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Stalling I, Gruber M, Bammann K. Sex differences in physical functioning among older adults: cross-sectional results from the OUTDOOR ACTIVE study. BMC Public Health 2024; 24:1766. [PMID: 38956507 PMCID: PMC11221023 DOI: 10.1186/s12889-024-19218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. METHODS Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. RESULTS Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. CONCLUSIONS We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. TRIAL REGISTRATION German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).
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Affiliation(s)
- Imke Stalling
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany.
| | - Martin Gruber
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany
| | - Karin Bammann
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany
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Nersesjan SC, Nilsson CJ, Davidsen K, Kriegbaum M, Lund R. Life course partnership history and objectively measured physical functional ability in Danish middle-aged adults. J Epidemiol Community Health 2023; 77:369-374. [PMID: 36914256 DOI: 10.1136/jech-2022-220194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Partnership break-up and living alone is associated with several negative health-related outcomes. Little is known about the association with physical functional ability in a life course perspective. The aim of this study is to investigate (1) the association between number of partnership break-ups and years living alone across 26 years of adult life respectively and objectively measured physical capability in midlife, (2) how the joint exposure of accumulated break-ups or years living alone respectively, and education relates to physical capability in midlife and (3) potential gender differences. METHODS Longitudinal study of 5001 Danes aged 48-62. Accumulated number of partnership break-ups and years living alone were retrieved from national registers. Handgrip strength (HGS) and number of chair rises (CR) were recorded as outcomes in multivariate linear regression analyses adjusted for sociodemographic factors, early major life events and personality. RESULTS Increasing number of years living alone was associated with poorer HGS and fewer CR. Concomitant exposure to short educational level and break-ups or long duration of time living alone respectively was associated with poorer physical capability compared with the groups with long educational level and no break-ups or few years lived alone. CONCLUSION Accumulated number of years living alone but not break-ups was associated with poorer physical functional ability. Joint exposure to a high number of years lived alone or break-ups respectively and having a short education was associated with the lowest levels of functional ability, which points towards an important target group for interventions. No gender differences were suggested.
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Affiliation(s)
| | - Charlotte Juul Nilsson
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - Karolina Davidsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark.,Section of General Practice, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - Margit Kriegbaum
- Section of General Practice, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark .,Section of General Practice, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark.,University of Copenhagen Center for Healthy Aging, Kobenhavn, Denmark
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Association between menopausal status and physical function: A systematic review protocol. PLoS One 2023; 18:e0280786. [PMID: 36693069 PMCID: PMC9873147 DOI: 10.1371/journal.pone.0280786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Physical function is considered an important marker of adverse health outcomes. Postmenopausal women seem to have worse physical function, but conflicting results have been reported in the literature. The aim of this systematic review is to assess the association between menopausal status and physical function in community-dwelling women. METHODS Cross-sectional and/or longitudinal studies which objectively or subjectively assess physical function at different menopausal stages will be included. Studies conducted in institutionalized populations or with any specific medical condition that may have induced menopause (i.e. cancer or degenerative diseases) will be excluded. This systematic review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The searches will be carried out in the Pubmed, Embase, SciELO (Scientific Electronic Library Online), LILACS (Latin American and Caribbean Literature on Health Sciences), VHL (Virtual Health Library), Scopus and Web of Science databases, using the search equation "Menopause AND (Physical Performance OR Function)". The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies will be considered to assess the methodological quality of the included studies. The selection and evaluation of the methodological quality of the studies will be carried out by independent researchers and the discrepancies will be resolved by a separate researcher. ETHICS AND DISCLOSURE Ethical approval is not required as this is a study using secondary data. The results will be published in a scientific journal. We intend to contribute to the expansion of knowledge regarding physical function of women according to the menopause status, thus helping in the perspective of improving health and functioning. This systematic review started in January 2022 and all steps are expected to be finished by October 2022. PROSPERO REGISTRATION NUMBER CRD42021289899.
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Corona LP, Andrade FCD, da Silva Alexandre T, de Brito TRP, Nunes DP, de Oliveira Duarte YA. Higher hemoglobin levels are associated with better physical performance among older adults without anemia: a longitudinal analysis. BMC Geriatr 2022; 22:233. [PMID: 35313814 PMCID: PMC8939094 DOI: 10.1186/s12877-022-02937-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 02/21/2022] [Indexed: 01/17/2023] Open
Abstract
Background Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia. Methods The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015-2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,023 who had complete data and did not have anemia in 2010. In the follow-up, there were 567 without anemia. Results In analyses adjusted for age, education, comorbidities, body mass index, and physical inactivity, we found a differential association between hemoglobin concentration and SBBP by sex, with a positive interaction (β Hb*female= 0.20, 95% CI 0.04,0.37). At lower levels of hemoglobin, women have lower levels of SPPB than men, but at higher levels of hemoglobin concentration, there are no sex differences in physical performance. In addition, higher age was negatively associated with SPPB levels and cardiometabolic diseases, other diseases, and physical inactivity. Education was positively associated with physical performance. Conclusion Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older adults without anemia in Brazil. However, there were sex differences in this association. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia, and highlights sex differences. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02937-4.
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Affiliation(s)
- Ligiana Pires Corona
- Faculty of Applied Sciences, University of Campinas (UNICAMP), R. Pedro Zaccaria, 1300 - 13484-350, Limeira, SP, Brazil.
