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Pitkälä KH, Aalto UL, Roitto HM, Öhman HR, Lehti TL, Knuutila MT, Kautiainen H, Tilvis R, Strandberg TE. Secular trends in frailty among community-dwelling 75-95-year-old cohorts over three decades in Helsinki, Finland. Age Ageing 2024; 53:afae172. [PMID: 39140371 DOI: 10.1093/ageing/afae172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Frailty Index (FI) reflects health, functioning and well-being of older people. It is valuable to compare how frailty has changed over time in ageing cohorts. This study aims to examine trends in frailty among 75-95-year-old men and women over three decades. METHODS The Helsinki Ageing Study started in 1989 and includes repeated cross-sectional postal surveys every 10 years examining community-dwelling cohorts of older people (75, 80, 85, 90 and 95 years). FI comprises the same 36 items in each cohort. RESULTS The mean FI was 0.22 (SD 0.12), 0.25 (SD 0.15), 0.26 (SD 0.15) and 0.23 (SD 0.15) in 1989, 1999, 2009 and 2019, respectively (P for linearity for crude values .11). Adjusted for age and sex, the four cohorts differed in their frailty the 2019 cohort having the lowest FI. This sex-adjusted difference was seen among 75-, 80-, 85- and 90-year-olds but not among 95-year-olds. FI decreased more among men than women (P for cohort <.001, P for sex <.01, P for interaction = .19). CONCLUSIONS The prevalence of frailty among community-dwelling individuals aged 75, 80, 85 and 90 years-but not among those aged 95 years-has significantly decreased over the last decades. This positive trend may have important implications for health policies in societies with increasing longevity.
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Affiliation(s)
- Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Ulla L Aalto
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna-Maria Roitto
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna R Öhman
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuuli L Lehti
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Mia T Knuutila
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Reijo Tilvis
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo E Strandberg
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Langén VL, Emidio A, Vire J, Viitanen M, Teppo K. Trends in Positive Life Orientation Among 70-Year-Olds: A Comparison of Two Finnish Cohorts Born 20 Years Apart. Clin Gerontol 2024:1-7. [PMID: 38414277 DOI: 10.1080/07317115.2024.2320927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVES We assessed if positive life orientation (PLO) has increased among older individuals and explored gender disparities in PLO changes. METHODS Two cohorts of 70-year-olds from Turku, Finland were included: the 1920 birth cohort (examined in 1991; n = 1,032) and the 1940 birth cohort (examined in 2011; n = 956). Participants completed an identical questionnaire assessing life satisfaction, feeling needed, future plans, zest for life, depression, and loneliness. A composite PLO score (range 0-1) was computed. RESULTS The 2011 cohort had a higher mean PLO score than the 1991 cohort (.87 vs. .83, p < .001). The 2011 cohort reported higher sense of being needed, more future plans, and reduced loneliness (all p < .001). No significant differences were found in life satisfaction, zest for life, or depression. Gender disparities in PLO persisted across both cohorts, with men scoring slightly higher but following similar trends as women. DISCUSSION PLO appears to have increased among older individuals. CLINICAL IMPLICATIONS Recognizing the rising trend of PLO in recent decades may influence the development of societal and healthcare policies to further improve overall well-being among older individuals.
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Affiliation(s)
- Ville L Langén
- Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Department of Geriatric Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Adriana Emidio
- Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Department of Geriatric Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Jenni Vire
- Department of Geriatric Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Matti Viitanen
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Konsta Teppo
- Heart Centre, Turku University Hospital and University of Turku, Turku, Finland
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Kekäläinen T, Koivunen K, Pynnönen K, Portegijs E, Taina Rantanen. Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds: A Comparison of Two Cohorts 28 Years Apart. J Aging Health 2024; 36:3-13. [PMID: 36947727 PMCID: PMC10693740 DOI: 10.1177/08982643231164739] [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] [Indexed: 03/24/2023]
Abstract
Objectives: To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods: Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989-1990 (n = 617) and 2017-2018 (n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results: The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the current life than the earlier-born cohort. Better self-rated health and education of the later-born cohort partly explain the cohort differences. Discussion: Older people in Finland report fewer depressive symptoms and they are more satisfied with their past life compared to their counterparts assessed 28 years ago.
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisa Koivunen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Pynnönen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Aalto UL, Knuutila M, Lehti T, Jansson A, Kautiainen H, Öhman H, Strandberg T, Pitkälä KH. Being actively engaged in life in old age: determinants, temporal trends, and prognostic value. Aging Clin Exp Res 2023:10.1007/s40520-023-02440-9. [PMID: 37225934 DOI: 10.1007/s40520-023-02440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE Recently, the concept of successful ageing has shifted from healthy ageing to active ageing, the latter emphasising even more the subjective perspective. Active agency is a marker for better functioning. However, the concept of active ageing lacks a clear definition so far. The specific aims of the study were to identify the determinants of being actively engaged in life (BAEL), to explore the changes in BAEL over 3 decades, and to explore the prognostic value of BAEL. METHODS This is a repeated cross-sectional cohort study of older (≥ 75 years) community-dwelling people in Helsinki in 1989 (N = 552), 1999 (N = 2396), 2009 (N = 1492), and 2019 (N = 1614). The data were gathered by a postal questionnaire at each time point. Being actively engaged in life was defined by two questions "Do you feel needed?" and "Do you have plans for the future?", which was further converted into BAEL score. RESULTS An increasing temporal trend in BAEL score was observed through the study years. Male sex, good physical functioning and subjective health, and meaningful social contacts were determinants for higher BAEL score. Active agency measured by BAEL score predicted lower 15-year mortality. CONCLUSIONS Older home-dwelling, urban Finnish people have become more actively engaged in recent years. The underlying causes are diverse but improved socioeconomic status observed over the study years was one of them. Social contacts and not feeling lonely were found to be determinants for being actively engaged. Two simple questions describing active engagement in life may help to predict mortality among older people.
