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.
To study anisometropia of spherical equivalent and astigmatism from the onset of myopia at school age to adulthood.
A total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Examinations with subjective cyclopedic refraction were repeated 3 years later (follow-up 1) for 238 subjects and thereafter at the mean ages of 23.2 (follow-up 2) and 33.9 years (follow-up 3) for 178 and 134 subjects. After exclusions, the 102 subjects who attended all three follow-ups were included in the analyses. Corneal refractive power and astigmatism and anterior chamber depth was measured with Pentacam topography and axial length with IOL master at study end. Prevalence and changes in anisometropia of spherical equivalent (AnisoSE) and astigmatism (AnisoAST) and their relationships with refractive and axial measures were studied.
Mean (±SD) of spherical equivalent (SE), AnisoSE and AnisoAST increased from baseline to follow-up end from -1.44 ± 0.57 D to -5.11 ± 2.23 D, from 0.28 ± 0.30 D to 0.68 ± 0.69 D and from 0.14 ± 0.18 D to 0.37 ± 0.36 D, respectively. Prevalence of AnioSE, =1 D, increased from 5% to 22.6% throughout follow-up. Higher AnisoSE was associated with SE in the less myopic eye at baseline and at follow-up 1, and with SE in the more myopic eye in follow-ups 2 and 3 in adulthood. At study end, AnisoSE was associated with the interocular difference in axial length (AL) (r = 0.612, p
To study the prevalence of and changes in astigmatism from the onset of myopia at school age.
Two hundred and forty myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Three annual examinations with subjective cycloplegic refraction were performed for 237-238 subjects. Subsequent examinations were performed at the mean ages of 23.2 and 33.9 years for 178 and 163 subjects, and the last examination, including data from prescriptions of different ophthalmologists, for 32 subjects. Corneal topography was studied at baseline, at the 3-year follow-up and at the two adulthood follow-ups. Prevalence and changes in refractive astigmatism (RA), in its polar values J0 and J45, and corneal astigmatism (CA) were studied.
Mean RA of the right eye increased during follow-up from 0.26 D (SD) ± 0.30 to 0.79 D ± 0.74. Mean CA was 1.07 D ± 0.74 at study end. The prevalence of RA =0.25 or =1.00 D increased from 54.9 and 3.8% to 83.4 and 34.4%, respectively. The main direction of the axis of RA and its polar value J0 and CA changed mainly through sphericity, from against the rule (ATR) to with the rule during the follow-up. There was a negative correlation between RA and spherical refraction in the ATR group at end of follow-up. Changes in RA were associated with increase in myopia and with changes in CA.
The prevalence and mean amount of RA associated with CA increased, and the axis of astigmatism changed among myopics during the 23-year follow-up.
A mixed picture emerges from the international literature about secular and cohort changes in the health and functioning of older adults. We conducted a repeated population based cross-sectional study to determine trends in health, functioning and physical activity in the young old Finnish population.
Representative samples of community-dwelling people aged 65-69 years in 1988 (n=362), 1996 (n=320) and 2004 (n=292) were compared in socio-economic status, self-rated health, chronic diseases, memory problems, ability to carry out instrumental activities of daily living, physical activity, and five-year mortality.
Significant improvement in all the investigated modalities, except that of chronic diseases, was observed in the newer cohorts. In logistic regression analysis, after controlling for socioeconomic status and gender, cohort effects remained significant for memory problems, IADL difficulties and physical activity. Cox regression analyses showed significant improvement in survival when later cohorts were compared with the earlier ones.
This study provides evidence of improving levels of socio-economic status, self-rated health, functioning, physical activity, and lower risk of mortality in the newer cohorts of the Finnish young-old, but this was not accompanied by a parallel diminution in chronic diseases.
