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Pitkälä KH, Aalto UL, Roitto HM, Öhman HR, Lehti TL, Knuutila MT, Kautiainen H, Tilvis R, Strandberg TE. Secular trends in frailty among community-dwelling 75-95-year-old cohorts over three decades in Helsinki, Finland. Age Ageing 2024; 53:afae172. [PMID: 39140371 PMCID: PMC11322735 DOI: 10.1093/ageing/afae172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Frailty Index (FI) reflects health, functioning and well-being of older people. It is valuable to compare how frailty has changed over time in ageing cohorts. This study aims to examine trends in frailty among 75-95-year-old men and women over three decades. METHODS The Helsinki Ageing Study started in 1989 and includes repeated cross-sectional postal surveys every 10 years examining community-dwelling cohorts of older people (75, 80, 85, 90 and 95 years). FI comprises the same 36 items in each cohort. RESULTS The mean FI was 0.22 (SD 0.12), 0.25 (SD 0.15), 0.26 (SD 0.15) and 0.23 (SD 0.15) in 1989, 1999, 2009 and 2019, respectively (P for linearity for crude values .11). Adjusted for age and sex, the four cohorts differed in their frailty the 2019 cohort having the lowest FI. This sex-adjusted difference was seen among 75-, 80-, 85- and 90-year-olds but not among 95-year-olds. FI decreased more among men than women (P for cohort <.001, P for sex <.01, P for interaction = .19). CONCLUSIONS The prevalence of frailty among community-dwelling individuals aged 75, 80, 85 and 90 years-but not among those aged 95 years-has significantly decreased over the last decades. This positive trend may have important implications for health policies in societies with increasing longevity.
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Affiliation(s)
- Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Ulla L Aalto
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna-Maria Roitto
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna R Öhman
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuuli L Lehti
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Mia T Knuutila
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Reijo Tilvis
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo E Strandberg
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Magalhães JP, Hetherington-Rauth M, Rosa GB, Correia IR, Pinto GM, Ferreira JP, Coelho-E-Silva MJ, Raimundo AM, Mota J, Sardinha LB. Functional fitness trends among older adults in Portugal between 2008 and 2018: Keeping up with a healthy aging process. J Sci Med Sport 2023; 26:622-627. [PMID: 37802759 DOI: 10.1016/j.jsams.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/05/2023] [Accepted: 09/02/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVES Maintaining a healthy aging process is vital to combating and delaying the adverse health outcomes faced by the growing older adult population, where a key aspect to achieving healthy aging is the preservation of functional fitness. This study aims to present trends on the functional fitness of Portuguese older adults between 2008 and 2018 and build new normative reference standards for the Senior Fitness Battery Tests. DESIGN Cross-sectional study. METHODS Functional fitness was measured with the Senior Fitness Battery Tests in two national representative cohorts of the Portuguese older adult population (≥65 years) using the 2008 (n = 4712) and 2018 (n = 2717) surveys. Changes were assessed according to sex and age group. Sex and age-group normative fitness scores were developed. RESULTS Overall findings suggested that older adults' point prevalence for arm-curl, 8-ft up-and-go, and 30-s chair sit-to-stand remained stable between 2008 and 2018, with declining trends being observed for the 6-min walk and back-scratch tests. However, results for trends varied when stratified by sex and age categories. CONCLUSIONS Our results suggest a trend toward a stabilization of most of the functional fitness tests over the past decade, but with a critical decline in the 6-min walk test. Thus, this test should be targeted by future health-care policies. Moreover, this investigation provides new and updated normative reference standards for the Senior Fitness Battery Tests that should be used as a tool to promote a healthy aging process among Portuguese older adults.
