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Knuutila MT, Lehti TE, Karppinen H, Kautiainen H, Strandberg TE, Öhman H, Savikko NM, Jansson AH, Pitkälä KH. Determinants of a sense of insecurity among home-dwelling older people. Scand J Public Health 2024; 52:64-70. [PMID: 36271626 PMCID: PMC10845813 DOI: 10.1177/14034948221131419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/01/2022] [Accepted: 09/21/2022] [Indexed: 11/15/2022]
Abstract
Aims: A sense of insecurity may have an impact on older people's well-being and their courage to engage actively in meaningful activities. Studies on a sense of insecurity among older people are scarce. The aim of this study was to determine the extent to which home-dwelling older adults perceive their life as being insecure and how a sense of insecurity is associated with their health, functional status, active social engagement, well-being and perceptions of the societal treatment of older people. Methods: This study is part of the Helsinki Aging Study, a cohort study ongoing since 1989. Data were collected using a postal questionnaire that was mailed in 2019 to a random sample of home-dwelling older people ⩾75 years of age living in Helsinki (N=2917; response rate 74%). The questionnaire inquired about the respondents' sense of security/insecurity, and they were subcategorised into those feeling secure and those feeling insecure based on their answers. Results: Seven per cent of respondents felt insecure in their lives. In a stepwise logistic regression analysis, loneliness, living alone and perceived poor societal treatment of older people were associated with a sense of insecurity, while having good self-rated health, having children and meeting friends at least weekly were associated with lower odds of insecurity. Conclusions: Our findings highlight the importance of recognising and combating loneliness, social isolation and societal ageism in order to reduce insecurity among older people and to support their active engagement in life.
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Affiliation(s)
- Mia T. Knuutila
- Social Services and Health Care, City of Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Finland
| | - Tuuli E. Lehti
- Social Services and Health Care, City of Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Finland
| | - Helena Karppinen
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Timo E. Strandberg
- Clinics of Internal Medicine and Geriatrics, Helsinki University Hospital, Finland
- Department of Internal Medicine and Geriatrics, University of Helsinki, Finland
| | - Hannareeta Öhman
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
- Clinics of Internal Medicine and Geriatrics, Helsinki University Hospital, Finland
| | - Niina M. Savikko
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
- City of Espoo, Elderly Care, Finland
| | - Anu H. Jansson
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
- The Finnish Association for the Welfare of Older People, Finland
| | - Kaisu H. Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Finland
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Knuutila MT, Rautiainen L, Lehti TE, Karppinen H, Kautiainen H, Strandberg TE, Öhman H, Savikko NM, Jansson AH, Pitkälä KH. Impact of the COVID-19 Pandemic on Older People's Loneliness: Findings from a Longitudinal Study between 2019 and 2021 among Older Home-Dwellers in Finland. J Nutr Health Aging 2023; 27:619-625. [PMID: 37702334 DOI: 10.1007/s12603-023-1949-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/15/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES To investigate the change in feelings of loneliness among Finnish community-dwelling older people from before the COVID-19 pandemic in 2019 to during the pandemic in 2021. Moreover, we explore the changes in other dimensions of psychological well-being (PWB) during the study period. DESIGN Questionnaires were mailed in the 2019 Helsinki Aging Study, a repeated cohort study. A follow-up interview was carried on over the telephone during the year 2021. SETTING AND PARTICIPANTS A random sample of 2,917 home-dwelling older people aged 75-104 years residing in Helsinki, Finland were mailed the questionnaire. Altogether 898 participated in the follow-up. MEASUREMENTS Loneliness was measured using a single item question "Do you suffer from loneliness?". Other items of psychological well-being were measured: "Are you satisfied with your life?" (yes/no), "Do you feel useful?" (yes/no), "Do you have a zest for life?" (yes/no),"Do you have plans for the future?" (yes/no), and "Do you feel depressed?"("rarely or never"/ "sometimes"/ "often or always"). RESULTS Altogether 898 people participated both in 2019 and 2021. The subjects' mean age was 83 years and 66% were women. Between 2019 and 2021, the prevalence of experienced loneliness increased among older home-dwellers from 26% to 30%. During two years of the pandemic feelings of loneliness (RR 1.79, 95% CI: 1.30 to 2.46) and depression (RR 1.37, 95% CI: 1.12 to 1.67) increased even adjusted with various confounders. CONCLUSION Considering the impact loneliness has on health and well-being, the finding of increased feelings of loneliness among older people is alarming. Actions to combat loneliness need to be taken.