This paper describes the research design of the NORA (Nordic Research on Ageing) study carried out in three Nordic localities. Response and participation rates in the baseline (age 75) and follow-up (age 80) studies are shown for each locality; in addition, the number of dead and censored cases are presented. In Göteborg, 450 persons were randomly sampled for invitation to the baseline study among all persons aged 75 years; in Glostrup, 571 persons aged 75 were selected, and in Jyväskylä all 388 persons aged 75 were selected. Baseline measurements were conducted in Jyväskylä and Glostrup in 1989, and in Göteborg in 1990. The participants were first interviewed at home, and afterwards went through tests and examinations in a standardized laboratory environment. The follow-up study was carried out five years after the baseline study. In Jyväskylä 92.9% (N=355), in Göteborg 82.5% (N=368), and in Glostrup 84.5% (N=480) of the eligible subjects took part in the baseline interview; corresponding figures for taking a test at the laboratory/clinic of the study center were 77.2% (N=295), 72.4% (N=323) and 72.4% (N=411). For the follow-up interview, those subjects who took part in the baseline interview were considered eligible. The participation rate was 93.6% (N=250) in Jyväskylä, 76.6% (N=226) in Göteborg, and 79.1% (N=277) in Glostrup. Corresponding figures for the tests at the study center were 71.5% (N=191), 71.9% (N=212) and 59.7% (N=209). The mortality rate was lowest in Göteborg (19.0%), and highest in Glostrup (27.2%). The data of the NORA study enables various types of descriptions and comparisons to be made across localities and measurement occasions.
To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain.
Three-year geriatric development project with randomized assignment to intervention and control group.
Research centre, community and assisted living facilities.
Seven hundred and eighty-one Finnish persons aged 75-98 years were assigned to an intervention (n = 404) or control (n = 377) group.
A comprehensive geriatric assessment with a multifactorial intervention lasting two years. The intervention included individualized referrals, recommendations, physical activity counselling and supervised resistance training.
Perceived limitation in walking 400m was gathered annually during the intervention and at the one-year post-intervention follow-up.
The proportion of persons with mobility limitation at the beginning, at the two-year intervention and at the one-year post-intervention follow-up was 16%, 15%, 12% and 14%, respectively, in the intervention group. In the control group, the corresponding proportions were 19%, 18%, 23% and 26%. The treatment effect was significant at the end of the two-year intervention (odds ratio 0.82, 95% confidence interval 0.70-0.96, P = 0.013), and at the one-year post-intervention follow-up (0.84, 0.75-0.94, P = 0.002). The parallel positive effect of the intervention on mobility was even greater among persons with musculoskeletal pain.
The comprehensive geriatric assessment and individually tailored multifactorial intervention had a positive effect on mobility, underlining their importance in health promotion and disability prevention in older people.
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.
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.
Cites: Am J Otolaryngol. 1999 Nov-Dec;20(6):371-810609481
Cites: J Gerontol A Biol Sci Med Sci. 2008 Feb;63(2):171-818314453
To examine the heritability of corneal refraction power (CR) and corneal astigmatism (AST) in older women.
Corneal refraction and AST were measured by IOL master in 52 monozygotic (MZ) and 47 dizygotic (DZ) female twin pairs aged 66-79 years. The relative contribution of genetic and environmental factors to individual differences in CR was estimated by applying an independent pathway model to the twin data and AST by intraclass correlations (ICC).
For the right eye, mean CR was 44.58 dioptres (D) (standard deviation (SD) ±1.28) When comparing CR of the right and left eye between MZ and DZ, no significant difference was found. Mean AST was 0.77 D (SD ±0.44) with no differences observed either between the MZ and the DZ individuals, or between the left and the right eyes. ICCs between the sisters for CR were, for the right eye, 0.882 and 0.378 for MZ and DZ, respectively, and for the left eye 0.855 and 0.358. For AST of the right eye, the ICCs were 0.533 and 0.096 for the MZ and DZ pairs, respectively, and for the left eye, the MZ and DZ correlations were 0.396 and 0.299. Quantitative genetic modelling showed that 81% of the variance in CR could be explained by genetic factors, additive genetic factors explaining 62% (95% confidence interval [CI] 44% -86%) and dominant genetic effect 19% (95% CI 7-49%) of the variance in CR. Different models were constructed to explain the heredity of AST. None of these models gave meaningful results, although the ICC values for MZ were higher than those for DZ.
Most of the variance in CR among older Finnish women could be explained by genetic factors.