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Aging in rural Canada: a retrospective and review.

https://arctichealth.org/en/permalink/ahliterature132883
Source
Can J Aging. 2011 Sep;30(3):323-38
Publication Type
Article
Date
Sep-2011
Author
Norah Keating
Jennifer Swindle
Stephanie Fletcher
Author Affiliation
Department of Human Ecology, University of Alberta. Norah.keating@ualberta.ca
Source
Can J Aging. 2011 Sep;30(3):323-38
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Aging
Canada
Family
Health Services for the Aged
Humans
Independent living
Leisure Activities
Research
Retrospective Studies
Rural Population
Social Participation
Social Support
Work
Abstract
Research on rural aging has developed considerably since publication of the book Aging in Rural Canada (Butterworths, 1991). The purpose of this article is twofold: to provide a retrospective on issues in rural aging from this book, and to review Canadian literature on rural aging since its publication. The review highlights new directions in conceptual definitions of rural, and in issues of social engagement, independence, family and social networks, and rural services and health. Two main research lenses are evident. The marginalization lens focuses on rural seniors with health problems, but has not included those marginalized by poverty or gender. The aging-well lens focuses on contributions and engagement, but has omitted research on social relationships and quality of family interaction. The report includes a call for interrogation about interaction between people and place, and for understanding issues of rural diversity and processes of rural aging.
PubMed ID
21767464 View in PubMed
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Clinical characteristics and mortality risk in relation to obstructive and central sleep apnoea in community-dwelling elderly individuals: a 7-year follow-up.

https://arctichealth.org/en/permalink/ahliterature125918
Source
Age Ageing. 2012 Jul;41(4):468-74
Publication Type
Article
Date
Jul-2012
Author
Peter Johansson
Urban Alehagen
Eva Svanborg
Ulf Dahlström
Anders Broström
Author Affiliation
Department of Cardiology, Linkoping University Hospital, Linkoping, Sweden. peter.johansson@aries.vokby.se
Source
Age Ageing. 2012 Jul;41(4):468-74
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases - mortality - physiopathology
Cause of Death
Comorbidity
Female
Follow-Up Studies
Humans
Independent living
Kaplan-Meier Estimate
Male
Proportional Hazards Models
Risk assessment
Risk factors
Sleep
Sleep Apnea, Central - mortality - physiopathology
Sleep Apnea, Obstructive - mortality - physiopathology
Stroke Volume
Sweden - epidemiology
Systole
Time Factors
Ventricular Function, Left
Abstract
little is known about demographic and clinical characteristics associated with sleep-disordered breathing (SDB) and obstructive sleep apnoea (OSA) or central sleep apnoea (CSA) in community-dwelling elderly. We also examined these (OSA and CSA) associations to all-cause and cardiovascular (CV) mortality.
a total of 331 community-dwelling elderly aged 71-87 years underwent a clinical examination and one-night polygraphic recordings in their homes. Mortality data were collected after seven years.
a total of 55% had SDB, 38% had OSA and 17% had CSA. Compared with those with no SDB and OSA, more participants with CSA had a left ventricular ejection fraction 75 years does not appear to be associated with cardiovascular disease (CVD) disease or mortality, whereas CSA might be a pathological marker of CVD and impaired systolic function associated with higher mortality.
PubMed ID
22440587 View in PubMed
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Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature273603
Source
Age Ageing. 2015 Sep;44(5):784-9
Publication Type
Article
Date
Sep-2015
Author
Saija Karinkanta
Pekka Kannus
Kirsti Uusi-Rasi
Ari Heinonen
Harri Sievänen
Source
Age Ageing. 2015 Sep;44(5):784-9
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Age Factors
Aged
Aging
Female
Finland - epidemiology
Follow-Up Studies
Fractures, Bone - diagnosis - epidemiology - physiopathology - prevention & control
Geriatric Assessment
Humans
Incidence
Independent living
Kaplan-Meier Estimate
Muscle strength
Odds Ratio
Postural Balance
Proportional Hazards Models
Prospective Studies
Registries
Resistance Training
Risk factors
Time Factors
Treatment Outcome
Women's health
Abstract
previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures.
five-year health-care register-based follow-up study after a 1-year, four-arm RCT.
community-dwelling older women in Finland.
one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning.
participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR).
eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97).
home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies.
PubMed ID
25990940 View in PubMed
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Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA).

https://arctichealth.org/en/permalink/ahliterature284013
Source
Arch Gerontol Geriatr. 2016 Sep-Oct;66:102-8
Publication Type
Article
Author
Jenny Hallgren
Eleonor I Fransson
Ingemar Kåreholt
Chandra A Reynolds
Nancy L Pedersen
Anna K Dahl Aslan
Source
Arch Gerontol Geriatr. 2016 Sep-Oct;66:102-8
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases - epidemiology
Female
Hospitalization - statistics & numerical data
Humans
Independent living
Male
Marital Status - statistics & numerical data
Middle Aged
Neoplasms - epidemiology
Proportional Hazards Models
Prospective Studies
Risk factors
Social Support
Socioeconomic Factors
Surveys and Questionnaires
Sweden
Abstract
The aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46-103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR=1.02, p
PubMed ID
27281475 View in PubMed
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Formal and Informal Care of Community-Living Older People: A Population-Based Study from the Swedish National Study on Aging and Care.

