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Alcohol consumption, 29-y total mortality, and quality of life in men in old age.

https://arctichealth.org/en/permalink/ahliterature177558
Source
Am J Clin Nutr. 2004 Nov;80(5):1366-71
Publication Type
Article
Date
Nov-2004
Author
Arto Y Strandberg
Timo E Strandberg
Veikko V Salomaa
Kaisu Pitkälä
Tatu A Miettinen
Author Affiliation
Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki, Finland. timo.strandberg@hus.fi
Source
Am J Clin Nutr. 2004 Nov;80(5):1366-71
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Adult
Aging
Alcohol Drinking - adverse effects
Cardiovascular Diseases - mortality
Cohort Studies
Finland
Health status
Health Surveys
Humans
Male
Middle Aged
Mortality
Quality of Life
Questionnaires
Social Class
Abstract
The negative effects of excessive alcohol consumption are well known, but moderate alcohol consumption is advocated for health reasons.
We compared 29-y total mortality and quality of life in old age by alcohol consumption in midlife.
Cardiovascular disease risk factors and alcohol consumption were assessed in 1974 in 1808 men (aged 40-55 y) of high socioeconomic status. At baseline, the men were without signs of chronic diseases. Baseline alcohol consumption was divided as zero (n = 116), moderate (1-349 g/wk; n = 1519), and high (>349 g/wk; n = 173). Quality of life was surveyed in 2000 with the RAND-36 (SF-36) health survey (n = 1216). Mortality was retrieved from registers during the 29-y follow-up.
Median alcohol consumption in 1974 and in 2000 was 123 (interquartile range: 56-238) and 84 (28-168) g/wk, respectively, and was significantly correlated. Values of cardiovascular disease risk factors measured in 1974 increased with increasing alcohol consumption. During the 29-y follow-up, 499 men (27.6%) died; mortality was significantly higher among men with the highest alcohol consumption (37.6%) than in abstainers (25.0%) or in men with moderate (26.7%) consumption. Quality of life was not significantly associated with baseline alcohol consumption in responding survivors but was worst in men with high consumption when deaths during follow-up were accounted for.
In this male cohort of high socioeconomic status, only the highest alcohol consumption (>3 drinks/d) affected mortality, and it was associated with worse quality of life in old age. Moderate alcohol consumption in middle age offered no special benefits compared with abstinence over the long term.
PubMed ID
15531688 View in PubMed
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All-Cause and Cause-Specific Mortality among Users of Basal Insulins NPH, Detemir, and Glargine.

https://arctichealth.org/en/permalink/ahliterature275159
Source
PLoS One. 2016;11(3):e0151910
Publication Type
Article
Date
2016
Author
Arto Y Strandberg
Fabian J Hoti
Timo E Strandberg
Solomon Christopher
Jari Haukka
Pasi Korhonen
Source
PLoS One. 2016;11(3):e0151910
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology - mortality
Cause of Death
Cohort Studies
Databases, Factual
Diabetes Mellitus, Type 2 - drug therapy
Female
Finland
Gastrointestinal Diseases - epidemiology - mortality
Humans
Hypoglycemic agents - therapeutic use
Insulin Glargine - therapeutic use
Insulin, Isophane - therapeutic use
Insulin, Long-Acting - therapeutic use
Male
Middle Aged
Neoplasms - epidemiology - mortality
Risk
Abstract
Insulin therapy in type 2 diabetes may increase mortality and cancer incidence, but the impact of different types of basal insulins on these endpoints is unclear. Compared to the traditional NPH insulin, the newer, longer-acting insulin analogues detemir and glargine have shown benefits in randomized controlled trials. Whether these advantages translate into lower mortality among users in real life is unknown.
To estimate the differences in all-cause and cause-specific mortality rates between new users of basal insulins in a population-based study in Finland.
23 751 individuals aged =40 with type 2 diabetes, who initiated basal insulin therapy in 2006-2009 were identified from national registers, with comprehensive data for mortality, causes of death, and background variables. Propensity score matching was performed on characteristics. Follow-up time was up to 4 years (median 1.7 years).
