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Strandberg TE, Pitkälä KH, Kivimäki M. Sleep duration in midlife and old age and risk of mortality over a 48-year follow-up: The Helsinki businessmen study (HBS) cohort. Maturitas 2024; 184:107964. [PMID: 38471293 DOI: 10.1016/j.maturitas.2024.107964] [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: 11/02/2023] [Revised: 02/19/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES Both short and long sleep duration have been associated with increased mortality, but there are few truly long-term studies. STUDY DESIGN This is a cohort study of 2504 men born between 1919 and 1934. In 1974-1975 (mean age 48), participants underwent baseline clinical examinations and sleep duration assessments. A follow-up examination took place 35 years later, in 2010 (mean age 82). MAIN OUTCOME MEASURE All-cause mortality data from baseline and from old age were collected through to December 31, 2022. RESULTS At baseline, short sleep duration (≤6 h per night), normal sleep duration (>6 and ≤ 8 h), and long sleep duration (>8 h) was reported by 266, 2019 and 219 men, respectively. Men with short sleep duration had higher levels of smoking, alcohol consumption, body mass index, and poorer self-rated health than those with normal sleep duration. During the 48-year follow-up, 2287 men died. The unadjusted hazard ratio for mortality was 1.20 (95 % confidence interval [CI] 1.05-1.37) for short compared with normal sleep duration, but this association vanished after adjustments (1.01, 95 % CI 0.87-1.17). In old age, the corresponding hazard ratios were 1.41 (1.16-1.72) and 1.19 (0.94-1.51) for short sleep duration and 1.33 (1.09-1.63) and 1.31 (1.02-1.67) for long sleep duration. CONCLUSIONS In a comprehensive lifespan follow-up, the modestly increased mortality among men with short sleep duration in midlife was attributed to unhealthy lifestyle factors. In old age both long and short sleep duration seemed to be associated with modestly increased mortality. CLINICALTRIALS gov identifier for the HBS: NCT02526082.
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Affiliation(s)
- Timo E Strandberg
- University of Helsinki and Helsinki University Hospital, PO Box 340, 00029 Helsinki, Finland.
| | - Kaisu H Pitkälä
- University of Helsinki and Helsinki University Hospital, PO Box 340, 00029 Helsinki, Finland.
| | - Mika Kivimäki
- University of Helsinki and Helsinki University Hospital, PO Box 340, 00029 Helsinki, Finland; UCL Brain Sciences, University College London, London, UK.
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Landré B, Ben Hassen C, Kivimaki M, Bloomberg M, Dugravot A, Schniztler A, Sabia S, Singh-Manoux A. Trajectories of physical and mental functioning over 25 years before onset of frailty: results from the Whitehall II cohort study. J Cachexia Sarcopenia Muscle 2023; 14:288-297. [PMID: 36397170 PMCID: PMC9891967 DOI: 10.1002/jcsm.13129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research on frailty, a major contributor to heterogeneity in health, is undertaken on older adults although the processes leading to frailty are likely to begin earlier in the life course. Using repeat data spanning 25 years, we examined changes in physical and mental functioning before the onset of frailty, defined using Fried's frailty phenotype (FFP). METHODS Functioning was measured using the Short-Form 36 General Health Survey (SF-36) on nine occasions from 1991 (age range 40-63 years) to 2015 (age range 63-85 years). The poorest of four FFP scores from 2002, 2007, 2012 and 2015 was used to classify participants as frail, pre-frail, or robust. We used linear mixed models with a backward timescale such that time 0 was the person-specific date of frailty classification for frail and pre-frail participants and the end of follow-up for robust participants. Analyses adjusted for socio-demographic factors, health behaviours, body mass index and multi-morbidity status were used to compare SF-36 physical (PCS) and mental (MCS) component summary scores over 25 years before time 0 as a function of FFP classification, with estimates extracted at time 0, -5, -10, -15, -20 and -25 years. We also used illness-death models to examine the prospective association between SF-36 component summary scores at age 50 and incident FFP-defined frailty. RESULTS Among 7044 participants of the Whitehall II cohort study included in the analysis [29% female, mean age 49.7 (SD = 6.0) at baseline in 1991], 2055 (29%) participants remained robust, and 4476 (64%) became pre-frail and 513 (7%) frail during follow-up. Frail compared with robust participants had lower SF-36 scores at t = -25 before onset of frailty with a difference of 3.4 [95% confidence interval (CI) 1.6, 5.1] in PCS and 1.8 (-0.2, 3.8) in MCS. At t = 0, the differences increased to 11.5 (10.5, 12.5) and 9.1 (8.0, 10.2), respectively. The differences in SF-36 between the robust and pre-frail groups, although smaller [at t = 0, 1.7 (1.2, 2.2) in PCS and 4.0 (3.4, 4.5) in MCS], were already observed 20 and 25 years, respectively, before the onset of pre-frailty. Prospective analyses showed that at age 50, scores in the bottom quartiles of PCS [hazard ratio (HR) compared with the top quartile = 2.39, 95% CI 1.85, 3.07] and MCS [HR = 1.49 (1.15, 1.93)] were associated with a higher risk of FFP-defined frailty at older ages. CONCLUSIONS Differences in trajectories of physical and mental functioning in individuals who developed physical frailty at older ages were observable 25 years before onset of FFP-defined frailty. These findings highlight the need for a life course approach in efforts to prevent frailty.
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Affiliation(s)
- Benjamin Landré
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Céline Ben Hassen
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Mika Kivimaki
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Mikaela Bloomberg
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Aline Dugravot
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Alexis Schniztler
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Séverine Sabia
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
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Strandberg TE, Levinson SL, DiNubile MJ, Jyväkorpi S, Kivimäki M. Association of plasma gelsolin with frailty phenotype and mortality among octogenarian community-dwelling men: a cohort study. Aging Clin Exp Res 2022; 34:1095-1101. [PMID: 35169987 PMCID: PMC9135837 DOI: 10.1007/s40520-022-02083-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Biomarkers are needed for frailty, a common phenotype often associated with muscle loss in older people. Plasma gelsolin (pGSN) is a protein largely synthesized and secreted by skeletal muscle. AIMS To investigate whether pGSN could be a biomarker of the frailty phenotype and predict mortality. METHODS A homogenous cohort of males (born 1919-1934, baseline n = 3490) has been followed since the 1960s. In 2010/11, frailty phenotypes by modified Fried criteria were assessed. pGSN was measured in a convenience subset (n = 469, mean age 83) and re-measured in survivors (n = 127) in 2017. Mortality through December 31, 2018 was retrieved from national registers. Regression models were used for analyses. RESULTS Of 469 males, 152 (32.4%) were robust, 284 (60.6%) prefrail, and 33 (7.0%) frail in 2010/11. There was a graded (p = 0.018) association between pGSN (mean 58.1 ug/mL, SD 9.3) and frailty. After multivariable adjustment, higher pGSN levels were associated with lower odds of having contemporaneous phenotypic prefrailty (OR per 1 SD 0.73, 95% CI 0.58-0.92) and frailty (OR per 1 SD 0.70, 95% CI 0.44-1.11). By 2018, 179 males (38.2%) had died, and higher baseline pGSN predicted a lower 7-year mortality rate (HR per 1 SD 0.85, 95% CI 0.72-1.00). pGSN concentrations in 2010/11 and 2017 were correlated (n = 127, r = 0.34, p < 0.001). DISCUSSION Higher baseline pGSN concentrations were associated with a persistently robust phenotype and lower mortality rate over 7 years in a cohort of octogenarian males with high socioeconomic status and may be a promising laboratory biomarker for the development of a frailty phenotype.