| | - Flavia Cristina Drumond Andrade
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada St, Urbana, IL, 61801, United States of America
| | - Tiago da Silva Alexandre
- Gerontology Department, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, SP-310, São Carlos, SP, Brazil
| | | | - Daniella Pires Nunes
- Medical-surgical Nursing Area, Faculty of Nursing, University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126, Campinas, SP, Brazil
| | - Yeda Aparecida de Oliveira Duarte
- Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 419, São Paulo, SP, Brazil
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do Nascimento RA, Vieira MCA, Dos Santos Aguiar Gonçalves RS, Moreira MA, de Morais MSM, da Câmara SMA, Maciel ÁCC. Cutoff points of adiposity anthropometric indices for low muscle mass screening in middle-aged and older healthy women. BMC Musculoskelet Disord 2021; 22:713. [PMID: 34416881 PMCID: PMC8379807 DOI: 10.1186/s12891-021-04532-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/20/2021] [Indexed: 12/25/2022] Open
Abstract
Background The reduction of female sex hormones causes changes in the contractile properties of muscles as well as infiltration of fat in the muscle tissue. This results in a consequent decline in muscle strength. These changes are related to higher levels of functional impairment and physical disability. In this sense, several anthropometric indices have been used to quantify body and visceral fat. Thus, the objective of this paper is to propose cutoff points for adiposity anthropometric indices in order to identify low muscle mass, as well as to analyze the relationship between these indices and low muscle mass in middle-aged and older women. Methods Cross-sectional analytical study carried out in the Northeast of Brazil. The sample was formed by 593 women between 40—80 years old. Data collection included anthropometric assessment (BMI: Body Mass Index – WC: Waist Circumference – WHR: Waist-to-hip Ratio – WHtR: Waist-to-height Ratio – CI: Conicity Index – BAI: Body Adiposity Index – VAI: Visceral Adiposity Index – LAP: Lipid Accumulation Product), bioimpedance test and biochemical dosage. Moreover, sociodemographic data and practice of physical activity were collected. Descriptive statistics, Student's t-test, ROC curves, chi-squared and logistic regression were performed. Results The participants had a mean age of 53.11 (8.89) years, BMI of 28.49 (5.17) kg/m2 and WC of 95.35 (10.39). The prevalence of low muscle mass was 19.4%. Based on sensitivity and specificity of adiposity anthropometric indices, cutoff points were developed to identify the presence of low muscle mass (p < 0.05), except for VAI. After logistic regression, WC (OR = 6.2; CI 95%: 1.4—28.1), WHR (OR = 1.8; CI: 1.0—3.4), WHtR (OR = 5.0; CI 95%: 1.0—23.7) and BAI (OR = 14.5; CI 95%: 6.6—31.7) were associated with low muscle mass. Conclusions All anthropometric indices, except VAI, showed adequate accuracy in identifying low muscle mass in women, especially those that took into account WC. This suggests that they can become accessible and also be cost-effective strategies for assessing and managing health outcomes related to muscle mass analysis.
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Affiliation(s)
- Rafaela Andrade do Nascimento
- Physiotherapy, Department of Federal, University of Rio Grande Do Norte, 3000 Senador Salgado Filho Avenue, S/N, Lagoa Nova, Natal, RN, CEP: 59072-970, Brazil.
| | - Mariana Carmem Apolinário Vieira
- Physiotherapy, Department of Federal, University of Rio Grande Do Norte, 3000 Senador Salgado Filho Avenue, S/N, Lagoa Nova, Natal, RN, CEP: 59072-970, Brazil
| | | | - Mayle Andrade Moreira
- Physiotherapy Department of Federal, University of Ceará, 949 Alexandre Baraúna St, Rodolfo Teófilo, Fortaleza, CEP: 60430-110, Brazil
| | - Maria Socorro Medeiros de Morais
- Health Sciences Center of Federal, University of Rio Grande Do Norte, General Gustavo Cordeiro de Farias St, Petrópolis, Natal, RN, CEP 59012-570, Brazil
| | | | - Álvaro Campos Cavalcanti Maciel
- Physiotherapy, Department of Federal, University of Rio Grande Do Norte, 3000 Senador Salgado Filho Avenue, S/N, Lagoa Nova, Natal, RN, CEP: 59072-970, Brazil
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Possible association of early menopause with worse physical function: a systematic review. ACTA ACUST UNITED AC 2021; 28:467-475. [PMID: 33399317 DOI: 10.1097/gme.0000000000001712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Menopause at younger ages is associated with a greater risk of adverse health outcomes such as osteoporosis, chronic diseases, and death. However, the association with physical function has not been well established. OBJECTIVE Assess the association between timing of menopause and different measures of physical function. EVIDENCE REVIEW Searches on the PubMed, Cochrane Library, SciELO, LILACS, and Web of Science databases were conducted. Observational studies on the association between age at menopause and measures of physical function were included, with no restriction for publication date or language. Methodological quality was assessed by the "Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies." FINDINGS Four cross-sectional studies were included, totaling 13,846 participants. These investigated five measures of physical function: gait speed, grip strength, standing balance, chair stand, and self-reported functional limitations. Poor physical function was associated with premature (<40 y) or early menopause (<45 y) in all the studies, with significant results only for grip strength, gait speed, and functional limitation. Premature and early menopause were associated with weaker grip strength [between 2.58 kg (95% CI = 0.74 to 4.43) and 5.21 kg (2.18 to 8.25)], and lower gait speed [between 0.03 m/s (0.01 to 0.06) and 0.06 m/s (0.02 to 0.09)]. Menopause after the age of 50 is associated with less likelihood of functional limitation [OR between 0.52 (95% CI = 0.29 to 0.95) and 0.61 (0.40 to 0.95)] compared with premature and early menopause. Two measures of physical function (chair stand test and standing balance) were not significantly associated with age at menopause. CONCLUSION Only four cross-sectional studies showed that earlier ages at menopause are associated with poor physical function (grip strength, gait speed, and self-reported functional limitations), but given the high heterogeneity of the studies, no consensus is possible. Longitudinal studies are needed to explore the association between age at menopause and different measures of physical function as well as the influence of different socioeconomic conditions between countries on functioning.