2078 deaths incurred. With NPH as reference, the adjusted HRs for all-cause mortality were 0.39 (95% CI, 0.30-0.50) for detemir, and 0.55 (95% CI, 0.44-0.69) for glargine. As compared to glargine, the HR was 0.71 (95% CI, 0.54-0.93) among detemir users. Compared to NPH, the mortality risk for both cardiovascular causes as well as cancer were also significantly lower for glargine, and especially for detemir in adjusted analysis. Furthermore, the results were robust in various sensitivity analyses.
In real clinical practice, mortality was substantially higher among users of NPH insulin as compared to insulins detemir or glargine. Considering the large number of patients who require insulin therapy, this difference in risk may have major clinical and public health implications. Due to limitations of the observational study design, further investigation using an interventional study design is warranted.
Notes
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PubMed ID
27031113 View in PubMed
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Apathy: prevalence, associated factors, and prognostic value among frail, older inpatients.

https://arctichealth.org/en/permalink/ahliterature124530
Source
J Am Med Dir Assoc. 2012 Jul;13(6):541-5
Publication Type
Article
Date
Jul-2012
Author
Eeva H Hölttä
Marja-Liisa Laakkonen
Jouko V Laurila
Timo E Strandberg
Reijo S Tilvis
Kaisu H Pitkälä
Author Affiliation
Helsinki University Central Hospital, Unit of General Practice and City of Helsinki, Health Center, Helsinki, Finland. eeva.holtta@hel.fi
Source
J Am Med Dir Assoc. 2012 Jul;13(6):541-5
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Apathy
Delirium - mortality - psychology
Dementia - mortality - psychology
Female
Finland - epidemiology
Frail Elderly - psychology
Humans
Inpatients - psychology
Male
Prevalence
Prognosis
Proportional Hazards Models
Risk factors
Sex Factors
Statistics, nonparametric
Abstract
The association of apathy with Alzheimer disease and other dementias and caregiver burden has been examined in a number of studies; however, less is known about its relationship with delirium and mortality. We aimed to investigate the prevalence, relationship with delirium and dementia, and prognostic value of apathy in an elderly and frail inpatient population.
The cohort included 425 patients in acute geriatric wards and in 7 nursing homes in Helsinki (1999-2000). Demographic factors, physical functioning, diagnoses, and drugs were assessed with special reference for dementia, delirium, and apathy. Mortality was registered from central registers.
Of the patients, 98 (23.1%) suffered from apathy, and it was more frequent among men (32% versus 21% women, P = .037 ). There was no difference in mean age, number of comorbidities, or in the mean number of medications between those with and without apathy; however, those with apathy had lower mean MMSE points (9.2 versus 14.0 without apathy, P
PubMed ID
22572553 View in PubMed
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Association between alcohol consumption in healthy midlife and telomere length in older men. The Helsinki Businessmen Study.

https://arctichealth.org/en/permalink/ahliterature121815
Source
Eur J Epidemiol. 2012 Oct;27(10):815-22
Publication Type
Article
Date
Oct-2012
Author
Timo E Strandberg
Arto Y Strandberg
Outi Saijonmaa
Reijo S Tilvis
Kaisu H Pitkälä
Frej Fyhrquist
Author Affiliation
Unit of General Practice, Institute of Health Sciences/Geriatrics, University of Oulu (Oulun Yliopisto) and University Hospital, Oulu, Finland. timo.strandberg@oulu.fi
Source
Eur J Epidemiol. 2012 Oct;27(10):815-22
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Alcohol Drinking - adverse effects - epidemiology
Finland - epidemiology
Health status
Humans
Male
Middle Aged
Prospective Studies
Telomere Shortening - drug effects
Abstract
There are scarce data of alcohol consumption and telomere length, an indicator of biological age. In 1974, detailed alcohol consumption was available for a socioeconomically homogenous cohort of middle-aged men (The Helsinki Businessmen Study). Their alcohol use, divided into 5 groups (zero, 1-98, 99-196, 197-490, >490 g/week) has been repeatedly assessed until old age. In 2002/2003, leukocyte telomere length (LTL) and the proportion of short telomeres (less than 5 kilobases) were measured in a random subcohort of 499 men (mean age 76 years) using the Southern blot. Age-adjusted mean LTL in the 5 midlife alcohol consumption groups were 8.33, 8.24, 8.12, 8.13, and 7.87 kilobases, respectively (P 
PubMed ID
22875407 View in PubMed
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Association of anticholinergic drugs with hospitalization and mortality among older cardiovascular patients: A prospective study.

