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Addressing social inequality in aging by the Danish occupational social class measurement.

https://arctichealth.org/en/permalink/ahliterature104848
Source
J Aging Health. 2014 Feb;26(1):106-27
Publication Type
Article
Date
Feb-2014
Author
Ulla Christensen
Rikke Krølner
Charlotte J Nilsson
Pernille W Lyngbye
Charlotte Ø Hougaard
Else Nygaard
Karsten Thielen
Bjørn E Holstein
Kirsten Avlund
Rikke Lund
Author Affiliation
University of Copenhagen, Denmark.
Source
J Aging Health. 2014 Feb;26(1):106-27
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Aging - physiology
Chronic Disease
Cohort Studies
Denmark
Diagnostic Self Evaluation
Female
Health Status Disparities
Humans
Male
Middle Aged
Mobility Limitation
Occupations
Questionnaires
Reproducibility of Results
Social Class
Abstract
To present the Danish Occupational Social Class (DOSC) measurement as a measure of socioeconomic position (SEP) applicable in a late midlife population, and to analyze associations of this measure with three aging-related outcomes in midlife, adjusting for education.
Systematic coding procedures of the DOSC measurement were applied to 7,084 participants from the Copenhagen Aging and Midlife Biobank (CAMB) survey. We examined the association of this measure of SEP with chronic conditions, self-rated health, and mobility in logistic regression analyses, adjusting for school education in the final analysis.
The measure of SEP showed a strong social gradient along the social classes in terms of prevalence of chronic conditions, poor self-rated health, and mobility limitations. Adjusting for school education attenuated the association only to a minor degree.
The DOSC measure was associated with aging-related outcomes in a midlife Danish population, and is, thus, well suited for future epidemiological research on social inequalities in health and aging.
PubMed ID
24584263 View in PubMed
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Amount and type of alcohol consumption and missing teeth among community-dwelling older adults: findings from the Copenhagen Oral Health Senior study.

https://arctichealth.org/en/permalink/ahliterature127155
Source
J Public Health Dent. 2011;71(4):318-26
Publication Type
Article
Date
2011
Author
Karen Heegaard
Kirsten Avlund
Poul Holm-Pedersen
Ulla A Hvidtfeldt
Allan Bardow
Morten Grønbaek
Author Affiliation
Copenhagen Gerontological Oral Health Research Centre, University of Copenhagen, Copenhagen, Denmark. karen.heegaard@mail.tele.dk
Source
J Public Health Dent. 2011;71(4):318-26
Date
2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol drinking - epidemiology
Alcoholic Beverages - classification - statistics & numerical data
Beer - statistics & numerical data
Cross-Sectional Studies
Denmark - epidemiology
Educational Status
Female
Follow-Up Studies
Humans
Income - statistics & numerical data
Independent Living - statistics & numerical data
Longitudinal Studies
Male
Population Surveillance
Sedentary lifestyle
Sex Factors
Smoking - epidemiology
Social Class
Temperance - statistics & numerical data
Tooth Loss - epidemiology
Wine - statistics & numerical data
Abstract
To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists.
A cross-sectional study including a total of 783 community-dwelling men and women aged 65-95 years who were interviewed about alcohol drinking habits and underwent a clinical oral and dental examination. Multiple regression analyses were applied for studying the association between total weekly alcohol consumption, beverage-specific alcohol consumption, beverage preference (defined as the highest intake of one beverage type compared with two other types), and the number of remaining teeth (= 20 versus >20 remaining teeth).
The odds ratio (OR) of having a low number of teeth decreased with the total intake of alcohol in women, with ORs for a low number of teeth of 0.40 [95 percent confidence interval (CI) 0.22-0.76] in women drinking 1-14 drinks per week and 0.34 (95 percent CI 0.16-0.74) in women with an intake of more than 14 drinks per week compared with abstainers. Similar relations could also be obtained for type-specific alcohol intake of wine and for wine and spirits preference among women. Men who preferred beer showed a decreased risk for a low number of teeth compared with men with other alcohol preferences.
In this study, alcohol consumption, wine drinking, and wine and spirits preference among women were associated with a higher number of teeth compared with abstainers. Among men, those who preferred beer also had a higher number of teeth.
PubMed ID
22320290 View in PubMed
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Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark.