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Affiliation(s)
- Timo E Strandberg
- Helsinki University Hospital, HUS, University of Helsinki, PO Box 340, FI-00029, Helsinki, Finland. .,Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | | | | | - Satu Jyväkorpi
- Helsinki University Hospital, HUS, University of Helsinki, PO Box 340, FI-00029, Helsinki, Finland
| | - Mika Kivimäki
- Helsinki University Hospital, HUS, University of Helsinki, PO Box 340, FI-00029, Helsinki, Finland.,Clinicum, Faculty of Medicine, PO Box 20, FI-00014, Helsinki, Finland
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Jajtner KM, Brucker DL, Mitra S. Midlife Work Limitations are Associated with Lower Odds of Survival and Healthy Aging. J Gerontol B Psychol Sci Soc Sci 2021; 77:790-802. [PMID: 34791218 PMCID: PMC8974351 DOI: 10.1093/geronb/gbab214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Health conditions that limit work are associated with myriad socioeconomic disadvantages and around half of Americans could face a work limitation at some point in their working career. Our study examines the relationship between midlife work limitations and two aging outcomes: longevity and healthy aging. METHODS Using longitudinal data from the Panel Study of Income Dynamics and restricted mortality data, multivariate logistic regressions estimate the odds of desirable aging outcomes around age 65 for individuals with various midlife work limitation histories in samples of around 2,000 individuals. RESULTS Midlife work limitations are consistently linked with a lower likelihood of desirable aging outcomes. Temporary limitations are associated with 59% and 69% lower survival and healthy aging odds, respectively. Chronic limitations are associated with approximately 80% lower survival odds and 90% lower healthy aging odds at age 65. DISCUSSION Even temporary work limitations can be highly disadvantageous for aging outcomes, emphasizing the need to understand different work limitation histories. Future research should identify underlying mechanisms linking midlife work limitations and less desirable aging outcomes.
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Affiliation(s)
- Katie M Jajtner
- Center for Demography of Health and Aging, University of Wisconsin–Madison, Madison, Wisconsin, USA,Address correspondence to: Katie M. Jajtner, PhD, University of Wisconsin–Madison, 1180 Observatory Dr. Rm. 4408, Madison, WI 53706, USA. E-mail:
| | - Debra L Brucker
- Institute on Disability, University of New Hampshire, Durham, New Hampshire, USA
| | - Sophie Mitra
- Department of Economics, Fordham University, Bronx, New York, USA
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Pilleron S, Le Goff M, Ajana S, Helmer C, Pérès K, Dartigues JF, Tabue-Teguo M, Féart C. Self-Rated Health and Frailty in Older Adults from the Population-Based Three-City Bordeaux Cohort. Gerontology 2021; 68:755-762. [PMID: 34818256 DOI: 10.1159/000518864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/04/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This study aimed to investigate whether self-rated health (SRH) predict frailty and its components among community dwellers aged 75 years and older. METHODS We ran a cross-sectional and prospective analysis from 643 and 379 participants of the Bordeaux Center (France) of the Three-City Study, respectively. We assessed SRH using a single question with 5 response options. We defined frailty as having at least 3 out of the following 5 criteria: weight loss, exhaustion, slowness, weakness, and low energy expenditure. We used multivariate logistic regression and Cox proportional hazard models. RESULTS At baseline, poor SRH was significantly associated with frailty (odds ratio = 5.2; 95% confidence interval [CI]: 2.9-9.5) and its components except for weakness. In the prospective analysis on nonfrail participants, poor SRH was associated with the 4-year risk of slowness (hazard ratio [HR] = 1.7; 95% CI: 1.1-2.6) but not with that of frailty (HR = 1.6; 95% CI: 0.9-2.9) or the other components. CONCLUSIONS In a French cohort of community dwellers aged 75 years or older, poorer SRH was associated with concomitant frailty and 70% higher risk of slowness over 4 years.
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Affiliation(s)
- Sophie Pilleron
- Univ. Bordeaux, Inserm, BPH, UMR 1219, Bordeaux, France.,CHU de Guadeloupe, Université des Antilles, Pointe-à-Pitre, France
| | | | | | - Catherine Helmer
- Univ. Bordeaux, Inserm, BPH, UMR 1219, Bordeaux, France.,Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, United Kingdom
| | - Karine Pérès
- Univ. Bordeaux, Inserm, BPH, UMR 1219, Bordeaux, France
| | | | - Maturin Tabue-Teguo
- Univ. Bordeaux, Inserm, BPH, UMR 1219, Bordeaux, France.,CIC-EC 1401, INSERM, Bordeaux University, CHU Bordeaux, Bordeaux, France
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Fässberg MM, Erhag HF, Skoog I, Finizia C. Dizziness and health-related quality of life among older adults in an urban population: a cross-sectional study. Health Qual Life Outcomes 2021; 19:231. [PMID: 34600557 PMCID: PMC8487566 DOI: 10.1186/s12955-021-01864-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Dizziness is a common complaint among older adults and may affect quality of life in a negative way. The aim of this study was to assess health-related quality of life (HRQL), sense of coherence (SOC), self-rated health (SRH) and comorbidity in relation to dizziness, among older persons from an urban population. Methods The study is part of the Gothenburg H70 Birth Cohort Studies (H70). A cross-sectional population-based sample including 662 79-years-olds (404 women, 258 men, 62% response rate) were surveyed with questions regarding dizziness, imbalance, comorbidities and general health. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36) and SOC with the 13-items questionnaire Sense of Coherence (SOC-13). Results Half of the participants reported problems with dizziness (54%). Dizziness was negatively associated with HRQL, including after adjusting for comorbidities, especially in the physical domains of SF-36. Having dizziness was also associated with poorer SRH, tiredness and comorbidity among both men and women. SOC (mean total score), however, did not differ between dizzy and non-dizzy participants. Conclusions Dizziness was negatively associated with HRQL, also after adjusting for comorbidities. Identification and treatment of dizziness, when possible, are important because reduction of dizziness symptoms may potentially help to enhance overall well-being in this age group.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden. .,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.
| | - Lena Kollén
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden
| | - Mia Johansson
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.,Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden
| | - Therese Karlsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| | - Lina Rydén
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Hanna Falk Erhag
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
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Strandberg TE, Lindström L, Jyväkorpi S, Urtamo A, Pitkälä KH, Kivimäki M. Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men : The Helsinki Businessmen Study (HBS). Eur Geriatr Med 2021; 12:953-961. [PMID: 33661507 PMCID: PMC8463371 DOI: 10.1007/s41999-021-00472-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/12/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Multimorbidity, prefrailty, and frailty are frequent in ageing populations, but their independent relationships to long-term prognosis in home-dwelling older people are not well recognised. METHODS In the Helsinki Businessmen Study (HBS) men with high socioeconomic status (born 1919-1934, n = 3490) have been followed-up from midlife. In 2000, multimorbidity (≥ 2 conditions), phenotypic prefrailty and frailty were determined in 1365 home-dwelling men with median age of 73 years). Disability was assessed as a possible confounder. 18-year mortality follow-up was established from registers and Cox regression used for analyses. RESULTS Of the men, 433 (31.7%) were nonfrail and without multimorbidity at baseline (reference group), 500 (36.6%) and 82 (6.0%) men had prefrailty or frailty, respectively, without multimorbidity, 84 (6.2%) men had multimorbidity only, and 201 (14.7%) and 65 (4.8%) men had prefrailty or frailty together with multimorbidity. Only 30 (2.2%) and 86 (6.3%) showed signs of ADL or mobility disability. In the fully adjusted analyses (including ADL disability, mental and cognitive status) of 18-year mortality, frailty without multimorbidity (hazard ratio 1.62, 95% confidence interval 1.13-2.31) was associated with similar mortality risk than multimorbidity without frailty (1.55, 1.17-2.06). The presence of both frailty and multimorbidity indicated a strong mortality risk (2.93, 2.10-4.07). CONCLUSION Although multimorbidity is generally considered a substantial health problem, our long-term observational study emphasises that phenotypic frailty alone, independently of disability, may be associated with a similar risk, and a combination of multimorbidity and frailty is an especially strong predictor of mortality.
