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Active aging - resilience and external support as modifiers of the disablement outcome: AGNES cohort study protocol.

https://arctichealth.org/en/permalink/ahliterature299192
Source
BMC Public Health. 2018 05 02; 18(1):565
Publication Type
Journal Article
Date
05-02-2018
Author
Taina Rantanen
Milla Saajanaho
Laura Karavirta
Sini Siltanen
Merja Rantakokko
Anne Viljanen
Timo Rantalainen
Katja Pynnönen
Anu Karvonen
Inna Lisko
Lotta Palmberg
Johanna Eronen
Eeva-Maija Palonen
Timo Hinrichs
Markku Kauppinen
Katja Kokko
Erja Portegijs
Author Affiliation
Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland. taina.rantanen@jyu.fi.
Source
BMC Public Health. 2018 05 02; 18(1):565
Date
05-02-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Aging - psychology
Cohort Studies
Disabled persons - statistics & numerical data
Exercise
Female
Finland
Health Behavior
Health Literacy
Humans
Male
Resilience, Psychological
Social Support
Abstract
Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual's striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of health, health behaviors, health literacy and functional abilities, environmental and social support with active aging and wellbeing. We will develop and validate assessment methods for physical activity and physical resilience suitable for research on older people, and examine their associations with active aging and wellbeing. We will examine cohort effects on functional phenotypes underlying active aging and disability.
For this population-based study, we plan to recruit 1000 participants aged 75, 80 or 85 years living in central Finland, by drawing personal details from the population register. Participants are interviewed on active aging, wellbeing, disability, environmental and social support, mobility, health behavior and health literacy. Physical activity and heart rate are monitored for 7 days with wearable sensors. Functional tests include hearing, vision, muscle strength, reaction time, exercise tolerance, mobility, and cognitive performance. Clinical examination by a nurse and physician includes an electrocardiogram, tests of blood pressure, orthostatic regulation, arterial stiffness, and lung function, as well as a review of chronic and acute conditions and prescribed medications. C-reactive protein, small blood count, cholesterol and vitamin D are analyzed from blood samples. Associations of factors potentially underlying active aging and wellbeing will be studied using multivariate methods. Cohort effects will be studied by comparing test results of physical and cognitive functioning with results of a cohort examined in 1989-90.
The current study will renew research on positive gerontology through the novel approach to active aging and by suggesting new biomarkers of resilience and active aging. Therefore, high interdisciplinary impact is expected. This cross-sectional study will not provide knowledge on temporal order of events or causality, but an innovative cross-sectional dataset provides opportunities for emergence of novel creative hypotheses and theories.
PubMed ID
29716566 View in PubMed
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Assessment of health literacy among older Finns.

https://arctichealth.org/en/permalink/ahliterature299832
Source
Aging Clin Exp Res. 2019 Apr; 31(4):549-556
Publication Type
Journal Article
Validation Studies
Date
Apr-2019
Author
Johanna Eronen
Leena Paakkari
Erja Portegijs
Milla Saajanaho
Taina Rantanen
Author Affiliation
Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyvaskyla, Finland. johanna.eronen@jyu.fi.
Source
Aging Clin Exp Res. 2019 Apr; 31(4):549-556
Date
Apr-2019
Language
English
Publication Type
Journal Article
Validation Studies
Keywords
Aged
Aged, 80 and over
Chronic Disease - epidemiology
Cohort Studies
Cross-Sectional Studies
Depression - epidemiology
Feasibility Studies
Female
Finland - epidemiology
Focus Groups
Health Literacy - statistics & numerical data
Health status
Humans
Male
Middle Aged
Reproducibility of Results
Socioeconomic Factors
Surveys and Questionnaires
Abstract
This study examined the feasibility of the HLS-EU-Q16 (in Finnish) for use among older Finns and whether the health literacy score correlates with indicators of health and functioning.
To determine the feasibility of the instrument, we first conducted a focus group discussion with nine participants. For the quantitative analyses, we used data from the AGNES cohort study, collected between October 2017 and April 2018 at the University of Jyväskylä in Finland. 292 75-year-old Finnish men and women were interviewed face-to-face in their homes. Health literacy was measured with the HLS-EU-Q16 and health literacy score, ranging from 0 to 50, computed. The reproducibility of the instrument was test-retested. Chi-square tests were used to compare health literacy scores between participants by different socioeconomic variables, and Spearman correlation coefficients were calculated to study the associations of health literacy with cognition, depressive symptoms, chronic conditions, life-space mobility and physical performance.
The mean health literacy score for all participants was 35.05 (SD 6.32). Participants who rated their financial situation and self-rated health as very good had the highest health literacy scores (38.85, SD 5.09 and 39.22, SD 6.77, respectively). Better health literacy was associated with better cognitive status, fewer depressive symptoms and chronic conditions, higher life-space mobility and better physical performance.
The HLS-EU-Q16 is a feasible measure for research purposes among older Finns. The associations between health literacy and indicators of health and functioning need to be more closely investigated in larger samples with a wider age-range.
PubMed ID
30578457 View in PubMed
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Associations Between Reasons to Go Outdoors and Objectively-Measured Walking Activity in Various Life-Space Areas Among Older People.

