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Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

https://arctichealth.org/en/permalink/ahliterature290462
Source
Aging Ment Health. 2017 Aug; 21(8):805-809
Publication Type
Journal Article
Date
Aug-2017
Author
Merja Rantakokko
Erja Portegijs
Anne Viljanen
Susanne Iwarsson
Markku Kauppinen
Taina Rantanen
Author Affiliation
a Gerontology Research Center and Department of Health Sciences , University of Jyväskylä , Jyväskylä , Finland.
Source
Aging Ment Health. 2017 Aug; 21(8):805-809
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Aging
Community Participation - statistics & numerical data
Environment
Female
Finland
Humans
Independent Living - statistics & numerical data
Male
Mobility Limitation
Personal Autonomy
Abstract
The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period.
Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy).
Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p
PubMed ID
26979293 View in PubMed
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Unmet physical activity need in old age.

https://arctichealth.org/en/permalink/ahliterature144173
Source
J Am Geriatr Soc. 2010 Apr;58(4):707-12
Publication Type
Article
Date
Apr-2010
Author
Merja Rantakokko
Susanne Iwarsson
Mirja Hirvensalo
Raija Leinonen
Eino Heikkinen
Taina Rantanen
Author Affiliation
Department of Health Sciences, Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Jyväskylä, Finland. merja.rantakokko@jyu.fi
Source
J Am Geriatr Soc. 2010 Apr;58(4):707-12
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Aged - psychology
Attitude to Health
Cross-Sectional Studies
Depression - psychology
Exercise - psychology
Exercise Test
Fear
Female
Finland
Geriatric Assessment
Health Services Accessibility
Health Services Needs and Demand - organization & administration
Humans
Life Style
Logistic Models
Male
Mobility Limitation
Multivariate Analysis
Musculoskeletal Diseases - psychology
Prospective Studies
Questionnaires
Residence Characteristics
Socioeconomic Factors
Walking
Abstract
To examine which individual and environmental factors correlate with unmet physical activity need in old age and predict development of unmet physical activity need (the feeling that one's level of physical activity is inadequate and thus distinct from the recommended amount of physical activity) over a 2-year follow-up.
Observational prospective cohort study and cross-sectional analyses.
Community and research center.
A total of 643 community-living ambulatory people aged 75 to 81 took part in face-to-face interviews and examinations at baseline and 314 at the 2-year follow-up.
Unmet physical activity need and its potential individual and environmental correlates were assessed at baseline. Development of unmet physical activity need was assessed over the 2-year follow-up period.
At baseline, all participants were able to walk at least 500 m outdoors, but 14% perceived unmet physical activity need. Unmet physical activity need was more prevalent in those with musculoskeletal diseases, depressive symptoms, and mobility limitations. Hills in the nearby environment, lack of resting places, and dangerous crossroads correlated with unmet physical activity need at baseline; the association was especially strong in those with walking difficulties. Significant baseline predictors for incident unmet physical activity need (15%) included fear of moving outdoors, hills in the nearby environment, and noisy traffic.
Unmet physical activity need is common in ambulatory community-living older people who have health and mobility problems and report negative environmental features in their neighborhood. Solutions to overcome barriers to physical activity need to be developed to promote equal opportunities for physical activity participation.
PubMed ID
20398151 View in PubMed
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Midlife work ability and mobility limitation in old age among non-disability and disability retirees--a prospective study.

https://arctichealth.org/en/permalink/ahliterature276746
Source
BMC Public Health. 2016 Feb 16;16:154
Publication Type
Article
Date
Feb-16-2016
Author
Monika E von Bonsdorff
Taina Rantanen
Timo Törmäkangas
Jenni Kulmala
Timo Hinrichs
Jorma Seitsamo
Clas-Håkan Nygård
Juhani Ilmarinen
Mikaela B von Bonsdorff
Source
BMC Public Health. 2016 Feb 16;16:154
Date
Feb-16-2016
Language
English
Publication Type
Article
Keywords
Age Factors - complications - complications - complications
Aged - complications - complications - complications
Aged, 80 and over - complications - complications - complications
Aging - complications - complications - complications
Cardiovascular Diseases - complications - complications - complications
Disabled Persons - complications - complications - complications
Female - complications - complications - complications
Finland - complications - complications - complications
Health Status - complications - complications - complications
Humans - complications - complications - complications
International Classification of Functioning, Disability and Health - complications - complications - complications
Longitudinal Studies - complications - complications - complications
Male - complications - complications - complications
Mental Disorders - complications - complications - complications
Middle Aged - complications - complications - complications
Mobility Limitation - complications - complications - complications
Musculoskeletal Diseases - complications - complications - complications
Occupations - complications - complications - complications
Prospective Studies - complications - complications - complications
Retirement - complications - complications - complications
Surveys and Questionnaires - complications - complications - complications
Work - complications - complications - complications
Work Capacity Evaluation - complications - complications - complications
Abstract
Little is known about the wellbeing and mobility limitation of older disability retirees. Personal and environmental factors, such as time spent in working life, may either exacerbate or mitigate the onset of mobility limitation in general population. We aimed to study perceived midlife work ability as a determinant of self-reported mobility limitation in old age among municipal employees who transitioned into non-disability and disability retirement.
4329 participants of the Finnish Longitudinal Study of Municipal Employees (FLAME) had retired during January 1985 and July 2000. They had data on retirement, perceived work ability in 1985, and self-reported mobility limitation (non-disability retirement n = 2870, men 39%; and diagnose-specific disability retirement n = 1459, men 48%). Self-reported mobility was measured in 1985, 1992, 1997 and 2009. The latest score available was used to assess the number of mobility limitation. Work ability was measured by asking the respondents to evaluate their current work ability against their lifetime best in 1985. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for work ability predicting mobility limitation in non-disability and diagnose-specific disability retirement groups were calculated using Poisson regression models.
The prevalence of mobility limitation for those who transitioned into non-disability retirement (Incidence Rate, IR = 0.45, 95% CI = 0.44-0.46) was lower compared to those who retired due to disability (IR = 0.65, CI = 0.63-0.66). A one-point increase in the work ability score decreased the risk for having one more mobility limitation among non-disability and all diagnose-specific retirement groups (musculoskeletal disease, cardiovascular disease, mental disorder, and other diseases).
Better midlife work ability may protect from old age mobility limitation among those who retire due to non-disability and disability. Promoting work ability in midlife may lead to more independent, active aging, regardless of type of retirement.
Notes
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PubMed ID
26880684 View in PubMed
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Environmental barriers, person-environment fit and mortality among community-dwelling very old people.