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Affiliation(s)
- Timo E Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland.
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | | | | | | | - Kaisu H Pitkälä
- University of Helsinki, Clinicum, and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland
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Chu WM, Ho HE, Yeh CJ, Hsiao YH, Hsu PS, Lee SH, Lee MC. Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA). BMJ Open 2021; 11:e049795. [PMID: 34362805 PMCID: PMC8351513 DOI: 10.1136/bmjopen-2021-049795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Self-rated health (SRH) is an assessment and predictor of health based on an individual's general condition; however, evidence of the value of SRH for predicting frailty remains scarce for older Asian adults. This study aimed to evaluate the relationship between SRH score trajectory and frailty among older individuals in Taiwan. DESIGN An 8-year retrospective cohort study. SETTING Data were retrieved from the Taiwan Longitudinal Study on Aging from 1999 to 2007. PARTICIPANTS Respondents aged 53-69 years old who were not frail or disabled in 1999 (n=1956). PRIMARY AND SECONDARY OUTCOME MEASURES Frailty was defined using the Fried criteria. The group-based trajectory modelling technique was used to estimate SRH trajectories. Logistic regression analysis was used to examine the associations between changes in SRH and frailty. RESULTS Four SRH trajectory classes were identified across the 8-year follow-up: 232 participants (11.9%) were classified into the constantly poor SRH group, 1123 (57.4%) into the constantly fair SRH group, 335 (17.1%) into the constantly good SRH group and 266 (13.6%) into the good-to-fair SRH group. After adjusting for gender, age, level of education, income, social participation, health behaviours and major comorbidities, it was found that age, poor income satisfaction, without job and constantly poor SRH were associated with increased risk of frailty, while constantly good SRH (OR 0.04, 95% CI (0.01 to 0.32)) and good-to-fair SRH (OR 0.19, 95% CI (0.06 to 0.63)) were associated with reduced risks of frailty. CONCLUSIONS Constantly poor SRH was associated with an increased risk of frailty in older age. SRH in older adults should be recognised as a predictive tool for future frailty. Diet and exercise interventions may help to prevent frailty among high-risk older individuals with constantly low SRH.
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Affiliation(s)
- Wei-Min Chu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
- Department of Occupational Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsin-En Ho
- Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
- Institution of Medicine, Chung Shan Medical University, Taichung, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Jung Yeh
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Han Hsiao
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Pi-Shan Hsu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Shu-Hsin Lee
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
- Instiute of Population Sciences, National Health Research Institutes, Miaoli County, Taiwan
- College of Management, Chaoyang University of Technology, Taichung, Taiwan
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9
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Alex D, Fauzi AB, Mohan D. Online Multi-Domain Geriatric Health Screening in Urban Community Dwelling Older Malaysians: A Pilot Study. Front Public Health 2021; 8:612154. [PMID: 33520920 PMCID: PMC7841455 DOI: 10.3389/fpubh.2020.612154] [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: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: With a rapidly aging population, the Malaysian health care system needs to develop solutions to address the lack of resources that are required for the assessment of the older person. The complex nature of geriatric syndromes coupled with the occurrence of multiple comorbid illnesses with aging, make geriatric assessment a resource intensive process. Digital health solutions could play an important role in supporting existing health care systems, especially in low and middle income countries, with limited speciality services in geriatrics. Objective: This is a pilot study aimed at screening for geriatric syndromes through self-administered online surveys in urban community dwelling older Malaysians and assessing the pattern of geriatric syndromes in relation to the frailty status of the study participants. Methods: This is a cross-sectional pilot study conducted between July-September 2020. Community dwelling adults aged 60 years and over were invited to take part in an online survey. Information on sociodemographic variables, comorbidities, and the self-reported results of geriatric syndromes (frailty, sarcopenia, anorexia of aging, urinary incontinence, falls, and cognitive impairment), were collected through the survey. Results: Data was collected for 162 participants over a period of 2 months. The mean (SD) age of the respondents was 66.42 (5.25) years with 64.9% females. Majority of the respondents were of Chinese ethnic origin (67.9%) and had tertiary level of education (75.9%). The average time taken by participants to complete the survey was 16.86 min. Urinary incontinence was the highest reported geriatric syndrome (55.1%) followed by falls (37.6%), anorexia of aging (32.8%), cognitive impairment (27.8%), and sarcopenia (8.3%). Frailty was detected in 4.5% of the study population. Loss of weight in the previous year was the highest reported component of the frailty assessment tool. The presence of sarcopenia, anorexia of aging, poor/fair self-rated health, urinary incontinence, and multimorbidity were significantly higher in older adults who were frail or prefrail. Conclusion: Screening for geriatric syndromes through online surveys is a feasible approach to identify older adults in the community who are likely to benefit from geriatric assessment. However, the demographic profile of the older population that are accessible through such digital platforms is limited.
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Affiliation(s)
- Deepa Alex
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Adhhani Binti Fauzi
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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10
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Haapanen MJ, von Bonsdorff MB, Perttilä NM, Törmäkangas T, von Bonsdorff ME, Strandberg AY, Strandberg TE. Retirement age and type as predictors of frailty: a retrospective cohort study of older businessmen. BMJ Open 2020; 10:e037722. [PMID: 33334827 PMCID: PMC7747567 DOI: 10.1136/bmjopen-2020-037722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To study the association between retirement characteristics and frailty in a homogenous population of former business executives. DESIGN Cross-sectional cohort study using data from the Helsinki Businessmen Study. SETTING Helsinki, Finland. PARTICIPANTS 1324 Caucasian men, born in 1919-1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires. PRIMARY AND SECONDARY OUTCOME MEASURES Frailty assessed according to a modified phenotype definition at mean age 73.3 years. RESULTS Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66-67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58-69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07-0.29, p<0.05). Compared with men who transitioned into old age retirement, those who retired due to disability were at increased risk of prefrailty (adjusted OR 1.53, 95% CI 1.01 to 2.32) and frailty (adjusted OR 3.52, 95% CI 1.97 to 6.29), relative to non-frailty. CONCLUSION Exiting working life early and continuing to be occupationally active until age 70 years and older were both associated with increased risk of frailty among the men. Promotion of longer work careers could, however, promote healthier ageing, as the lowest prevalence of frailty was observed in former business executives who retired at ages 66-67 years.