https://arctichealth.org/en/permalink/ahliterature277247
Source
J Aging Phys Act. 2016 Jan;24(1):85-91
Publication Type
Article
Date
Jan-2016
Author
Li-Tang Tsai
Merja Rantakokko
Anne Viljanen
Milla Saajanaho
Johanna Eronen
Taina Rantanen
Erja Portegijs
Source
J Aging Phys Act. 2016 Jan;24(1):85-91
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Accelerometry
Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Finland
Humans
Male
Residence Characteristics
Walking - physiology
Abstract
This cross-sectional study investigated associations between reasons to go outdoors and objectively-measured walking activity in various life-space areas among older people. During the study, 174 community-dwelling older people aged 75-90 from central Finland wore an accelerometer over seven days and recorded their reasons to go outdoors in an activity diary. The most common reasons for going outdoors were shopping, walking for exercise, social visits, and running errands. Activities done in multiple life-space areas contributed more to daily step counts than those done in the neighborhood or town and beyond. Those who went shopping or walked for exercise accumulated higher daily step counts than those who did not go outdoors for these reasons. These results show that shopping and walking for exercise are common reasons to go outdoors for community-dwelling older people and may facilitate walking activity in older age. Future studies on how individual trips contribute to the accumulation of steps are warranted.
PubMed ID
25951008 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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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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Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? A longitudinal study.

https://arctichealth.org/en/permalink/ahliterature287407
Source
Age Ageing. 2016 Jul;45(4):550-3
Publication Type
Article
Date
Jul-2016
Author
Erja Portegijs
Merja Rantakokko
Anne Viljanen
Sarianna Sipilä
Taina Rantanen
Source
Age Ageing. 2016 Jul;45(4):550-3
Date
Jul-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Exercise
Fatigue - physiopathology - psychology
Female
Finland
Frail Elderly - psychology
Frailty - diagnosis - physiopathology - psychology
Geriatric Assessment
Humans
Longitudinal Studies
Male
Mobility Limitation
Muscle Weakness - physiopathology - psychology
Personal Autonomy
Risk factors
Social Participation - psychology
Weight Loss
Abstract
essential aspects of independence in community mobility among older people concern the control over where, when and how to participate (perceived autonomy), and actual mobility (life-space mobility; frequency, distance and need of assistance). We studied relationships between frailty and life-space mobility and perceived autonomy in participation outdoors among community-dwelling 75-90 years old people.
longitudinal analyses of the 'Life-space mobility in old age' cohort study (n = 753). Life-space mobility (Life-Space Assessment, range 0-120) and perceived autonomy in participation outdoors (Impact on Participation and Autonomy subscale 'autonomy outdoors', range 0-20) were assessed at baseline and 2 years later. Baseline frailty indicators were unintentional weight loss (self-report), weakness (5 times chair rise), exhaustion (self-report), slowness (2.44 m walk) and low physical activity (self-report).
in total, 53% had no frailty, 43% pre-frailty (1-2 frailty indicators) and 4% frailty (=3 indicators). Generalised estimation equation models showed that life-space mobility was lower among those with frailty and pre-frailty compared with those without frailty and, in addition, declined at a faster pace. Perceived autonomy in participation outdoors was more restricted among those with frailty and pre-frailty compared with those without frailty, but the rate of decline did not differ.
frailty was associated with more restricted life-space mobility and poorer perceived autonomy in the decision-making concerning community mobility. Over the follow-up, frailty predicted a steeper decline in life-space mobility but not in perceived autonomy. Further study is warranted to determine whether compensation strategies or changes in the valuation of activities underlie this discrepancy.
PubMed ID
27126330 View in PubMed
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Life-space mobility assessment in older people in Finland; measurement properties in winter and spring.