https://arctichealth.org/en/permalink/ahliterature265500
Source
BMC Public Health. 2013;13:783
Publication Type
Article
Date
2013
Author
Merja Rantakokko
Timo Törmäkangas
Taina Rantanen
Maria Haak
Susanne Iwarsson
Source
BMC Public Health. 2013;13:783
Date
2013
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Architectural Accessibility
Environment
Female
Frail Elderly
Housing for the Elderly
Humans
Male
Mobility Limitation
Mortality - trends
Proportional Hazards Models
Sweden - epidemiology
Abstract
Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people.
This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002-2003, and 393 were followed up for mortality until May 15, 2012.Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for objective assessments of Person-Environment (P-E) fit problems in housing and the immediate outdoor environment. Mortality data were gathered from the public national register. Cox regression models were used for the analyses.
A total of 264 (67%) participants died during follow-up. Functional limitations increased mortality risk. Among the specific environmental barriers that generate the most P-E fit problems, lack of handrails in stairs at entrances was associated with the highest mortality risk (adjusted RR 1.55, 95% CI 1.14-2.10), whereas the total number of environmental barriers at entrances and outdoors was not associated with mortality. A higher number of environmental barriers indoors showed a slight protective effect against mortality even after adjustment for functional limitations (RR 0.98, 95% CI 0.96-1.00).
Specific environmental problems may increase mortality risk among very-old single-living people. However, the association may be confounded by individuals' health status which is difficult to fully control for. Further studies are called for.
Notes
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PubMed ID
23981906 View in PubMed
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Fear of moving outdoors and development of outdoor walking difficulty in older people.

https://arctichealth.org/en/permalink/ahliterature151341
Source
J Am Geriatr Soc. 2009 Apr;57(4):634-40
Publication Type
Article
Date
Apr-2009
Author
Merja Rantakokko
Minna Mänty
Susanne Iwarsson
Timo Törmäkangas
Raija Leinonen
Eino Heikkinen
Taina Rantanen
Author Affiliation
Department of Health Sciences, Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Jyväskylä, Finland. merja.rantakokko@sport.jyu.fi
Source
J Am Geriatr Soc. 2009 Apr;57(4):634-40
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Chi-Square Distribution
Cross-Sectional Studies
Environment
Fear
Female
Finland
Geriatric Assessment
Humans
Interviews as Topic
Logistic Models
Male
Mobility Limitation
Musculoskeletal Diseases - complications
Prospective Studies
Residence Characteristics
Risk factors
Socioeconomic Factors
Abstract
To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation.
Observational prospective cohort study and cross-sectional analyses.
Community and research center.
Seven hundred twenty-seven community-living people aged 75 to 81 were interviewed at baseline, of whom 314 took part in a 3.5-year follow-up.
Fear of moving outdoors and its potential individual and environmental correlates were assessed at baseline. Perceived difficulties in walking 0.5 km and 2 km were assessed twice a year over a 3.5-year period.
At baseline, 65% of the women and 29% of the men reported fear of moving outdoors. Poor socioeconomic status; musculoskeletal diseases; slow walking speed; and the presence of poor street conditions, hills in the nearby environment, and noisy traffic correlated with fear of moving outdoors. At the first 6-month follow-up, participants with fear of moving outdoors had more than four times the adjusted risk (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.92-11.00) of developing difficulties in walking 0.5 km and a three times greater adjusted risk (OR=3.10, 95% CI=1.49-6.46) for developing difficulty in walking 2 km compared with those without fear. The difference in the prevalence of walking difficulties remained statistically significant over the 3.5-year follow-up (P=.02 and P=.009, respectively).
Fear of moving outdoors is common in older adults and increases the risk of developing self-reported difficulties in walking 0.5 km and 2 km. Knowledge about individual and environmental factors underlying fear of moving outdoors and finding ways to alleviate fear of moving outdoors are important for community planning and prevention of disability.
PubMed ID
19392955 View in PubMed
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Perceived environmental barriers to outdoor mobility and feelings of loneliness among community-dwelling older people.