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Affiliation(s)
- Markus J Haapanen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Centre, Helsinki, Finland
- Department of Health Sciences, Gerontology Research Centre, University of Jyväskylä Faculty of Sport and Health Sciences, Jyvaskyla, Finland
| | - Niko M Perttilä
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Törmäkangas
- Department of Health Sciences, Gerontology Research Centre, University of Jyväskylä Faculty of Sport and Health Sciences, Jyvaskyla, Finland
| | - Monika E von Bonsdorff
- School of Business and Kokkola University Consorium Chydenius, University of Vaasa, Vaasa, Finland
- Department of Management and Leadership, Jyväskylä University School of Business and Economics, Jyväskylä, Finland
| | - Arto Y Strandberg
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo E Strandberg
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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11
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Jyväkorpi SK, Urtamo A, Kivimäki M, Salomaa V, Strandberg TE. Association of midlife body composition with old-age health-related quality of life, mortality, and reaching 90 years of age: a 32-year follow-up of a male cohort. Am J Clin Nutr 2020; 112:1287-1294. [PMID: 32844221 DOI: 10.1093/ajcn/nqaa230] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Overweight and obesity increase the risk of morbidity and mortality. The relations between body composition at midlife, health-related quality of life (HRQoL) in old age, and longevity are, however, less studied. OBJECTIVES We examined the association of midlife body composition with successful aging, defined as high HRQoL and reaching 90 y of age, during 32 y follow-up. METHODS Participants were 1354 men from the Helsinki Businessmen Study, born 1919-1934. In 1985/1986 (mean age: 60 y) various health measurements were performed. Percentages of body fat (BF) and skeletal muscle mass (SM) were calculated using validated formulas (including waist and hip circumferences, weight, and age) and divided into quartiles. In 2000 and 2007 (mean ages: 74 and 80 y, respectively), HRQoL was assessed using RAND-36/Short Form-36 scales. Mortality was retrieved from registers through 2018, and longevity determined by calculating the proportion of participants reaching 90 y. Logistic regression was used to assess ORs with 95% CIs. RESULTS Higher SM% at midlife in 1985/1986 was associated (P < 0.05) with higher scores in the RAND-36 scales of physical functioning, role limitations caused by physical health problems, vitality, social functioning, and general health in old age in 2000. In 2007 only the association with physical domain (physical functioning, role limitations caused by physical health problems) remained statistically significant (P < 0.01). BF% quartiles in 1985/1986 were inversely associated with several RAND-36 scales in 2000 and 2007. During the 32-y follow-up, 982 participants died and 281 reached 90 y of age. Being in the highest SM% quartile at midlife increased (adjusted OR: 2.32; 95% CI: 1.53, 3.53; lowest SM% quartile as reference) and being in the highest BF% quartile decreased (OR: 0.43; 95% CI: 0.28, 0.66; lowest BF% quartile as reference) the odds of reaching 90 y. CONCLUSIONS Desirable body composition in terms of both fat and skeletal muscle mass at midlife was associated with successful aging in men.This trial was registered at clinicaltrials.gov as NCT02526082.
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Affiliation(s)
- Satu K Jyväkorpi
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland
| | - Annele Urtamo
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Kivimäki
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
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12
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Falk Erhag H, Ahlner F, Rydberg Sterner T, Skoog I, Bergström A. Internet use and self-rated health among Swedish 70-year-olds: a cross-sectional study. BMC Geriatr 2019; 19:365. [PMID: 31870313 PMCID: PMC6929471 DOI: 10.1186/s12877-019-1392-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/17/2019] [Indexed: 11/17/2022] Open
Abstract
Background The Internet is increasingly becoming an infrastructure for a number of services, both commercial, public (including health related) and personal. Using the internet have the potential to promote social interaction and social connectedness by upholding social networks and social contacts. However, Internet use is lower in older adults compared to other age groups. This digital divide is considered a risk to the health of older adults since it limits their participation in society, access and use of relevant health related information and services. This study focuses on whether there is an association between Internet use and self-rated health. Method A cross-sectional population-based sample of 70-year-olds from The Gothenburg H70 Birth Cohort Study (n = 1136) was examined in 2014–16. All data was collected using structured interviews and questionnaires. Differences in proportions were tested with chi-square test and ordinary least square regression analysis was used to estimate the relationship between Internet use and self-rated health controlling for health factors, hearing and visual impairment, and social contacts. Results There is a relationship between more frequent Internet use and good self-rated health (unstandardized β 0.101 p < 0.001), and the effect remained after adjusting for all covariates (unstandardized β 0.082 p < 0.001). Our results also show that, in comparison to health factors, Internet use is of minor importance to the SRH of older adults, since adding these improved the explanatory power of the model by approximately 400% (from 0.04 to 0.18). Conclusion Although the direction of the relationship between more frequent interne use and better self-rated health is undetermined in the present study, it can be suggested that using the Internet informs and educates older adults, strengthening their position as active and engaged participants of society. It can also be suggested that those using the Internet report less loneliness and a possibility to establish new computer-mediated relationships within online communities. Further research needs to examine what aspects of Internet use, and in what contexts such positive perceptions arise.
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Affiliation(s)
- Hanna Falk Erhag
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, S-431 41, Molndal, Sweden. .,Age Cap - Centre for Ageing and Health, University of Gothenburg, Wallinsgatan 6, S-431 41, Mölndal, Sweden.
| | - Felicia Ahlner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, S-431 41, Molndal, Sweden.,Age Cap - Centre for Ageing and Health, University of Gothenburg, Wallinsgatan 6, S-431 41, Mölndal, Sweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, S-431 41, Molndal, Sweden.,Age Cap - Centre for Ageing and Health, University of Gothenburg, Wallinsgatan 6, S-431 41, Mölndal, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, S-431 41, Molndal, Sweden.,Age Cap - Centre for Ageing and Health, University of Gothenburg, Wallinsgatan 6, S-431 41, Mölndal, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Neuropsychiatry, Gothenburg, Sweden
| | - Annika Bergström
- Age Cap - Centre for Ageing and Health, University of Gothenburg, Wallinsgatan 6, S-431 41, Mölndal, Sweden.,Department of Journalism, Media and Communication, University of Gothenburg, PO Box 100, S-405 30, Gothenburg, Sweden
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13
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Strandberg TE, Urtamo A, Kähärä J, Strandberg AY, Pitkälä KH, Kautiainen H. Statin Treatment Is Associated With a Neutral Effect on Health-Related Quality of Life Among Community-Dwelling Octogenarian Men: The Helsinki Businessmen Study. J Gerontol A Biol Sci Med Sci 2019; 73:1418-1423. [PMID: 29659717 DOI: 10.1093/gerona/gly073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Indexed: 11/14/2022] Open
Abstract
Background Statin treatment is common among 80+ people, but little is known about statin effects on health-related quality of life (HRQoL) in this oldest age group. Methods In the Helsinki Businessmen Study (HBS), men born from 1919 to 1934 (original n = 3,490), have been followed-up since the 1960s. In 2015, a questionnaire about lifestyle, diseases, and medications, and including RAND-36/SF-36 HRQoL instrument was mailed to survivors. About 612 men (72.6%) responded, 530 of them reporting their medications (98% community-living). Propensity score analysis was used to compare statin users and nonusers for HRQoL. Results We compared 229 current statin users (median age 85 years, interquartile range 84-88 years) with 301 nonusers (86; 84-89 years). Current statin users had had significantly higher serum cholesterol level in midlife (p < .001), but current lifestyle-related characteristics were similar in users and nonusers. Statin users reported more hypertension (61.1%, p < .001), diabetes (23.6%, p <.001), and atherosclerotic cardiovascular disease (ASCVD, 33.6%, p <.001), than nonusers. Statin users reported higher mean scores than nonusers in all eight RAND-36 subscales, but after adjustments for multiplicity and a propensity score we found no significant differences between statin users and nonusers. Stratification for primary (no ASCVD) and secondary (with CVD) prevention supported the main results. Conclusions Our study suggests that statin treatment has no significant effect on health-related quality of life among octogenarian, community-dwelling men. The results contradict concerns about statin treatment in the oldest-old, and may caution against deprescribing of statins due to old age alone.
