Physical performance in relation to birth cohort: A comparison of 60 year old Swedish men and women born twelve years apart

Gait Speed Reserve in the general population-based 'Good Aging in Skåne' cohort study-distribution and associated factors

Gait Speed Reserve (GSR) expresses a difference between fast and comfortable gait speed and may have an impact on everyday functioning. It was also hypothesized as a useful proxy measure of physiological reserve. However, height-normalizing values of GSR and its associated factors have not been evaluated in a general population of older adults. Therefore, we aimed to investigate the distribution of height-normalized GSR (HN-GSR) in an elderly population-based cohort from urban and rural areas (n = 4342) aged 60-93 years and evaluate associated physiological and lifestyle factors. Using linear mixed models, we identified gender and nine modifiable factors as significantly associated with HN-GSR across four age groups. Better handgrip strength, cognition and standing balance, higher physical activity level, larger calf circumference, and less smoking had positive associations with HN-GSR, while female gender, more leg pain, higher weight and, alcohol consumption had opposite effects. The Marginal R2 imply that this model explained 26% of the variance in HN-GSR. Physical activity and handgrip strength varied across age groups in impact on HN-GSR. The differences were however comparatively minor. In this large cohort study of older adults, we proposed for the first time that factors associated with HN-GSR represented multi-domain features that are in line with previous findings reported for GSR. Measuring HN-GSR/GSR may help clinicians identify early physiological impairments or unhealthy lifestyle habits, especially among older women, and may also have safety implications in daily life. Further work is needed to find out if measuring HN-GSR/GSR may be useful in identifying adverse health outcomes and overall physiological reserve.

The Association between Untreated and Treated Hearing Loss and Cognitive Performance in Men and Women Aged 60-96 Years: Data from the Swedish "Good Aging in Skåne" Population Study

Background/Objectives: Recent decades have witnessed a sharp increase in research investigating the association between hearing loss and cognitive impairment. Few previous studies have stratified for sex when investigating this issue, where results were inconsistent and require further clarification. Thus, the objective was to investigate the association between self-reported hearing loss and levels of cognitive impairment, stratified for sex. Methods: In this cross-sectional study, data were collected from 2001 to 2016. The study sample consisted of 5075 individuals, 2325 (45.8%) men, mean age 68.3 years, and 2750 (54.2%) women, mean age 70.0 years. Multiple variate ordinal regression models were constructed and adjusted for age, marital status, education, physical activity, depressive mood, hypertension, stroke, diabetes, and use of sedatives to investigate associations between groups of self-reported untreated and treated hearing loss and those reporting no hearing loss in relation to levels of cognitive impairment assessed by the Mini-Mental State Examination scale. Results: In men, treated hearing loss was associated with levels of cognitive impairment, odds ratio (OR) = 1.64, 95% confidence interval (CI) = 1.14-2.36. In women, both untreated hearing loss, (OR = 1.45, CI 1.07-1.98) and treated hearing loss (OR= 1.46, CI 1.06-2.04) were associated with levels of cognitive impairment. Conclusions: Hearing loss was found to be associated with cognitive impairment despite hearing aid use as well as awareness amongst physicians. The introduction of screening programs for hearing loss in older adults could be a crucial step for earlier identification of individuals at higher risk of developing cognitive impairment and dementia.

Association of polypharmacy with occurrence of loneliness and social isolation among older adults

BACKGROUND

Polypharmacy is increasing. The longitudinal association of polypharmacy and social isolation has not been previously reported. The aim of this study was to explore longitudinal associations of polypharmacy with loneliness and social isolation among older adults.

METHODS

Participants aged 60 years and above in southern Sweden were invited for participation. A total of 1526 and 2556 participants were included in the separate analyses for loneliness and social isolation. Polypharmacy was defined as taking five or more medications. Associations of polypharmacy with occurrence of loneliness and social isolation were estimated using logistic regression models.

RESULTS

During follow-up, 409 and 414 participants developed loneliness and social isolation, respectively. The odds for loneliness occurrence were higher for participants with polypharmacy compared to participants without polypharmacy (OR, 1.37; 95% CI, 1.05-1.78; P = 0.020). For participants without polypharmacy, the probability of developing loneliness was 0.28 (95% CI, 0.25-0.31), while for those with polypharmacy this probability was 25% higher (0.35; 95% CI, 0.30-0.39). The odds for social isolation occurrence were higher for participants with polypharmacy compared to participants without polypharmacy (OR, 1.29; 95% CI, 1.02-1.64; P = 0.036). For participants without polypharmacy, the probability of developing social isolation was 0.16 (95% CI, 0.14-0.18), while for those with polypharmacy this probability was 18% higher (0.19; 95% CI, 0.17-0.22).

CONCLUSIONS

Polypharmacy was associated with loneliness and social isolation occurrence among older adults. Consideration of loneliness and social isolation are warranted when caring for older adults taking multiple medications.