https://arctichealth.org/en/permalink/ahliterature259883
Source
J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1562-8
Publication Type
Article
Date
Dec-2014
Author
Merja Rantakokko
Susanne Iwarsson
Satu Vahaluoto
Erja Portegijs
Anne Viljanen
Taina Rantanen
Source
J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1562-8
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Aging
Cross-Sectional Studies
Environment
Female
Finland
Follow-Up Studies
Geriatric Assessment - methods
Humans
Loneliness - psychology
Male
Mobility Limitation
Motor Activity - physiology
Odds Ratio
Prospective Studies
Questionnaires
Abstract
We examined the association between perceived environmental barriers to outdoor mobility and loneliness among community-dwelling older people. In addition, we studied whether walking difficulties and autonomy in participation outdoors affected this association.
Cross-sectional analyses of face-to-face home interview data with 848 people aged 75-90 years (mean age: 80.1 years; 62% women) gathered within the "Life-Space Mobility in Old Age" (LISPE) project. Self-reports of loneliness, environmental barriers to outdoor mobility, and difficulties in walking 2 km were obtained with structured questionnaires. Autonomy in participation outdoors was assessed with the "Impact on Participation and Autonomy" questionnaire.
Altogether, 28% of participants reported experiencing loneliness sometimes or often. These participants also reported more difficulties in walking 2 km, restricted autonomy in participation outdoors, and more environmental barriers to outdoor mobility than people not experiencing loneliness. Snowy and icy winter conditions (odds ratio: 1.59 [95% confidence interval: 1.15-2.20]), long distances to services (odds ratio: 1.57 [1.00-2.46]), and hills in the nearby environment (odds ratio: 1.49 [1.05-2.12]) significantly increased the odds for loneliness, even after adjustments for walking difficulties, autonomy in participation outdoors, perceived financial situation, living alone, and health. Path modeling revealed that environmental barriers increased loneliness either through direct association or indirectly through restricted autonomy in participation outdoors.
Prospective studies should investigate whether removing environmental barriers to outdoor mobility improves autonomy in participation outdoors and alleviates loneliness among older people.
PubMed ID
24864307 View in PubMed
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Perceived stress symptoms in midlife predict disability in old age: a 28-year prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature116696
Source
J Gerontol A Biol Sci Med Sci. 2013 Aug;68(8):984-91
Publication Type
Article
Date
Aug-2013
Author
Jenni Kulmala
Mikaela B von Bonsdorff
Sari Stenholm
Timo Törmäkangas
Monika E von Bonsdorff
Clas-Håkan Nygård
Matti Klockars
Jorma Seitsamo
Juhani Ilmarinen
Taina Rantanen
Author Affiliation
Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FIN - 40014, Jyväskylä, Finland. jenni.kulmala@jyu.fi
Source
J Gerontol A Biol Sci Med Sci. 2013 Aug;68(8):984-91
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Aging - physiology - psychology
Cohort Studies
Disabled Persons
Female
Finland
Humans
Male
Middle Aged
Mobility Limitation
Prospective Studies
Risk factors
Stress, Psychological - physiopathology
Abstract
Stress has damaging effects on individual's health. However, information about the long-term consequences of mental stress is scarce.
This 28-year prospective cohort study examined on the associations between midlife stress and old age disability among 2,994 Finnish municipal professionals aged 44-58 years at baseline. Self-reported stress symptoms were assessed at baseline in 1981 and 4 years later in 1985 and perceived disability in 2009. For the baseline data, principal component analysis was used for differentiation into stress symptom profiles. The regression coefficient estimates for self-care disability (activities of daily living) and instrumental activities of daily living disability were estimated using left-censored regression. The odds ratios for mobility limitation were estimated using logistic regression.
Four midlife stress profiles were identified: negative reactions to work and depressiveness, perceived decrease in cognition, sleep disturbances, and somatic symptoms. We saw a clear gradient of increasing disability severity in old age for increasing intensity of midlife stress symptoms. In comparison with the participants with no stress symptoms, the extensively adjusted left-censored and logistic regression models showed that in old age, disability scores were almost 2-4 units higher and risk for mobility limitation was 2-3 times higher for those with constant stress symptoms in midlife.
Among occupationally active 44- to 58-year-old men and women, perceived stress symptoms in midlife correlated with disability 28 years later. Stress symptoms may be the first signs of decompensation of individual functioning relative to environmental demands, which may later manifest in disabilities.
PubMed ID
23371968 View in PubMed
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Hearing as a predictor of falls and postural balance in older female twins.