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Affiliation(s)
- Timo E Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Finland.,Center for Life Course Health Research, University of Oulu, Finland
| | - Annele Urtamo
- University of Helsinki, Clinicum, and Helsinki University Hospital, Finland
| | - Juuso Kähärä
- University of Helsinki, Clinicum, and Helsinki University Hospital, Finland
| | - Arto Y Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Finland
| | - Kaisu H Pitkälä
- University of Helsinki, Clinicum, and Helsinki University Hospital, Finland
| | - Hannu Kautiainen
- Kuopio University Hospital, Finland.,Folkhälsan Research Centre, Helsinki, Finland
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14
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von Bonsdorff MB, Haapanen MJ, Törmäkangas T, Pitkälä KH, Stenholm S, Strandberg TE. Midlife Cardiovascular Status and Old Age Physical Functioning Trajectories in Older Businessmen. J Am Geriatr Soc 2019; 67:2490-2496. [PMID: 31444889 DOI: 10.1111/jgs.16150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/02/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The associations between cardiovascular disease (CVD) risk and later physical functioning have been observed, but only a few studies with follow-up into old age are available. We investigated the association between cardiovascular status in midlife and physical functioning trajectories in old age. DESIGN Prospective cohort study. SETTING Helsinki Businessmen Study. PARTICIPANTS We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3490). MEASUREMENTS Three CVD status groups were formed based on clinical measurements carried out in 1974: signs of CVD (diagnosed clinically or with changes in ECG, chronic disease present or used medication, n = 563); healthy and low CVD risk (n = 593) and high CVD risk (n = 1222). Of them, 1560 men had data on physical functioning from at least one of four data collection waves between 2000-2010. Ten questions from the RAND-36 (SF-36) survey were used to construct physical functioning trajectories with latent class growth mixture models. Mortality was accounted for in competing risk models. RESULTS A five-class solution provided the optimal number of trajectories: "intact," "high stable," "high and declining," "intermediate and declining," and "consistently low" functioning. Compared with low CVD risk, high CVD risk in midlife decreased the risk of being classified into the intact (fully adjusted β = -3.98; standard error = 2.0; P = .046) relative to the consistently low physical functioning trajectory. Compared with low CVD risk, those with signs of CVD were less likely to follow the intact, high stable, or high and declining relative to the consistently low trajectory (all P < .018). CONCLUSION Among businessmen, a more favorable CVD profile in midlife was associated with better development of physical functioning in old age. J Am Geriatr Soc 67:2490-2496, 2019.
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Affiliation(s)
- Mikaela B von Bonsdorff
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Markus J Haapanen
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Timo E Strandberg
- University of Helsinki, Clinicum and Helsinki University Hospital, Helsinki, Finland.,Centre for Life Course Health Research, University of Oulu, Oulu, Finland
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15
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Jyväkorpi SK, Urtamo A, Strandberg AY, von Bonsdorff M, Salomaa V, Kivimäki M, Luotola K, Strandberg TE. Associations of overweight and metabolic health with successful aging: 32-year follow-up of the Helsinki Businessmen Study. Clin Nutr 2019; 39:1491-1496. [PMID: 31256807 DOI: 10.1016/j.clnu.2019.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/01/2019] [Accepted: 06/11/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Prognostic significance of metabolically healthy overweight and obesity (MHO) is under debate. However the relationship between MHO and health-related quality of life (HRQoL) is less studied. We compared successful aging (longevity plus HRQoL) in men with MHO, metabolically healthy normal weight (MHN) and metabolically unhealthy overweight and obesity (MUO). METHODS In the Helsinki Businessmen Study longitudinal cohort, consisting of men born 1919 to 1934. In 1985/86, overweight (BMI≥25 kg/m2) and metabolic health were determined in 1309 men (median age 60 years). HRQoL was assessed using RAND-36/SF-36 in 2000 and 2007, and all-cause mortality retrieved from registers up to 2018. The proportion of men reaching 90 years was also calculated. RESULTS Of the men, 469 (35.8%), 538 (41.1%), 276 (21.1%), and 26 (2.0%) were MHN, MHO, MUO and MUN, respectively. During the 32-year follow-up, 72.3% men died. With MHN as reference, adjusted hazard ratio with all-cause mortality was 1.08 (95% confidence interval [CI] 0.93 to 1.27) for MHO, and 1.18 (95% CI 0.95 to 1.47) for MUO. During follow-up, 273 men reached 90 years. With MHN as reference, adjusted odds ratio for MHO was 0.82 (95% CI 0.59 to 1.14) and 0.62 (95% CI 0.41 to 0.95) for MUO. Men in MHN group scored generally highest in RAND-36 HRQoL subscales in 2000 and 2007, of those significantly better in Physical functioning, Role physical, Role emotional, Bodily Pain, and General health sub-scales compared to MHO group in 2000. CONCLUSIONS As compared to MHN, MHO in late midlife does not increase mortality, but impairs odds for successful aging.
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Affiliation(s)
- Satu K Jyväkorpi
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland.
| | - Annele Urtamo
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Arto Y Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Mikaela von Bonsdorff
- Folkhälsan Research Centre, Helsinki, Finland; University of Jyväskylä, Faculty of Sport and Health Sciences, Jyväskylä, Finland
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Mika Kivimäki
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, UK
| | - Kari Luotola
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland; University of Oulu, Center for Life Course Health Research, Oulu, Finland
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16
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Coombe AH, Epps F, Lee J, Chen ML, Imes CC, Chasens ER. Sleep and Self-Rated Health in an Aging Workforce. Workplace Health Saf 2019; 67:302-310. [PMID: 30999809 DOI: 10.1177/2165079919828748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The labor force participation rate for adults aged 55 years and older has increased nearly 10% over the past two and a half decades. As workers age, they frequently experience increased chronic health conditions and impaired sleep, which may negatively influence their self-rated health (SRH) and work performance. This study aimed to examine the associations between nonrestorative sleep (NRS) and work performance (i.e., difficulty concentrating or having lower productivity at work) and associations between demographic and sleep characteristics with SRH in middle-aged workers. We conducted a secondary data analysis among working middle-aged adults 50 to 65 years of age ( N = 392) from the 2008 Sleep in America Poll. Respondents frequently reported impaired sleep such as frequent insomnia symptoms, NRS, and short sleep duration. Nonrestorative sleep was associated with decreased work performance such as trouble organizing work, doing work over due to mistakes, and lower productivity. Nonrestorative sleep and short sleep duration were significantly associated with lower SRH. Strategies for the early detection of impaired sleep and implementation of interventions to improve sleep may improve SRH and work performance in working middle-aged adults.