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Cognitive Ability in Midlife and Labor Market Participation Among Older Workers: Prospective Cohort Study With Register Follow-up. Saf Health Work 2020; 11:291-300. [PMID: 32995054 PMCID: PMC7502611 DOI: 10.1016/j.shaw.2020.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/02/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background The study aimed to determine the association of individual cognitive ability in late midlife with labor market participation among older workers. Methods This prospective cohort study estimates the risk of long-term sickness absence, disability pension, early retirement, and unemployment from scores on the Intelligenz-Struktur-Test 2000R by combining data from 5076 workers from the Copenhagen Aging and Midlife Biobank with a register on social transfer payments. Analyses were stepwise adjusted for age, gender, physical and psychosocial work environment, health behaviors, occupational social class, education, and chronic diseases. Results In the fully adjusted model, low cognitive ability (≥1 standard deviation below the mean for each gender) and high cognitive ability (≥1 standard deviation above the mean for each gender) were not associated with risk of any of the four labor market outcomes. Conclusion Individual cognitive ability in late midlife was not associated with risk of long-term sickness absence, disability pension, early retirement, and unemployment in the fully adjusted model. Thus, no direct effect of individual cognitive ability in late midlife was observed on the risk of permanently or temporarily leaving the labor market.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Corresponding author. National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Åse M. Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Denmark
| | - Erik L. Mortensen
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Denmark
| | - Otto M. Poulsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Copenhagen University Holbæk, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Lars L. Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Sport Sciences, Department of Health Science and Technology Aalborg University, Denmark
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Nilsson K. When is work a cause of early retirement and are there any effective organizational measures to combat this? A population-based study of perceived work environment and work-related disorders among employees in Sweden. BMC Public Health 2020; 20:716. [PMID: 32430030 PMCID: PMC7236147 DOI: 10.1186/s12889-020-08865-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ageing workforce has an impact on public health. The aim of this study was to evaluate work-related disorders, work tasks and measures associated with the possibility of working beyond 65 years of age or not. METHOD The data comprised two sample surveys based on the Swedish population: the Survey of National Work-Related Health Disorders, and the National Work Environment Survey. RESULTS A logistic regression analysis showed that an active systematic work environmental management in the workplace was a statistically significant association with whether individuals could work in their current occupation until 65 years of age (OR 1.7). The final multivariate model stated that whether individuals could work until 65 years was associated with bodily exhaustion after work, frequent feeling of the own work effort being insufficient at the end of the day, experience of the work as restricted and with a lack of freedom, working alone and at risk of unsafe or threatening situations, and generally feeling dissatisfied with the work tasks. Women-dominated workplaces were more highly associated with both male and female employees not being able to work until age 65 (OR 1.6). CONCLUSION Deficiencies in the working environment seems to be a threat to the public health. An active systematic work environmental management in the workplace increases the possibility to extend the working life. Tools for managers, like the swAge-model, to easily perform active systematic work environmental controls could therefore be a possible way to decrease the risk of work injury as well as increase the possibility for a sustainable extended working life.
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Affiliation(s)
- Kerstin Nilsson
- Division of Occupational and Environmental Medicine, Lund University, Medicon Village, Scheelevägen 8, By 402A, SE-223 81, Lund, Sweden. .,Division of Public Health, Kristianstad University, SE-291 88, Kristianstad, Sweden.
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Cumulative physical workload and mobility limitations in middle-aged men and women: a population-based study with retrospective assessment of workload. Int Arch Occup Environ Health 2019; 92:651-660. [PMID: 30659363 PMCID: PMC6556152 DOI: 10.1007/s00420-019-01399-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/09/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess the association between exposure to physical workload throughout working life and risk of mobility limitations in midlife in a population-based Danish cohort. METHODS The study was cross-sectional with a retrospective exposure assessment, and data were from a questionnaire used in the Copenhagen Aging and Biobank. Cumulative physical workload was estimated by combining information about the participants' employments and data from a job exposure matrix. Daily amount of lifting was standardised in ton-years (lifting 1000 kg/day/year) and grouped in 5 exposure groups (no/minor (1-2 ton-years)/low (3-10 ton-years)/moderate (11-20 ton-years)/high exposure (> 20 ton-years)). The outcome was self-reports of mobility limitations (running 100 m, walking 400 m, and climbing stairs to the 2nd floor) in midlife. The association between exposure and outcome was analysed using logistic regression models. RESULTS We included 4996 men and 2247 women, mean age 56 years. 21% of men and 10% of women were in the highest exposure-group (> 20 ton-years). Higher cumulative exposure was associated with higher odds for mobility limitations. Exposure to more than 20 ton-years compared to no exposure increased the odds for limitations in walking, age-adjusted odds ratio (OR) 3.2 (95% CI: 2.4-4.3) for men, 2.3 (1.4-3.8) for women. Corresponding results for running: 2.5 (2.2-3.0) for men, 1.6 (1.2-2.2) for women, and for limitations in climbing stairs: 4.2 (3.3-5.2) for men, 1.7 (1.2-2.4) for women. Results were attenuated when confounders were added. CONCLUSIONS Exposure to physical workload throughout working life is associated with higher odds for mobility limitations in midlife.
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Petersen GL, Pedersen JLM, Rod NH, Mortensen EL, Kawachi I, Osler M, Hansen ÅM, Lund R. Childhood socioeconomic position and physical capability in late-middle age in two birth cohorts from the Copenhagen aging and midlife biobank. PLoS One 2018; 13:e0205019. [PMID: 30273400 PMCID: PMC6166988 DOI: 10.1371/journal.pone.0205019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/18/2018] [Indexed: 02/03/2023] Open
Abstract
This study examines the association between childhood socioeconomic position and objective physical capability including new functional measures of potential relevance to a population in late-middle age. The study population covers two Danish birth cohorts followed-up in the Copenhagen Aging and Midlife Biobank (age 48–58 years, 2009–2011, N = 4,204). Results from linear regression models revealed that being born in higher socioeconomic position was associated with higher jump height: Paternal occupational class four = 0.19 cm (95% confidence interval (CI): -0.44, 0.82), three = 0.59 cm (95% CI: -0.02, 1.19), two = 1.29 cm (95% CI: 0.64, 1.94), and one = 1.29 cm (95% CI: 0.45, 2.13) (reference = five); medium parental social class = 0.88 cm (95% CI: 0.03, 1.72) and high = 1.79 cm (95% CI: 0.94, 2.63) (reference = low). Higher childhood socioeconomic position was also associated with better chair rise performance and hand grip strength, while among women it was related to reduced flexibility: Medium parental social class = -1.31 cm (95% CI: -3.05, 0.42) and high = -2.20 cm (95% CI: -3.94, -0.47) (reference = low); unwed mother = 1.75 cm (95% CI: 0.36, 3.14) (reference = married). Overall, the findings suggest that higher childhood socioeconomic position is primarily related to moderately better scores in the most strenuous physical capability measures and hand grip strength among healthy adults in late-middle age.
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Affiliation(s)
- Gitte Lindved Petersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Jolene Lee Masters Pedersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States of America
| | - Merete Osler
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark
| | - Åse Marie Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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Abstract
BACKGROUND Societal interest in enabling older workers to prolong their working life has increased in recent years due to demographic change. Managers have a key role in extending working life among employees, because they control the organisation, work environment and potential measures enabling older workers to extend their working life. OBJECTIVE To examine managers' attitudes to their older workers. METHOD A cross-sectional study based on a questionnaire answered by 905 managers working in different municipal departments in Sweden. RESULTS Managers' attitude to their older workers' retirement time appeared to be associated with their own retirement planning. Managers who themselves wanted to work beyond 66 years considered it more important to keep older workers beyond that age than managers planning to retire at 66. The managers reported that older people were more careful, possessed experiences, skills and life knowledge that were useful in the workplace and helped guide new employees and younger employees. On the other hand, the majority of managers agreed with the stereotypical claim that older people are slower, resistant to change, less well educated and hostile to technology. CONCLUSION The study stated that the managers' attitude to their own retirement planning affected their attitude to the retirement age for their older employees. This is important to consider in the debate of delayed retirement, and to perform activities and incentives in the society to change those attitudes if more people should get the possibility to an extended working life. Additional, almost 50% of the managers surveyed recognised possible measures for adapting work tasks to suit their ageing employees. However, only 5% of managers reported the existence of organisational measures targeted at promoting a sustainable work situation for older employees in their municipal department. The managers were interested in retaining older employees mainly if those older employees had some specific skills that were needed by the department, and not in general.