https://arctichealth.org/en/permalink/ahliterature152870
Source
J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):312-7
Publication Type
Article
Date
Feb-2009
Author
Anne Viljanen
Jaakko Kaprio
Ilmari Pyykkö
Martti Sorri
Satu Pajala
Markku Kauppinen
Markku Koskenvuo
Taina Rantanen
Author Affiliation
Department of Health Sciences, Finnish Centre for Interdisciplinary Gerontology, Finland. anne.viljanen@sport.jyu.fi
Source
J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):312-7
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Aged
Aging - genetics - physiology
Audiometry
Confidence Intervals
Female
Finland
Hearing - genetics
Hearing Loss - diagnosis - epidemiology - genetics
Humans
Incidence
Middle Aged
Postural Balance - physiology
Predictive value of tests
Risk assessment
Sampling Studies
Sensitivity and specificity
Twins
Twins, Dizygotic
Twins, Monozygotic
Abstract
The purpose of the present study was to examine, first, whether hearing acuity predicts falls and whether the potential association is explained by postural balance and, second, to examine whether shared genetic or environmental effects underlie these associations.
Hearing was measured using a clinical audiometer as a part of the Finnish Twin Study on Aging in 103 monozygotic and 114 dizygotic female twin pairs aged 63-76 years. Postural balance was indicated as a center of pressure (COP) movement in semi-tandem stance, and participants filled in a fall-calendar daily for an average of 345 days after the baseline.
Mean hearing acuity (better ear hearing threshold level at 0.5-4 kHz) was 21 dB (standard deviation [SD] 12). Means of the COP velocity moment for the best to the poorest hearing quartiles increased linearly from 40.7 mm(2)/s (SD 24.4) to 52.8 mm(2)/s (SD 32.0) (p value for the trend = .003). Altogether 199 participants reported 437 falls. Age-adjusted incidence rate ratios (IRRs) for falls, with the best hearing quartile as a reference, were 1.2 (95% confidence interval [CI] = 0.4-3.8) in the second, 4.1 (95% CI = 1.1-15.6) in the third, and 3.4 (95% CI = 1.0-11.4) in the poorest hearing quartiles. Adjustment for COP velocity moment decreased IRRs markedly. Twin analyses showed that the association between hearing acuity and postural balance was not explained by genetic factors in common for these traits.
People with poor hearing acuity have a higher risk for falls, which is partially explained by their poorer postural control. Auditory information about environment may be important for safe mobility.
Notes
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PubMed ID
19182227 View in PubMed
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Genetic influences underlying self-rated health in older female twins.

https://arctichealth.org/en/permalink/ahliterature174438
Source
J Am Geriatr Soc. 2005 Jun;53(6):1002-7
Publication Type
Article
Date
Jun-2005
Author
Raija Leinonen
Jaakko Kaprio
Marja Jylhä
Asko Tolvanen
Markku Koskenvuo
Eino Heikkinen
Taina Rantanen
Author Affiliation
Finnish Center for Interdisciplinary Gerontology, Department of Health Sciences, University of Jyväskylaä, Finland. raija.leinonen@sport.jyu.fi
Source
J Am Geriatr Soc. 2005 Jun;53(6):1002-7
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Cross-Sectional Studies
Depression - epidemiology
Diseases in Twins - epidemiology
Environment
Female
Finland - epidemiology
Health status
Humans
Logistic Models
Mental health
Middle Aged
Multivariate Analysis
Self Concept
Twins - genetics
Walking
Abstract
To examine the genetic and environmental sources of variation in self-rated health (SRH) in older female twins and to explore the roles of morbidity, functional limitation, and psychological well-being as mediators of genetic and environmental effects on SRH.
Cross-sectional analysis of twin data.
Research laboratory.
One hundred two monozygotic and 115 dizygotic female twin pairs aged 63 to 76.
SRH was categorized as good, average, or poor. Morbidity was described using a physician-assessed disease-severity scale together with information about the presence of diabetes mellitus and cancer. Maximal walking speed measured over 10 m was used to assess physical functional limitation; the Mini-Mental State Examination and the Center for Epidemiologic Studies Depression Scale were used to characterize psychological well-being. The contributions of genetic and environmental (defined as familial (shared by siblings) or nonshared (unique to each sibling)) effects were assessed using univariate and multivariate structural equation modeling of twin data.
SRH did not have its own specific genetic effect but shared a genetic component in common with the genetic components underlying liability to disease severity, maximal walking speed, and depressive symptoms. It accounted for 64% of the variation in SRH, with environmental effects accounting for the remaining variation.
The current results suggest that there are no specific genetic effects on SRH but rather that genetic influences on SRH are mediated through genetic influences affecting chronic diseases, functional limitation, and mood.
PubMed ID
15935024 View in PubMed
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Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland.

https://arctichealth.org/en/permalink/ahliterature286530
Source
Int J Environ Res Public Health. 2017 Mar 22;14(3)
Publication Type
Article
Date
Mar-22-2017
Author
Erja Portegijs
Kirsi E Keskinen
Li-Tang Tsai
Taina Rantanen
Merja Rantakokko
Source
Int J Environ Res Public Health. 2017 Mar 22;14(3)
Date
Mar-22-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Architectural Accessibility - statistics & numerical data
Cross-Sectional Studies
Environment Design
Exercise
Female
Finland - epidemiology
Geriatric Assessment
Health promotion
Housing for the Elderly - standards
Humans
Male
Mobility Limitation
Quality of Life
Residence Characteristics
Socioeconomic Factors
Walking
Abstract
The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75-90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-reported physical activity one or two years later (n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score =9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week (n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators (p
Notes
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PubMed ID
28327543 View in PubMed
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Barriers to outdoor physical activity and unmet physical activity need in older adults.