https://arctichealth.org/en/permalink/ahliterature123849
Source
BMC Public Health. 2012;12:396
Publication Type
Article
Date
2012
Author
Yukari Yamada
Anette Ekmann
Charlotte Juul Nilsson
Mikkel Vass
Kirsten Avlund
Author Affiliation
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. yukari.yamada@upol.cz
Source
BMC Public Health. 2012;12:396
Date
2012
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Cross-Sectional Studies
Denmark
Female
Financing, Personal - economics - statistics & numerical data
Geriatric Assessment
Health Services for the Aged - economics
Healthcare Disparities - economics
Home Care Services - economics - utilization
House Calls - utilization
Humans
Logistic Models
Male
Patient Acceptance of Health Care - psychology - statistics & numerical data
Physicians, Family - education - standards
Prevalence
Preventive Health Services - economics - methods
Program Evaluation
Questionnaires
Residence Characteristics
Sex Distribution
Social Class
Abstract
Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association.
The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender.
Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0)). However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals.
High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.
Notes
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PubMed ID
22656647 View in PubMed
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Brain-derived neurotrophic factor predicts mortality risk in older women.

https://arctichealth.org/en/permalink/ahliterature150397
Source
J Am Geriatr Soc. 2009 Aug;57(8):1447-52
Publication Type
Article
Date
Aug-2009
Author
Karen S Krabbe
Erik L Mortensen
Kirsten Avlund
Agnes N Pedersen
Bente K Pedersen
Torben Jørgensen
Helle Bruunsgaard
Author Affiliation
Center of Inflammation and Metabolism, Department of Infectious Diseases, Faculty of Health Sciences, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. karen.krabbe@dadlnet.dk
Source
J Am Geriatr Soc. 2009 Aug;57(8):1447-52
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged, 80 and over
Biological Markers - blood
Brain-Derived Neurotrophic Factor - blood
Denmark - epidemiology
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Humans
Male
Mortality - trends
Predictive value of tests
Proportional Hazards Models
Sensitivity and specificity
Statistics, nonparametric
Survival Rate
Abstract
To test the hypothesis that low circulating brain-derived neurotrophic factor (BDNF), a secretory member of the neurotrophin family that has a protective role in neurodegeneration and stress responses and a regulatory role in metabolism, predicts risk of all-cause mortality in 85-year-old men and women.
Longitudinal study with 50- to 58-month follow-up.
The 1914 cohort, a population-based cohort established in 1964 by the Research Center for Prevention and Health at Glostrup Hospital.
One hundred eighty-eight unselected 85-year-old Danes.
BDNF was measured in plasma and serum. The Danish National Register of Patients was used to collect data on morbidity. The primary outcome in Cox regression analyses was all-cause mortality.
Women with low plasma BDNF (lowest tertile) had greater all-cause mortality risk than women with high plasma BDNF (highest tertile) (hazard ratio=2.2, 95% confidence interval=1.1-4.7). Low plasma BDNF predicted mortality independently of activities of daily living; education; and a history of central nervous system disease, cerebrovascular accidents, cardiovascular disease, cancer, respiratory disease, and low-grade inflammation. No association was found between plasma BDNF and mortality in men, and serum BDNF did not influence mortality in either sex.
Low plasma BDNF is a novel, independent, and robust biomarker of mortality risk in old women. BDNF may be a central factor in the network of multimorbidity in old populations.
PubMed ID
19515111 View in PubMed
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Can the higher risk of disability onset among older people who live alone be alleviated by strong social relations? A longitudinal study of non-disabled men and women.

https://arctichealth.org/en/permalink/ahliterature97796
Source
Age Ageing. 2010 May;39(3):319-26
Publication Type
Article
Date
May-2010
Author
Rikke Lund
Charlotte Juul Nilsson
Kirsten Avlund
Author Affiliation
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. r.lund@sund.ku.dk
Source
Age Ageing. 2010 May;39(3):319-26
Date
May-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging - physiology - psychology
Denmark
Female
Follow-Up Studies
Geriatric Assessment
Health status
Humans
Interpersonal Relations
Logistic Models
Longitudinal Studies
Male
Risk assessment
Sex Factors
Social Isolation
Social Support
Abstract
PURPOSE: to investigate if the increased risk of disability onset among older people who live alone could possibly be moderated by either high social participation or by being satisfied with the social relations. DESIGN AND METHODS: logistic regression models were tested using two waves in a study population of 2,697 non-disabled older men and women from The Danish Longitudinal Study on Preventive Home Visits. RESULTS: living alone and low social participation were significant risk factors for later male disability onset. Not being satisfied with the social relations was significantly associated with onset of disability for both genders. Among men who lived alone low social participation was a significant predictor of disability onset [odds ratio, OR = 2.30 (1.00-5.29)]; for cohabiting men social participation was not associated with disability onset, [adjusted OR = 0.91 (0.49-1.71)]. Similar results were present concerning satisfaction with the social relations among men. There was no significant interaction for women. CONCLUSIONS: the study suggests that men who live alone can possibly alleviate their risk of disability onset by being socially active and by having access to satisfactory social relations. Women do not seem to benefit as much from cohabitation as men, although women who live alone and who are not satisfied with their social relations also constitute a significant risk category.
PubMed ID
20208073 View in PubMed
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Changes in household composition as determinant of changes in functional ability among old men and women.

