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Change in the prevalence of coronary heart disease among Finnish elderly men and women in the 1990s.

https://arctichealth.org/en/permalink/ahliterature183395
Source
Scand J Prim Health Care. 2003 Sep;21(3):178-81
Publication Type
Article
Date
Sep-2003
Author
Sirpa Hartikainen
Merja Ahto
Minna Löppönen
Hannu Puolijoki
Pekka Laippala
Ansa Ojanlatva
Sirkka-Liisa Kivelä
Raimo Isoaho
Author Affiliation
University of Kuopio, Department of Public Health and General Practice, Division of Geriatrics, Kuopio, Finland. sirpa.hartikainen@uku.fi
Source
Scand J Prim Health Care. 2003 Sep;21(3):178-81
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Aged
Coronary Disease - epidemiology
Female
Finland - epidemiology
Geriatric Assessment
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology
Prevalence
Abstract
To characterise the prevalence of, and changes in, coronary heart disease (CHD) among men and women aged between 64 and 71 years in the 1990s.
A study of clinical epidemiology involving two cohorts of elderly persons in 1990-1991 and 1998-1999.
Primary health care in the municipality of Lieto in southwestern Finland.
Persons between 64 and 71 years of age in the southwest of Finland in 1990-1991 and 1998-1999.
The occurrences of CHD were estimated using the history of a previous myocardial infarction or coronary revascularisation procedure evident in the medical records and with ischaemia or infarction as established on ECG according to the Whitehall criteria.
The prevalence of 'probable' CHD decreased among men and women aged between 64 and 71 years, whereas the prevalence of 'possible' CHD decreased among women alone. Silent myocardial infarctions were common among women of both cohorts. Many more men of the second cohort, compared to the first one, had undergone a coronary angioplasty or bypass operation.
The prevalence of CHD decreased among elderly women more clearly than among young elderly men. The favourable development illustrating a decrease in the prevalence of CHD among women should be sustained, while health promotion activities will need to be directed more actively towards men.
PubMed ID
14531511 View in PubMed
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Changes in lifestyle modestly reduce the estimated cardiovascular disease risk in one-year follow-up of the Finnish diabetes prevention program (FIN-D2D).

https://arctichealth.org/en/permalink/ahliterature269353
Source
Eur J Cardiovasc Nurs. 2015 Apr;14(2):145-52
Publication Type
Article
Date
Apr-2015
Author
Nina Rautio
Jari Jokelainen
Auli Pölönen
Heikki Oksa
Markku Peltonen
Mauno Vanhala
Hannu Puolijoki
Leena Moilanen
Jaakko Tuomilehto
Matti Uusitupa
Sirkka Keinänen-Kiukaanniemi
Timo Saaristo
Source
Eur J Cardiovasc Nurs. 2015 Apr;14(2):145-52
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - epidemiology
Diabetes Mellitus, Type 2 - prevention & control - psychology
Diet
Directive Counseling
Exercise
Female
Finland
Follow-Up Studies
Health Behavior
Humans
Life Style
Male
Middle Aged
Primary Health Care
Risk factors
Time Factors
Abstract
The purpose of this study was to assess whether changes in self-rated physical activity and diet during a type 2 diabetes (T2D) prevention program were associated with changes in estimated 10-year risk for cardiovascular disease (CVD) events and mortality in people at high risk for T2D.
Individuals were identified and offered lifestyle counseling as part of the Finnish diabetes prevention program. Ten-year risk for estimated CVD events and mortality were calculated with Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE) formula. FRS was available for 774 men and 1474 women and SCORE for 961 men and 1766 women.
During the one-year follow-up, 9.6% of the men reported both an increase in physical activity and improved dietary pattern, 4.1% an increase in physical activity, 39.3% an increase in improved dietary pattern, while 47.0% reported no lifestyle changes. Corresponding numbers for women were 14.2%, 3.8%, 39.2% and 42.7%. Estimated 10-year risk for CVD events decreased 3.5% in men and 1.5% in women reporting an increase in physical activity and improvement in diet, compared to an increase of 0.15% in men (p
PubMed ID
24452452 View in PubMed
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Dementia associates with undermedication of cardiovascular diseases in the elderly: a population-based study.