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17
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Midlife predictors of active and healthy aging (AHA) among older businessmen. Aging Clin Exp Res 2019; 31:225-231. [PMID: 30584642 PMCID: PMC6373373 DOI: 10.1007/s40520-018-1100-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022]
Abstract
Background Active and healthy aging (AHA) is an important phenomenon in aging societies. Aims Our aim was to investigate midlife predictors of AHA in a socioeconomically homogenous male cohort. Methods In 2010, AHA was defined in the Helsinki Businessmen Study (men born in 1919–1934) with six criteria: (1) being alive, (2) responding to the mailed survey, (3) no reported cognitive problems, (4) feeling of happiness, (5) no difficulties in activities of daily living (ADL), and (6) no significant chronic diseases. Midlife factors were assessed in 1974 (n = 1759, mean age 47 years). Of the survivors in 2010 (n = 839), 10.0% (n = 84) fulfilled all AHA criteria, whilst 13.7% (n = 115) had chronic diseases but fulfilled other five criteria. Midlife predictors of AHA were analyzed with logistic models. Results Of the midlife factors, smoking [Odds ratio (OR) 0.44, 95% confidence interval (CI) 0.25–0.77], higher body mass index (BMI) (OR 0.75, 0.59–0.96), and higher total cholesterol (OR 0.76, 0.60–0.97) prevented significantly full AHA criteria, whereas higher self-rated health (SRH) (OR 1.73, 1.07–2.80) predicted significantly of fulfilling all AHA criteria. Midlife smoking (OR 0.87, 0.84–0.91), higher BMI (OR 0.73, 0.61–0.86), and higher alcohol consumption (OR 0.73, 0.60–0.90) prevented significantly of fulfilling the five AHA criteria with chronic diseases, and higher SRH (OR 1.90, 1.37–2.63) predicted significantly the five AHA criteria (chronic diseases present). Discussion Our study suggests that midlife factors, especially good SRH and low levels of cardiovascular risk factors, are associated with AHA. Conclusions The study emphasizes the importance of life-course predictors of healthy aging.
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18
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Dent E, Morley JE, Cruz-Jentoft AJ, Woodhouse L, Rodríguez-Mañas L, Fried LP, Woo J, Aprahamian I, Sanford A, Lundy J, Landi F, Beilby J, Martin FC, Bauer JM, Ferrucci L, Merchant RA, Dong B, Arai H, Hoogendijk EO, Won CW, Abbatecola A, Cederholm T, Strandberg T, Gutiérrez Robledo LM, Flicker L, Bhasin S, Aubertin-Leheudre M, Bischoff-Ferrari HA, Guralnik JM, Muscedere J, Pahor M, Ruiz J, Negm AM, Reginster JY, Waters DL, Vellas B. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. J Nutr Health Aging 2019; 23:771-787. [PMID: 31641726 PMCID: PMC6800406 DOI: 10.1007/s12603-019-1273-z] [Citation(s) in RCA: 425] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. METHODS These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.
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Affiliation(s)
- E Dent
- E. Dent, Torrens University Australia, Adelaide, Australia,
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19
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Oliveira BS, Pirkle CM, Zunzunegui MV, Batistuzzo de Medeiros SR, Thomasini RL, Guerra RO. Leukocyte Telomere Length and Chronic Conditions in Older Women of Northeast Brazil: A Cross-Sectional Study. Cells 2018; 7:cells7110193. [PMID: 30400186 PMCID: PMC6262387 DOI: 10.3390/cells7110193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/17/2018] [Accepted: 10/25/2018] [Indexed: 12/22/2022] Open
Abstract
This study assessed whether telomere length is related to chronic conditions, cardiovascular risk factors, and inflammation in women aged 65 to 74 from Northeast Brazil. Participants were selected from two sources, a representative sample of the International Mobility in Aging Study (n = 57) and a convenience sample (n = 49) recruited at senior centers. Leukocyte telomere length was measured by quantitative polymerase chain reaction from blood samples in 83 women. Natural log-transformed telomere/single copy gene ratio was used as the dependent variable in the analysis. Blood analyses included inflammatory markers (high-sensitivity C-reactive protein and interleukin-6), total, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, glucose and glycosylated hemoglobin. Self-rated health, chronic conditions, cardiovascular risk factors and inflammatory markers were not associated with telomere length. No significant independent association was found between telomere length and anthropometric measures or blood markers, even after adjusting for age, education and adverse childhood events among these older women in Northeast Brazil. Our results did not confirm the hypothesis that chronic conditions, cardiovascular risk factors or inflammation are associated with shorter telomere length in these women who have exceptional survival relative to the life expectancy of their birth cohort.
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Affiliation(s)
- Bruna Silva Oliveira
- Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte 59078970, Brazil.
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI 96822, USA.
| | - Maria Victoria Zunzunegui
- Département de Médecine sociale et préventive, École de santé publique, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montréal, QC H3C 3J7, Canada.
| | | | - Ronaldo Luis Thomasini
- Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF), Núcleo de Estudos de Patologias Inflamatórias e Infecciosas (NEPii) and Faculdade de Medicina de Diamantina-FAMED, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais 39100000, Brazil.
| | - Ricardo Oliveira Guerra
- Campus Universitário Natal, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte 59078970, Brazil.
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Wirtz MA, Morfeld M, Brähler E, Hinz A, Glaesmer H. Association of Physical Morbidity and Health-Related Quality of Life in a Representative Sample of Older German People. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2018. [DOI: 10.1027/2512-8442/a000019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion problems (12.9%), general impairments (4.9%), and general impairments with no bowel and digestion problems (4.8%). The participants’ SF-12 Physical Health Scores (η2 = .39) and their Mental Health Scores (η2 = .28) are highly associated with these latent classes. These associations remain virtually identical after controlling for age. The results provide evidence that profiles of patient-reported physical impairments correspond strongly with reduced HRQoL independently from aging processes.
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Affiliation(s)
- Markus A. Wirtz
- Department of Research Methods, Institute of Psychology, University of Education, Freiburg, Germany
| | - Matthias Morfeld
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
- University Medical Center of the Johannes Gutenberg University Mainz, Clinic for Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
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21
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Baniak LM, Yang K, Choi J, Chasens ER. Long Sleep Duration Is Associated With Increased Frailty Risk in Older Community-Dwelling Adults. J Aging Health 2018; 32:42-51. [PMID: 30270714 DOI: 10.1177/0898264318803470] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: To examine whether sleep duration is correlated with increased frailty risk and investigate the determinants of frailty status. Method: Data on 3,632 participants from the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES, community-dwelling >60 years, 52.1% prefrail, 13.6% frail, 55% women) were used. Frailty status was categorized by Fried Phenotype (robust, prefrail, and frail) with customized criteria for the NHANES data set. Hours of self-reported sleep duration were categorized as short (⩽6), normal (7-9), and long (⩾10). Multinomial regression analysis identified risk factors for each frailty state. Results: Only long sleep duration was associated with increased odds (2.86 [1.09-7.50]) of being characterized as frail but not prefrail. Frail and prefrail states had shared risk factors but also had many distinct to each state. Discussion: Sleep duration is a potential, modifiable therapeutic target for frailty management. Multicomponent interventions should be tailored for frailty status.