https://arctichealth.org/en/permalink/ahliterature187417
Source
Aging Clin Exp Res. 2002 Jun;14(3 Suppl):65-74
Publication Type
Article
Date
Jun-2002
Author
Kirsten Avlund
Pernille Due
Bjorn E Holstein
Ulla Sonn
Pia Laukkanen
Author Affiliation
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark. K.Avlund@socmed.ku.dk
Source
Aging Clin Exp Res. 2002 Jun;14(3 Suppl):65-74
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging - physiology
Female
Housing for the Elderly
Humans
Male
Scandinavia
Sex Characteristics
Social Environment
Abstract
The aims of this article were 1) to describe changes in functional ability from ages 75 to 80 among men and women in three Nordic localities, and 2) to analyze whether these changes are determined by changes in household composition from ages 70 to 75. The present analyses include the persons who participated in the NORA follow-up study of 75-80 year-old men and women in Jyväskylä, Finland (N=243), Göteborg, Sweden (N=226), and Glostrup, Denmark (N=274). Functional ability was measured by tiredness and need for help in Physical and Instrumental Activities of Daily Living (PADL and IADL). Changes in functional ability are described as 1) sustained good, 2) decreased, 3) improved, and 4) sustained poor, and changes in household composition as 1) sustained living alone, 2) from living with others to living alone, and 3) sustained living with others. Number of chronic diseases and home help were included as covariates in the multivariate analyses. A large proportion of men and women had sustained good functional ability from age 75 to 80, but we observed both improvement and deterioration over time. For example, with regard to need for help in PADL: 64/59% of the mer/women had sustained good function, 19/21% deteriorated, 3/6% improved, and 14/14% had sustained poor function. Among the women in need of help at age 75, those who lived alone/became alone had a higher risk of sustained need for help from age 75 to 80 compared to women who lived with others [adjusted OR=4.0 (1.3-12.2/4.4 (0.7-26.9)]. This was not seen among the poor-functioning men. It is concluded that poor-functioning, single-living women are at higher risk of not regaining functional ability compared to cohabiting women.
PubMed ID
12475135 View in PubMed
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Changes in social relations in old age. Are they influenced by functional ability?

https://arctichealth.org/en/permalink/ahliterature31239
Source
Aging Clin Exp Res. 2002 Jun;14(3 Suppl):56-64
Publication Type
Article
Date
Jun-2002
Author
Kirsten Avlund
Pernille Due
Bjorn E Holstein
Riitta-Liisa Heikkinen
Stig Berg
Author Affiliation
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark. K.Avlund@socmed.ku.dk
Source
Aging Clin Exp Res. 2002 Jun;14(3 Suppl):56-64
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging - psychology
Female
Humans
Interpersonal Relations
Male
Research Support, Non-U.S. Gov't
Abstract
The aims of this article were to describe changes in social relations from ages 75 to 80, and analyze whether changes in social relations are influenced by functional ability at age 75. The study includes data from the NORA follow-up study of 75-80 year-old men and women in Jyväskylä (Finland), Göteborg (Sweden) and Glostrup (Denmark). The present analyses include the 743 persons who participated in both studies and who answered the questions about social relations. The structure of social relations was measured by: 1) frequency of contacts with children, grand/greatgrandchildren, relatives, close friends, acquaintances, and neighbors; 2) diversity of social relations (number of types of social contacts); 3) telephone contacts; and 4) social participation. The function of social relations was measured by instrumental social support. Functional ability was measured by tiredness and need for help in Physical Activities of Daily Living (PADL). Depressive symptoms, living alone and locality were included as covariates in the multivariate analyses. There were large changes in social relations in old age, but the changes included widely varying patterns of losses and gains among the participants. Women who felt tired in their daily activities had more sustained little contact with children [OR=4.2 (1.4-12.1)] and more sustained little diversity in social relations [OR=2.2 (0.95-5.3)]. Both men and women in need of help had more sustained little diversity in social relations compared to the well-functioning persons [men: OR=4.4 (1.3-15.0); women: OR=3.0 (0.93-9.6)].
PubMed ID
12475134 View in PubMed
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Childhood social circumstances and body mass index in adult life: the Metropolit 1953 Danish male birth cohort.