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Affiliation(s)
- João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal.
| | - Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Graça M Pinto
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Department of Sport Sciences, Exercise and Health, University of Trás-os-Montes and Alto Douro, Portugal
| | - José P Ferreira
- University of Coimbra, Faculty of Sport Sciences and Physical Education, Portugal
| | | | - Armando M Raimundo
- Comprehensive Health Research Centre, Departamento Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Portugal
| | - Jorge Mota
- Laboratory for Integrative and Translational Research in Population Health (ITR), Portugal; CIAFEL - Research Center in Physical Activity, Health and Leisure, University of Porto, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
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3
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Zhang FM, Song CH, Guo ZQ, Yu Z, Weng M, Zhou FX, Liu M, Cong MH, Li T, Li ZN, Chen JQ, Cui JW, Xu HX, Li W, Shi HP, Zhuang CL. Sarcopenia prevalence in patients with cancer and association with adverse prognosis: A nationwide survey on common cancers. Nutrition 2023; 114:112107. [PMID: 37356170 DOI: 10.1016/j.nut.2023.112107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/09/2023] [Accepted: 05/24/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Although previous studies have implicated the negative outcomes of sarcopenia, evidence is limited to one or a few types of cancer. The aim of this study was to evaluate the distribution and influencing factors of sarcopenia, and explore the relationship between sarcopenia and cancer prognosis in a large oncological population. METHODS This observational cohort study included patients diagnosed with malignant cancer between May 2011 and January 2019. Hematologic and anthropometric parameters were collected prospectively. Low skeletal muscle mass and radiodensity were diagnosed using clinical indicators, according to the two prediction models. The importance of potential risk factors for sarcopenia was estimated by subtracting the predicted degrees of freedom from the partial χ2 statistic. Hazard rates of death were calculated using the hazard function and Cox regression analyses. RESULTS We included 13 761 patients with cancer; the prevalence of sarcopenia was 33%. The median age was 58 y and 7135 patients (52%) were men. Patients with sarcopenia had a worse nutritional status and quality of life than those without sarcopenia. Age was the most important risk factor for sarcopenia compared with body mass index or TNM stage. Additionally, patients with sarcopenia had a significantly higher and earlier peak risk for mortality. After adjusting for baseline characteristics, sarcopenia was independently associated with mortality in the research population (hazard ratio, 1.429; P < 0.001) and most cancer types. CONCLUSION Age is the most important risk factor for sarcopenia even in patients with cancer. Sarcopenia is strongly associated with a poor quality of life and reduced overall survival.
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Affiliation(s)
- Feng-Min Zhang
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chun-Hua Song
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zeng-Qing Guo
- Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Zhen Yu
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Min Weng
- Department of Nutrition, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fu-Xiang Zhou
- Department of Oncology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Ming Liu
- General Surgery Department, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ming-Hua Cong
- Comprehensive Oncology Department, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Li
- Department of Radiotherapy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zeng-Ning Li
- Department of Nutrition, the First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jun-Qiang Chen
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jiu-Wei Cui
- Cancer Center, the First Hospital, Jilin University, Changchun, China
| | - Hong-Xia Xu
- Department of Nutrition, Daping Hospital, Army Medical University, Chongqing, China
| | - Wei Li
- Cancer Center, the First Hospital, Jilin University, Changchun, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University/ Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.
| | - Cheng-Le Zhuang
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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Kleven AG, Miaskowski C, Torstveit AH, Ritchie CS, Engh ME, Andersen E, Utne I. Quality of life of older gynecologic oncology patients at the initiation of chemotherapy. Nurs Open 2023; 10:6749-6757. [PMID: 37337353 PMCID: PMC10495706 DOI: 10.1002/nop2.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 05/14/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Abstract