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Affiliation(s)
- M T Knuutila
- Mia Knuutila, Tammisalontie 20 as 4, 00830 Helsinki, Finland, , ORCID ID: 0000-0001-5220-103X
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Lehti TE, Rinkinen MO, Aalto U, Roitto HM, Knuutila M, Öhman H, Kautiainen H, Karppinen H, Tilvis R, Strandberg T, Pitkälä KH. Prevalence of Musculoskeletal Pain and Analgesic Treatment Among Community-Dwelling Older Adults: Changes from 1999 to 2019. Drugs Aging 2021; 38:931-937. [PMID: 34386937 PMCID: PMC8484214 DOI: 10.1007/s40266-021-00888-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2021] [Indexed: 11/28/2022]
Abstract
Background Pain is undertreated in older populations. At the same time, increased use of opioids is of concern in the Western world. Aims We sought to analyze temporal trends in musculoskeletal pain and prescribed analgesic treatment among community-dwelling people aged 75–95 years using cross-sectional cohort data spanning 20 years. Methods The Helsinki Aging Study recruited random samples of people aged 75, 80, 85, 90, and 95 years in 1999, 2009, and 2019. In total, 5707 community-dwelling persons participated in the study. The participants reported their medical diagnoses, regular prescription medications, and the presence of back pain or joint pain within the last 2 weeks (never, sometimes, or daily). We compared analgesic use among participants reporting and not reporting musculoskeletal pain in 1999, 2009, and 2019. Results Of the participants, 57–61% reported intermittent or daily musculoskeletal pain. The percentage receiving a prescribed daily analgesic increased from 9% in 1999 to 16% in 2019. The use of non-steroidal anti-inflammatory drugs (NSAIDs) decreased from 1999 to 2019, while the use of paracetamol increased from 2 to 11%. Opioids were taken by 2% in 1999 and 3% in 2019. Of those reporting daily musculoskeletal pain, 20%, 35%, and 32% received regular pain medication in 1999, 2009, and 2019, respectively. Conclusions Pain remains undertreated in the community-dwelling older population, although the use of regular prescribed analgesics increased between 1999 and 2019. The use of NSAIDs has decreased, while the use of paracetamol has increased. Daily opioid use has remained modest.
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Affiliation(s)
- Tuuli Elina Lehti
- Primary Health Care Unit, Helsinki University Hospital, Ilkantie 10 B 22, 00400, Helsinki, Finland. .,Social Services and Health Care Division, City of Helsinki, Helsinki, Finland. .,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - M-O Rinkinen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - U Aalto
- Social Services and Health Care Division, City of Helsinki, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - H M Roitto
- Social Services and Health Care Division, City of Helsinki, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - M Knuutila
- Social Services and Health Care Division, City of Helsinki, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - H Öhman
- Geriatric Medicine, University of Helsinki and Helsinki University Hospital, 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 Unit, Department of Internal Medicine, University of Helsinki, Helsinki, Finland
| | - T Strandberg
- Geriatric Unit, Department of Internal Medicine, University of Helsinki, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - K H Pitkälä
- Primary Health Care Unit, Helsinki University Hospital, Ilkantie 10 B 22, 00400, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
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Jyväkorpi SK, Ramel A, Strandberg TE, Piotrowicz K, Błaszczyk-Bębenek E, Urtamo A, Rempe HM, Geirsdóttir Ó, Vágnerová T, Billot M, Larreur A, Savera G, Soriano G, Picauron C, Tagliaferri S, Sanchez-Puelles C, Cadenas VS, Perl A, Tirrel L, Öhman H, Weling-Scheepers C, Ambrosi S, Costantini A, Pavelková K, Klimkova M, Freiberger E, Jonsson PV, Marzetti E, Pitkälä KH, Landi F, Calvani R. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans. Eur Geriatr Med 2021; 12:303-312. [PMID: 33583000 PMCID: PMC7990826 DOI: 10.1007/s41999-020-00438-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/09/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. METHODS SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. RESULTS Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. CONCLUSION The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations.