https://arctichealth.org/en/permalink/ahliterature137518
Source
Drugs Aging. 2011 Feb 1;28(2):131-8
Publication Type
Article
Date
Feb-1-2011
Author
Juho Uusvaara
Kaisu H Pitkala
Hannu Kautiainen
Reijo S Tilvis
Timo E Strandberg
Author Affiliation
Helsinki University Hospital, Finland. juho.uusvaara@kauniala.fi
Source
Drugs Aging. 2011 Feb 1;28(2):131-8
Date
Feb-1-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cardiovascular Diseases - drug therapy - mortality - therapy
Cholinergic Antagonists - adverse effects - therapeutic use
Cognition Disorders - chemically induced
Cohort Studies
Female
Finland - epidemiology
Hospitalization - statistics & numerical data
Humans
Inappropriate Prescribing
Male
Multivariate Analysis
Prognosis
Prospective Studies
Risk Assessment - methods
Abstract
Many potentially inappropriate drugs prescribed to older people have anticholinergic properties as adverse effects and are therefore potentially harmful. These effects typically include constipation, dry mouth, blurred vision, dizziness and slowing of urination. It has been shown that drugs with anticholinergic properties (DAPs) are associated with cognitive decline and dementia, may contribute to events such as falls, delirium and impulsive behaviour, are associated with self-reported adverse effects and physical impairment, and may even be associated with mortality. However, studies of the prognostic implications of DAPs remain scarce.
To evaluate the impact of DAPs on hospitalization and mortality in older patients with stable cardiovascular disease (CVD).
This was a prospective study with a mean follow-up of 3.3 years involving two study groups: users (n?=?295) and non-users (n?=?105) of DAPs. The participants were 400 community-dwelling older people (aged 75-90 years) with stable CVD participating in a secondary prevention study of CVD (DEBATE) in Helsinki, Finland. The use of DAPs was estimated using definitions from the previous scientific literature. The Charlson Comorbidity Index (CCI) was used to estimate the burden of co-morbidity and the Mini-Mental State Examination test was used to assess cognitive function. The risks in the two study groups for hospital visits, number of days spent in hospital care and mortality were measured from 2000 to the end of 2003.
The unadjusted follow-up mortality was 20.7% and 9.5% among the users and non-users of DAPs, respectively (p?=?0.010). However, the use of DAPs was not a significant predictor of mortality in multivariate analysis after adjustment for age, sex and CCI score (hazard ratio 1.57; 95% CI 0.78, 3.15). The mean?±?SD number of hospital days per person-year was higher in the DAP user group (14.9?±?32.5) than in the non-user group (5.2?±?12.3) [p?
PubMed ID
21275438 View in PubMed
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Association of Self-Rated Health in Midlife With Mortality and Old Age Frailty: A 26-Year Follow-Up of Initially Healthy Men.

https://arctichealth.org/en/permalink/ahliterature284814
Source
J Gerontol A Biol Sci Med Sci. 2016 Jul;71(7):923-8
Publication Type
Article
Date
Jul-2016
Author
Emmi Huohvanainen
Arto Y Strandberg
Sari Stenholm
Kaisu H Pitkälä
Reijo S Tilvis
Timo E Strandberg
Source
J Gerontol A Biol Sci Med Sci. 2016 Jul;71(7):923-8
Date
Jul-2016
Language
English
Publication Type
Article
Keywords
Aged
Diagnostic Self Evaluation
Finland - epidemiology
Follow-Up Studies
Frail Elderly - psychology - statistics & numerical data
Health status
Humans
Male
Men's health
Middle Aged
Primary Prevention - statistics & numerical data
Quality of Life
Risk factors
Socioeconomic Factors
Surveys and Questionnaires
Abstract
The aim was to investigate the relationship between self-rated health (SRH) in healthy midlife, mortality, and frailty in old age.
In 1974, male volunteers for a primary prevention trial in the Helsinki Businessmen Study (mean age 47 years, n = 1,753) reported SRH using a five-step scale (1 = "very good," n = 124; 2 = "fairly good," n = 862; 3 = "average," n = 706; 4 = "fairly poor," or 5 = "very poor"; in the analyses, 4 and 5 were combined as "poor", n = 61). In 2000 (mean age 73 years), the survivors were assessed using a questionnaire including the RAND-36/SF-36 health-related quality of life instrument. Simplified self-reported criteria were used to define phenotypic prefrailty and frailty. Mortality was retrieved from national registers.