AIM To evaluate older gynecologic oncology patients' quality of life (QOL) at the initiation of chemotherapy and compare their QOL scores with a female age-matched general population (GP) sample. DESIGN Cross-sectional. METHODS Older (n = 122) gynecologic oncology patients completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) that evaluates global health and five functional scales (range from 0 to 100). Differences in QOL scores between our sample and the GP were evaluated using one-sample t-tests and effect sizes were calculated using Cohen's d. RESULTS Patients' mean age was 70.7 years (±6.6). Mean scores for the function scales ranged from 58.5 (±31.1) for role function to 86.1 (±17.0) for cognitive function. Compared to the GP, our sample reported significantly lower scores for global health status, social, role and physical functioning, and a significantly higher score for cognitive functioning. No differences were found in emotional functioning scores. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Anne Grethe Kleven
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet ‐ Oslo Metropolitan UniversityOsloNorway
| | | | - Ann Helen Torstveit
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet ‐ Oslo Metropolitan UniversityOsloNorway
| | - Christine Seel Ritchie
- Division of Palliative Care and Geriatric MedicineMassachusetts General Hospital Mongan Institute Center for Aging and Serious IllnessBostonMassachusettsUSA
| | - Marie Ellström Engh
- Division Akershus University Hospital, Faculty of MedicineUniversity of OsloOsloNorway
- Department of Obstetrics and GynecologyAkershus University HospitalLørenskogNorway
| | - Elin Andersen
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet ‐ Oslo Metropolitan UniversityOsloNorway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet ‐ Oslo Metropolitan UniversityOsloNorway
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5
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Nishita Y, Makizako H, Jeong S, Otsuka R, Kim H, Obuchi S, Fujiwara Y, Ohara Y, Awata S, Yamada M, Iijima K, Shimada H, Suzuki T. Temporal trends in cognitive function among community-dwelling older adults in Japan: Findings from the ILSA-J integrated cohort study. Arch Gerontol Geriatr 2022; 102:104718. [DOI: 10.1016/j.archger.2022.104718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/01/2022] [Accepted: 05/07/2022] [Indexed: 11/02/2022]
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6
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Kahraman T, Çekok FK, Üğüt BO, Keskinoğlu P, Genç A. One-Year Change in the Physical Functioning of Older People According to the International Classification of Functioning Domains. J Geriatr Phys Ther 2021; 44:E9-E17. [PMID: 30883529 DOI: 10.1519/jpt.0000000000000234] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE It is important to determine physical functioning declines in older people according to the International Classification of Functioning, Disability and Health (ICF) framework, given its advantages. This study was performed to investigate 1-year changes in the physical functioning of older people using the ICF framework. METHODS Eighty older people were enrolled and completed baseline measures in this longitudinal, single-group study while 33 of these participants were reassessed at 1 year. Reliable and valid methods commonly used in geriatric rehabilitation settings for determining physical functioning were applied to evaluate ICF domains including Body Functions, Activities (capacity), and Activities and Participation (performance). Body Functions were assessed by measuring lower extremity muscle strength and exercise tolerance test performance. The Activities (capacity) measures included walking, balance, mobility, sit-to-stand, and upper extremity functional performance. The Activities and Participation (performance) domain included the Falls Efficacy Scale-International, Modified Barthel Index, and Rapid Assessment of Physical Activity scale. RESULTS There were significant decreases in muscle strength in both hip abductors and knee extensors (P < .001, d > 0.80) at 1 year versus baseline, but there were no significant changes in exercise tolerance test parameters (P > .05, d = 0.44-0.71), with the exception of diastolic blood pressure (P = .019, d = 0.90). Significant deterioration was observed in all Activities (capacity) measures (P < .05, d > 0.80). No significant changes were observed in the Falls Efficacy Scale-International (P = .051, d = 0.72), Modified Barthel Index (P = .107, d = 0.59), or Rapid Assessment of Physical Activity-Flexibility and Strength subscale (P = .763, d = 0.11). CONCLUSIONS Significant declines were seen in lower extremity muscle strength, walking capacity, speed, mobility, sit-to-stand performance, upper extremity function, and balance performance at 1 year. On the contrary, no significant changes were observed in the levels of participation in activities of daily living, activities related to balance, or physical activity. According to the ICF framework, during 1 year, our sample of older people showed declines in the Body Functions and Activities (capacity) domains, but the Activities and Participation (performance) domain remained stable.