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Affiliation(s)
- S K Jyväkorpi
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland.
| | - A Ramel
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland
| | - T E Strandberg
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | - K Piotrowicz
- Faculty of Medicine, Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - E Błaszczyk-Bębenek
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, Krakow, Poland
| | - A Urtamo
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | - H M Rempe
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Ó Geirsdóttir
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland
| | - T Vágnerová
- 1St Faculty of Medicine, Department of Gerontology & Geriatrics, Charles University in Prague, General University Hospital Prague, Nové Město, Czech Republic
| | - M Billot
- PRISMATICS Lab (Predictive Research In Spine/Neuromodulation Management And Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - A Larreur
- Department of Geriatrics, University Hospital of Limoges, Limoges, France
| | - G Savera
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Soriano
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - C Picauron
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - S Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | | | - A Perl
- Medical University of Graz, Graz, Austria
| | - L Tirrel
- Diabetes Frail, Medici Medical Practice, Luton, UK
| | - H Öhman
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | | | | | | | | | - M Klimkova
- Silesian Hospital, Opava, Czech Republic
| | - E Freiberger
- 1St Faculty of Medicine, Department of Gerontology & Geriatrics, Charles University in Prague, General University Hospital Prague, Nové Město, Czech Republic
| | - P V Jonsson
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland
| | - E Marzetti
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - K H Pitkälä
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | - F Landi
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - R Calvani
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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Lehti TE, Öhman H, Knuutila M, Kautiainen H, Karppinen H, Tilvis R, Strandberg TE, Pitkala KH. Symptom Burden Is Associated with Psychological Wellbeing and Mortality in Older Adults. J Nutr Health Aging 2021; 25:330-334. [PMID: 33575724 DOI: 10.1007/s12603-020-1490-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
IMPORTANCE Over half of outpatient visits are due to physical symptoms; yet, the significance of symptoms in relation to older people's wellbeing and prognosis has gained very little research attention. OBJECTIVES This study aims to analyze the prognostic value of symptom burden, derived from symptom count and frequency, in an older cohort aged 75 to 95. We also explore the association between symptom burden and psychological wellbeing. DESIGN Randomly assigned cohorts of community-dwelling people aged 75-95 filled in the postal questionnaire of the Helsinki Aging Study in 2009. SETTING Community-based, postal questionnaires (survey response rate 74%). PARTICIPANTS 1583 community-dwelling people aged 75-95 in the urban Helsinki area. Main outcomes and measures: The inquired symptoms were dizziness, back pain, joint pain, chest pain or discomfort, shortness of breath, leg pain when walking, loss of appetite, and urinary incontinence. Symptom burden was calculated according to the number of symptoms and their frequency (score range: 0-8). The participants were subdivided into four groups according to their symptom burden. Mortality data was extracted from the Finnish Population Register in 2014. Psychological wellbeing (PWB) was measured using the validated PWB score. RESULTS Of 1583 participants, 18% reported no symptoms over the past 2 weeks (Group 0), 31% scored 0.5-1 in the symptom burden score (Group 1), 23% scored 1.5-2 (Group 2), and 28% scored 2.5-8 (Group 3). There was a linear relationship between symptom burden and comorbidities, functional status, falls, and PWB. The groups showed a significant difference in 5-year mortality, even adjusted for age, sex, and comorbidities: Group 1 1.18, 95% CI 0.84-1.66; Group 2 1.63, 95% CI 1.15-2.31, and Group 3 2.08, 95% CI 1.49-2.91 compared to Group 0 (p for linearity <0.001). Conclusion and relevance: Symptom burden is associated with higher mortality and lower PWB independent of comorbidities in community-dwelling people aged 75-95. We conclude that somatic symptoms need to be assessed when examining the general health status of an aging patient. Self-reported symptoms seem to convey information about health that cannot be derived from medical diagnoses only.