https://arctichealth.org/en/permalink/ahliterature169022
Source
Dement Geriatr Cogn Disord. 2006;22(2):132-41
Publication Type
Article
Date
2006
Author
Minna Lopponen
Ismo Raiha
Raimo Isoaho
Tero Vahlberg
Hannu Puolijoki
Sirkka-Liisa Kivela
Author Affiliation
Department of Family Medicine, University of Turku, Lemminkäisenkatu 1, Turku, Finland. minna.lopponen@utu.fi
Source
Dement Geriatr Cogn Disord. 2006;22(2):132-41
Date
2006
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Agents - administration & dosage - therapeutic use
Cardiovascular Diseases - complications - drug therapy - epidemiology
Dementia - complications - diagnosis - epidemiology
Electrocardiography - drug effects
Female
Finland - epidemiology
Humans
Longitudinal Studies
Male
Neuropsychological Tests
Patient compliance
Population
Risk assessment
Abstract
To compare medication use in patients suffering from cardiovascular disease with and without dementia.
All inhabitants aged 75 and older in Lieto, Finland (n = 462, participation rate 82%).
Direct standardised assessments of dementia and cardiovascular diseases. Quantification of drug use by self-report and by prescription and drug container checks.
In multivariate analyses, the odds ratio for demented cardiovascular patients receiving any cardiovascular medication (use vs. non-use) was 0.31 (95% confidence interval 0.12-0.82). Compared to the non-demented, demented stroke patients were treated less often with antithrombotic agents (p = 0.041) and demented hypertensive patients less often with beta-blockers (p = 0.045).
Demented cardiovascular patients, even mildly to moderately demented, were prescribed fewer evidence-based cardiovascular medications than non-demented patients.
PubMed ID
16741361 View in PubMed
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Financial satisfaction and its relationship to depressive symptoms in middle-aged and older adults: results from the FIN-D2D survey.

https://arctichealth.org/en/permalink/ahliterature128097
Source
Int J Soc Psychiatry. 2013 May;59(3):239-46
Publication Type
Article
Date
May-2013
Author
Nina Rautio
Hannu Kautiainen
Hannu Koponen
Pekka Mäntyselkä
Markku Timonen
Leo Niskanen
Timo Saaristo
Heikki Oksa
Markku Peltonen
Hannu Puolijoki
Mauno Vanhala
Sirkka Keinänen-Kiukaanniemi
Author Affiliation
Pirkanmaa Hospital District, Tampere, Finland. nina.rautio@oulu.fi
Source
Int J Soc Psychiatry. 2013 May;59(3):239-46
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Depression - epidemiology - psychology
Female
Finland - epidemiology
Health Surveys - methods - statistics & numerical data
Humans
Income - statistics & numerical data
Male
Middle Aged
Personal Satisfaction
Questionnaires
Socioeconomic Factors
Abstract
Studies using traditional measures of socio-economic position, such as education, income and occupation, have found inequalities in depressive symptoms, but less is known about the association between financial satisfaction and depressive symptoms.
To examine the association of depressive symptoms with financial satisfaction in Finnish adults in a population-based cross-sectional FIN-D2D survey.
Four thousand, five hundred randomly selected individuals aged 45-74 years were invited to the study. Participation rate for health examinations was 64%. Complete information on depressive symptoms and financial satisfaction was available for 2,819 individuals. Financial satisfaction was asked using a questionnaire. Depressive symptoms were measured by Beck Depression Inventory (= 10) and/or use of antidepressants.
Altogether 11.6% of individuals who were satisfied with their financial situation had depressive symptoms. Corresponding figures for individuals who were somewhat satisfied or dissatisfied were 20.6% and 42.6%, respectively. Individuals who were less satisfied with their financial situation were more likely to suffer from depressive symptoms even after adjusting for gender, age, marital status, number of chronic diseases, smoking, binge drinking, physical activity, education and household income.
Instead of more traditional measures of socio-economic position, financial dissatisfaction seems to be associated with depressive symptoms in Finnish adults.
PubMed ID
22234975 View in PubMed
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High prevalence of obesity, central obesity and abnormal glucose tolerance in the middle-aged Finnish population.