https://arctichealth.org/en/permalink/ahliterature285244
Source
J Nutr Health Aging. 2017;21(1):17-24
Publication Type
Article
Date
2017
Author
A. Wimo
S. Elmståhl
L. Fratiglioni
B-M Sjölund
A. Sköldunger
C. Fagerström
J. Berglund
M. Lagergren
Source
J Nutr Health Aging. 2017;21(1):17-24
Date
2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging
Cognition
Cognition Disorders - therapy
Cohort Studies
Cross-Sectional Studies
Female
Humans
Independent living
Male
Patient Care
Sweden
Abstract
Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC).
Cross-sectional, population based cohort.
Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County.
3,338 persons =72 years.
Patterns and amounts of informal and formal care by cognition and area of residence.
73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole.
More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.
PubMed ID
27999845 View in PubMed
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Glycemic control and health-related quality of life among older home-dwelling primary care patients with diabetes.

https://arctichealth.org/en/permalink/ahliterature293508
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Publication Type
Journal Article
Date
Dec-2017
Author
Anna-Kaisa Aro
Merja Karjalainen
Miia Tiihonen
Hannu Kautiainen
Juha Saltevo
Maija Haanpää
Pekka Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland; Rantakylä Health Center, Siunsote, Finland. Electronic address: koistine@student.uef.fi.
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging
Biomarkers - blood
Blood Glucose - metabolism
Cognition
Cross-Sectional Studies
Diabetes Mellitus - blood - diagnosis - psychology - therapy
Female
Finland
Geriatric Assessment
Glycated Hemoglobin A - metabolism
Humans
Independent living
Male
Mental health
Mental Status and Dementia Tests
Mobility Limitation
Predictive value of tests
Primary Health Care
Quality of Life
Risk factors
Self Care - methods
Time Factors
Treatment Outcome
Abstract
To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients.
Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15).
EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c.
Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
PubMed ID
28754430 View in PubMed
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The impact of social vulnerability on the survival of the fittest older adults.

https://arctichealth.org/en/permalink/ahliterature127519
Source
Age Ageing. 2012 Mar;41(2):161-5
Publication Type
Article
Date
Mar-2012
Author
Melissa K Andrew
Arnold Mitnitski
Susan A Kirkland
Kenneth Rockwood
Author Affiliation
Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. mandrew@dal.ca
Source
Age Ageing. 2012 Mar;41(2):161-5
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Canada - epidemiology
Female
Frail Elderly
Geriatric Assessment - statistics & numerical data
Health Surveys
Humans
Independent living
Kaplan-Meier Estimate
Male
Physical Fitness
Proportional Hazards Models
Risk assessment
Risk factors
Socioeconomic Factors
Survival Rate
Time Factors
Vulnerable Populations - statistics & numerical data
Abstract
even older adults who are fit experience adverse health outcomes; understanding their risks for adverse outcomes may offer insight into ambient population health. Here, we evaluated mortality risk in relation to social vulnerability among the fittest older adults in a representative community-dwelling sample of older Canadians.
in this secondary analysis of the Canadian Study of Health and Aging, participants (n = 5,703) were aged 70+ years at baseline. A frailty index was used to grade relative levels of fitness/frailty, using 31 self-reported health deficits. The analysis was limited to the fittest people (those reporting 0-1 health deficit). Social vulnerability was trichotomised from a social vulnerability scale, which consisted of 40 self-reported social deficits.
five hundred and eighty-four individuals had 0-1 health deficit. Among them, absolute mortality risk rose with increasing social vulnerability. In those with the lowest level of social vulnerability, 5-year mortality was 10.8%, compared with 32.5% for those with the highest social vulnerability (adjusted hazard ratio 2.5, 95% CI: 1.5-4.3, P = 0.001).
a 22% absolute mortality difference in the fittest older adults is of considerable clinical and public health importance. Routine assessment of social vulnerability by clinicians could have value in predicting the risk of adverse health outcomes in older adults.
PubMed ID
22287038 View in PubMed
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Inner strength and its relationship to health threats in ageing-A cross-sectional study among community-dwelling older women.