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Affiliation(s)
- T E Lehti
- Tuuli Elina Lehti, Ilkantie 10 B 22 00400 Helsinki, Finland,
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Aalto UL, Finne-Soveri H, Kautiainen H, Öhman H, Roitto HM, Pitkälä KH. Relationship between Anticholinergic Burden and Health-Related Quality of Life among Residents in Long-Term Care. J Nutr Health Aging 2021; 25:224-229. [PMID: 33491038 DOI: 10.1007/s12603-020-1493-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Anticholinergic burden defined by the Anticholinergic Risk Scale (ARS) has been associated with cognitive and functional decline. Associations with health-related quality of life (HRQoL) have been scarcely studied. The aim of this study was to examine the association between anticholinergic burden and HRQoL among older people living in long-term care. Further, we investigated whether there is an interaction between ARS score and HRQoL in certain underlying conditions. DESIGN AND PARTICIPANTS Cross-sectional study in 2017. Participants were older people residing in long-term care facilities (N=2474) in Helsinki. MEASUREMENTS Data on anticholinergic burden was assessed by ARS score, nutritional status by Mini Nutritional Assessment, and HRQoL by the 15D instrument. RESULTS Of the participants, 54% regularly used ARS-defined drugs, and 22% had ARS scores ≥2. Higher ARS scores were associated with better cognition, functioning, nutritional status and higher HRQoL. When viewing participants separately according to a diagnosis of dementia, nutritional status or level of dependency, HRQoL was lower among those having dementia, worse nutritional status, or being dependent on another person's help (adjusted for age, sex, comorbidities). Significant differences within the groups according to ARS score were no longer observed. However, interactions between ARS score and dementia and dependency emerged. CONCLUSION In primary analysis there was an association between ARS score and HRQoL. However, this relationship disappeared after stratification by dementia, nutritional status and dependency. The reasons behind the interaction concerning dementia or dependency remain unclear and warrant further studies.
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Affiliation(s)
- U L Aalto
- Ulla L. Aalto, MD; Dept of Social Services and Health Care, Helsinki Hospital, Home-care Services, PO BOX 6540, FI-00099 City of Helsinki, Finland, e-mail:
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Roitto HM, Öhman H, Salminen K, Kautiainen H, Laurila J, Pitkälä KH. Neuropsychiatric Symptoms as Predictors of Falls in Long-Term Care Residents With Cognitive Impairment. J Am Med Dir Assoc 2020; 21:1243-1248. [PMID: 32467074 DOI: 10.1016/j.jamda.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Falls and neuropsychiatric symptoms (NPS) are common among long-term care residents with cognitive impairment. Despite the high prevalence of falls and NPS, little is known about their association. The aim of our study was to explore how NPS, particularly the severity of NPS and specific NPS subgroups, are associated with falls and how psychotropics modify this association. DESIGN Longitudinal cohort study. SETTING AND PARTICIPANTS In total, 532 long-term care residents aged 65 years or older in Helsinki, Finland. METHODS NPS were measured with Neuropsychiatric Inventory (NPI) at baseline. Participants were grouped into 3 groups: no significant NPS (NPI points 0‒3), low NPS burden (NPI 4‒12), and high NPS burden (NPI >12). The number of falls, injuries, fractures, and hospitalizations were collected from medical records over 12 months following baseline assessment. RESULTS Altogether, 606 falls occurred during the follow-up year. The falls led to 121 injuries, 42 hospitalizations, and 20 fractures. Falls and injuries increased significantly with NPS burden (P < .001): 330 falls in the high NPS group (n = 184), 188 falls in the low NPS group (n = 181), and 88 falls in the no significant NPS group (n = 167). The risk of falling showed a curvilinear association with NPI total score. Of NPS subgroups, psychosis and hyperactivity were associated with a higher incidence rate ratio of falls, whereas apathy had a protective association even after adjustment for age, sex, and mobility. Affective symptoms were not associated with falls. Psychotropics did not modify the association between NPS burden and falls. CONCLUSIONS AND IMPLICATIONS The results of this study show that NPS, especially NPS severity, may predict falls and fall-related negative consequences. Severity of NPS should be taken into account when assessing fall risk in long-term care residents with cognitive impairment.
