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Imoh Udoh I, Mpofu E, Prybutok G, Ingman S. Subjective Aging and Basic Activities of Daily Living: Moderation by Health Care Access and Mediation by Health Care Resources. J Appl Gerontol 2024:7334648241257993. [PMID: 38830307 DOI: 10.1177/07334648241257993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Subjective aging in older adults is associated with a decline in basic activities of daily living (bADL), although this is less well studied with increasing age cohorts by their healthcare resources (HCR) and healthcare access (HCA) controlling for sociodemographics. We aimed to address this gap in knowledge by analyzing the National Health and Aging Trends round 11 data set on 3303 older adults aged 70 to above 90, comprising 42% male and 58% female by age cohort (middle-old -70-79, n = 1409; older-old -80-89, n = 1432, oldest-old- 90 plus, n = 462). Results of mediation-moderation analysis show the subjective aging whole model comprising subjective cognitive decline, HCR, HCA, and sociodemographic to predict a decline in bADL with increasing age to be higher among the older-old age (80-89) compared to the middle-old age (70-79) or oldest-old (90 years +) cohorts. These findings suggest a "doughnut" effect by which the older-old age cohort of 80-89 may be coping less well with their bADL, while the oldest-old may have adapted to functional loss in their everyday living and/or comprises adults who may have passed a mortality selection despite a more significant burden of comorbidity.
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Affiliation(s)
- Idorenyin Imoh Udoh
- Rehabilitaion and Health Services, University of North Texas, Denton, TX, USA
| | - Elias Mpofu
- Rehabilitaion and Health Services, University of North Texas, Denton, TX, USA
- School of Health Sciences, University of Sydney, Sydney, NSW, Australia
- Educational Psychology, University of Johannesburg, Johannesburg, South Africa
| | - Gayle Prybutok
- Rehabilitaion and Health Services, University of North Texas, Denton, TX, USA
| | - Stan Ingman
- Rehabilitaion and Health Services, University of North Texas, Denton, TX, USA
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Bautin V, Zadorozhnyy VY, Korol A, Bazhenov V, Shinkarev A, Chernyshikhin S, Moskovskikh D, Samoshina M, Khort A. Selective laser melting of low-alloyed titanium based alloy with a large solidification range. Heliyon 2024; 10:e25513. [PMID: 38352734 PMCID: PMC10862687 DOI: 10.1016/j.heliyon.2024.e25513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
In this work, thermodynamic calculations for α + β Type Ti-Fe-Cu-Sn alloy were carried out by the Thermo-Calc software. Powders from this alloy were obtained by plasma sputtering and used for subsequent 3D printing of experimental samples. The effect of various selective laser melting (SLM) parameters on porosity and hot cracking susceptibility as well as the electrochemical characteristics of the alloy have been studied. The optimal technological regime for the manufacture of samples by the SLM method was determined. It has been established that to obtain relatively dense samples without cracks, regimes with volumetric energy density Ev = 250-300 J/mm3 are required. It has been established that a change in the electrochemical behavior of the Ti94Fe1Cu1Sn4 alloy is related to the formation of a nonequilibrium Ti2Cu phase. Based on the findings we recomended directions for further research.
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Affiliation(s)
- V.A. Bautin
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - V. Yu Zadorozhnyy
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - A.A. Korol
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - V.E. Bazhenov
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - A.S. Shinkarev
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - S.V. Chernyshikhin
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - D.O. Moskovskikh
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - M.E. Samoshina
- National University of Science and Technology MISIS, 119049, Moscow, Russian Federation
| | - A. Khort
- KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
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Ungvari A, Gulej R, Csik B, Mukli P, Negri S, Tarantini S, Yabluchanskiy A, Benyo Z, Csiszar A, Ungvari Z. The Role of Methionine-Rich Diet in Unhealthy Cerebrovascular and Brain Aging: Mechanisms and Implications for Cognitive Impairment. Nutrients 2023; 15:4662. [PMID: 37960316 PMCID: PMC10650229 DOI: 10.3390/nu15214662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
As aging societies in the western world face a growing prevalence of vascular cognitive impairment and Alzheimer's disease (AD), understanding their underlying causes and associated risk factors becomes increasingly critical. A salient concern in the western dietary context is the high consumption of methionine-rich foods such as red meat. The present review delves into the impact of this methionine-heavy diet and the resultant hyperhomocysteinemia on accelerated cerebrovascular and brain aging, emphasizing their potential roles in cognitive impairment. Through a comprehensive exploration of existing evidence, a link between high methionine intake and hyperhomocysteinemia and oxidative stress, mitochondrial dysfunction, inflammation, and accelerated epigenetic aging is drawn. Moreover, the microvascular determinants of cognitive deterioration, including endothelial dysfunction, reduced cerebral blood flow, microvascular rarefaction, impaired neurovascular coupling, and blood-brain barrier (BBB) disruption, are explored. The mechanisms by which excessive methionine consumption and hyperhomocysteinemia might drive cerebromicrovascular and brain aging processes are elucidated. By presenting an intricate understanding of the relationships among methionine-rich diets, hyperhomocysteinemia, cerebrovascular and brain aging, and cognitive impairment, avenues for future research and potential therapeutic interventions are suggested.
