension status. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD. We also examined risk gradients by the number of impaired IC domains, domain-specific associations, and incremental model discrimination using Harrell's C-index. RESULTS:Among 13,807 participants, 3650 incident CVD events occurred. Compared with participants with intact IC and no hypertension, impaired IC alone (HR 1.53, 95% CI 1.34-1.74) and hypertension alone (HR 1.68, 95% CI 1.46-1.93) were associated with higher CVD risk, while their coexistence conferred the highest risk (HR 2.29, 95% CI 2.02-2.59). CVD risk increased progressively with accumulating impaired IC domains. Impairments in the locomotion, psychological function, and sensory function domains were the main contributors. Adding IC impairment and hypertension modestly improved model discrimination, increasing Harrell's C-index from 0.619 to 0.649. CONCLUSION:IC impairment and hypertension were independently and jointly associated with incident CVD. Integrating multidimensional functional assessment with hypertension status may improve cardiovascular risk stratification in aging populations.
Objective Evidence on the association of levels of serum uric acid (SUA) with muscle mass has been inconsistent and limited to that from studies with a cross-sectional design. This study investigated the longitudinal association of baseline and changes in SUA levels with low muscle mass and distinct trajectories of muscle mass. Methods Data were taken from the Kailuan study (an ongoing Chinese population-based cohort study), in which 87,284 and 66,129 participants respectively had records of baseline SUA levels and changes in SUA levels from baseline to the second follow-up visit. The primary outcome was incident low muscle mass, and the secondary outcome was muscle mass trajectory, which was identified by group-based trajectory modeling. Cox regressions and multinominal logistic regressions were performed to assess the aforementioned associations. Results During a median follow-up of 13.05 years, a total of 5916 (6.78%) cases of incident low muscle mass occurred, and three trajectories of muscle mass were identified. The risk of incident low muscle mass decreased by 28% (hazard ratio [HR] 0.72; 95% confidence interval [CI] 0.66–0.78) in the Q4 group of baseline SUA, 23% (HR 0.77; 95% CI 0.71–0.85) in the stable high SUA, and 22% (HR 0.78; 95% CI 0.70–0.87) in the Q4 group of changes in SUA, compared with their counterparts. Additionally, these participants were associated with 53%, 50%, and 57% higher risks of following a low-stable pattern of muscle mass, with relative risks (95% CI) of 0.47 (0.39–0.56), 0.50 (0.41–0.60), and 0.43 (0.37–0.50), respectively. Conclusions Higher SUA levels were longitudinally associated with a lower incidence of low muscle mass; however, causality cannot be inferred.
OBJECTIVES:The reproductive lifespan encompasses important transitions in women's health, including midlife and menopause, yet whole-person strengths, challenges, and unmet needs across this continuum remain poorly characterized. This study examined multidimensional self-reported health profiles across three age-based groups representing different stages of adult life. STUDY DESIGN:Retrospective comparative study using de-identified consumer-generated health data from the MyStrengths+MyHealth digital assessment, a validated whole-person tool grounded in the Omaha System. Data were collected from community-based settings in a Midwestern metropolitan area (2019-2023). Women were categorized by age as a proxy for reproductive stage: reproductive-aged (25-44, n = 253), midlife (45-64, n = 329), and later adulthood (65+, n = 124). Group differences in Strengths, Challenges, and Needs across four whole-person health domains were analyzed using descriptive and inferential statistics. MAIN OUTCOME MEASURES:Self-reported domain-level Strengths rating, Challenge counts, and Need counts across 37 health concepts. RESULTS:Later adulthood and midlife women reported significantly higher Strengths than reproductive-aged women (p < 0.001). Reproductive-aged women reported the greatest burden of Challenges (M = 44.9, SD = 32.0) and Needs (M = 33.6, SD = 22.7) distributed across the widest range of health concepts (all p < 0.001). Exercise was the most prevalent Challenge across all groups. Midlife women generated the highest total volume of Needs at the population level. CONCLUSIONS:Whole-person consumer-generated health data suggest that substantial challenges and unmet needs emerge well before midlife, underscoring the potential value of upstream, strengths-based, and personalized interventions to promote resilience and healthy aging across the reproductive lifespan. Additional longitudinal and population-based studies are needed to confirm these findings and evaluate their implications for clinical practice.