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Affiliation(s)
- Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | | | - Birön Onur Üğüt
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
- Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Pembe Keskinoğlu
- Department of Biostatistics and Medical Informatics, Dokuz Eylül University, Izmir, Turkey
| | - Arzu Genç
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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7
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Kidokoro T, Peterson SJ, Reimer HK, Tomkinson GR. Walking speed and balance both improved in older Japanese adults between 1998 and 2018. J Exerc Sci Fit 2021; 19:204-208. [PMID: 34276805 PMCID: PMC8246636 DOI: 10.1016/j.jesf.2021.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/05/2021] [Accepted: 06/13/2021] [Indexed: 02/05/2023] Open
Abstract
Background/objective Physical function, the ability of an individual to carry out physical tasks, is meaningfully related to health among older adults. Few studies have analyzed temporal trends in objective performance measures of physical function for older adults. The aim of this study was to estimate temporal trends in balance and walking speed for older Japanese adults (aged 65–79 years) between 1998 and 2018. Methods Annual, cross-sectional, national fitness surveillance data for balance (n = 114,785) and walking speed (n = 112,289) were reported descriptively by the Japanese Ministry of Education, Culture, Sports, Science and Technology across the 1998–2018 period. Trends in means were estimated by sample-weighted regression, with trends in variability estimated as the ratio of coefficients of variation. Results There was a moderate improvement in both mean balance (standardized effect size (ES) change (95% confidence interval (CI)): 0.50 (0.48–0.52)) and mean walking speed (ES change (95%CI): 0.53 (0.51–0.55)). Improvements were seen in all gender and age groups, with small gender-related and negligible age-related temporal differences. Variability declined substantially for both balance (ratio of CVs (95%CI): 0.77 (0.75–0.79)) and walking speed (ratio of CVs (95%CI): 0.87 (0.85–0.89)). Conclusion Improved physical performance is suggestive of a corresponding improvement in health. Declines in variability indicate that temporal improvements were not uniform across the distribution.
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Affiliation(s)
- Tetsuhiro Kidokoro
- Faculty of Sport Science, Nippon Sport Science University 7-1-1, Fukasawa, Setagaya, 158-8508, Tokyo, Japan
| | - Samantha J Peterson
- Department of Medical Laboratory Science, University of North Dakota, Grand Forks, ND, USA
| | - Hannah K Reimer
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA
| | - Grant R Tomkinson
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, Australia
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8
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Öhman HR, Karppinen H, Lehti TE, Knuutila MT, Tilvis R, Strandberg T, Kautiainen H, Pitkala KH. Secular trends in functional abilities, health and psychological well-being among community-dwelling 75- to 95-year-old cohorts over three decades in Helsinki, Finland. Scand J Public Health 2021; 50:524-531. [PMID: 33899588 PMCID: PMC9152590 DOI: 10.1177/14034948211007688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Life expectancy has increased markedly in the past
decades. Thus, it is of great importance to understand how people are ageing and
if the trajectories of health and disability are changing over time. This study
aimed to examine trends in functional abilities and health in independent
cohorts of people aged 75–95 over three decades. Methods: This
Helsinki Ageing Study consists of repeated cross-sectional postal surveys
examining independent cohorts of old people (75, 80, 85 and 90+ years old). This
study combined data from four waves (1989, 1999, 2009 and 2019).
Results: In the most recent wave, there was an increase in
the portion of participants who were able to walk outdoors easily (75-year-olds
p=0.03, 80-year-olds p=0.002, 85-year-olds
p<0.001; p for linearity for the study
year effect, all adjusted for sex). Fewer people in the youngest age group
(75-year-olds) needed daily help from another person in 2019 compared to the
earlier waves (p=0.02 for linearity for the study year). Over
the past three decades, the proportions of self-reported good mobility have
risen 8.7% (95% confidence interval (CI) 2.3–15.1) in 75-year-olds, 11.7% (95%
CI 3.9–19.6) in 80-year-olds and 20.1% (95% CI 10.7–29.4) in 85-year-olds, after
adjusting for sex. Furthermore, in 2019, more people rated their health as good
and scored better in psychological well-being than in the previous waves among
75-, 80- and 85-year-olds. However, no improvements were found among
90+-year-olds in any of these variables. Conclusions: People between 75
and 85 years old are presently feeling and functioning better than their
predecessors. This may be an important objective for both economics and
health policy.