https://arctichealth.org/en/permalink/ahliterature153454
Source
BMC Public Health. 2008;8:423
Publication Type
Article
Date
2008
Author
Timo E Saaristo
Noël C Barengo
Eeva Korpi-Hyövälti
Heikki Oksa
Hannu Puolijoki
Juha T Saltevo
Mauno Vanhala
Jouko Sundvall
Liisa Saarikoski
Markku Peltonen
Jaakko Tuomilehto
Author Affiliation
Finnish Diabetes Association, Tampere, Finland. timo.saaristo@diabetes.fi
Source
BMC Public Health. 2008;8:423
Date
2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Anthropometry
Blood Glucose - metabolism
Body mass index
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - diagnosis - epidemiology
Female
Finland - epidemiology
Glucose Intolerance - blood - diagnosis - epidemiology
Glucose Tolerance Test
Health Surveys
Humans
Male
Middle Aged
Obesity - blood - diagnosis - epidemiology
Prevalence
Sex Distribution
Waist Circumference - physiology
Abstract
There is a worldwide increase in the prevalence of obesity and disturbances in glucose metabolism. The aim of this study was to assess the current prevalence of obesity, central obesity and abnormal glucose tolerance in Finnish population, and to investigate the associations between body mass index (BMI), waist circumference and abnormal glucose tolerance.
A cross-sectional population-based survey was conducted in Finland during October 2004 and January 2005. A total of 4500 randomly selected individuals aged 45-74 years were invited to a health examination that included an oral glucose tolerance test. The participation rate was 62% in men and 67% in women.
The prevalence of obesity was 23.5% (95% Confidence Interval (CI) 21.1-25.9) in men, and 28.0% (95% CI 25.5-30.5) in women. The overall prevalence of abnormal glucose tolerance (including type 2 diabetes, impaired glucose tolerance, or impaired fasting glucose) was 42.0% (95% CI 39.2-44.8) in men and 33.4% (95% CI 30.9-36.0) in women. The prevalence of previously unknown, screen-detected type 2 diabetes was 9.3% (95% CI 7.7-11.0) in men and 7.3% (95% CI 5.9-8.7) in women. Central obesity was associated with abnormal glucose tolerance within each of the three BMI categories normal (or= 30 kg/m2).
In a population-based random sample of Finnish population, prevalences of obesity, central obesity and abnormal glucose tolerance were found to be high. A remarkably high number of previously undetected cases of type 2 diabetes was detected. Waist circumference is a predictor of abnormal glucose tolerance in all categories of obesity.
Notes
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PubMed ID
19113993 View in PubMed
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Population-level effects of the national diabetes prevention programme (FIN-D2D) on the body weight, the waist circumference, and the prevalence of obesity.

https://arctichealth.org/en/permalink/ahliterature134352
Source
BMC Public Health. 2011;11:350
Publication Type
Article
Date
2011
Author
Titta M Salopuro
Timo Saaristo
Heikki Oksa
Hannu Puolijoki
Mauno Vanhala
Tapani Ebeling
Leo Niskanen
Jaakko Tuomilehto
Matti Uusitupa
Markku Peltonen
Author Affiliation
Pirkanmaa Hospital District, Tampere, Finland. titta.salopuro@thl.fi
Source
BMC Public Health. 2011;11:350
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Body Weight
Diabetes Mellitus, Type 2 - prevention & control
Female
Finland - epidemiology
Health Surveys
Humans
Male
Middle Aged
Obesity - epidemiology - prevention & control
Program Evaluation
Waist Circumference
Young Adult
Abstract
The implementation project of the national diabetes prevention programme in Finland, FIN-D2D, was carried out in primary health care in the area of five hospital districts during 2003-2007.
The population strategy of FIN-D2D was primarily aimed at increasing the awareness of type 2 diabetes and preventing obesity. To investigate the effects of this strategy, we studied the changes in the prevalence of obesity, overweight, and central obesity among a random independent sample of individuals aged 45-74 years in the FIN-D2D area; and assessed whether they differed from a sample of individuals in the control area, which consisted of four geographical areas not participating in FIN-D2D (FINRISK study). Data was obtained for 5850/ 6406 (in the beginning/ in the end) individuals. The duration of the observation period varied from three to five years.
The mean body weight decreased from 78.7 to 78.1 kg (p = 0.041) in the FIN-D2D area, and from 78.7 to 78.0 kg (p = NS) in the control area. The prevalence of obesity (BMI =30 kg/m(2)) decreased in the FIN-D2D area (26.5% vs. 24.4%, p = 0.015), and in the control area (28.4% vs. 25.2%, p = 0.005). The prevalence of morbid obesity (BMI =40 kg/m(2)) remained unchanged in the FIN-D2D area, but increased in the control area (1.2% vs. 2.3%, p = 0.007). The mean waist circumference remained unchanged in the FIN-D2D area, but increased in the control area (92.8 vs. 94.0 cm, p = 0.005).
The prevalence of obesity may be decreasing among 45-74 year old Finns. We still need a longer time perspective and future studies to see whether this favourable trend can be sustained in Finland. The actions of this implementation project can at least partly explain the differences in the mean waist circumference and the prevalence of morbid obesity between the intervention and control areas.
Notes
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PubMed ID
21595955 View in PubMed
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Sleep duration is associated with an increased risk for the prevalence of type 2 diabetes in middle-aged women - The FIN-D2D survey.