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Affiliation(s)
- Hanna-Maria Roitto
- Department of General Practice, University of Helsinki, Helsinki, Finland; Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland.
| | - Hannareeta Öhman
- Department of General Practice, University of Helsinki, Helsinki, Finland; Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Karoliina Salminen
- Department of General Practice, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Jouko Laurila
- Center for Life-Course Health Research, University of Oulu, Oulu, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
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Aalto UL, Finne-Soveri H, Kautiainen H, Roitto HM, Öhman H, Pitkälä KH. Use of Anticholinergic Drugs According to Various Criteria and Their Association With Psychological Well-Being and Mortality in Long-Term Care Facilities. J Am Med Dir Assoc 2019; 20:1156-1162. [PMID: 30910551 DOI: 10.1016/j.jamda.2019.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/28/2019] [Accepted: 02/03/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To compare 3 internationally established criteria for drugs with anticholinergic properties (DAPs) and their associated factors in long-term care facilities, and to investigate the association between use of DAPs and psychological well-being (PWB) or mortality. DESIGN Cross-sectional study and 1-year follow-up of all-cause mortality. SETTING AND PARTICIPANTS Of all 4449 residents living in long-term care facilities in Helsinki in 2011, 2432 (≥65 years of age) participated after exclusion of residents with severe dementia. MEASUREMENTS Data on demographics, medication use, and active diagnoses were collected by trained staff using structured questionnaires. DAP use was defined by the following 3 international criteria: Chew's list, the Anticholinergic Risk Scale, and the Anticholinergic Drug Scale. The total number of DAPs was counted and referred to as anticholinergic burden. PWB was assessed by a questionnaire and yielded a score ranging from 0 to 1. Mortality data was retrieved from central registers. RESULTS Of all participants, 85% were DAP users according to at least 1 of the 3 criteria used. Overlap between the 3 criteria was only moderate. DAP users were younger and a larger proportion of them had better cognition. However, they suffered more often from depression and other psychiatric diagnoses than nonusers. DAP users had lower PWB scores than those not using DAPs, and PWB decreased linearly in the overlapping groups from nonusers to those using DAPs according to all 3 criteria. The total number of DAPs used predicted mortality. CONCLUSIONS AND IMPLICATIONS DAP use and PWB appear to be negatively associated. When combining several criteria of DAPs, their burden predicted mortality. Clinicians should carefully consider the potential benefits and harms when prescribing DAPs to older persons.
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Affiliation(s)
- Ulla L Aalto
- Department of General Practice, University of Helsinki, Helsinki, Finland; Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland.
| | - Harriet Finne-Soveri
- Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Kautiainen
- Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Hanna-Maria Roitto
- Department of General Practice, University of Helsinki, Helsinki, Finland; Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Hannareeta Öhman
- Department of General Practice, University of Helsinki, Helsinki, Finland; Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland; Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
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10
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Roitto HM, Kautiainen H, Aalto UL, Öhman H, Laurila J, Pitkälä KH. Fourteen-Year Trends in the Use of Psychotropic Medications, Opioids, and Other Sedatives Among Institutionalized Older People in Helsinki, Finland. J Am Med Dir Assoc 2019; 20:305-311. [DOI: 10.1016/j.jamda.2018.12.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
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11
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Roitto HM, Kautiainen H, Öhman H, Savikko N, Strandberg TE, Raivio M, Laakkonen ML, Pitkälä KH. Relationship of Neuropsychiatric Symptoms with Falls in Alzheimer's Disease - Does Exercise Modify the Risk? J Am Geriatr Soc 2018; 66:2377-2381. [PMID: 30320427 DOI: 10.1111/jgs.15614] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/13/2018] [Accepted: 08/18/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore how neuropsychiatric symptoms (NPS) are associated with number of falls and how exercise modifies the risk of falling in community-dwelling people with Alzheimer's disease (AD) and NPS. DESIGN Secondary analysis of a randomized controlled trial. SETTING Community. PARTICIPANTS Community-dwelling individuals with AD (N=210) who completed the Neuropsychiatric Inventory (NPI) (N = 179). INTERVENTION Participants were randomized into 3 groups: group-based exercise (4-hour sessions with approximately 1 hour of training) and tailored home-based exercise (1 hour of training) twice a week for 1 year and a control group receiving usual community care. In this secondary analysis, we merged the home-based and group-based exercise groups and compared this group with the control group. MEASUREMENTS NPS were measured using the NPI at baseline, and spousal caregivers recorded falls in daily fall diaries during 1 year of follow-up. RESULTS The number of falls increased linearly with NPI score in the control group. Fall rates were 1.48 (95% confidence interval (CI)=1.26-1.73) per person-year in the intervention group and 2.87 (95% CI=2.43-3.35) in the control group. Adjusted for age, sex, Mini-Mental State Examination (MMSE) score, and Short Physical Performance Battery (SPPB) score, incidence rate ratio (IRR) was 0.48 (95% Cl=0.39-0.60, p < .001). Main effects for fall rate were significant for group (p < .001) and NPI total (p < .02); the interaction effect was also significant (p = .009) (adjusted for sex, age, MMSE score, SPPB score, and psychotropic medication use). CONCLUSION Exercise may decrease the risk of falling in community-dwelling individuals with AD and NPS. Future exercise trials should confirm this finding in participants with significant NPS. TRIAL REGISTRATION ACTRN12608000037303. J Am Geriatr Soc 66:2377-2381, 2018.