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Affiliation(s)
- Hanna R Öhman
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Finland
| | - Helena Karppinen
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Tuuli E Lehti
- Department of General Practice and Primary Health Care, University of Helsinki, Finland.,Social Services and Health Care, City of Helsinki, Finland
| | - Mia T Knuutila
- Department of General Practice and Primary Health Care, University of Helsinki, Finland.,Social Services and Health Care, City of Helsinki, Finland
| | - Reijo Tilvis
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Timo Strandberg
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Kaisu H Pitkala
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
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9
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Henchoz Y, Büla C, von Gunten A, Blanco JM, Seematter-Bagnoud L, Démonet JF, Waeber G, Nanchen D, Santos-Eggimann B. Trends in Physical and Cognitive Performance Among Community-Dwelling Older Adults in Switzerland. J Gerontol A Biol Sci Med Sci 2021; 75:2347-2353. [PMID: 31942995 DOI: 10.1093/gerona/glaa008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND With population aging, a key question is whether new cohorts of older people are in better health than previous ones. This study aimed to compare the physical and cognitive performance of community-dwelling older adults assessed at similar age in 2005, 2010, and 2015. METHODS This repeated cross-sectional analysis used data from the Lausanne cohort 65+, a three random sample population-based study. Performance of participants aged 66-71 years in 2005 (N = 1,309), 2010 (N = 1,253), and 2015 (N = 1,328) was compared using a battery of six physical and four cognitive tests. Analyses included tests for trend across samples and multivariable linear regression models. RESULTS Adjusted performance in all four timed physical tests (gait speed, Timed Up-and-Go, five times chair stand, and Moberg Picking-Up) improved across samples from 2005 to 2015, by +12.7% (95% confidence interval {CI} +10.5%; +14.9%) to +20.4% (95% CI +17.7%; +23.0%) in females, and by +10.6% (95% CI +8.7%; +12.4%) to +16.7% (95% CI +13.4%; +20.0%) in males. In contrast, grip strength and balance did not improve across samples. Adjusted cognitive performance showed no change in the Trail Making Test, but worsened significantly across samples for the Mini-Mental State Examination, verbal fluency, and the clock drawing test in both females (-1.9% [95% CI -2.7%; -1.1%] to -6.7% [95% CI -8.9%; -4.6%]) and males (-2.5% [95% CI -3.4%; -1.6%] to -8.0% [95% CI -11.1%; -4.9%]). CONCLUSIONS Over the last decade, performance of adults aged 66-71 years improved significantly in timed physical tests but worsened in most cognitive measures among later-born samples.
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Affiliation(s)
- Yves Henchoz
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Christophe Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Switzerland
| | - Armin von Gunten
- Service of Geriatric Psychiatry, Department of Psychiatry, University of Lausanne Hospital Centre, Switzerland
| | - Juan Manuel Blanco
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Laurence Seematter-Bagnoud
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Switzerland
| | | | - Gérard Waeber
- Department of Internal Medicine, University of Lausanne Hospital Centre, Switzerland
| | - David Nanchen
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
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10
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Pandey N, Darin-Mattsson A, Nilsen C. Working conditions mediate the association between social class and physical function in older age in Sweden: a prospective cohort study. BMC Public Health 2020; 20:1360. [PMID: 32887580 PMCID: PMC7487473 DOI: 10.1186/s12889-020-09431-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/23/2020] [Indexed: 11/22/2022] Open
Abstract
Background Global demographics are changing as societies all over the world are aging. This puts focus on maintaining functional ability and independence into older age. Individuals from lower social classes are at greater risk of developing limitations in physical function later in life. In this study, we investigated the mediating role of working conditions in the association between occupation-based social class and physical function measured as self-reported mobility limitations and objectively measured physical impairment in older age. Methods Two Swedish surveys, linked at the individual level, were used (n = 676–814 depending on the outcome). Follow-up time was 20–24 years. Multiple logistic regression analyses were performed with adjustments for age, sex, level of education, mobility, and health problems at baseline. This was followed by analyses of the size of the mediating effect of working conditions. Results Working conditions seem to mediate 35–74% of the association between social class and physical impairment in older age. The pattern of mediation was primarily driven by passive jobs, i.e., low psychological demands and low control, among blue-collar workers. Working conditions did not mediate the association between social class and self-reported mobility limitations in older age. Conclusions The results of this study indicate that working conditions are important in combating the social gradient in healthy aging, contributing to the evidence regarding the magnitude of impact exerted by both the physical and psychosocial work environment separately and in conjunction.