https://arctichealth.org/en/permalink/ahliterature162345
Source
Sleep Med. 2008 Mar;9(3):221-7
Publication Type
Article
Date
Mar-2008
Author
Henri Tuomilehto
Markku Peltonen
Markku Partinen
Juha Seppä
Timo Saaristo
Eeva Korpi-Hyövälti
Heikki Oksa
Hannu Puolijoki
Juha Saltevo
Mauno Vanhala
Jaakko Tuomilehto
Author Affiliation
Department of Otorhinolaryngology, Kuopio University Hospital, and University of Kuopio, Finland. henri.tuomilehto@kuh.fi
Source
Sleep Med. 2008 Mar;9(3):221-7
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - epidemiology - etiology
Disorders of Excessive Somnolence - complications - epidemiology
Female
Finland
Glucose Tolerance Test
Health Surveys
Humans
Male
Middle Aged
Risk factors
Sex Factors
Sleep Deprivation - complications - epidemiology
Abstract
To examine the association between sleep duration with type 2 diabetes and abnormal glucose tolerance among middle-aged men and women in Finland.
The FIN-D2D survey is a population-based cross-sectional multicentre study in Finland, with 1336 men and 1434 women aged 45-74 participating in the survey during 2004 and 2005. A health examination including an oral glucose tolerance test and sleep questionnaire was performed for all participants.
There was an independent association between abnormal sleeping times and type 2 diabetes in middle-aged women. Even after adjustments for age, body mass index, sleep apnea probability, smoking, physical activity, and central nervous system-affecting medication, sleep duration of 6h or less or 8h or longer was independently associated with type 2 diabetes. There was no increase in the prevalence of diabetes in middle-aged men with abnormal sleeping times.
Short ( or = 8h) sleep duration is related to an increased risk of type 2 diabetes in middle-aged women but not in men.
Notes
Comment In: Sleep Med. 2008 Mar;9(3):219-2017681882
PubMed ID
17644479 View in PubMed
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Socioeconomic position and effectiveness of lifestyle intervention in prevention of type 2 diabetes: one-year follow-up of the FIN-D2D project.

https://arctichealth.org/en/permalink/ahliterature134101
Source
Scand J Public Health. 2011 Aug;39(6):561-70
Publication Type
Article
Date
Aug-2011
Author
Nina Rautio
Jari Jokelainen
Heikki Oksa
Timo Saaristo
Markku Peltonen
Leo Niskanen
Hannu Puolijoki
Mauno Vanhala
Matti Uusitupa
Sirkka Keinänen-Kiukaanniemi
Author Affiliation
Pirkanmaa Hospital District, Oulu, Finland. nina.rautio@oulu.fi
Source
Scand J Public Health. 2011 Aug;39(6):561-70
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Diabetes Mellitus, Type 2 - prevention & control
Educational Status
Female
Finland
Follow-Up Studies
Health Behavior
Health Status Disparities
Humans
Life Style
Male
Middle Aged
Occupations
Program Evaluation
Risk factors
Socioeconomic Factors
Abstract
Lifestyle intervention is effective in prevention of type 2 diabetes (T2D) in high-risk individuals. However, health behaviour and health outcomes are modified by socioeconomic position through various mechanisms. It is therefore possible that success in lifestyle intervention may be determined by factors such as level of education or occupation. In this study we assessed the impact of the level of education and occupation on the baseline anthropometric and clinical characteristics and their changes during a one-year follow-up in a cohort of Finnish men and women at high risk for T2D aged 20-64 years.
As part of a Finnish national diabetes prevention programme 2003-2007 (FIN-D2D), high-risk individuals were identified using opportunistic screening for lifestyle intervention in primary health care. 1,067 men and 2,122 women had one-year follow-up data. Education and occupation were used as factors of socioeconomic position. Measures of anthropometric and clinical characteristics included weight, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, total, HDL and LDL cholesterol, triglycerides, FINDRISC scores and glucose tolerance status.
The effect of intervention was similar in all socioeconomic groups, but the level of education was related to glucose tolerance status in both genders. In addition, socioeconomic differences existed in blood pressure, weight, BMI, waist circumference and HDL cholesterol.
Socioeconomic position did not seem to have any impact on the effectiveness of lifestyle intervention in individuals at high risk for T2D, which is encouraging from the point of view of reducing health inequalities.
PubMed ID
21622677 View in PubMed
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Stronger symptoms of depression predict high coronary heart disease mortality in older men and women.