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Affiliation(s)
- Anna Ungvari
- Department of Public Health, Semmelweis University, 1089 Budapest, Hungary
| | - Rafal Gulej
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Boglarka Csik
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Department of Public Health, Doctoral School of Basic and Translational Medicine, Semmelweis University, 1089 Budapest, Hungary
| | - Peter Mukli
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Department of Public Health, Doctoral School of Basic and Translational Medicine, Semmelweis University, 1089 Budapest, Hungary
| | - Sharon Negri
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Stefano Tarantini
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Department of Public Health, Doctoral School of Basic and Translational Medicine, Semmelweis University, 1089 Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Department of Public Health, Doctoral School of Basic and Translational Medicine, Semmelweis University, 1089 Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Zoltan Benyo
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary;
- Cerebrovascular and Neurocognitive Disorders Research Group, Eötvös Loránd Research Network, Semmelweis University, 1094 Budapest, Hungary
| | - Anna Csiszar
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Department of Translational Medicine, Doctoral School of Basic and Translational Medicine, Semmelweis University, 1089 Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.G.); (B.C.); (P.M.); (S.N.); (S.T.); (A.Y.); (A.C.); (Z.U.)
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Department of Public Health, Doctoral School of Basic and Translational Medicine, Semmelweis University, 1089 Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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Vargese SS, Jylhä M, Raitanen J, Enroth L, Halonen P, Aaltonen M. Dementia-related disability in the population aged 90 years and over: differences over time and the role of comorbidity in the vitality 90 + study. BMC Geriatr 2023; 23:276. [PMID: 37149593 PMCID: PMC10163713 DOI: 10.1186/s12877-023-03980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND The burden of dementia, multimorbidity, and disability is high in the oldest old. However, the contribution of dementia and comorbidities to functional ability in this age group remains unclear. We examined the combined effects of dementia and comorbidities on ADL and mobility disability and differences between dementia-related disability between 2001, 2010, and 2018. METHODS Our data came from three repeated cross-sectional surveys in the population aged 90 + in the Finnish Vitality 90 + Study. The associations of dementia with disability and the combined effects of dementia and comorbidity on disability adjusted for age, gender, occupational class, number of chronic conditions, and study year were determined by generalized estimating equations. An interaction term was calculated to assess differences in the effects of dementia on disability over time. RESULTS In people with dementia, the odds of ADL disability were almost five-fold compared to people with three other diseases but no dementia. Among those with dementia, comorbidities did not increase ADL disability but did increase mobility disability. Differences in disability between people with and without dementia were greater in 2010 and 2018 than in 2001. CONCLUSION We found a widening gap in disability between people with and without dementia over time as functional ability improved mainly in people without dementia. Dementia was the main driver of disability and among those with dementia, comorbidities were associated with mobility disability but not with ADL disability. These results imply the need for strategies to maintain functioning and for clinical updates, rehabilitative services, care planning, and capacity building among care providers.
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Affiliation(s)
- Saritha Susan Vargese
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland.
- Believers Church Medical College Hospital, Thiruvalla, India.