During the 26-year follow-up, 410 men had died. Frailty status was assessed in 81.0% (n = 1,088) of survivors: 434 (39.9%), 552 (50.7%), and 102 (9.4%) were classified as not frail, prefrail, and frail, respectively. With fairly good SRH as reference, and adjusted for cardiovascular risk in midlife and comorbidity in old age, midlife SRH was related to mortality in a J-shaped fashion: significant increase with both very good and poor SRH. In similar analyses, average SRH in midlife (n = 425) was related to prefrailty (odds ratio: 1.52, 95% confidence interval: 1.14-2.04) and poor SRH (n = 31) both to prefrailty (odds ratio: 3.56, 95% confidence interval: 1.16-10.9) and frailty (odds ratio: 8.38, 95% confidence interval: 2.32-30.3) in old age.
SRH in clinically healthy midlife among volunteers of a primary prevention trial was related to the development of both prefrailty and frailty in old age, independent of baseline cardiovascular risk and later comorbidity.
PubMed ID
26774116 View in PubMed
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Association of telomere length in older men with mortality and midlife body mass index and smoking.

https://arctichealth.org/en/permalink/ahliterature133497
Source
J Gerontol A Biol Sci Med Sci. 2011 Jul;66(7):815-20
Publication Type
Article
Date
Jul-2011
Author
Timo E Strandberg
Outi Saijonmaa
Reijo S Tilvis
Kaisu H Pitkälä
Arto Y Strandberg
Tatu A Miettinen
Frej Fyhrquist
Author Affiliation
Unit of General Practice, Institute of Health Sciences/Geriatrics, University of Oulu and University Hospital, Finland. timo.strandberg@oulu.fi
Source
J Gerontol A Biol Sci Med Sci. 2011 Jul;66(7):815-20
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aging - genetics
Blotting, Southern
Body mass index
Cardiovascular Diseases - etiology - genetics - mortality
DNA - analysis - genetics
Finland - epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Overweight - etiology - genetics - mortality
Questionnaires
Retrospective Studies
Risk factors
Smoking - adverse effects - genetics - mortality
Survival Rate - trends
Telomere - chemistry - genetics
Time Factors
Abstract
Leukocyte telomere length has been taken as a measure of biological age but several inconsistencies exist.
We investigated associations between leukocyte telomere length in old age, midlife risk factors, and mortality. The Helsinki Businessmen Study (a cohort of mainly business executives, born 1919-1934) had baseline assessments of cardiovascular risk factors including body mass index between 1964 and 1973 at a mean age of 40. Leukocyte telomere length and proportion of short telomeres were measured from DNA samples collected in 2002-2003 (n = 622, mean age 78 years). Body mass index and smoking in old age were assessed from questionnaires. Total mortality was verified from registers through January 2010. Main outcome measures were relationships between telomeres, body mass index, smoking, and mortality.
Leukocyte telomere length and notably proportion of short telomeres (
PubMed ID
21697500 View in PubMed
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Source
Biogerontology. 2010 Dec 14;
Publication Type
Article
Date
Dec-14-2010
Author
Timo E Strandberg
Sarianna Sipilä
Author Affiliation
Institute of Health Sciences/Geriatrics, Oulu University Hospital, University of Oulu, Unit of General Practice, PO Box 5000, 90014, Oulu, Finland, timo.strandberg@oulu.fi.
Source
Biogerontology. 2010 Dec 14;
Date
Dec-14-2010
Language
English
Publication Type
Article
Abstract
This paper describes current biogerontology research in Finland especially in the universities with professorships in gerontology/geriatrics. If biogerontology is broadly taken to include all research in basic mechanisms of normal ageing as well as age-related diseases, the most prevalent current topics include basic research in genetics, mitochondrial function, musculoskeletal physiology, neurodegenerative and vascular diseases. The research activity of each institute and their international collaboration is briefly described with examples focused on recent publications in the field of biogerontology.
PubMed ID
21161378 View in PubMed
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Clinical and laboratory characteristics of active and healthy aging (AHA) in octogenarian men.