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Affiliation(s)
- Nikita Pandey
- Aging Research Center (ARC), Karolinska Institutet/Stockholm University, SE-171 65, Stockholm, Sweden
| | - Alexander Darin-Mattsson
- Aging Research Center (ARC), Karolinska Institutet/Stockholm University, SE-171 65, Stockholm, Sweden
| | - Charlotta Nilsen
- Aging Research Center (ARC), Karolinska Institutet/Stockholm University, SE-171 65, Stockholm, Sweden. .,Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden.
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11
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Liu N, Cadilhac DA, Kilkenny MF, Liang Y. Changes in the prevalence of chronic disability in China: evidence from the China Health and Retirement Longitudinal Study. Public Health 2020; 185:102-109. [PMID: 32603874 DOI: 10.1016/j.puhe.2020.03.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Chinese adults are the biggest users of healthcare services, and understanding current trends in disability profiles is relevant to planning healthcare workforce infrastructure. We investigated the trends over time for disability and physical functional limitations from 2011 to 2015 among Chinese adults and identified the factors associated with these limitations. STUDY DESIGN We used nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS); the CHARLS participants were followed up every 2 years as they moved from work to retirement with an emphasis on their health status and functional abilities. METHODS Participants aged ≥50 years from three waves of the CHARLS were included. Data were collected on physical functioning limitations, disabilities in activities of daily living (ADLs) and disabilities in instrumental activities of daily living (IADLs). Multilevel logistic regression models were used to test for changes and factors associated with limitations and disabilities between 2011 and 2015 adjusting for sociodemographic, medical history and health measures. RESULTS There were 44,447 eligible participants (mean age: 63 years; standard deviation [SD], 9 years; 51% female). After adjustment, there was no significant increase in reporting of ADLs or IADLs in the 2015 survey compared with the 2011 survey. After adjustment, there was a 26% significant increase in reporting of physical functioning limitations in the 2015 survey compared with the 2011 survey (odds ratio: 1.26; 95% confidence interval, 1.17 to 1.35). Factors associated with ADL disability were being female, being older, minimal education, no alcohol intake in the previous year, falls, fractured hip, feeling depressed and being obese. Factors associated with IADL disabilities were being female, being older, minimal education and feeling depressed. CONCLUSIONS Chinese health agencies should consider the growing need for sufficient community services infrastructure to maximise independence, particularly in the context of ageing populations.
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Affiliation(s)
- N Liu
- Nursing Faculty, Zhuhai Campus of Zunyi Medical University, Zhuhai, People's Republic of China.
| | - D A Cadilhac
- Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Public Health, Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
| | - M F Kilkenny
- Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Public Health, Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
| | - Y Liang
- Nanjing University of Finance and Economics, School of Public Administration, Nanjing, People's Republic of China.