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Affiliation(s)
- Hanna-Maria Roitto
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Hannareeta Öhman
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Niina Savikko
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Home Care, City of Espoo, Espoo, Finland
| | - Timo E Strandberg
- Department of Medicine, University of Helsinki, Helsinki, Finland.,Geriatric Clinic, Helsinki University Hospital, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Minna Raivio
- Department of General Practice, University of Helsinki, Helsinki, Finland
| | - Marja-Liisa Laakkonen
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
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Kallio EL, Öhman H, Hietanen M, Soini H, Strandberg TE, Kautiainen H, Pitkälä KH. Effects of Cognitive Training on Cognition and Quality of Life of Older Persons with Dementia. J Am Geriatr Soc 2018; 66:664-670. [DOI: 10.1111/jgs.15196] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Eeva-Liisa Kallio
- Department of General Practice and Primary Health Care; University of Helsinki; and Unit of Primary Health Care; Helsinki University Hospital; Helsinki Finland
- Clinical Neurosciences; Neuropsychology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Hannareeta Öhman
- Department of General Practice and Primary Health Care; University of Helsinki; and Unit of Primary Health Care; Helsinki University Hospital; Helsinki Finland
- City of Helsinki; Hospital; Rehabilitation; and Care Services; Helsinki Finland
| | - Marja Hietanen
- Clinical Neurosciences; Neuropsychology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Helena Soini
- City of Helsinki; Social Services and Health Care Department; Helsinki Finland
| | - Timo E. Strandberg
- University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Center for Life Course Health Research; University of Oulu; Oulu Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care; University of Helsinki; and Unit of Primary Health Care; Helsinki University Hospital; Helsinki Finland
| | - Kaisu H. Pitkälä
- Department of General Practice and Primary Health Care; University of Helsinki; and Unit of Primary Health Care; Helsinki University Hospital; Helsinki Finland
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13
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Öhman H, Savikko N, Strandberg T, Kautiainen H, Raivio M, Laakkonen ML, Tilvis R, Pitkälä KH. Effects of Exercise on Functional Performance and Fall Rate in Subjects with Mild or Advanced Alzheimer's Disease: Secondary Analyses of a Randomized Controlled Study. Dement Geriatr Cogn Disord 2017; 41:233-41. [PMID: 27160164 DOI: 10.1159/000445712] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Exercise improves functional performance in subjects with dementia. However, whether the benefits of exercise are evident in all stages of dementia remains uncertain. This study examines how people in different stages of Alzheimer's disease (AD) benefit from exercise intervention in their physical functioning and risk of falling. METHODS The present study is a subanalysis of a randomized controlled trial examining the effects of exercise intervention (twice a week for 12 months) in AD patients (n = 194). We studied the effects separately in participants with mild dementia and in participants with advanced dementia. RESULTS In subjects with mild dementia, the deterioration in physical functioning was slower in the intervention group than in the controls. Changes in Functional Independence Measure at 12 months were -2.7 (95% CI -0.5 to -4.9) in the intervention group and -10.1 (95% CI -7.0 to -13.3) in the control group (p < 0.001). The exercise intervention proved effective in preventing falls among patients with advanced AD, with an incidence rate ratio of 0.47 (95% CI 0.37-0.60; p < 0.001). CONCLUSIONS Regular exercise may slow the rate of functional deterioration in mild AD and reduce falls in patients suffering from advanced AD.