Lean mass, grip strength, and hospital-associated disability among older adults in Health ABC

INTRODUCTION

Older adults with cognitive impairment, including those with Alzheimer's disease and related dementias, are particularly at risk for hospitalization and hospital-associated disability. Understanding of key risk factors for hospital-associated disability is limited. Sarcopenia, age-related declines in muscle mass and strength, is common in older adults with cognitive impairment and may be an important risk factor for hospital-associated disability.

METHODS

Using data from the Health ABC Study, we examined associations of pre-hospitalization appendicular lean mass (ALM) and grip strength with the development of a new activity of daily living (ADL) disability at the next annual assessment after hospitalization.

RESULTS

Grip strength, but not ALM, was negatively associated with increased risk of hospital-associated ADL disability, and this association was greater among those with cognitive impairment compared to those without.

DISCUSSION

Lower grip strength may be an important risk factor for hospital-associated ADL disability in older adults, particularly those with cognitive impairment.

Physical Performance in Older Cohorts: A Comparison of 81-Year-Old Swedish Men and Women Born Twelve Years Apart-Results from the Swedish Study "Good Aging in Skåne"

Materials and Methods

Birth cohorts of both sexes drawn from the Swedish study “Good Aging in Skåne” for the years 1920–22 and 1932–34 were compared. Walking, the step test, the chair stand test, and the handgrip strength test were used as proxies for the physical performance. The results were adjusted for lifestyle habits and common chronic geriatric diseases.

Results

Both men and women in the later-born cohort walked more quickly and completed the chair stand test faster, and women were also quicker in the step test. No significant differences were found in the grip test, in either the male or female cohorts. Discussion. Normative reference values for physical tests of subjects of different ages can be misleading unless cohort effects are considered. Furthermore, age-related trajectories can also be misinterpreted if cohort effects are neglected which, in the longer perspective, could affect health care planning.

Conclusion

Birth cohort effects should be considered when comparing walking speed, number of steps, chair stands, and the step test, in men and women of older age.

Age-Related Changes in Physical Fitness Among Community-Living Middle-Aged and Older Japanese: A 12-Year Longitudinal Study

Physical fitness is one of the key factors in healthy aging. Although physical fitness is widely recognized to decline with age, age-related decreases in the individual dimensions of physical fitness in later life are less clear. Purpose: The purpose of the present study was to describe the age-related changes in six fitness components covering a variety of motor dimensions in men and women through a 12-year longitudinal epidemiological study. Method: Participants were randomly selected community-living men (n = 1,139) and women (n = 1,128) aged 40 to 79 years at baseline who were repeatedly tested over a mean (standard deviation) follow-up period of 9.8 (3.4) years with a mean of 4.9 (2.3) examinations. The six physical fitness tests were sit-and-reach, grip strength, sit-ups, one-leg standing, reaction time and leg extension power. The effect of age on each physical fitness task was analyzed using a mixed-effects model controlling for habitual physical activity level. Results: The fixed effect of the interaction of age and time in all fitness tests was significant in men. Higher age at baseline was significantly associated with a greater decrease over time except in one-leg standing. In women, no significant interaction effect of age and time was found in grip strength or reaction time. Age-related changes in grip strength and reaction time were constant with increasing age. Conclusion: Twelve-year longitudinal data showed that the age-related decrease in physical fitness over time, especially musculoskeletal fitness in men, was pronounced, whereas in women, the decrease was less pronounced.

Cohort Differences in Maximal Physical Performance: A Comparison of 75- and 80-Year-Old Men and Women Born 28 Years Apart

BACKGROUND

Whether increased life expectancy is accompanied by increased functional capacity in older people at specific ages is unclear. We compared similar validated measures of maximal physical performance in 2 population-based older cohorts born and assessed 28 years apart.

METHOD

Participants in the first cohort were born in 1910 and 1914 and were assessed at age 75 and 80 years, respectively (N = 500, participation rate 77%). Participants in the second cohort were born in 1938 or 1939 and 1942 or 1943 and were assessed at age 75 and 80 years, respectively (N = 726, participation rate 40%). Participants were recruited using a population register and all community-dwelling persons in the target area were eligible. Both cohorts were interviewed at home and were examined at the research center with identical protocols. Maximal walking speed, maximal isometric grip and knee extension strength, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were assessed. Data on non-participation were systematically collected.

RESULTS

Walking speed was on average 0.2-0.4 m/s faster in the later than earlier cohort. In grip strength, the improvements were 5%-25%, and in knee extension strength 20%-47%. In FVC, the improvements were 14-21% and in FEV1, 0-14%.

CONCLUSIONS

The later cohort showed markedly and meaningfully higher results in the maximal functional capacity tests, suggesting that currently 75- and 80-year-old people in Finland are living to older ages nowadays with better physical functioning.