https://arctichealth.org/en/permalink/ahliterature136786
Source
Scand J Public Health. 2011 May;39(3):296-302
Publication Type
Article
Date
May-2011
Author
Anne-Mette Larsen
Rikke Lund
Margit Kriegbaum
Kirsten Avlund
Merete Osler
Author Affiliation
Department of Social Medicine, Institut of Public Health, 1014 Copenhagen K, Denmark.
Source
Scand J Public Health. 2011 May;39(3):296-302
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Body mass index
Child
Cognition - physiology
Cohort Studies
Denmark - epidemiology
Educational Status
Fathers
Follow-Up Studies
Health Behavior
Humans
Male
Obesity - epidemiology
Overweight - epidemiology
Prevalence
Questionnaires
Social Class
Socioeconomic Factors
Young Adult
Abstract
To examine whether father's social class was associated with body mass index (BMI) at age 20 and 50 years in a cohort of men born in 1953 and to explore the role of birth weight, cognitive function (IQ), and educational status in these relationships.
We used data from the Metropolit cohort which includes 11,532 Danish men born in 1953 with information on father's socioeconomic position (SEP) at participant's birth and assessments of height, weight, cognitive performance, and education at age 20. In 2004, 6292 of these men participated in a follow-up survey on health and behaviour. Linear and logistic regression were used to investigate the association of father's social class with BMI among the 5117 men with complete information on all variables.
Between age 20 and 50, mean BMI increased from 21.4 to 26.1 kg/m(2), while the prevalence of overweight (BMI =25 kg/m(2)) increased from 8.1 to 57.8%. Men of fathers who were skilled or unskilled workers had higher odds of being overweight (OR = 1.32, 95% CI 1.13-1.53) or often obese (OR = 1.28, 95% CI 1.03-1.60) at age 50 years compared to those with fathers being self-employed, employee, or civil servants when adjusted for the other socially correlated indicators of impaired childhood development. In the linear regression analyses, mean BMI at both age 20 and 50 were around 0.3 kg/m(2) higher in men with fathers from working class compared to those self-employed, employee, or civil servants.
This study supports that among men, father's SEP influences the development of obesity later in adult life.
PubMed ID
21343314 View in PubMed
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Cohabitation status and onset of disability among older Danes: is social participation a possible mediator?

https://arctichealth.org/en/permalink/ahliterature159745
Source
J Aging Health. 2008 Mar;20(2):235-53
Publication Type
Article
Date
Mar-2008
Author
Charlotte Juul Nilsson
Rikke Lund
Kirsten Avlund
Author Affiliation
Department of Social Medicine, Institute of Public Health Science, University of Copenhagen, Copenhagen K. c.nilsson@socmed.ku.dk
Source
J Aging Health. 2008 Mar;20(2):235-53
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Denmark
Disability Evaluation
Disabled Persons
Family Characteristics
Female
Humans
Male
Residence Characteristics
Social Environment
Social Support
Abstract
To investigate the effect of cohabitation status in older men and women on (a) onset of disability at 3- and 4.5-year follow-up and (b) changes in functional ability between 3- and 4.5-year follow-up, and to analyze whether this effect was mediated by social participation.
A total of 2,533 nondisabled older men and women enrolled in the Danish Intervention Study on Preventive Home Visits constituted the study population. Data were collected by mailed questionnaires in 1998-1999, 2000, 2001-2002, and 2003.
Living alone significantly increased the risk of onset of disability (T3 OR = 1.60[1.06-2.43], T4 OR = 1.74[1.22-2.47]) and the risk of sustained poor functional ability (OR = 2.35[1.44-3.84]) among men, but not among single-living women. Social participation mediated only a small part of the effect of cohabitation status on functional ability.
Our results underline the importance of cohabitation/marriage for maintaining a high functional ability among older men.
PubMed ID
18089766 View in PubMed
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Content validity and reliability of the Copenhagen social relations questionnaire.

https://arctichealth.org/en/permalink/ahliterature104847
Source
J Aging Health. 2014 Feb;26(1):128-50
Publication Type
Article
Date
Feb-2014
Author
Rikke Lund
Lene Snabe Nielsen
Pia Wichmann Henriksen
Lone Schmidt
Kirsten Avlund
Ulla Christensen
Author Affiliation
University of Copenhagen, Denmark.
Source
J Aging Health. 2014 Feb;26(1):128-50
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Denmark
Female
Focus Groups
Humans
Interpersonal Relations
Male
Middle Aged
Qualitative Research
Questionnaires
Reproducibility of Results
Social Support
Abstract
The aim of the present article is to describe the face and content validity as well as reliability of the Copenhagen Social Relations Questionnaire (CSRQ).
The face and content validity test was based on focus group discussions and individual interviews with 31 informants. Another 94 men and women participated in an 8-day test-retest analysis.
Informants generally expressed that the questions and response categories were relevant and easy to understand. Themes on structure of social relations, social support, and negative aspects of social relations emerged clearly from the interviews. Two additional themes not covered by CSRQ on dynamics and reciprocity of social relations were identified.
CSRQ holds satisfactory face and content validity as well as reliability, and is suitable for measuring structure and function of social relations including the negative aspects among middle-aged individuals.
PubMed ID
24584264 View in PubMed
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