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Affiliation(s)
- Kerstin Nilsson
- Division of Occupational and Environmental Medicine, Lund University, Sweden.,Department of Work Science, Economic and Environmental Psychology, Swedish University of Agricultural Sciences, Sweden
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Corrêa LCDAC, Pirkle CM, Wu YY, Vafaei A, Curcio CL, Câmara SMAD. Urinary Incontinence Is Associated With Physical Performance Decline in Community-Dwelling Older Women: Results From the International Mobility in Aging Study. J Aging Health 2018; 31:1872-1891. [PMID: 30203699 DOI: 10.1177/0898264318799223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objective: The objective of this study is to evaluate the influence of urinary incontinence (UI) on physical performance. Method: In prospective analyses from the International Mobility in Aging Study (IMIAS), 915 women (65-74 years) from Canada, Colombia, Albania, and Brazil were evaluated in relation to self-reported UI (past week) and physical performance (Short Physical Performance Battery [SPPB]), with reevaluation after 2 years. Linear mixed models examined the influence of UI on SPPB, adjusted by covariates (age, study site, education, income sufficiency, body mass index [BMI] and parity). Results: Women reporting some UI presented lower SPPB mean (β = -0.41, p = .009) and a greater reduction (β = -0.53, p = .001) over 2 years than those reporting no UI. Discussion: Compared with no reported UI, some UI was associated with worse and more pronounced declines in physical performance over 2 years. This study highlights the importance of practices to reduce UI to contribute to healthier aging.
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Affiliation(s)
| | | | - Yan Yan Wu
- University of Hawai'i at Mānoa, Honolulu, Canada
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Lund R, Laban J, Petersen GL, Dissing A, Hansen ÅM, Rod NH. Loneliness and objectively measured physical capability in middle-aged adults. Eur J Public Health 2018; 28:16-23. [PMID: 28549101 DOI: 10.1093/eurpub/ckx069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Loneliness is associated with poor functional ability in older people. Little is known about this association in the middle-aged. The aim is to investigate if perceived loneliness is associated with lower physical capability among middle-aged men and women and if the associations of loneliness with physical capability interact with socioeconomic position and cohabitation status. Methods 5224 participants from Copenhagen Aging and Midlife Biobank (CAMB) aged 49-62 years (mean age 54) were included. Handgrip strength (measured by a dynamometer) and maximal number of chair rises in 30 s was recorded. Multivariate linear regression analyses were adjusted for age, occupational social class, cohabitation status, morbidity and personality traits. Results No association was found between loneliness and physical capability. For example estimates for handgrip strength in 'often' lonely men and women compared with the 'not lonely' were 1.2 kg (95% CI - 0.5;2.9)/1.0 kg (-0.7;2.6). Low occupational social class was associated with poorer physical capability, and living alone was associated with poorer handgrip strength in men [-2.4 kg (95% CI - 3.2;-1.5)] and poorer chair rise test in women [-0.8 rises (95% CI - 1.6;-0.1)]. There was no support for interactions. Conclusion In contrast to earlier studies among older people, no association between loneliness and physical capability was found in this cohort of middle-aged men and women. Loneliness may not yet have resulted in detectable differences in physical capability in this age group. Further research is needed to clarify if, and at what point in the life course loneliness begins to affect physical capability.
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Affiliation(s)
- Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.,Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Jelena Laban
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Gitte L Petersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.,Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Agnete Dissing
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Åse Marie Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Naja H Rod
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
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Wimmelmann CL, Lund R, Flensborg-Madsen T, Christensen U, Osler M, Lykke Mortensen E. Associations of Personality with Body Mass Index and Obesity in a Large Late Midlife Community Sample. Obes Facts 2018; 11:129-143. [PMID: 29631276 PMCID: PMC5981669 DOI: 10.1159/000487888] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 02/18/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The study examined cross-sectional associations of personality with BMI and obesity among men and women in a large late midlife community sample. METHODS The sample comprised 5,286 Danish individuals aged 49-63 years from the Copenhagen Ageing and Midlife Biobank (CAMB) with complete information on measured BMI, personality assessed by the NEO Five Factor Inventory (NEO FFI), and sociodemographic factors including sex, age and educational length. Analysis of variance and logistic regression models were used to investigate associations between personality and BMI as well as obesity. Personality traits were analyzed separately and combined in the same model. RESULTS All personality traits except for neuroticism were significantly associated with BMI, with extraversion (p value ranged from <0.001 to 0.012) and agreeableness (p value ranged from 0.001 to 0.002) being the most consistent predictors of BMI among men and women, respectively. Furthermore, extraversion among men (high scores) (p = 0.016) and agreeableness among women (low scores) (p = 0.026) were the only personality traits significantly associated with obesity when adjusting for duration of education. CONCLUSION Personality was significantly associated with BMI and to a lesser extent with obesity, and these associations differed between men and women. Also, it was suggested that the interrelations of the five personality traits should be considered in future research of personality and health outcomes.