https://arctichealth.org/en/permalink/ahliterature266937
Source
Prev Med. 2014 Oct;67:106-11
Publication Type
Article
Date
Oct-2014
Author
Johanna Eronen
Mikaela B von Bonsdorff
Timo Törmäkangas
Merja Rantakokko
Erja Portegijs
Anne Viljanen
Taina Rantanen
Source
Prev Med. 2014 Oct;67:106-11
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Cohort Studies
Cross-Sectional Studies
Environment
Environment Design
Exercise
Female
Finland
Geriatric Assessment
Health status
Humans
Male
Mobility Limitation
Questionnaires
Walking
Abstract
To profile participants based on reported outdoor physical activity barriers using a data-driven approach, describe the profiles and study their association with unmet physical activity need.
Cross-sectional analyses of 848 community-dwelling men and women aged 75-90 living in Central Finland in 2012. Barriers to outdoor physical activity and unmet physical activity need were enquired with a questionnaire. The latent profiles were identified by profiling participants into latent groups using a mixture modeling technique on the multivariate set of indicators of outdoor physical activity barriers. A path model was used to study the associations of the profiles with unmet physical activity need.
Five barrier profiles were identified. Profile A was characterized with minor barriers, profile B with weather barriers, profile C with health and weather barriers, profile D with barriers concerning insecurity, health and weather; and profile E with mobility and health barriers. The participants in the profiles differed in the proportion of individual and environmental barriers. The risk for unmet physical activity need was highest among people whose severe mobility difficulties restricted their outdoor physical activity.
Outdoor physical activity barriers reflect the imbalance in person-environment fit among older people, manifested as unmet physical activity need.
PubMed ID
25045839 View in PubMed
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Noise sensitivity and hearing disability.

https://arctichealth.org/en/permalink/ahliterature138473
Source
Noise Health. 2011 Jan-Feb;13(50):51-8
Publication Type
Article
Author
Marja Heinonen-Guzejev
Tapani Jauhiainen
Heikki Vuorinen
Anne Viljanen
Taina Rantanen
Markku Koskenvuo
Kauko Heikkilä
Helena Mussalo-Rauhamaa
Jaakko Kaprio
Author Affiliation
Department of Public Health, The Hjelt Institute, University of Helsinki, Helsinki, Finland. marja.heinonen@helsinki.fi
Source
Noise Health. 2011 Jan-Feb;13(50):51-8
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Audiometry
Case-Control Studies
Ear Protective Devices - utilization
Environmental Exposure - adverse effects
Female
Finland
Hearing Disorders - etiology - prevention & control
Humans
Hypertension - etiology
Logistic Models
Loudness Perception - physiology
Male
Middle Aged
Noise - adverse effects
Self Report
Stress, Psychological - etiology - psychology
Twin Studies as Topic
Abstract
The aim of this study was to investigate the association of noise sensitivity with self-reported hearing disability and hearing levels, with consideration of the role of self-reported history of noise exposure and use of hearing protectors. The study is based on the Finnish Twin Cohort. In 1988, a noise questionnaire was sent to 1005 twin pairs, 1495 individuals (688 men, 807 women) replied. The age range was 31-88 years. Information on some potential confounders was obtained from the questionnaire in 1981 for the same individuals. A subsample of thirty-eight elderly women with noise sensitivity response from 1988 had audiometry data from 2000 to 2001. Noise sensitivity was associated with self-reported hearing disability among all subjects [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.14-2.12] and among women (OR 1.90, 95% CI 1.19-3.04), but no-more significantly among men (OR 1.31, 95% CI 0.86-1.98). The association was primarily seen among younger subjects (50 years or less). The difference between noise sensitive and non-noise sensitive elderly women in the average of thresholds at frequencies of 0.5-4 kHz in the better ear was not significant (Pr = 0.18). Noise sensitivity did not modify the association of hearing disability with the self-reported history of occupational noise exposure. Noise sensitivity was associated with the use of hearing protectors at work. The study shows the importance of recognizing the noise sensitive in noise effect studies, since sensitivity in annoyance has implications in most of the effect categories.
PubMed ID
21173487 View in PubMed
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Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people.

https://arctichealth.org/en/permalink/ahliterature129064
Source
BMC Musculoskelet Disord. 2011;12:277
Publication Type
Article
Date
2011
Author
Sarianna Sipilä
Anu Salpakoski
Johanna Edgren
Ari Heinonen
Markku A Kauppinen
Marja Arkela-Kautiainen
Sanna E Sihvonen
Maija Pesola
Taina Rantanen
Mauri Kallinen
Author Affiliation
Gerontology Research Centre, University of Jyväskylä, Jyväskylä, Finland. sarianna.sipila@jyu.fi
Source
BMC Musculoskelet Disord. 2011;12:277
Date
2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Biomechanical Phenomena
Disability Evaluation
Female
Finland
Hip Fractures - diagnosis - physiopathology - rehabilitation
Hip Joint - physiopathology
Humans
Independent living
Male
Middle Aged
Patient compliance
Physical Therapy Modalities
Program Evaluation
Range of Motion, Articular
Recovery of Function
Research Design
Time Factors
Treatment Outcome
Abstract
To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture.
Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women) participated in this study and were randomly allocated into control (Standard Care) and ProMo intervention groups on average 10 weeks post fracture and 6 weeks after discharged to home. Standard Care included written home exercise program with 5-7 exercises for lower limbs. Of all participants, 12 got a referral to physiotherapy. After discharged to home, only 50% adhered to Standard Care. None of the participants were followed-up for Standard Care or mobility recovery. ProMo-intervention included Standard Care and a year-long program including evaluation/modification of environmental hazards, guidance for safe walking, pain management, progressive home exercise program and physical activity counseling. Measurements included a comprehensive battery of laboratory tests and self-report on mobility limitation, disability, physical functional capacity and health as well as assessments for the key prerequisites for mobility, disability and functional capacity. All assessments were performed blinded at the research laboratory. No significant differences were observed between intervention and control groups in any of the demographic variables.
Ten weeks post hip fracture only half of the participants were compliant to Standard Care. No follow-up for Standard Care or mobility recovery occurred. There is a need for rehabilitation and follow-up for mobility recovery after hip fracture. However, the effectiveness of the ProMo program can only be assessed at the end of the study.
Current Controlled Trials ISRCTN53680197.
Notes
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PubMed ID
22145912 View in PubMed
Less detail