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Mari Aaltonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Seematter-Bagnoud L, Belloni G, Zufferey J, Pellegrini S, Bula C, Peytremann-Bridevaux I. Trends in the disability-free life expectancy in Switzerland over a 10-year period: an analysis of survey-based data. Swiss Med Wkly 2023; 153:40043. [PMID: 36800890 DOI: 10.57187/smw.2023.40043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION Increasing life expectancy raises concerns whether the years gained will be spent free of disability. Lately, trends across countries have been heterogeneous. This work examined recent trends in disability-free life expectancy and life expectancy with mild or severe disability in Switzerland. METHODS Life expectancy was estimated using national life tables, by sex and 5-year age groups. Based on Sullivan's method, disability-free life expectancy and life expectancy with disability were computed using information from the Swiss Health Survey on age- and sex-specific prevalence of mild and severe disability. Life expectancy, disability-free life expectancy and life expectancy with disability were estimated in 2007, 2012, and 2017, at 65 and 80 years of age, for both sexes. RESULTS Between 2007 and 2017, disability-free life expectancy at 65 and 80 years of age increased by 2.1 and 1.4 years, respectively, in men and by 1.5 and 1.1 years, respectively, in women. Meanwhile, life expectancy with mild disability decreased by 6 months in both sexes at age 65 and in men at age 80, but only 1 month in women at age 80. Life expectancy with severe disability also decreased at both ages, by approximately 6 months in women but only 2 to 3 months in men. The proportion of disability-free life expectancy increased significantly in both sexes and ages. For example, disability-free life expectancy / life expectancy at age 65 increased from 67% (95% confidence interval [CI] 66‒69) to 73% (95% CI 71‒74) in women and from 77% (95% CI 75‒79) to 82% (95% CI 81‒84) in men. CONCLUSION From 2007 to 2017, disability-free life expectancy at age 65 and 80 increased in Swiss women and men. These gains outweighed those in life expectancy, reflecting some compression of morbidity.
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Affiliation(s)
- Laurence Seematter-Bagnoud
- Centre for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Switzerland.,Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | - Giulia Belloni
- Centre for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Switzerland
| | | | | | - Christophe Bula
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- Centre for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Switzerland
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Enroth L, Halonen P, Tiainen K, Raitanen J, Jylhä M. Cohort profile: The Vitality 90+ Study-a cohort study on health and living conditions of the oldest old in Tampere, Finland. BMJ Open 2023; 13:e068509. [PMID: 36750290 PMCID: PMC9906174 DOI: 10.1136/bmjopen-2022-068509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Vitality 90+ is an ongoing population-based study with repeated cross-sectional data collections. The study was designed to examine trends in health, functioning, living conditions, quality of life and care needs among the oldest old in Finland. PARTICIPANTS Nine mailed surveys have been conducted in the city of Tampere between 1995 and 2018. The first three surveys in 1995, 1996 and 1998 included all community-dwelling individuals aged 90 years or older; and the following six surveys in 2001, 2003, 2007, 2010, 2014 and 2018 covered all individuals in Tampere regardless of their living arrangements. In total, the surveys have included 5935 participants (8840 observations). Around 80% of the participants have been women. The participants' age range has been between 90 and 107 years. FINDINGS TO DATE The surveys have consistently asked the same questions over time, covering basic sociodemographic factors, morbidity, functioning, self-rated health (SRH), living arrangements, social relations, quality of life, care needs and providers of care. Survey data have been linked with national register data on health and social service use, mortality and medication. The main findings regarding the time trends show an increase in the proportion of people independent in activities of daily living and mobility. Along with improved functioning, the number of chronic conditions has increased, and SRH has shown a tendency to decline. In addition, we have found increasing occupational class inequalities in functioning and SRH over time. FUTURE PLANS The next round of data collection will be completed by the end of 2022. The Vitality 90+ Study welcomes research collaborations that fall within the general aims of the project. The research data 1995-2014 are archived at the Finnish Social Science Data Archive and the data for years 2018 and 2022 will be archived in 2023.
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Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Kristina Tiainen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
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Escourrou E, Laurent S, Leroux J, Oustric S, Gardette V. The shift from old age to very old age: an analysis of the perception of aging among older people. BMC PRIMARY CARE 2022; 23:3. [PMID: 35331144 PMCID: PMC8753908 DOI: 10.1186/s12875-021-01616-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/17/2021] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The oldest-old (individuals over 90 years) are a fast-growing population. Understanding the perceptions of older people about very old age is the first step towards developing optimal geriatric care for an aging population. This study aimed to explore the potential shift from old age to very old age through the exploration of older people’s perception of aging.
Methods
Qualitative study conducted through individual interviews in the homes of older people. We voluntarily chose to include persons a decade under and above 90 years old to explore other factors than age that could participate in the shift from old age to very old age. The sampling was theoretical. We carried out the analyses using an inductive approach based on the phases of grounded theory. The researchers used triangulation. Collection was concluded when theoretical saturation was reached.
Results
Fourteen participants were interviewed. The shift from old age to very old age was not based on age but occurred when participants became conscious of the irreversibility of aging and its effects, and when they started living day-by-day, renouncing to any plan in a near future. The transition to very old age seemed to be preceded by a progressive disengagement from non-essentials activities. Participants reported a sensation of progressive social exclusion due to the loss of contemporaries or spouse, the difficulty to connect with younger generations or the absence of relationships in their neighborhood. The last step of life was feared, not because of the idea of death itself but because of the associated suffering and loss of autonomy.