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Affiliation(s)
- Ulla L Aalto
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland.
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - Mia Knuutila
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland
- Social Services and Health Care, City of Helsinki, Helsinki, Finland
| | - Tuuli Lehti
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland
- Social Services and Health Care, City of Helsinki, Helsinki, Finland
- Oulunkylä Rehabilitation Center, Helsinki, Finland
| | - Anu Jansson
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- The Finnish Association for the Welfare of Older Adults, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Hanna Öhman
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Timo Strandberg
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
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Kim A, Kim Y, Rhee J, Lee S, Jeong Y, Lee J, Yoo Y, Kim H, So H, Park J. A Study on Emotions to Improve the Quality of Life of South Korean Senior Patients Residing in Convalescent Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14480. [PMID: 36361370 PMCID: PMC9654472 DOI: 10.3390/ijerph192114480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
This study examined the occurrence of emotion types and the contents and meanings of individual emotion types to improve the quality of life of South Korean senior patients in convalescent hospitals. This research is a sequential mixed study in which we conducted emotion frequency and content analyses with 20 elderly resident patients in a convalescent hospital. In the emotion frequency analysis, we performed emotion occurrence frequency analysis and clustering to create groups of subjects that showed similar distributions of emotions. The study results found that South Korean senior patients displayed six major emotions: joy, sorrow, anger, surprise, fear, and tranquility, including mixed emotional states. In the emotion content analysis, we used NVivo to categorize and analyze the interview contents based on emotion types. The study results show the characteristics of emotions according to patients' treatment and recovery, life within narrow boundaries, relationships with new people and family, and the appearances of themselves that they could not easily but must accept. In addition, these characteristics appeared in health, environment, relationships, and psychological structures. Ultimately, the study results suggest that improving the quality of life of South Korean senior patients requires understanding of their emotions and examining diverse emotions in multiple dimensions.
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Affiliation(s)
- Aeju Kim
- Department of English Language and Literature, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
| | - Yucheon Kim
- Department of Counseling and Coaching, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
| | - Jongtae Rhee
- Department of Industrial and Systems Engineering, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
| | - Songyi Lee
- Department of Counseling and Coaching, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
| | - Youngil Jeong
- Dharma College, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
| | - Jeongeun Lee
- Department of Counseling and Coaching, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
| | - Youngeun Yoo
- Department of Agricultural, Wonkwang University-Iksan, 460, Iksan-daero, Iksan 54538, Korea
| | - Haechan Kim
- SNA-DDI, 97, Uisadandg-daero, Yeongdeungpo-gu, Seoul 07327, Korea
| | - Hyeonji So
- Interdisciplinary Program in Artificial Intelligence, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
| | - Junhyeong Park
- Department of Industrial and Systems Engineering, Dongguk University-Seoul, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
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Lehti TE, Öhman H, Knuutila M, Kautiainen H, Karppinen H, Tilvis R, Strandberg T, Pitkälä KH. Symptom burden in community-dwelling older people: temporal trends in the Helsinki Aging Study. Aging Clin Exp Res 2021; 33:3065-3071. [PMID: 34216378 PMCID: PMC8595189 DOI: 10.1007/s40520-021-01918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022]
Abstract
Background Changes in older people’s symptoms across recent decades have not been investigated. Aims We analyzed temporal trends in symptom burden by comparing data from independent, cross-sectional cohorts retrieved in 1989, 1999, 2009, and 2019. Furthermore, we compared the association between symptom burden and psychological wellbeing (PWB) in older men and women. Methods The Helsinki Aging Study recruited a random sample of people aged 75, 80, and 85 in 1989, and random samples aged 75, 80, 85, 90, and 95 in 1999, 2009, and 2019 (four study waves). Altogether, 6263 community-dwelling people answered the questions concerning symptoms in the questionnaire surveys. The symptoms inquired in all study waves were dizziness, back pain, joint pain, chest pain, shortness of breath, and loss of appetite. Symptom burden was calculated according to the number of symptoms and their frequency (score range: 0–6). PWB and the Charlson comorbidity index were calculated. Results Symptom burden decreased in both men and women aged 75 and 80 from 1989 to 2019. Changes in cohorts aged 85 + were nonsignificant. There was a significant difference in symptom burden between men and women in all ages with men having fewer symptoms. PWB decreased with increasing symptom burden. Men had greater PWB than women up to severe levels of symptom burden. Conclusions Symptom burden decreased from 1989 to 2019 in cohorts aged 75–80, whereas changes remained nonsignificant in cohorts aged 85 +. To our knowledge, this is the first study to examine temporal trends in symptom burden.
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Affiliation(s)
- T E Lehti
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
- Social Services and Health Care, Helsinki, Finland.
- Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland.
- , Tukholmankatu 8 B, Biomedicum 2 B, 00290, Helsinki, Finland.
| | - H Öhman
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M Knuutila
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Social Services and Health Care, Helsinki, Finland
| | - H Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - H Karppinen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - R Tilvis
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Strandberg
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - K H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland
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