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Affiliation(s)
- Hannareeta Öhman
- Department of General Practice and Unit of Primary Health Care, Helsinki University Central Hospital, University of Helsinki, Finland
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14
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Perttila NM, Öhman H, Strandberg TE, Kautiainen H, Raivio M, Laakkonen ML, Savikko N, Tilvis RS, Pitkala KH. How Do Community-Dwelling Persons with Alzheimer Disease Fall? Falls in the FINALEX Study. Dement Geriatr Cogn Dis Extra 2017; 7:195-203. [PMID: 28690633 PMCID: PMC5498949 DOI: 10.1159/000477394] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 05/02/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND People with dementia are at high risk for falls. However, little is known of the features causing falls in Alzheimer disease (AD). Our aim was to investigate how participants with AD fall. METHODS In the FINALEX (Finnish Alzheimer Disease Exercise Trial) study, participants' (n = 194) falls were followed up for 1 year by diaries kept by their spouses. RESULTS The most common reason for falls (n = 355) was stumbling (n = 61). Of the falls, 123 led to injuries, 50 to emergency department visits, and 13 to fractures. The participants without falls (n = 103) were younger and had milder dementia than those with 1 (n = 34) or ≥2 falls (n = 57). Participants with a Mini Mental State Examination score of around 10 points were most prone to fall. In adjusted regression models, good nutritional status, good physical functioning, and use of antihypertensive medication (incident rate ratio [IRR] 0.68, 95% confidence interval [CI] 0.54-0.85) protected against falls, whereas fall history (IRR 2.71, 95% CI 2.13-3.44), osteoarthritis, diabetes mellitus, chronic obstructive pulmonary disease, higher number of drugs, drugs with anticholinergic properties, psychotropics, and opioids (IRR 4.27, 95% CI 2.92-6.24) were risk factors for falls. CONCLUSIONS Our study provides a detailed account on how and why people with AD fall, suggesting several risk and protective factors.
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Affiliation(s)
- Niko M Perttila
- Department of General Practice and Unit of Primary Health Care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Hannareeta Öhman
- Department of General Practice and Unit of Primary Health Care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Rehabilitation and Care Services, City Hospital, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Hannu Kautiainen
- Department of General Practice and Unit of Primary Health Care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Minna Raivio
- Department of General Practice and Unit of Primary Health Care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Marja-Liisa Laakkonen
- Department of General Practice and Unit of Primary Health Care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Rehabilitation and Care Services, City Hospital, Helsinki, Finland
| | - Niina Savikko
- University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Elderly Care, Espoo, Finland
| | - Reijo S Tilvis
- University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Kaisu H Pitkala
- Department of General Practice and Unit of Primary Health Care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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15
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Öhman H, Savikko N, Strandberg T, Kautiainen H, Raivio M, Laakkonen M, Tilvis R, Pitkälä K. Effects of frequent and long-term exercise on neuropsychiatric symptoms in patients with Alzheimer's disease – Secondary analyses of a randomized, controlled trial (FINALEX). Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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16
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Öhman H, Savikko N, Strandberg TE, Kautiainen H, Raivio MM, Laakkonen ML, Tilvis R, Pitkälä KH. Effects of Exercise on Cognition: The Finnish Alzheimer Disease Exercise Trial: A Randomized, Controlled Trial. J Am Geriatr Soc 2016; 64:731-8. [PMID: 27037872 DOI: 10.1111/jgs.14059] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine whether a regular, long-term exercise program performed by individuals with Alzheimer's disease (AD) at home or as group-based exercise at an adult daycare center has beneficial effects on cognition; to examine secondary outcomes of a trial that has been published earlier. DESIGN Randomized, controlled trial. SETTING Community. PARTICIPANTS Community-dwelling dyads (N = 210) of individuals with AD and their spousal caregivers randomized into three groups. INTERVENTION Two types of intervention comprising customized home-based exercise (HE) and group-based exercise (GE), each twice a week for 1 year, were compared with a control group (CG) receiving usual community care. MEASUREMENTS Cognitive function was measured using the Clock Drawing Test (CDT), Verbal Fluency (VF), Clinical Dementia Rating (CDR), and Mini-Mental State Examination (MMSE) at baseline and 3, 6, and 12 months of follow-up. RESULTS Executive function, measured using CDT, improved in the HE group, and changes in the score were significantly better than those of the CG at 12 months (adjusted for age, sex, and CDR, P = .03). All groups deteriorated in VF and MMSE score during the intervention, and no significant differences between the groups were detected at 12-month follow-up when analyses were adjusted for age, sex, and CDR. CONCLUSION Regular, long-term, customized HE improved the executive function of community-dwelling older people with memory disorders, but the effects were mild and were not observed in other domains of cognition.