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12
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Xu F, Cohen SA, Greaney ML, Earp JE, Delmonico MJ. Longitudinal
Sex‐Specific
Physical Function Trends by Age, Race/Ethnicity, and Weight Status. J Am Geriatr Soc 2020; 68:2270-2278. [DOI: 10.1111/jgs.16638] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Furong Xu
- Department of Kinesiology University of Rhode Island Kingston Rhode Island USA
| | - Steven A. Cohen
- Department of Health Studies University of Rhode Island Kingston Rhode Island USA
| | - Mary L. Greaney
- Department of Health Studies University of Rhode Island Kingston Rhode Island USA
| | - Jacob E. Earp
- Department of Kinesiology University of Rhode Island Kingston Rhode Island USA
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13
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Enroth L, Raitanen J, Halonen P, Tiainen K, Jylhä M. Trends of Physical Functioning, Morbidity, and Disability-Free Life Expectancy Among the Oldest Old: Six Repeated Cross-Sectional Surveys Between 2001 and 2018 in the Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2020; 76:1227-1233. [PMID: 32506117 DOI: 10.1093/gerona/glaa144] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It remains unclear whether increasing longevity is accompanied by a compression or expansion of poor health and disability. We examined trends of physical functioning and morbidity in a population aged 90 and older, and disease- and disability-free life expectancy (LE) at age 90 between 2001 and 2018 in Finland's third most populated city. METHODS We used survey data from the Vitality 90+ Study, which comprises a series of six repeated mailed surveys (7,590 observations). Information on mortality came from Statistics Finland. We examined trends of functioning (activities of daily living [ADL] and mobility) and cardiovascular and dementia morbidity using age-adjusted generalized estimating equation models stratified by sex. In addition, age-, sex-, and period-specific health expectancies were calculated using Sullivan's method. RESULTS Over time, functioning improved, especially, in women, and morbidity increased in men. From 2001 to 2018, LE at age 90 increased by 5.3 months for men and 6.4 months for women. LE without ADL disability increased by 5.0 months for men and 8.4 months for women, and LE without mobility disability by 6.0 months for men and 4.4 months for women. LE without cardiovascular and dementia morbidity decreased for men (2.6 months) and increased for women (1.9 months). CONCLUSIONS In relative terms, we found a compression of disability for both sexes and an expansion of morbidity for men. Although the trends overall are rather positive, the increase in absolute morbidity and, to some extent, in disability will inevitably mean increasing care needs with population aging.
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Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Kristina Tiainen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
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14
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Meyer AC, Drefahl S, Ahlbom A, Lambe M, Modig K. Trends in life expectancy: did the gap between the healthy and the ill widen or close? BMC Med 2020; 18:41. [PMID: 32192480 PMCID: PMC7082956 DOI: 10.1186/s12916-020-01514-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/06/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND During the past decades, life expectancy has continued to increase in most high-income countries. Previous research suggests that improvements in life expectancy have primarily been driven by advances at the upper end of the health distribution, while parts of the population have lagged behind. Using data from the entire Swedish population, this study aims to examine the life expectancy development among subgroups of individuals with a history of common diseases relative to that of the general population. METHODS The remaining life expectancy at age 65 was estimated for each year in 1998-2017 among individuals with a history of disease, and for the total Swedish population. We defined population subgroups as individuals with a history of myocardial infarction, ischemic or hemorrhagic stroke, hip fracture, or colon, breast, or lung cancer. We further distinguished between different educational levels and Charlson comorbidity index scores. RESULTS Life expectancy gains have been larger for men and women with a history of myocardial infarction, ischemic or hemorrhagic stroke, and colon or breast cancer than for the general population. The life expectancy gap between individuals with a history of hip fracture or lung cancer and the general population has, however, been growing. Education and comorbidity have affected mortality levels, but have not altered the rate of increase in life expectancy among individuals with disease history. The female advantage in life expectancy was less pronounced among individuals with disease history than among the general population. CONCLUSIONS Life expectancy has increased faster in many subpopulations with a history of disease than in the general population, while still remaining at lower levels. Improvements in life expectancy have been observed regardless of comorbidity or educational level. These findings suggest that the rise in overall life expectancy reflects more than just improved survival among the healthy or the delayed onset of disease.
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Affiliation(s)
- Anna C Meyer
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77, Stockholm, Sweden.