https://arctichealth.org/en/permalink/ahliterature259870
Source
BMC Res Notes. 2014;7:323
Publication Type
Article
Date
2014
Author
Erja Portegijs
Susanne Iwarsson
Merja Rantakokko
Anne Viljanen
Taina Rantanen
Source
BMC Res Notes. 2014;7:323
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Finland
Humans
Movement
Seasons
Abstract
Life-space mobility refers to the spatial area an individual moves through, the frequency and need for assistance. Based on the assumption that measurement scale properties are context-specific, we tested the scale distribution, responsiveness, and reproducibility of the 15-item University of Alabama at Birmingham Study of Aging Life-Space Assessment in older people in Finland, specifically accounting for season.
Community-dwelling older men and women in central Finland aged 75-90 years were interviewed to determine life-space mobility (score range 0-120). Baseline (January-June 2012) and one-year follow-up data (January-June 2013; n?=?806) from the cohort study "Life-space mobility in old age" were used to investigate the scale distribution and responsiveness over a period of one year. In addition, with a sub-sample in conjunction with the one-year follow-up, we collected data to study the two-week test-retest reproducibility (n?=?18 winter and n?=?21 spring 2013).
The median life-space mobility score at baseline was 64. The median change in score over the one-year follow-up was zero. However, participants reporting a decline in health (repeated measures ANOVA p?=?.016) or mobility (p?=?.002) status demonstrated a significantly larger decrease in life-space mobility score than those reporting no or positive changes over the year. The two-week intra-class correlation (ICC) coefficient was .72. Lower ICC was found in the winter than in the spring sample and for items that represent higher life-space levels.
The test-retest reproducibility of the Life-Space Assessment was fair but somewhat compromised in the winter. Mobility of older people at the life-space levels of "town" and "beyond town" may be more variable. Life-space mobility was responsive to change, regardless of season. Further study is warranted to obtain insight in the factors contributing to seasonal effects.
Notes
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PubMed ID
24886670 View in PubMed
Less detail

Moving through Life-Space Areas and Objectively Measured Physical Activity of Older People.

https://arctichealth.org/en/permalink/ahliterature273374
Source
PLoS One. 2015;10(8):e0135308
Publication Type
Article
Date
2015
Author
Erja Portegijs
Li-Tang Tsai
Taina Rantanen
Merja Rantakokko
Source
PLoS One. 2015;10(8):e0135308
Date
2015
Language
English
Publication Type
Article
Keywords
Accelerometry
Aged
Aged, 80 and over
Aging
Cohort Studies
Female
Finland
Humans
Life Style
Male
Motor Activity
Reproducibility of Results
Residence Characteristics
Spatial Navigation
Walking
Abstract
Physical activity-an important determinant of health and function in old age-may vary according to the life-space area reached. Our aim was to study how moving through greater life-space areas is associated with greater physical activity of community-dwelling older people. The association between objectively measured physical activity and life-space area reached on different days by the same individual was studied using one-week longitudinal data, to provide insight in causal relationships.
One-week surveillance of objectively assessed physical activity of community-dwelling 70-90-year-old people in central Finland from the "Life-space mobility in old age" cohort substudy (N = 174). In spring 2012, participants wore an accelerometer for 7 days and completed a daily diary including the largest life-space area reached (inside home, outside home, neighborhood, town, and beyond town). The daily step count, and the time in moderate (incl. walking) and low activity and sedentary behavior were assessed. Differences in physical activity between days on which different life-space areas were reached were tested using Generalized Estimation Equation models (within-group comparison).
Participants' mean age was 80.4±4.2 years and 63.5% were female. Participants had higher average step counts (p
Notes
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PubMed ID
26252537 View in PubMed
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Nature diversity and well-being in old age.

https://arctichealth.org/en/permalink/ahliterature294458
Source
Aging Clin Exp Res. 2018 May; 30(5):527-532
Publication Type
Journal Article
Date
May-2018
Author
Merja Rantakokko
Kirsi E Keskinen
Katja Kokko
Erja Portegijs
Author Affiliation
Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, P.O. Box 35 (viv), 40014, Jyvaskyla, Finland. merja.rantakokko@jyu.fi.
Source
Aging Clin Exp Res. 2018 May; 30(5):527-532
Date
May-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Depression - diagnosis
Exercise
Female
Finland
Humans
Independent Living - psychology
Male
Quality of Life
Self Report
Abstract
The research aim was to study the associations of nature diversity with quality of life (QoL) and depressive symptoms among older people, and whether physical activity explains the associations.
Community-dwelling people aged 75-90 years (n?=?848) living in Central Finland were interviewed in their homes. QoL was assessed with a short version of the World Health Organization Quality-of-Life Assessment (range 0-130, higher score indicates better QoL) and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (range 0-30, higher scores indicate more depressive symptoms). Self-reported physical activity was assessed by intensity and duration using a single question with seven response options ranging from mostly resting to competitive sports. Nature diversity (Shannon Diversity Index) was assessed objectively within a 500-m buffer around participants' homes using a geographic information system (GIS).
Mean QoL was 100.3 (SD 11.8) and mean CES-D 9.6 (SD 6.8). Those in the highest nature diversity tertile had better QoL than those in the lowest tertile (p?=?.022). Physical activity did not explain the association between nature diversity and QoL. Adjustment for health indicators did not change the results. Nature diversity was not associated with depressive symptoms.
A diverse environment, especially when this includes elements of nature, is associated with better QoL. Good quality of the green infrastructure and adding natural elements to residential areas may enhance well-being among community-dwelling older people.
PubMed ID
28699000 View in PubMed
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