https://arctichealth.org/en/permalink/ahliterature166323
Source
Int J Geriatr Psychiatry. 2007 Aug;22(8):757-63
Publication Type
Article
Date
Aug-2007
Author
Merja Ahto
Raimo Isoaho
Hannu Puolijoki
Tero Vahlberg
Sirkka-Liisa Kivelä
Author Affiliation
Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland. merahto@utu.fi
Source
Int J Geriatr Psychiatry. 2007 Aug;22(8):757-63
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cause of Death
Cohort Studies
Coronary Disease - diagnosis - mortality - psychology
Cross-Sectional Studies
Depressive Disorder - diagnosis - mortality - psychology
Female
Finland
Geriatric Assessment - statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - diagnosis - mortality - psychology
Proportional Hazards Models
Risk factors
Sex Factors
Abstract
Most cohort studies have found depressive symptoms to be associated with increased cardiovascular mortality in the elderly, but follow-up times have often been short and study populations small.
To describe associations between stronger symptoms of depression and the risk of death from coronary heart disease (CHD) or myocardial infarction (MI) in elderly Finnish subjects free of CHD at the baseline.
This study is a prospective population-based epidemiological and clinical twelve-year follow-up study in Lieto Health Centre, Finland. The basic population consisted of 1196 elderly (64 years of age or older) persons who lived in the municipality of Lieto in southwestern Finland in 1990. The occurrence of CHD was determined on the basis of electrocardiographic (ECG) findings, Rose questionnaire and the diagnoses in medical records. The persons with CHD were excluded from the study population. Symptoms of depression at the baseline were measured with the Zung Self-rating Depression Scale (ZSDS). Mortality was followed up for about 12 years.
The Kaplan-Meier survival curves showed stronger symptoms of depression to be related to high risks of mortality from CHD or MI among men and women. According to the Cox model for men significant predictors for higher risk of CHD or MI mortality were stronger symptoms of depression, higher age and a large number of medications in use. When women were examined, significant predictors were stronger symptoms of depression and a large number of medications in use.
Stronger symptoms of depression are an independent risk factor for high CHD or MI mortality in aged Finnish men and women free of CHD at baseline.
Notes
Comment In: Evid Based Ment Health. 2008 May;11(2):5618441145
PubMed ID
17133654 View in PubMed
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Undiagnosed diseases in patients with dementia--a potential target group for intervention.

https://arctichealth.org/en/permalink/ahliterature178887
Source
Dement Geriatr Cogn Disord. 2004;18(3-4):321-9
Publication Type
Article
Date
2004
Author
Minna K Löppönen
Raimo E Isoaho
Ismo J Räihä
Tero J Vahlberg
Saila M Loikas
Timo I Takala
Hannu Puolijoki
Kerttu M Irjala
Sirkka-Liisa Kivelä
Author Affiliation
Department of General Practice, University of Turku, Turku City Hospital, Turku, Finland. minna.lopponen@utu.fi
Source
Dement Geriatr Cogn Disord. 2004;18(3-4):321-9
Date
2004
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - diagnosis - epidemiology
Catchment Area (Health)
Central Nervous System Diseases - diagnosis - epidemiology
Comorbidity
Cross-Sectional Studies
Dementia - diagnosis - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Electrocardiography
Female
Finland - epidemiology
Humans
Hypothyroidism - diagnosis - epidemiology
Male
Middle Aged
Population Surveillance - methods
Abstract
To study undiagnosed diseases in older people with and without dementia.
Cross-sectional population-based study in Lieto, southwestern Finland.
All the inhabitants aged 64 and more in Lieto. Participation rate was 82% (n = 1,260).
Dementia and its subtypes were diagnosed according to prevailing criteria. Medical conditions were assessed in clinical examinations and from medical records.
112 patients with dementia were found; 66% of them had at least 1 undiagnosed disease compared to 48% of the non-demented group (p = 0.041). The demented subjects had more undiagnosed hypercholesterolaemia (p = 0.039) and undiagnosed hypothyroidism (p = 0.032) than the controls.
Undiagnosing is more common among patients with dementia. Screening strategies should be developed further to find these patients.
PubMed ID
15305110 View in PubMed
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