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Affiliation(s)
- Cathrine Lawaetz Wimmelmann
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- *Dr. Cathrine Lawaetz Wimmelmann, Department of Public Health, Unit of Medical Psychology, University of Copenhagen, Øster Farimagsgade 5A, Building 5, 1. Floor, 1353 Copenhagen K, Denmark,
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Christensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Research Center for Prevention and Health, Glostrup Hospital, Glostrup, Denmark
- Danish Aging Research Center, Universities of Aarhus, Southern Denmark and Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wimmelmann CL, Lund R, Christensen U, Osler M, Mortensen EL. Associations between obesity and mental distress in late midlife: results from a large Danish community sample. BMC OBESITY 2016; 3:54. [PMID: 27999678 PMCID: PMC5154079 DOI: 10.1186/s40608-016-0137-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 12/02/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND To examine associations of Body mass Index (BMI) and mental distress in late midlife in a large Danish community sample and to investigate the effect of socio-demographic factors. METHODS The study sample comprised 3613 Danish men and 1673 women aged 49-63 years from the Copenhagen Ageing and Midlife Biobank (CAMB) with complete information on measured BMI, severity of mental symptoms assessed by the Symptom Check-List' (SCL-90), and socio-demographic factors including sex, age, occupational social class, and educational duration. Linear and logistic regression were used to evaluate associations between BMI category and SCL-90. RESULTS Unadjusted SCL-90 subscale scores differed significantly across BMI categories (p < 0.001) among both men and women with more mental distress in the underweight, obese and severely obese BMI categories except for the anxiety scale which was not associated with BMI category in women. In the adjusted analyses, all symptom scales remained significantly associated with BMI among men after adjusting for socio-demographic factors while only associations with somatization and depression scales remained significant for women.. When SCL-90 case status was applied as an outcome, significant unadjusted associations with BMI category were observed for somatization (p < 0.001), depression (p = 0.026) and the General Severity Index (p = 0.002) among men and somatization (p = 0.002) among women. Furthermore, somatization case-status was significantly predicted by BMI category (p < 0.001) in men after adjusting for socio-demographic factors. CONCLUSION Results indicate more mental distress among underweight, obese and severely obese men and women after adjusting for socio-demographic factors. Furthermore, obese men have higher risk of reporting clinically relevant symptoms of somatization independently of socio-demographic factors.
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Affiliation(s)
- Cathrine Lawaetz Wimmelmann
- Department of Public Health, Medical Psychology Unit, University of Copenhagen, Center for Healthy Aging, Østerfarimagsgade 5A, Building 5, 1. Floor, 1353 Copenhagen K, Denmark
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark ; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Christensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark ; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark ; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ; Research Center for Prevention and Health, Glostrup Hospital, Glostrup, Denmark ; Danish Aging Research Center, Universities of Aarhus, Southern Denmark, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark ; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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16
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Intelligence in early adulthood and midlife physical performance in men: The mediating roles of education and physical activity. INTELLIGENCE 2016. [DOI: 10.1016/j.intell.2016.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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17
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Influence of physical and psychosocial work environment throughout life and physical and cognitive capacity in midlife on labor market attachment among older workers: study protocol for a prospective cohort study. BMC Public Health 2016; 16:629. [PMID: 27449417 PMCID: PMC4957894 DOI: 10.1186/s12889-016-3290-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 07/02/2016] [Indexed: 11/12/2022] Open
Abstract
Background As average life span increases, elderly will account for an increasing proportion of the total population in most parts of the world. Thus, initiatives to retain older workers at the labor market are becoming increasingly important. This study will investigate the influence of physical and psychosocial work environment throughout working life and physical and cognitive capacity in midlife on labor market attachment among older workers. Methods/Design Approximately 5000 participants (aged 50–60 years) from the Copenhagen Aging and Midlife Biobank (CAMB) will be followed prospectively in a national register (DREAM), containing information on a week-to-week basis about social transfer payments for about 5 million Danish residents. Using Cox regression, we will model the risk of long-term sickness absence, disability pension, early retirement and unemployment within a 4 to 6 year period from the baseline measurement as a function of the following predictors: 1) physical work demands throughout working life, 2) psychosocial working conditions throughout working life, 3) physical capacity in midlife, 4) cognitive capacity in midlife. Estimates will be adjusted for age, sex, lifestyle, socioeconomic position, chronic disease and long-term sickness absence prior to baseline. Discussion The project will generate new knowledge on risk factors for loss of labor market attachment. The results will potentially contribute in identifying factors that could be targeted in future interventions for maintaining a longer and healthier working life among older workers.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Otto Melchior Poulsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Holbæk Hospital, Holbæk, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Aalborg, Denmark
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18
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Szulc P, Feyt C, Chapurlat R. High risk of fall, poor physical function, and low grip strength in men with fracture-the STRAMBO study. J Cachexia Sarcopenia Muscle 2016; 7:299-311. [PMID: 27239407 PMCID: PMC4864191 DOI: 10.1002/jcsm.12066] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/22/2015] [Accepted: 07/31/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Several studies assessed the association of prevalent fractures with muscle mass, strength, and physical capacity in men. Clinical impact of these associations is not clear, and they could be influenced by confounders. Our aim was to assess the association of the prevalent fractures with muscle strength, physical function, and the risk of subsequent falls in older men after adjustment for muscle mass and potential confounders. METHODS In a cohort of 890 men aged 50 and older, we assessed appendicular skeletal muscle mass (ASM) by DXA, grip strength, physical function (chair stands, static, and dynamic balance). Relative ASM (RASM) was calculated as ASM / (height)(2). Then, 813 men aged 60 and over were followed up prospectively for 5 years and 144 sustained >1 incident falls. All the analyses were adjusted for lifestyle factors, co-morbidities, and hormones known to influence muscle and physical function. RESULTS Low leisure physical activity, very high occupational physical activity, Parkinson's disease, diabetes mellitus, low apparent free testosterone concentration (AFTC), as well as Grade 2 and 3 vertebral fractures and multiple fractures were associated with lower grip strength when adjusted for confounders including upper limb RASM. Low leisure physical activity, very high occupational physical activity, diabetes mellitus, prior stroke, low AFTC and 25-hydroxycholecalciferol, high C-reactive protein, vertebral fractures, and non-vertebral fractures were associated with poor physical function (lowest quintile of the score of tests) when adjusted for confounders including lower limb RASM. Grade 2 and 3 and multiple vertebral fractures were associated with twofold higher risk of multiple falls after adjustment for confounders. Men having multiple fractures had a twofold higher risk of multiple falls after adjusting for confounders. In multivariable models, risk of falls increased proportionally to the increasing severity and number of vertebral fractures as well as to the increasing number of all fractures. CONCLUSIONS In older men, Grade 2 and 3 vertebral fractures and multiple vertebral and non-vertebral fractures are associated with lower grip strength, poor physical function, and higher risk of multiple falls after adjustment for multiple confounders. This suggests a real direct association. One fracture can initiate a vicious circle leading to another fracture; thus, patients with fractures need physical therapy regardless of their general health status.