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Affiliation(s)
| | - Kyeongra Yang
- Rutgers, The State University of New Jersey, Newark, USA
| | - JiYeon Choi
- University of Pittsburgh, Pittsburgh, USA.,Yonsei University, Seoul, Korea
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22
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Strandberg AY, Trygg T, Pitkälä KH, Strandberg TE. Alcohol consumption in midlife and old age and risk of frailty: Alcohol paradox in a 30-year follow-up study. Age Ageing 2018; 47:248-254. [PMID: 29088316 DOI: 10.1093/ageing/afx165] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Indexed: 01/12/2023] Open
Abstract
Background alcohol consumption has many harmful health effects, but also benefits of moderate consumption on frailty have been reported. We examined this relationship longitudinally from midlife to old age. Methods data of reported alcohol consumption in midlife (year 1974) and in old age (years 2000 and 2003) were available of a socioeconomically homogenous sample of 2360 men (born 1919-34, the Helsinki Businessmen Study). Alcohol consumption was divided into zero (N = 131 at baseline), light (1-98 g/week, N = 920), moderate (99-196, N = 593), and high consumption (>196, n = 716). Incidence of phenotypic frailty and prefrailty was assessed in 2000 and 2003. Alcohol consumption (reference 1-98 g/week, adjusted for age, body mass index and smoking) was related to frailty both longitudinally (from 1974 to 2000, and from 2000 to 2003) and cross-sectionally in 2000 and 2003. Results during a 30-year follow-up, high consumption clearly decreased whereas lighter consumption remained stable. High consumption in midlife predicted both frailty (odds ratio = 1.61, 95% confidence interval = 1.01-2.56) and prefrailty (1.42; 1.06-1.92) in 2000, association with zero and moderate consumption was insignificant. Cross-sectionally in 2000, both zero (2.08; 1.17-3.68) and high consumption (1.83; 1.07-3.13) were associated with frailty, while in 2003 only zero consumption showed this association (2.47; 1.25-4.88). Conclusion the relationship between alcohol and frailty is a paradox during the life course. High, not zero, consumption in midlife predicts old age frailty, while zero consumption in old age is associated with frailty, probably reflecting reverse causality.
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Affiliation(s)
- Arto Y Strandberg
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Teemu Trygg
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and
Helsinki University Central Hospital, University of Helsinki, Unit of Primary Health Care, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- University of Oulu, Center for Life Course Health Research, Oulu, Finland
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23
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Urtamo A, Kautiainen H, Pitkälä KH, Strandberg TE. Association of midlife value priorities with health-related quality of life, frailty and mortality among older men: a 26-year follow-up of the Helsinki Businessmen Study (HBS). Qual Life Res 2018; 27:1269-1275. [PMID: 29417426 DOI: 10.1007/s11136-018-1805-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 01/10/2023]
Abstract
PURPOSE Personal values influence behavior and decision making, but their long-term associations with health-related quality of life (HRQoL), frailty, and mortality are less clear. We studied these associations from midlife to old age in a 26-year follow-up of the Helsinki Businessmen Study (HBS) cohort. METHODS In 1974, 1320 clinically healthy men (born 1919-1934) reported in a 12-item questionnaire their personal values. In 2000, a mailed questionnaire, including assessment of HRQoL with RAND-36 (SF-36) instrument, was sent to survivors, and 1025 men responded. In 2000, the presence of phenotypic frailty was assessed using modified Fried criteria including indicators of shrinking, physical weakness, exhaustion, and physical inactivity. Mortality through December 31, 2000 was verified from national registries. RESULTS Using a factor analysis, the data of the 12-item questionnaire of personal values were loaded in 3 factors: valuing health ("Health"), enjoyable and varying life ("Enjoyment"), and comfort and work-oriented life ("Work-life-balance"). Adjusted for age, we found a significant positive association between valuing "Health" in midlife and RAND-36 domains of Physical functioning (p = .032) and Vitality (p = .005) in old age. "Health" also predicted less frailty (p = .008), and "Enjoyment" was associated with higher mortality (p = .017). CONCLUSIONS Value priorities of men assessed in midlife had long-term associations with HRQoL and frailty in old age, and they may also predict mortality.
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Affiliation(s)
- Annele Urtamo
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 340, 00029, Helsinki, Finland. .,Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland.
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 340, 00029, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 340, 00029, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Timo E Strandberg
- Helsinki University Hospital, University of Helsinki, Clinicum, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
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24
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Falk H, Skoog I, Johansson L, Guerchet M, Mayston R, Hörder H, Prince M, Prina AM. Self-rated health and its association with mortality in older adults in China, India and Latin America-a 10/66 Dementia Research Group study. Age Ageing 2017; 46:932-939. [PMID: 28985329 PMCID: PMC5860352 DOI: 10.1093/ageing/afx126] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 05/03/2017] [Accepted: 06/26/2017] [Indexed: 11/13/2022] Open
Abstract
Background empirical evidence from high-income countries suggests that self-rated health (SRH) is useful as a brief and simple outcome measure in public health research. However, in many low- and middle-income countries (LMIC) there is a lack of evaluation and the cross-cultural validity of SRH remains largely untested. This study aims to explore the prevalence of SRH and its association with mortality in older adults in LMIC in order to cross-culturally validate the construct of SRH. Methods population-based cohort studies including 16,940 persons aged ≥65 years in China, India, Cuba, Dominican Republic, Peru, Venezuela, Mexico and Puerto Rico in 2003. SRH was assessed by asking 'how do you rate your overall health in the past 30 days' with responses ranging from excellent to poor. Covariates included socio-demographic characteristics, use of health services and health factors. Mortality was ascertained through a screening of all respondents until 2007. Results the prevalence of good SRH was higher in urban compared to rural sites, except in China. Men reported higher SRH than women, and depression had the largest negative impact on SRH in all sites. Without adjustment, those with poor SRH showed a 142% increase risk of dying within 4 years compared to those with moderate SRH. After adjusting for all covariates, those with poor SRH still showed a 43% increased risk. Conclusion our findings support the use of SRH as a simple measure in survey settings to identify vulnerable groups and evaluate health interventions in resource-scares settings.
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Affiliation(s)
- Hanna Falk
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Sahlgrenska Academy, Center for Ageing and Health—AGECAP, Gothenburg University, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Sahlgrenska Academy, Center for Ageing and Health—AGECAP, Gothenburg University, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| | - Lena Johansson
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Sahlgrenska Academy, Center for Ageing and Health—AGECAP, Gothenburg University, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| | - Maëlenn Guerchet
- Health Services and Population Research Department, Psychology and Neuroscience, Centre for Global Mental Health, Institute of Psychiatry, King's College London, Strand, London WC2R2LS, UK
| | - Rosie Mayston
- Health Services and Population Research Department, Psychology and Neuroscience, Centre for Global Mental Health, Institute of Psychiatry, King's College London, Strand, London WC2R2LS, UK
| | - Helena Hörder
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Sahlgrenska Academy, Center for Ageing and Health—AGECAP, Gothenburg University, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| | - Martin Prince
- Health Services and Population Research Department, Psychology and Neuroscience, Centre for Global Mental Health, Institute of Psychiatry, King's College London, Strand, London WC2R2LS, UK
| | - A Matthew Prina
- Health Services and Population Research Department, Psychology and Neuroscience, Centre for Global Mental Health, Institute of Psychiatry, King's College London, Strand, London WC2R2LS, UK
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25
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Rantanen K, Strandberg AY, Salomaa V, Pitkälä K, Tilvis RS, Tienari P, Strandberg T. Cardiovascular risk factors and glucose tolerance in midlife and risk of cognitive disorders in old age up to a 49-year follow-up of the Helsinki businessmen study. Ann Med 2017; 49:462-469. [PMID: 28151011 DOI: 10.1080/07853890.2017.1290821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE The purpose of this study is to compare midlife predictors of old age dementia with or without concomitant atherosclerotic cardiovascular disease (ASCVD). DESIGN In the Helsinki Businessmen Study (men born in 1919-1934, n = 3309), death certificates (n = 1885) during up to 49-year follow-up (through 31 December 2013) were screened for dementia (n = 365) and ASCVD, and categorized as (1) AD without ASCVD ("pure" AD, n = 93), (2) AD + ASCVD (n = 126), (3) vascular dementia (VD, n = 82), (4) other or undefined etiology (n = 64). Using Cox analyses, death without dementia and dementia types were compared for the prediction by midlife ASCVD risk factors. Men without diagnosed dementia during follow-up were used as reference. RESULTS ASCVD risk factors predicted death without dementia during follow-up. Midlife cholesterol was higher in AD + ASCVD and VD as compared with men surviving to old age without known dementia. None of the midlife factors including cholesterol and glucose tolerance predicted pure AD, but midlife cholesterol predicted AD + ASCVD, both as a continuous (hazard ratio [HR] per SD 1.24, 95% CI, 1.04-1.47), and dichotomous variable (cutpoint 6.5 mmol/L; HR 1.67, 95% CI, 1.16-2.40). CONCLUSION Midlife cholesterol predicted dementia with vascular features, but midlife vascular risk factors and glucose intolerance were not related to pure Alzheimer disease without concomitant atherosclerotic cardiovascular disease. Key messages Heterogenous etiology of dementia, which in old age is usually a clinical diagnosis, may confound the role of long-term risk factors. In a longitudinal study with autopsy records, midlife cholesterol predicted dementia with features of atherosclerotic cardiovascular disease but not "pure" Alzheimer disease Glucose tolerance in midlife was not associated with pure Alzheimer's disease.