Conclusion
Precipitating and slowing factors of the shift to very old age were identified to help general practitioners support older patients throughout their life trajectories.
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Halonen P, Enroth L, Jämsen E, Vargese S, Jylhä M. Dementia and Related Comorbidities in the Population Aged 90 and Over in the Vitality 90+ Study, Finland: Patterns and Trends From 2001 to 2018. J Aging Health 2022; 35:370-382. [PMID: 36256914 PMCID: PMC10150268 DOI: 10.1177/08982643221123451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine trends in the prevalence of dementia and related comorbidities among the oldest old. METHODS Six repeated cross-sectional surveys were conducted between 2001 and 2018, each including all inhabitants aged over 90 in Tampere, Finland (n = 5386). Co-occurring conditions and their time trends among participants with dementia were examined using logistic regression and generalized estimating equations. RESULTS The prevalence of dementia decreased from 47% in 2007 to 41% in 2018. Throughout the study period, depression was more common among people with dementia compared to those without. The prevalence of hypertension, diabetes, and osteoarthritis increased and the prevalence of depression decreased among people with dementia. The mean number of comorbidities increased from 2.0 in 2001 to 2.3 in 2018. DISCUSSION Dementia remains highly prevalent among the oldest old and it is accompanied by an increasing burden of comorbidities, posing a challenge to people with dementia, their caregivers, and care systems.
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Affiliation(s)
- Pauliina Halonen
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
| | - Linda Enroth
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
| | - Esa Jämsen
- Gerontology Research Center, Tampere, Finland.,Faculty of Medicine and Health Technology, 7840Tampere University, Tampere, Finland.,Department of Geriatrics, 7840Tampere University HospitalHospital, Tampere, Finland
| | - Saritha Vargese
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
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Han Y, Zhang L, Fang Y. Novel subgroups of functional ability in older adults and their associations with adverse outcomes. BMC Geriatr 2022; 22:390. [PMID: 35505297 PMCID: PMC9066860 DOI: 10.1186/s12877-022-03081-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background There is no general agreement on a standard form of functional classification in older adults and is mainly assessed by Activities of Daily Living (ADL) and/or Instrument Activity of Daily Living. A refined classification based on evaluation the limitations of intrinsic capacity, environment and social interaction, could provide a basis to predict the future disability and identify individuals with increased risk of adverse outcomes. Methods A new functional classification among older adults aged 60 and over was conducted by latent class analysis and compared with the traditional classifications, based on the China Health and Retirement Longitudinal Study. To further investigate the scientific validity of this new classification, associations with 7-year mortality and ADLs impairments among categories were tested by using Survival curves and Cox proportional hazard models. This was followed by the confirmatory analysis related to the prospective data. Competing risk analysis was also performed to analysis the sensitivity to further support our conclusions. Results Five categories were identified among 5,992 older adults which gave the best fitting, yielding a significant Bootstrap Likelihood Ratio Test (p < 0.001) and Lo-Mendell-Rubin adjusted likelihood ratio test (p < 0.001), with an entropy over 0.80. The presence of five categories: “health” (34.0%), “sub-disorder status” (36.6%), “acute diseases” (10.3%), “somatic functional disorder” (7.7%), and “viability disorder” (11.4%), which matched well with the functional independence rates by the international classifications. Among them, those in “sub-disorder status” were considered as an intermediate status between disability and health. The findings also revealed that those who were in “acute disease”, “somatic functional disorders”, “health” and “sub-disorder status” had a significant lower risk of mortality and ADLs limitations than “viability disorder”. And the risks gradually increased towards the less functionally independent end of the classification. However, the distribution of characteristics among five categories were in a synchronous change, indicating a stable classification. Conclusions A new classification representing the functional heterogeneity of older adults could effectively stratify the risk of mortality and ADLs limitations. Identifying the clusters of functional decline might be useful in predicting subsequent ageing trends, designing personalized intervention, and delaying the progression of disability and preventing its occurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03081-9.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China.,School of Economics, Xiamen University, 422 Siming South Road, Xiamen, Fujian, 361005, PR China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China.