Shared genetic and environmental effects on strength and power in older female twins.

https://arctichealth.org/en/permalink/ahliterature176744
Source
Med Sci Sports Exerc. 2005 Jan;37(1):72-8
Publication Type
Article
Date
Jan-2005
Author
Kristina Tiainen
Sarianna Sipilä
Markku Alén
Eino Heikkinen
Jaakko Kaprio
Markku Koskenvuo
Asko Tolvanen
Satu Pajala
Taina Rantanen
Author Affiliation
The Finnish Centre for Interdisciplinary Gerontology, Department of Health Sciences, University of Jyväskylä, P.O. Box 35(Viveca), Fin-40014 University of Jyväskylä, Finland. tiainen@sport.jyu.fi
Source
Med Sci Sports Exerc. 2005 Jan;37(1):72-8
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Exercise - physiology
Female
Finland
Humans
Knee - physiology
Lower Extremity - physiology
Middle Aged
Muscles - physiology
Twins - physiology
Twins, Dizygotic
Twins, Monozygotic
Abstract
This study examined the relative contribution of genetic and environmental effects on maximal leg extensor power and also investigated whether leg extensor power and maximum voluntary isometric knee extensor strength share a genetic component.
Muscle functions were measured as part of the Finnish Twin Study on Aging in 101 monozygotic (MZ) and 116 dizygotic (DZ) female twin pairs aged 63-76 yr. Leg extensor power was measured using the Nottingham Leg Extensor Power Rig and maximum voluntary isometric knee extensor strength using an adjustable dynamometer chair. The analyses were carried out using the maximum likelihood method in Mx-program on the raw data set.
A bivariate Cholesky decomposition model showed that leg extensor power and isometric knee extensor strength shared a genetic component in common, which accounted for 32% of the total variance in leg extensor power and 48% in isometric knee extensor strength. In addition, power and strength had a nonshared environmental effect in common accounting for four percent of the variance in power and 52% in strength. Remaining variance for leg extensor power was due to trait-specific shared and nonshared environmental effects.
Observed genetic effect in common for leg extensor power and maximum voluntary isometric knee extensor strength indicated that these two traits are regulated by the same genes. However, also environmental effects have a significant role in explaining the variability in power and strength.
PubMed ID
15632671 View in PubMed
Less detail

The genetic and environmental effects on depressive symptoms among older female twins.

https://arctichealth.org/en/permalink/ahliterature176906
Source
Twin Res. 2004 Dec;7(6):626-36
Publication Type
Article
Date
Dec-2004
Author
Sanna Takkinen
Asko Tolvanen
Jaakko Kaprio
Stig Berg
Markku Koskenvuo
Taina Rantanen
Author Affiliation
Institute of Gerontology, School of Health Sciences, Jönköping, Sweden.
Source
Twin Res. 2004 Dec;7(6):626-36
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Depression - epidemiology - genetics - psychology
Environment
Female
Finland - epidemiology
Humans
Models, Biological
Risk factors
Twins - genetics - psychology
Twins, Dizygotic - genetics - psychology
Twins, Monozygotic - genetics - psychology
Abstract
The aim of the present study was to examine the contribution of genetic and environmental factors to depressive symptoms among older women. The participants were 102 monozygotic and 115 dizygotic female twin pairs aged 64 to 76 years. Depressive symptoms were assessed by the Center for the Epidemiologic Studies Depression Scale. The contribution of genetic and environmental effects was estimated for the constructed depressiveness factor and for the subscales which were depressed mood, psychomotor retardation, lack of wellbeing and interpersonal difficulties. Of the variance in depressiveness, shared environmental influences accounted for 39% and nonshared environmental influences 61%. For the subscales, 24% to 62% of the variance was explained by individual, and 13% to 23% by shared, environmental factors. Lack of wellbeing had its own moderate additive genetic effect explaining 30% of the variance. This study showed that in older women predominantly environmental factors underlay individual differences in depressiveness; however, the factors varied to some extent between dimensions measured by the subscales.
PubMed ID
15607014 View in PubMed
Less detail

Genetic influences on resting electrocardiographic variables in older women: a twin study.