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Affiliation(s)
- Kirsi Rantanen
- a Department of Neurology , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | | | - Veikko Salomaa
- c THL-National Institute for Health and Welfare , Helsinki , Finland
| | - Kaisu Pitkälä
- d Department of General Practice , Helsinki University Central Hospital, Unit of General Practice, and University of Helsinki , Helsinki , Finland
| | - Reijo S Tilvis
- e University of Helsinki, and Helsinki University Hospital , Helsinki , Finland
| | - Pentti Tienari
- a Department of Neurology , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - Timo Strandberg
- e University of Helsinki, and Helsinki University Hospital , Helsinki , Finland.,f University of Oulu, Center for Life-Course Health Research , Oulu , Finland
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26
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Strandberg T, von Bonsdorff M, Strandberg A, Pitkälä K, Räikkönen K. Associations of vacation time with lifestyle, long-term mortality and health-related quality of life in old age: The Helsinki Businessmen Study. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Strandberg T, Levälahti E, Ngandu T, Solomon A, Kivipelto M, Kivipelto M, Ngandu T, Lehtisalo J, Laatikainen T, Soininen H, Strandberg T, Antikainen R, Jula A, Tuomilehto J, Peltonen M, Levälahti E, Lindström J, Rauramaa R, Pajala S, Hänninen T, Solomon A, Paajanen T, Mangialasche F. Health-related quality of life in a multidomain intervention trial to prevent cognitive decline (FINGER). Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2016.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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28
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Quality of life independently predicts long-term mortality but not vascular events: the Northern Manhattan Study. Qual Life Res 2017; 26:2219-2228. [PMID: 28357682 DOI: 10.1007/s11136-017-1567-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Cardiovascular disease is a major contributor to morbidity and mortality, and prevention relies on accurate identification of those at risk. Studies of the association between quality of life (QOL) and mortality and vascular events incompletely accounted for depression, cognitive status, social support, and functional status, all of which have an impact on vascular outcomes. We hypothesized that baseline QOL is independently associated with long-term mortality in a large, multi-ethnic urban cohort. METHODS In the prospective, population-based Northern Manhattan Study, Spitzer QOL index (SQI, range 0-10, with ten signifying the highest QOL) was assessed at baseline. Participants were followed over a median 11 years for stroke, myocardial infarction (MI), and vascular and non-vascular death. Multivariable Cox proportional hazards regression estimated hazard ratio and 95% confidence interval (HR, 95% CI) for each outcome, with SQI as the main predictor, dichotomized at 10, adjusting for baseline demographics, vascular risk factors, history of cancer, social support, cognitive status, depression, and functional status. RESULTS Among 3298 participants, mean age was 69.7 + 10.3 years; 1795 (54.5%) had SQI of 10. In fully adjusted models, SQI of 10 (compared to SQI <10) was associated with reduced risk of all-cause mortality (HR 0.80, 95% CI 0.72-0.90), vascular death (0.81, 0.69-0.97), non-vascular death (0.78, 0.67-0.91), and stroke or MI or death (0.82, 0.74-0.91). In fully adjusted competing risk models, there was no association with stroke (0.93, 0.74-1.17), MI (0.98, 0.75-1.28), and stroke or MI (1.03, 0.86-1.24). Results were consistent when SQI was analyzed continuously. CONCLUSION In this large population-based cohort, highest QOL was inversely associated with long-term mortality, vascular and non-vascular, independently of baseline primary vascular risk factors, social support, cognition, depression, and functional status. QOL was not associated with non-fatal vascular events.
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Pilleron S, Ajana S, Jutand MA, Helmer C, Dartigues JF, Samieri C, Féart C. Dietary Patterns and 12-Year Risk of Frailty: Results From the Three-City Bordeaux Study. J Am Med Dir Assoc 2017; 18:169-175. [DOI: 10.1016/j.jamda.2016.09.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 12/16/2022]
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30
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von Bonsdorff MB, Strandberg A, von Bonsdorff M, Törmäkangas T, Pitkälä KH, Strandberg TE. Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen. Age Ageing 2017; 46:108-112. [PMID: 28181632 DOI: 10.1093/ageing/afw178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/31/2016] [Indexed: 11/13/2022] Open
Abstract
Background Long working hours and short sleep duration are associated with a range of adverse health consequences. However, the combined effect of these two exposures on health-related quality of life (HRQoL) has not been investigated. Methods We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3,490). Data on clinical variables, self-rated health (SRH), working hours and sleep duration in 1974, and RAND-36 (SF-36) HRQoL survey in the year 2000 were available for 1,527 men. Follow-up time was 26 years. By combining working hours and sleep duration, four categories were formed: (i) normal work (≤50 hours/week) and normal sleep (>47 hours/week); (ii) long work (>50 hours/week) and normal sleep; (iii) normal work and short sleep (≤47 hours/week); and (iv) long work and short sleep. The association with RAND-36 domains was examined using multiple linear regression models adjusted for age, smoking and SRH. Results Compared to those with normal work and sleep in midlife, men with long work and short sleep had poorer RAND-36 scores for physical functioning, vitality and general health, and those with long work and normal sleep had poorer scores for physical functioning in old age. Adjustment for midlife smoking and SRH attenuated the associations, but the one for long work and short sleep and physical functioning remained significant (difference in mean physical functioning score −4.58, 95% confidence interval −9.00 to −0.15). Conclusion Businessmen who had long working hours coupled with short sleep duration in midlife had poorer physical health in old age.
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Affiliation(s)
- Mikaela Birgitta von Bonsdorff
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Arto Strandberg
- University of Helsinki Department of General Practice and Primary Health Care and Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Monika von Bonsdorff
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Timo Törmäkangas
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Kaisu H Pitkälä
- University of Helsinki Department of General Practice and Primary Health Care and Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki Department of General Practice and Primary Health Care and Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
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Yeap BB, Manning L, Chubb SAP, Hankey GJ, Golledge J, Almeida OP, Flicker L. Reference Ranges for Thyroid-Stimulating Hormone and Free Thyroxine in Older Men: Results From the Health In Men Study. J Gerontol A Biol Sci Med Sci 2016; 72:444-449. [DOI: 10.1093/gerona/glw132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/26/2016] [Indexed: 01/07/2023] Open
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