| | - Sven Drefahl
- Demography Unit, Stockholm University, SE-10691, Stockholm, Sweden
| | - Anders Ahlbom
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77, Stockholm, Sweden
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, SE-17177, Stockholm, Sweden.,Regional Cancer Centre, University Hospital, SE-751 85, Uppsala, Sweden
| | - Karin Modig
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77, Stockholm, Sweden
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15
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Martin FC, Romero Ortuño R. Longitudinal studies of ageing: from insights to impacts: commentary to accompany themed collection on longitudinal studies. Age Ageing 2019; 48:481-485. [PMID: 31008499 DOI: 10.1093/ageing/afz028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Indexed: 11/14/2022] Open
Abstract
'Time is the best diagnostician': who has not thought this? In clinical practice, presentations are often subtle and decisions made in the face of a 'snapshot.' Crystal balls do not exist; yet, insights from longitudinal studies can help to recognise emerging pictures and anticipate typical trajectories. In the multifactorial, biopsychosocial world of geriatrics, the determinants of those trajectories, and hence opportunities to modify them, can be better understood through careful longitudinal disentangling of the wider determinants of health, and this can be done at multiple levels of analysis, from molecules to society. With this collection and commentary, we highlight the approaches, scope and impacts of a selection of longitudinal studies of ageing published in Age and Ageing within the past 10 years. Longitudinal studies can illuminate disease mechanisms, how declines in multiple domains of intrinsic capacity interact, how losses in one domain may influence the path of another, and in turn, how these changes translate to functional disability, or not. Observing trajectories of geriatric syndromes can suggest opportunities for optimisation and prevention in clinical practice and policy. With global opportunities for harmonising data, longitudinal studies are already offering the opportunity for cross-national comparisons and for developing hypotheses about the relative contributions of time, place and society in the trajectories of frailty, disability and quality of life. We also include studies which show how research-based longitudinal data can be synthesised or be linked to administrative datasets. We hope you find this collection as interesting and encouraging as we have.
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Affiliation(s)
- Finbarr C Martin
- Emeritus Professor of Medical Gerontology, King’s College London and Emeritus Consultant Geriatrician, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Román Romero Ortuño
- Associate Professor in Medical Gerontology, Trinity College Dublin and Consultant Physician, St James’s Hospital, Dublin
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16
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Bergquist R, Weber M, Schwenk M, Ulseth S, Helbostad JL, Vereijken B, Taraldsen K. Performance-based clinical tests of balance and muscle strength used in young seniors: a systematic literature review. BMC Geriatr 2019; 19:9. [PMID: 30626340 PMCID: PMC6327480 DOI: 10.1186/s12877-018-1011-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many balance and strength tests exist that have been designed for older seniors, often aged ≥70 years. To guide strategies for preventing functional decline, valid and reliable tests are needed to detect early signs of functional decline in young seniors. Currently, little is known about which tests are being used in young seniors and their methodological quality. This two-step review aims to 1) identify commonly used tests of balance and strength, and 2) evaluate their measurement properties in young seniors. METHODS First, a systematic literature search was conducted in MEDLINE to identify primary studies that employed performance-based tests of balance and muscle strength, and which aspects of balance and strength these tests assess in young seniors aged 60-70. Subsequently, for tests used in ≥3 studies, a second search was performed to identify method studies evaluating their measurement properties. The quality of included method studies was evaluated using the Consensus-based Standards for selection of health Measurement Instruments (COSMIN) checklist. RESULTS Of 3454 articles identified, 295 met the inclusion criteria. For the first objective, 69 balance and 51 muscle strength tests were identified, with variations in administration mode and outcome reporting. Twenty-six balance tests and 15 muscle strength tests were used in ≥3 studies, with proactive balance tests and functional muscle power tests used most often. For the second objective, the search revealed 1880 method studies, of which nine studies (using 5 balance tests and 1 strength test) were included for quality assessment. The Timed Up and Go test was evaluated the most (4 studies), while the Community Balance and Mobility (CBM) scale was the second most assessed test (3 studies). For strength, one study assessed the reliability of the Five times sit-to-stand. CONCLUSION Commonly used balance and muscle strength tests in young seniors vary greatly with regards to administration mode and outcome reporting. Few studies have evaluated measurement properties of these tests when used in young seniors. There is a need for standardisation of existing tests to improve their informative value and comparability. For measuring balance, the CBM is a new and promising tool to detect even small balance deficits in balance in young seniors.
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Affiliation(s)
- Ronny Bergquist
- Department of Neuromedicine and Movement Science, Norwegian Univerity of Science and Technology, Trondheim, Norway.
| | - Michaela Weber
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Michael Schwenk
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany.,Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Synnøve Ulseth
- Department of Neuromedicine and Movement Science, Norwegian Univerity of Science and Technology, Trondheim, Norway
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Norwegian Univerity of Science and Technology, Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian Univerity of Science and Technology, Trondheim, Norway
| | - Kristin Taraldsen
- Department of Neuromedicine and Movement Science, Norwegian Univerity of Science and Technology, Trondheim, Norway
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