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Affiliation(s)
- Hannareeta Öhman
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of General Practice, Helsinki University Hospital, Helsinki, Finland.,Hospital, Rehabilitation, and Care Services, Helsinki, Finland
| | | | - Timo E Strandberg
- Department of Internal Medicine and Geriatrics, University of Helsinki, Helsinki, Finland.,Clinics of Internal Medicine and Geriatrics, Helsinki University Central Hospital, Helsinki, Finland.,Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Hannu Kautiainen
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of General Practice, Helsinki University Hospital, Helsinki, Finland
| | - Minna M Raivio
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of General Practice, Helsinki University Hospital, Helsinki, Finland
| | - Marja-Liisa Laakkonen
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of General Practice, Helsinki University Hospital, Helsinki, Finland.,Hospital, Rehabilitation, and Care Services, Helsinki, Finland
| | - Reijo Tilvis
- Department of Internal Medicine and Geriatrics, University of Helsinki, Helsinki, Finland.,Clinics of Internal Medicine and Geriatrics, Helsinki University Central Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of General Practice, Helsinki University Hospital, Helsinki, Finland
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Perttila N, Öhman H, Strandberg T, Kautiainen H, Raivio M, Laakkonen ML, Savikko N, Tilvis R, Pitkala K. Severity of frailty and the outcome of exercise intervention among participants with Alzheimer disease: A sub-group analysis of a randomized controlled trial. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Öhman H, Natividad A, Bailey R, Ragoussis J, Johnson LL, Tiitinen A, Halttunen M, Paavonen J, Surcel HM. Contribution of IL-12A and IL-12B polymorphisms to Chlamydia trachomatis-specific cell-mediated immune responses. Scand J Immunol 2015; 81:209-13. [PMID: 25565213 DOI: 10.1111/sji.12264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/27/2014] [Indexed: 11/27/2022]
Abstract
Inherited variance in the IL-12B gene is associated with susceptibility to Chlamydia trachomatis-induced tubal factor infertility and disease severity. In this study, our aim was to discover how polymorphisms in IL-12-coding genes influence C. trachomatis-induced immune responses and IL-12 production. The study population consisted of 240 women. IL-12A and IL-12B single nucleotide polymorphisms (SNPs) were determined from isolated DNA using the Sequenom system with matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. We studied lymphocyte proliferative (LP) responses to C. trachomatis strains E and F elementary bodies (EBs) and recombinant chlamydial heat-shock protein 60 (CHSP60) antigen. IL-12p40 and IL-12p70 levels were measured using the BD Flex Set method. We found a statistically significant association between the C. trachomatis EB antigen-specific LP response and the rs2853694 SNP (P = 0.02). Our study demonstrates that the IL-12 cytokine family is involved in C. trachomatis-specific immune responses. Moreover, C. trachomatis-induced IL-12 production and the IL-12B rs2853694 SNP partially explain individual variation in the C. trachomatis LP response.
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Affiliation(s)
- H Öhman
- National Institute for Health and Welfare, Oulu, Finland
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19
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Öhman H, Tiitinen A, Halttunen M, Paavonen J, Surcel HM. Cytokine gene polymorphism and Chlamydia trachomatis-specific immune responses. Hum Immunol 2011; 72:278-82. [DOI: 10.1016/j.humimm.2010.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 11/30/2010] [Accepted: 12/27/2010] [Indexed: 10/18/2022]
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