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Affiliation(s)
- Pawel Szulc
- INSERM UMR 1033 Hôpital Edouard Herriot University of Lyon Lyon France
| | - Clément Feyt
- INSERM UMR 1033 Hôpital Edouard Herriot University of Lyon Lyon France
| | - Roland Chapurlat
- INSERM UMR 1033 Hôpital Edouard Herriot University of Lyon Lyon France
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Hagen EH, Rosenström T. Explaining the sex difference in depression with a unified bargaining model of anger and depression. Evol Med Public Health 2016; 2016:117-32. [PMID: 26884416 PMCID: PMC4804352 DOI: 10.1093/emph/eow006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 02/03/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Women are twice as likely as men to be depressed, a bias that is poorly understood. One evolutionary model proposes that depression is a bargaining strategy to compel reluctant social partners to provide more help in the wake of adversity. An evolutionary model of anger proposes that high upper body strength predisposes individuals to angrily threaten social partners who offer too few benefits or impose too many costs. Here, we propose that when social partners provide too few benefits or impose too many costs, the physically strong become overtly angry and the physically weak become depressed. The sexual dimorphism in upper body strength means that men will be more likely to bargain with anger and physical threats and women with depression. METHODOLOGY We tested this idea using the 2011-12 National Health and Nutrition Examination Survey (NHANES), a large nationally representative sample of US households that included measures of depression and upper body strength. RESULTS A 2 SD increase in grip strength decreased the odds of depression by more than half ([Formula: see text],[Formula: see text]), which did not appear to be a consequence of confounds with anthropometric, hormonal or socioeconomic variables, but was partially explained by a confound with physical disability. Nevertheless, upper body strength mediated 63% of the effect of sex on depression, but the mediation effect was unexpectedly moderated by age. CONCLUSIONS Low upper body strength is a risk factor for depression, especially in older adults, and the sex difference in body strength appears to explain much of the perplexing sex difference in depression.
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Affiliation(s)
- Edward H Hagen
- Department of Anthropology, Washington State University, 14204 NE Salmon Creek Avenue, Vancouver, WA 98686, USA
| | - Tom Rosenström
- Institute of Behavioural Sciences, University of Helsinki, Helsinki 00014 (PO Box 9), Finland
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20
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Hansen ÅM, Andersen LL, Mendes de Leon CF, Bruunsgaard H, Lund R. School education, physical performance in late midlife and allostatic load: a retrospective cohort study. J Epidemiol Community Health 2016; 70:748-54. [DOI: 10.1136/jech-2015-205664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 12/22/2015] [Indexed: 11/04/2022]
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21
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Roomi MA, Farooq A, Ullah E, Lone KP. Hypovitaminosis D and its association with lifestyle factors. Pak J Med Sci 2015; 31:1236-40. [PMID: 26649021 PMCID: PMC4641290 DOI: 10.12669/pjms.315.7196] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The present study was designed to determine the serum vitamin D levels and their relation with demographic features and life style factors in young adults. METHODS It was an analytical cross-sectional study on 88 subjects aged 18-40 years. Relevant information about physical activity, job place, duration of sun exposure, educational status and socioeconomic conditions was obtained. Serum levels of 25-OH vitamin D were measured by ELISA. Data was analyzed using SPSS 20. RESULTS Mean serum vitamin D level was 8.44±0.49 (Range: 1.00-21.08) ng/ml in participants. Vitamin D deficiency was found in 98.86% of the population. Mean vitamin D levels were significantly lower in females (p=0.0001), physically less active (p=0.006), indoor job holders (p=0.0001), less sun exposed (p=0.001), highly educated (p=0.020) and high socioeconomic status (p=0.007) bearing and in subjects having relatively fair skin complexion (p=0.041). CONCLUSIONS Serum vitamin D levels of study population were below normal and were associated with female gender, less physical activity, indoor jobs, less sun exposure, higher education and higher socioeconomic class and relatively fair skin complexion.
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Affiliation(s)
- Mudassar Ali Roomi
- Mudassar Ali Roomi, MBBS, M.Phil. Assistant Professor Physiology at Fiji National University, Fiji
| | - Ansa Farooq
- Ansa Farooq, M.Sc., M.S. Lecturer Biochemistry at Fiji National University, Fiji
| | - Ehsan Ullah
- Ehsan Ullah, MBBS, M.Phil. Ph.D. Candidate, Faculty of Health, AUT University, Auckland, New Zealand
| | - Khalid Parvez Lone
- Khalid Parvez Lone, Professor and Head Department of Physiology and Cell Biology, UHS, Lahore, Pakistan
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Møller A, Reventlow S, Hansen ÅM, Andersen LL, Siersma V, Lund R, Avlund K, Andersen JH, Mortensen OS. Does physical exposure throughout working life influence chair-rise performance in midlife? A retrospective cohort study of associations between work and physical function in Denmark. BMJ Open 2015; 5:e009873. [PMID: 26537502 PMCID: PMC4636598 DOI: 10.1136/bmjopen-2015-009873] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Our aim was to study associations between physical exposures throughout working life and physical function measured as chair-rise performance in midlife. METHODS The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and measures of physical function. Individual job histories were assigned exposures from a job exposure matrix. Exposures were standardised to ton-years (lifting 1000 kg each day in 1 year), stand-years (standing/walking for 6 h each day in 1 year) and kneel-years (kneeling for 1 h each day in 1 year). The associations between exposure-years and chair-rise performance (number of chair-rises in 30 s) were analysed in multivariate linear and non-linear regression models adjusted for covariates. RESULTS Mean age among the 5095 participants was 59 years in both genders, and, on average, men achieved 21.58 (SD=5.60) and women 20.38 (SD=5.33) chair-rises in 30 s. Physical exposures were associated with poorer chair-rise performance in both men and women, however, only associations between lifting and standing/walking and chair-rise remained statistically significant among men in the final model. Spline regression analyses showed non-linear associations and confirmed the findings. CONCLUSIONS Higher physical exposure throughout working life is associated with slightly poorer chair-rise performance. The associations between exposure and outcome were non-linear.