https://arctichealth.org/en/permalink/ahliterature272779
Source
Aging Clin Exp Res. 2015 Oct;27(5):581-7
Publication Type
Article
Date
Oct-2015
Author
Kirsi K Rantanen
Timo E Strandberg
Sari S Stenholm
Arto Y Strandberg
Kaisu H Pitkälä
Veikko V Salomaa
Reijo S Tilvis
Source
Aging Clin Exp Res. 2015 Oct;27(5):581-7
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - physiology - psychology
Blood Pressure - physiology
Cholesterol, LDL - blood
Cognition
Cross-Sectional Studies
Finland - epidemiology
Follow-Up Studies
Geriatric Assessment
Hand Strength
Health Status Disparities
Humans
Longitudinal Studies
Male
Socioeconomic Factors
Surveys and Questionnaires
Abstract
To investigate clinical and laboratory variables associated with good subjective and objective health ("active and healthy aging", AHA) in a cohort of octogenarian men.
Cross-sectional analyses of a longitudinal study.
The Helsinki Businessmen Study in Finland.
A socioeconomically homogenous cohort of men (baseline n = 3293), born in 1919-1934, has been followed up from the 1960s. From 2000, the men have been regularly sent mailed questionnaires and mortality has been retrieved from national registers.
In 2010 survey, AHA was defined as independently responding to the mailed survey, feeling happy without cognitive or functional impairments and without major diseases. In 2010/11, a random subgroup men was clinically investigated and survivors with healthy and nonhealthy aging were compared.
By 2010, 1788 men of the baseline cohort had died, and 894 men responded to the mailed survey. 154 (17.2 %) of those fulfilled the present AHA criteria. Increasing number of criteria were negatively (P 
PubMed ID
25725634 View in PubMed
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Clinical findings, outcome and treatment in patients > or = 75 years with acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature183657
Source
Eur J Epidemiol. 2003;18(8):781-6
Publication Type
Article
Date
2003
Author
Mervi Kotamäki
Timo E Strandberg
Markku S Nieminen
Author Affiliation
Department of Medicine, Division of Cardiology, University of Helsinki, Finland. mervi.kotamaki@hus.fi
Source
Eur J Epidemiol. 2003;18(8):781-6
Date
2003
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Female
Finland - epidemiology
Hospital Mortality
Hospitals, Teaching
Humans
Logistic Models
Male
Myocardial Infarction - complications - drug therapy - mortality
Pneumonia - complications
Registries
Risk factors
Sex Factors
Thrombolytic Therapy - utilization
Treatment Outcome
Abstract
Treatment of acute myocardial infarction (AMI) has changed dramatically during the 1990s, and the patients are older. Our aim was to characterize current clinical course, medication and invasive treatment in elderly patients with AMI, compare treatment between sexes and also with data from 1994.
The study population included all patients aged > or = 75 years (n = 197, 68% female), who were admitted from January 1997 to December 1998 to our hospital because of AMI.
Sixty-six percent of both sexes had non-Q AMI. Peak creatine kinase (CK)-MB fraction values were significantly higher in men (p = 0.035). Thrombolysis was performed on 16% and coronary angiography, coronary angioplasty/cardiac surgery on 8% of patients each. In-hospital mortality was high (25%). Cholesterol-lowering agents were used for only 8% of patients. During hospitalization, 15% of patients had an infection requiring intravenous antibiotics. Multivariate analysis revealed that infection increased in-hospital mortality 2.90-fold (95% CI: 1.23-6.82) and congestive heart failure (CHF) 2.25-fold (95% CI: 1.02-4.97). Post-discharge mortality was 10% during the median follow-up of 12 months; 75% of deaths were due to re-infarction. Compared with the year 1994, the use of beta-blockers (84 vs. 70%, p = 0.010) and angiotensin-converting enzyme inhibitors (43 vs. 31%, p = 0.062) had increased, and digitalis (27 vs. 43%, p = 0.0065) and calcium antagonists (13 vs. 26%, p = 0.0086) had decreased.
Treatment and hospital course of AMI in these elderly patients did not differ between sexes. Although drug treatments have become more evidence-based during the end of 1990s, in-hospital mortality was still high and more effective prevention, effective treatment of infections and CHF may be important for improving prognosis.
PubMed ID
12974554 View in PubMed
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61 records – page 1 of 7.