https://arctichealth.org/en/permalink/ahliterature153101
Source
Ann Noninvasive Electrocardiol. 2009 Jan;14(1):57-64
Publication Type
Article
Date
Jan-2009
Author
Sara Mutikainen
Alfredo Ortega-Alonso
Markku Alén
Jaakko Kaprio
Jouko Karjalainen
Taina Rantanen
Urho M Kujala
Author Affiliation
Department of Health Sciences, University of Jyväskylä, Finland. sara.mutikainen@gmail.com
Source
Ann Noninvasive Electrocardiol. 2009 Jan;14(1):57-64
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Aged
Aging - genetics
Cohort Studies
Confidence Intervals
Electrocardiography
Female
Finland
Genetic Predisposition to Disease
Heart rate - genetics
Humans
Middle Aged
Reference Values
Rest
Twins
Twins, Dizygotic
Twins, Monozygotic
Abstract
Previous studies in young and middle-aged men and women have shown that resting electrocardiographic (ECG) variables are influenced by genetic factors. However, the extent to which resting ECG variables are influenced by genetic factors in older women is unknown. Thus, the aim of this study was to estimate the relative contribution of genetic and environmental influences to individual differences in resting ECG variables among older female twins without overt cardiac diseases.
Resting ECG recordings were obtained from 186 monozygotic and 203 dizygotic twin individuals, aged 63-76 years. Quantitative genetic modeling was used to decompose the phenotypic variance in each resting ECG variable into additive genetic, dominance genetic, shared environmental, and unique environmental influences.
The results showed that individual differences in the majority of the resting ECG variables were moderately to highly explained by additive genetic influences, ranging from 32% for T axis to 72% for TV(5). The results also suggested dominance genetic influences on QRS duration, TV(1), and Sokolow-Lyon voltage (36%, 53%, and 57%, respectively). Unique environmental influences were important for each resting ECG variable, whereas shared environmental influences were detected only for QT interval and QTc.
In older women without overt cardiac diseases, genetic influences explain a moderate to high proportion of individual differences in the majority of the resting ECG variables. Genetic influences are especially strong for T-wave amplitudes, left ventricular mass, and hypertrophy indices, whereas other variables, including heart rate, intervals, and axes, are more affected by environmental influences.
PubMed ID
19149794 View in PubMed
Less detail

Body fat and mobility are explained by common genetic and environmental influences in older women.

https://arctichealth.org/en/permalink/ahliterature157662
Source
Obesity (Silver Spring). 2008 Jul;16(7):1616-21
Publication Type
Article
Date
Jul-2008
Author
Alfredo Ortega-Alonso
Sarianna Sipilä
Urho M Kujala
Jaakko Kaprio
Taina Rantanen
Author Affiliation
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. alfredo.ortega@sport.jyu.fi
Source
Obesity (Silver Spring). 2008 Jul;16(7):1616-21
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adiposity - genetics
Age Factors
Aged
Aging - genetics
Electric Impedance
Environment
Female
Finland
Genetic Predisposition to Disease
Humans
Locomotion - genetics
Middle Aged
Mobility Limitation
Models, Genetic
Obesity - genetics - physiopathology
Physical Endurance - genetics
Risk factors
Twins, Dizygotic - genetics
Twins, Monozygotic - genetics
Walking
Abstract
In older adults, mobility limitations often coexist with overweight or obesity, suggesting that similar factors may underlie both traits. This study examined the extent to which genetic and environmental influences explain the association between adiposity and mobility in older women. Body fat percentage (bioimpedance test), walking speed over 10 m, and distance walked in a 6-min test were evaluated in 92 monozygotic (MZ) and 104 dizygotic (DZ) pairs of twin sisters reared together, aged 63-76 years. Genetic and environmental influences on each trait were estimated using age-adjusted multivariate genetic modeling. The analyses showed that the means (and s.d.) for body fat percentage, walking speed, and walking endurance were 33.2+/-7.3%, 1.7+/-0.3 m/s and 529.7+/-75.4 m, respectively. The phenotypic correlation between adiposity and walking speed was -0.32 and between adiposity and endurance it was -0.33. Genetic influences explained 80% of the association between adiposity and speed, and 65% of adiposity and walking endurance. Cross-trait genetic influences accounted for 12% of the variability in adiposity, 56% in walking speed, and 34% in endurance. Trait-specific genetic influences were also detected for adiposity (54%) and walking endurance (13%), but not speed. In conclusion, among community-living older women, an inverse association was found between adiposity and mobility that was mostly due to the effect of shared genes. This result suggests that the identification of genetic variants for body fat metabolism may also provide understanding of the development of mobility limitations in older women.
PubMed ID
18421266 View in PubMed
Less detail

Do Associations Between Perceived Environmental and Individual Characteristics and Walking Limitations Depend on Lower Extremity Performance Level?