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Affiliation(s)
- Anne Møller
- Department of Occupational Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Reventlow
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Section of Social Medicine, Copenhagen, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Volkert Siersma
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Section of Social Medicine, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Avlund
- Department of Public Health, University of Copenhagen, Section of Social Medicine, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Center, Regional Hospital West Jutland—University Clinic, Herning, Denmark
| | - Ole Steen Mortensen
- Department of Occupational Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Câmara SMA, Pirkle C, Moreira MA, Vieira MCA, Vafaei A, Maciel ÁCC. Early maternal age and multiparity are associated to poor physical performance in middle-aged women from Northeast Brazil: a cross-sectional community based study. BMC WOMENS HEALTH 2015; 15:56. [PMID: 26243283 PMCID: PMC4526418 DOI: 10.1186/s12905-015-0214-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/23/2015] [Indexed: 11/10/2022]
Abstract
Background Adolescent childbirth and elevated parity are relatively common in middle and low-income countries and they may be related to the higher prevalence and earlier onset of physical decline documented in these settings, especially in women. The aim of this paper is to investigate whether reproductive history is associated with physical function in middle-aged women from Northeast Brazil. Methods The relationship between poor physical performance (grip strength, gait speed and chair stand), early maternal age at first birth (<18 years old), and multiparity (≥3 children) was evaluated in a community sample of 473 women living in Parnamirim (Northeast Brazil). Linear regression models were used to examine the relationship of interest; in addition, mediation analyses were employed to assess indirect effects of obesity and family income. Results Women who gave birth at less than 18 years of age took approximately 0.50 s longer to complete the chair stand test compared to women who gave birth at 18 years or older. Moreover, women who gave birth to < 3 children completed the chair stand test 0.42 s faster compared to those who had ≥ 3 children. The relation between reproductive history and physical performance was mediated by BMI. Reproductive history was not associated with performance in gait speed. Conclusions This study provides evidence that adolescent childbirth and multiparity are related to worse physical performance in middle-aged women from a low income setting. Reproductive history may partially account for earlier physical decline and greater disability in women from lower income settings.
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Affiliation(s)
- Saionara Maria Aires Câmara
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
| | - Catherine Pirkle
- Office of Public Health Studies, University of Hawaii-Manoa, 1960 East-West Road, Biomedical D104H, Honolulu, HI, 96822-2319, USA.
| | - Mayle Andrade Moreira
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
| | - Mariana Carmem Apolinário Vieira
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
| | - Afshin Vafaei
- Department of Public Health Sciences, Carruthers Hall, Queen's University, Kingston, Canada.
| | - Álvaro Campos Cavalcanti Maciel
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
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Lund R, Mortensen EL, Christensen U, Bruunsgaard H, Holm-Pedersen P, Fiehn NE, Molbo D, Jepsen E, Hansen ÅM, Osler M. Cohort Profile: The Copenhagen Aging and Midlife Biobank (CAMB). Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv149] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Meincke RH, Osler M, Mortensen EL, Hansen ÅM. Is Intelligence in Early Adulthood Associated With Midlife Physical Performance Among Danish Males? J Aging Health 2015; 28:530-45. [DOI: 10.1177/0898264315594139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Insights into the causes of variances in physical performance are important to prevent mobility limitations in old age. We examined associations between intelligence in early adulthood and midlife physical performance. Method: Data from the Copenhagen Aging and Midlife Biobank were analyzed using linear regression. In total, 2,848 male cohort members had intelligence scores from conscription and physical performance measures from midlife. Results: In adjusted models, a 1 SD increase in intelligence resulted in 1.10 more chair-rises ( p < .001), a 1.03 cm higher jump ( p < .001), a 3.69% smaller balance area ( p < .001), a 0.71 kg increase in handgrip strength ( p < .001), and a 5.03 N increase in back force ( p < .001). Results for flexibility and abdominal force were not significant. Discussion: Public health interventions should focus on addressing people with different cognitive abilities and bear in mind that prevention of mobility limitations might need to start early in life.
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Affiliation(s)
- Rikke Hodal Meincke
- Center for Healthy Aging, University of Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
| | - Merete Osler
- Research Centre for Prevention and Health, The Capital Region of Denmark
- Danish Aging Research Center, University of Aarhus, Southern Denmark and Copenhagen
| | - Erik Lykke Mortensen
- Center for Healthy Aging, University of Copenhagen, Denmark
- The Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Denmark
- Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
| | - Åse Marie Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
- Research Centre for the Working Environment, Denmark
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Menopausal status and physical performance in middle aged women: a cross-sectional community-based study in Northeast Brazil. PLoS One 2015; 10:e0119480. [PMID: 25822526 PMCID: PMC4378898 DOI: 10.1371/journal.pone.0119480] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/14/2015] [Indexed: 11/30/2022] Open
Abstract
Objective To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. Methods Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). Results The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 – 4.091) higher than the postmenopausal group. Conclusions This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.
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Samuel LJ, Glass TA, Thorpe RJ, Szanton SL, Roth DL. Household and neighborhood conditions partially account for associations between education and physical capacity in the National Health and Aging Trends Study. Soc Sci Med 2015; 128:67-75. [PMID: 25594954 DOI: 10.1016/j.socscimed.2015.01.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Socioeconomic resources, such as education, prevent disability but are not readily modifiable. We tested the hypothesis that household and neighborhood conditions, which may be modifiable, partially account for associations between education and physical capacity in a population-based sample of older adults. The National Health and Aging Trends Study measured education (<high school, high school, some college, and ≥Bachelor's), household and neighborhood conditions, using a 16-item environmental checklist and a 3-item social cohesion scale, and physical capacity with the Short Physical Performance Battery (SPPB), grip strength and peak expiratory flow. Structural equation models were used to decompose total educational effects into direct effects and indirect effects via household and neighborhood conditions, using sample weights and adjusting for age, sex, race/ethnicity, marital status, household size, BMI, self-reported health, and number of medical conditions in 6874 community-dwelling participants. Education was directly associated with SPPB scores (β = 0.055, p < 0.05) and peak flow (β = 0.095, p < 0.05), but not grip strength. Also, indirect effects were found for household disorder with SPPB scores (β = 0.013, p < 0.05), grip strength (β = 0.007, p < 0.05), and peak flow (β = 0.010, p < 0.05). Indirect effects were also found for street disorder with SPPB scores (β = 0.012, p < 0.05). Indirect effects of household and neighborhood conditions accounted for approximately 35%, 27% and 14% of the total association between education and SPPB scores, grip strength level, and peak expiratory flow level, respectively. Household disorder and street disorder partially accounted for educational disparities in physical capacity. However, educational disparities in SPPB scores and peak expiratory flow persisted after accounting for household and neighborhood conditions and chronic conditions, suggesting additional pathways. Interventions and policies aiming to support aging in place should consider addressing household-level and street-level disorder.