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10
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Enroth L, Fors S. Trends in the Social Class Inequalities in Disability and Self-Rated Health: Repeated Cross-Sectional Surveys from Finland and Sweden 2001-2018. Int J Public Health 2021; 66:645513. [PMID: 34744593 PMCID: PMC8565263 DOI: 10.3389/ijph.2021.645513] [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] [Received: 12/23/2020] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess time trends in the social class inequalities and in total inequality in disability and self-rated health (SRH) in two oldest old populations. Methods: The data came from the Finnish Vitality 90+ Study (2001, 2003, 2007, 2010, 2014 and 2018; n = 5,440) and from the Swedish Panel Study of Living Conditions of the Oldest Old (2002, 2004, 2011 and 2014; n = 1,645). Inequalities in mobility and activities of daily living (ADL) disability and SRH were examined cross-sectionally and over time using relative and absolute measures. Results: Lower social classes had greater mobility and ADL disability and worse SRH than higher social classes and the inequalities tended to increase over time. Findings were remarkably similar in both studies and with absolute and relative measures. Total inequality, referring to the variance in health outcome in the total population, remained stable or decreased. Conclusion: The study suggests that the earlier findings of improved mobility and ADL are largely driven by the positive development in higher social classes while findings of decline in SRH are related to the worsening of SRH in lower social classes
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Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Center for Epidemiology and Community Medicine, Region Stockholm, Sweden
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11
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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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12
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Bouchard DR, Olthuis JV, Bouffard-Levasseur V, Shannon C, McDonald T, Sénéchal M. Peer-led exercise program for ageing adults to improve physical functions - a randomized trial. Eur Rev Aging Phys Act 2021; 18:2. [PMID: 33573594 PMCID: PMC7879524 DOI: 10.1186/s11556-021-00257-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background A peer-led exercise program is one way to empower people sharing similar characteristics to encourage others to be active, but there is a lack of evidence that these programs have physical function and other benefits when delivered to ageing adults. Methods This randomized controlled trial lasting 12 weeks proposed an exercise peer-led program offered to 31 adults aged 50 and above, twice a week, by a trained leader of the same age from March to May 2019. The program was offered for free with limited space and equipment. Valid tests of physical function (e.g., 30-s chair stand, 6-min walk test) were used to assess the functional benefits. Psychosocial outcomes were assessed using self-reported questionnaires and metabolic outcomes via a fasted blood draw. Results A significant difference was found between pre-and post-values in most physical function tests in the intervention group (all p < 0.05). When adjusted for potential confounders, the intervention group was significantly associated with a more significant improvement on the chair stand test (ß = .26; p < 0.001; r2 = 0.26), the arm curl (ß = .29; p < 0.001; r2 = 0.49), as well as the 6-min walk test (ß = -.14; p < 0.001; r2 = 0.62) compared with the control group. Using repetitive measures generalized linear model, the interaction between the changes and the group was significant for all three tests. Benefits were also observed for participants’ stress level and perceived health in the intervention group compared to the control. Finally, no significant difference was observed between groups for metabolic health. Conclusions The current work suggests that a 12-week peer-led exercise program can improve physical function for adults age 50 and above. Trial registration NCT03799952(ClinicalTrials.gov) 12/20/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00257-x.
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Affiliation(s)
- D R Bouchard
- Cardiometabolic Exercise & Lifestyle Laboratory, Fredericton, NB, Canada. .,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada.
| | - J V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
| | - V Bouffard-Levasseur
- Secteur Éducation et kinésiologie, Université de Moncton, Fredericton, NB, Canada
| | - C Shannon
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada
| | - T McDonald
- Faculty of Law, University of New Brunswick, Fredericton, NB, Canada
| | - M Sénéchal
- Cardiometabolic Exercise & Lifestyle Laboratory, Fredericton, NB, Canada.,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada
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13
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Lin CY, Tsang HWH. Stigma, Health and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7615. [PMID: 33086659 PMCID: PMC7589594 DOI: 10.3390/ijerph17207615] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/15/2020] [Indexed: 02/05/2023]
Abstract
In order to understand the phenomenon of stigma in different populations (e.g., different ethnicities, different diseases, and different conditions), this Special Issue collects papers from around the world to illustrate the stigma phenomenon. After a rigorous process of peer review, a total of 24 papers were published and included in the Special Issue. These papers were contributed from different continents and countries, including the Americas (e.g., United States), Europe (e.g., Finland), and Asia (e.g., Saudi Arabia). Therefore, the diversity of ethnicity was ensured in the Special Issue. Moreover, these papers address different stigmatized populations/conditions (e.g., mental illness, obesity, public housing, homosexuality, and transgender). The most discussed populations were those with mental illness and those with obesity/overweight. However, additional evidence on the stigma topic is still needed. Specifically, future studies could consider the following directions to explore in depth the issues of stigma in different populations: (1) using longitudinal designs to understand the temporal or causal relationship between stigma and other related psychosocial factors; (2) designing treatment programs to fight stigma-this could be carried out in healthcare providers, healthcare trainees, the public, caregivers, and the stigmatized populations.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Hector W. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China;
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