https://arctichealth.org/en/permalink/ahliterature291084
Source
J Aging Health. 2017 Jun; 29(4):640-656
Publication Type
Comparative Study
Journal Article
Date
Jun-2017
Author
Ritva Sakari
Merja Rantakokko
Erja Portegijs
Susanne Iwarsson
Sarianna Sipilä
Anne Viljanen
Taina Rantanen
Author Affiliation
1 University of Jyvaskyla, Finland.
Source
J Aging Health. 2017 Jun; 29(4):640-656
Date
Jun-2017
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Disability Evaluation
Environment
Female
Geriatric Assessment - methods
Humans
Independent living
Interviews as Topic
Lower Extremity - physiopathology
Male
Mobility Limitation
Perception
Physical Fitness - physiology
Sweden
Task Performance and Analysis
Walking - physiology
Abstract
The aim of this study was to analyze whether the associations between perceived environmental and individual characteristics and perceived walking limitations in older people differ between those with intact and those with poorer lower extremity performance.
Persons aged 75 to 90 ( N = 834) participated in interviews and performance tests in their homes. Standard questionnaires were used to obtain walking difficulties; environmental barriers to and, facilitators of, mobility; and perceived individual hindrances to outdoor mobility. Lower extremity performance was tested using Short Physical Performance Battery (SPPB).
Among those with poorer lower extremity performance, the likelihood for advanced walking limitations was, in particular, related to perceived poor safety in the environment, and among those with intact performance to perceived social issues, such as lack of company, as well as to long distances.
The environmental correlates of walking limitations seem to depend on the level of lower extremity performance.
PubMed ID
27056910 View in PubMed
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Individual and environmental factors underlying life space of older people - study protocol and design of a cohort study on life-space mobility in old age (LISPE).

https://arctichealth.org/en/permalink/ahliterature118779
Source
BMC Public Health. 2012;12:1018
Publication Type
Article
Date
2012
Author
Taina Rantanen
Erja Portegijs
Anne Viljanen
Johanna Eronen
Milla Saajanaho
Li-Tang Tsai
Markku Kauppinen
Eeva-Maija Palonen
Sarianna Sipilä
Susanne Iwarsson
Merja Rantakokko
Author Affiliation
Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P,O,Box 35, Jyväskylä, FI-40014, Finland. taina.rantanen@jyu.fi
Source
BMC Public Health. 2012;12:1018
Date
2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging
Cohort Studies
Female
Finland
Humans
Male
Quality of Life
Walking
Abstract
A crucial issue for the sustainability of societies is how to maintain health and functioning in older people. With increasing age, losses in vision, hearing, balance, mobility and cognitive capacity render older people particularly exposed to environmental barriers. A central building block of human functioning is walking. Walking difficulties may start to develop in midlife and become increasingly prevalent with age. Life-space mobility reflects actual mobility performance by taking into account the balance between older adults internal physiologic capacity and the external challenges they encounter in daily life. The aim of the Life-Space Mobility in Old Age (LISPE) project is to examine how home and neighborhood characteristics influence people's health, functioning, disability, quality of life and life-space mobility in the context of aging. In addition, examine whether a person's health and function influence life-space mobility.
This paper describes the study protocol of the LISPE project, which is a 2-year prospective cohort study of community-dwelling older people aged 75 to 90 (n?=?848). The data consists of a baseline survey including face-to-face interviews, objective observation of the home environment and a physical performance test in the participant's home. All the baseline participants will be interviewed over the phone one and two years after baseline to collect data on life-space mobility, disability and participation restriction. Additional home interviews and environmental evaluations will be conducted for those who relocate during the study period. Data on mortality and health service use will be collected from national registers. In a substudy on walking activity and life space, 358 participants kept a 7-day diary and, in addition, 176 participants also wore an accelerometer.
Our study, which includes extensive data collection with a large sample, provides a unique opportunity to study topics of importance for aging societies. A novel approach is employed which enables us to study the interactions of environmental features and individual characteristics underlying the life-space of older people. Potentially, the results of this study will contribute to improvements in strategies to postpone or prevent progression to disability and loss of independence.
Notes
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PubMed ID
23170987 View in PubMed
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Genetic and environmental influences on hearing at different frequencies separately for the better and worse hearing ear in older women.

https://arctichealth.org/en/permalink/ahliterature160056
Source
Int J Audiol. 2007 Dec;46(12):772-9
Publication Type
Article
Date
Dec-2007
Author
Anne Viljanen
Jaakko Kaprio
Ilmari Pyykkö
Martti Sorri
Markku Kauppinen
Markku Koskenvuo
Taina Rantanen
Author Affiliation
Finnish Centre for Interdisciplinary Gerontology, Department of Health Sciences, University of Jyväskylä, Finland. anne.viljanen@sport.jyu.fi
Source
Int J Audiol. 2007 Dec;46(12):772-9
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Aged
Aging - physiology
Auditory Threshold - physiology
Diseases in Twins - epidemiology
Environmental Exposure - adverse effects
Female
Finland - epidemiology
Hearing Disorders - epidemiology - etiology - genetics
Humans
Middle Aged
Registries
Severity of Illness Index
Twins, Dizygotic
Abstract
The purpose of the present study was to examine the relative contribution of genetic and environmental effects on the air-conducted hearing threshold levels at low (0.125-0.5 kHz), mid (1-2 kHz), and high (4-8 kHz) frequencies separately for the better and worse hearing ear in older women. We also examined the distribution of audiogram configurations. Data was analysed using quantitative genetic modelling. As part of the Finnish twin study on aging (FITSA), hearing was measured in 103 monozygotic and 114 dizygotic female twin pairs aged 63-76 years. Approximately every third subject had a flat type, and two-thirds a descending type of audiogram configuration. No significant difference was observed in the distribution of audiogram configurations between zygosity groups. In the better ear, additive genetic effects accounted for 64%-74% of the total variance at different frequencies. For the worse ear, environmental effects were larger. Although overall heritability is rather constant across the frequency spectrum, it is noteworthy that at low and high frequencies frequency-specific genetic and environmental effects together accounted for the majority of the total variance.
PubMed ID
18049966 View in PubMed
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