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Affiliation(s)
- Laura J Samuel
- Johns Hopkins University, Department of Epidemiology, Center on Aging and Health, 2024 East Monument St., Suite 2-700, Baltimore, MD 21205, USA.
| | - Thomas A Glass
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe St., E6144, Baltimore, MD 21205, USA.
| | - Roland J Thorpe
- Johns Hopkins University, Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 North Broadway, Baltimore, MD 21205, USA.
| | - Sarah L Szanton
- Johns Hopkins University, School of Nursing and Bloomberg School of Public Health, Department of Health Policy and Management, 525 North Wolfe Street #424, Baltimore, MD 21205, USA.
| | - David L Roth
- Johns Hopkins Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Department of Medicine, Center on Aging and Health, 2024 East Monument St., Suite 2-700, Baltimore, MD 21205, USA.
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Maynard S, Keijzers G, Hansen ÅM, Osler M, Molbo D, Bendix L, Møller P, Loft S, Moreno-Villanueva M, Bürkle A, Hvitby CP, Schurman SH, Stevnsner T, Rasmussen LJ, Avlund K, Bohr VA. Associations of subjective vitality with DNA damage, cardiovascular risk factors and physical performance. Acta Physiol (Oxf) 2015; 213:156-70. [PMID: 24703498 DOI: 10.1111/apha.12296] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/09/2013] [Accepted: 03/27/2014] [Indexed: 12/21/2022]
Abstract
AIM To examine associations of DNA damage, cardiovascular risk factors and physical performance with vitality, in middle-aged men. We also sought to elucidate underlying factors of physical performance by comparing physical performance parameters to DNA damage parameters and cardiovascular risk factors. METHODS We studied 2487 participants from the Metropolit cohort of 11 532 men born in 1953 in the Copenhagen Metropolitan area. The vitality level was estimated using the SF-36 vitality scale. Cardiovascular risk factors were determined by body mass index (BMI), and haematological biochemistry tests obtained from non-fasting participants. DNA damage parameters were measured in peripheral blood mononuclear cells (PBMCs) from as many participants as possible from a representative subset of 207 participants. RESULTS Vitality was inversely associated with spontaneous DNA breaks (measured by comet assay) (P = 0.046) and BMI (P = 0.002), and positively associated with all of the physical performance parameters (all P < 0.001). Also, we found several associations between physical performance parameters and cardiovascular risk factors. In addition, the load of short telomeres was inversely associated with maximum jump force (P = 0.018), with lowered significance after exclusion of either arthritis sufferers (P = 0.035) or smokers (P = 0.031). CONCLUSION Here, we show that self-reported vitality is associated with DNA breaks, BMI and objective (measured) physical performance in a cohort of middle-aged men. Several other associations in this study verify clinical observations in medical practice. In addition, the load of short telomeres may be linked to peak performance in certain musculoskeletal activities.
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Affiliation(s)
- S. Maynard
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
| | - G. Keijzers
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
| | - Å.-M. Hansen
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
- National Research Centre for the Working Environment; Copenhagen Denmark
| | - M. Osler
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Research Centre for prevention and Health; Glostrup University Hospital; Glostrup Denmark
| | - D. Molbo
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - L. Bendix
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - P. Møller
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - S. Loft
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | | | - A. Bürkle
- Molecular Toxicology Group; University of Konstanz; Konstanz Germany
| | - C. P. Hvitby
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Molecular Biology and Genetics; University of Aarhus; Aarhus Denmark
| | - S. H. Schurman
- Clinical Research Program; National Institute of Environmental Health Sciences; National Institutes of Health; Research Triangle Park NC USA
| | - T. Stevnsner
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Molecular Biology and Genetics; University of Aarhus; Aarhus Denmark
| | - L. J. Rasmussen
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
| | - K. Avlund
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - V. A. Bohr
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Laboratory of Molecular Gerontology; National Institute on Aging; National Institutes of Health; Baltimore MD USA
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Christensen U, Krølner R, Nilsson CJ, Lyngbye PW, Hougaard CØ, Nygaard E, Thielen K, Holstein BE, Avlund K, Lund R. Addressing social inequality in aging by the Danish occupational social class measurement. J Aging Health 2014; 26:106-27. [PMID: 24584263 DOI: 10.1177/0898264314522894] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To present the Danish Occupational Social Class (DOSC) measurement as a measure of socioeconomic position (SEP) applicable in a late midlife population, and to analyze associations of this measure with three aging-related outcomes in midlife, adjusting for education. METHOD Systematic coding procedures of the DOSC measurement were applied to 7,084 participants from the Copenhagen Aging and Midlife Biobank (CAMB) survey. We examined the association of this measure of SEP with chronic conditions, self-rated health, and mobility in logistic regression analyses, adjusting for school education in the final analysis. RESULTS The measure of SEP showed a strong social gradient along the social classes in terms of prevalence of chronic conditions, poor self-rated health, and mobility limitations. Adjusting for school education attenuated the association only to a minor degree. DISCUSSION The DOSC measure was associated with aging-related outcomes in a midlife Danish population, and is, thus, well suited for future epidemiological research on social inequalities in health and aging.
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Avlund K, Osler M, Mortensen EL, Christensen U, Bruunsgaard H, Holm-Pedersen P, Fiehn NE, Hansen ÅM, Bachkati SH, Meincke RH, Jepsen E, Molbo D, Lund R. Copenhagen Aging and Midlife Biobank (CAMB). J Aging Health 2014; 26:5-20. [DOI: 10.1177/0898264313509277] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Kirsten Avlund
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
- Danish Centre for Aging Research, University of Southern Denmark, Aarhus University and University of Copenhagen
| | - Merete Osler
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
- Danish Centre for Aging Research, University of Southern Denmark, Aarhus University and University of Copenhagen
- Research Centre for Prevention and Health, Glostrup University Hospital, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg Hospital, Capital Region of Denmark
| | - Ulla Christensen
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
| | - Helle Bruunsgaard
- Center of Inflammation and Metabolism, National University Hospital, Copenhagen Denmark
| | | | - Nils-Erik Fiehn
- Department of Public Health, University of Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Stine Harrsen Bachkati
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
- Danish Centre for Aging Research, University of Southern Denmark, Aarhus University and University of Copenhagen
| | - Rikke Hodal Meincke
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
| | - Eva Jepsen
- Department of Public Health, University of Copenhagen, Denmark
| | - Drude Molbo
- Department of Public Health, University of Copenhagen, Denmark
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Ageing, University of Copenhagen, Denmark
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