https://arctichealth.org/en/permalink/ahliterature292392
Source
J Adv Nurs. 2017 Nov; 73(11):2720-2729
Publication Type
Journal Article
Date
Nov-2017
Author
Erika Boman
Berit Lundman
Björn Nygren
Kristofer Årestedt
Regina Santamäki Fischer
Author Affiliation
Department of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
Source
J Adv Nurs. 2017 Nov; 73(11):2720-2729
Date
Nov-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Aging
Cross-Sectional Studies
Female
Finland
Humans
Independent living
Mental health
Middle Aged
Surveys and Questionnaires
Abstract
To explore the relationship between inner strength and health threats among community-dwelling older women.
Inner strength is described as a resource that promotes experiences of health, despite adversities. Inner strength and its dimensions (i.e. connectedness, creativity, firmness and flexibility) can be assessed using the Inner Strength Scale (ISS). Exploring attributes of weaker inner strength may yield valuable information about areas to focus on in enhancing a person's inner strength and may ultimately lead to the perception of better health.
Cross-sectional questionnaire survey.
The study is based on responses from 1270 community-dwelling older women aged 65 years and older; these were collected in the year 2010 and describe the situation that still exists today for older women. The questionnaire included the ISS, background characteristics and explanatory variables known to be health threats in ageing. Data were analysed using descriptive and inferential statistics.
Poorer mental health was related to weaker inner strength in total and in all the dimensions. Symptoms of depressive disorders and feeling lonely were related to three of the dimensions, except firmness and creativity respectively. Furthermore, poor physical health was associated with the dimensions firmness and flexibility. Other health threats were significantly related to only one of the dimensions, or not associated at all.
Mental ill health has overall the strongest association with weaker inner strength. Longitudinal studies are recommended to confirm the results. However, the ISS does not only estimate inner strength but can also be a tool for discovering where (i.e. dimension) interventions may be most profitable.
PubMed ID
28513995 View in PubMed
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Modifiable midlife risk factors, independent aging, and survival in older men: report on long-term follow-up of the Uppsala Longitudinal Study of Adult Men cohort.

https://arctichealth.org/en/permalink/ahliterature265380
Source
J Am Geriatr Soc. 2015 May;63(5):877-85
Publication Type
Article
Date
May-2015
Author
Kristin Franzon
Björn Zethelius
Tommy Cederholm
Lena Kilander
Source
J Am Geriatr Soc. 2015 May;63(5):877-85
Date
May-2015
Language
English
Publication Type
Article
Keywords
Aging
Follow-Up Studies
Humans
Independent living
Life Style
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Risk factors
Survival Rate
Sweden
Time Factors
Abstract
To examine relationships between modifiable midlife factors, aging, and physical and cognitive function (independent aging) and survival in very old age.
Prospective cohort.
Uppsala Longitudinal Study of Adult Men, Uppsala, Sweden.
Swedish men investigated in 1970-74 (aged 48.6-51.1) and followed up for four decades (N=2,293).
Conventional cardiovascular risk factors, body mass index (BMI), and dietary biomarkers were measured, and a questionnaire was used to gather information on lifestyle variables at age 50. Four hundred seventy-two men were reinvestigated in 2008-09 (aged 84.8-88.9). Independent aging was defined as survival to age 85, Mini-Mental State Examination score of 25 or greater, not living in an institution, independent in personal care and hygiene, able to walk outdoors without personal help, and no diagnosis of dementia. The National Swedish Death Registry provided survival data.
Thirty-eight percent of the cohort survived to age 85. Seventy-four percent of the participants in 2008-09 were aging independently. In univariable analyses, high leisure-time physical activity predicted survival but not independent aging. Low work-time physical activity was associated more strongly with independent aging (odds ratio (OR)=1.84, 95% confidence interval (CI)=1.18-2.88) than with survival (OR=1.27, 95% CI=1.05-1.52). In multivariable analyses, midlife BMI was negatively associated (OR=0.80/SD, 95% CI=0.65-0.99/SD), and never or former smoking was positively associated (OR=1.66, 95% CI=1.07-2.59), with independent aging. As expected, conventional cardiovascular and lifestyle risk factors were associated with mortality.
A normal midlife BMI and not smoking were associated with independent aging close to four decades later, indicating that normal weight at midlife has the potential not only to increase survival, but also to preserve independence with aging.
PubMed ID
25919442 View in PubMed
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Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

https://arctichealth.org/en/permalink/ahliterature290462
Source
Aging Ment Health. 2017 Aug; 21(8):805-809
Publication Type
Journal Article
Date
Aug-2017
Author
Merja Rantakokko
Erja Portegijs
Anne Viljanen
Susanne Iwarsson
Markku Kauppinen
Taina Rantanen
Author Affiliation
a Gerontology Research Center and Department of Health Sciences , University of Jyväskylä , Jyväskylä , Finland.
Source
Aging Ment Health. 2017 Aug; 21(8):805-809
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Aging
Community Participation - statistics & numerical data
Environment
Female
Finland
Humans
Independent Living - statistics & numerical data
Male
Mobility Limitation
Personal Autonomy
Abstract
The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period.
Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy).
Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p
PubMed ID
26979293 View in PubMed
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14 records – page 1 of 2.