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Anticholinergic drug use and its association with self-reported symptoms among older persons with and without diabetes.

https://arctichealth.org/en/permalink/ahliterature298928
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Publication Type
Journal Article
Date
Apr-2019
Author
Niina-Mari Inkeri
Merja Karjalainen
Maija Haanpää
Hannu Kautiainen
Juha Saltevo
Pekka Mäntyselkä
Miia Tiihonen
Author Affiliation
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus - epidemiology
Female
Finland
Humans
Independent living
Male
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care
Self Report
Surveys and Questionnaires
Abstract
Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes.
The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older. Persons with diabetes were identified according to the ICD-10 diagnostic codes from electronic patient records. Two controls adjusted by age and gender were selected for each person with diabetes. This cross-sectional study was based on electronic primary care patient records and a structured health questionnaire. The health questionnaire was returned by 430 (81.6%) persons with diabetes and 654 (73.5%) persons without diabetes. Data on prescribed drugs were obtained from the electronic patient records. Anticholinergic drug use was measured according to the Anticholinergic Risk Scale. The presence and strength of anticholinergic symptoms were asked in the health questionnaire.
The prevalence of anticholinergic drug use was 8.9% in the total study cohort. There were no significant differences in anticholinergic drug use between persons with and without diabetes. There was no consistent association between anticholinergic drug use and self-reported symptoms.
There is no difference in anticholinergic drug use in older community-dwelling persons with and without diabetes. Anticholinergic drug use should be considered individually and monitored carefully.
PubMed ID
30315583 View in PubMed
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Attitudes to ageing among older Norwegian adults living in the community.

https://arctichealth.org/en/permalink/ahliterature283443
Source
Br J Community Nurs. 2017 May 02;22(5):238-245
Publication Type
Article
Date
May-02-2017
Author
Mary H Kalfoss
Source
Br J Community Nurs. 2017 May 02;22(5):238-245
Date
May-02-2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adaptation, Psychological
Aged
Aged, 80 and over
Aging - psychology
Attitude of Health Personnel
Attitude to Health
Depression - psychology
Female
Humans
Independent living
Loneliness
Male
Middle Aged
Norway
Nurses
Surveys and Questionnaires
Abstract
Attitudes toward ageing have powerful influences and impact older adults' own perception of health, quality of life and utilisation of health and social care services. This study describes attitudes to ageing among 490 Norwegian older adults living in the community who responded to The Attitudes to Ageing Questionnaire. Results showed that in spite of physical changes and psychological losses, the attitudes of older adults support life acceptance with gained wisdom in feeling that there were many pleasant things about growing older and that their identity was not defined by their age. They demonstrated the ability to incorporate age-related changes within their identities and at the same time maintain a positive view of self. Although they acknowledged that old age represented a time of loss with decreasing physical independence, they meant that their lives had made a difference, they wanted to give a good example to younger persons and felt it was a privilege to grow old.
PubMed ID
28467243 View in PubMed
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Chronic pain among community-dwelling elderly: a population-based clinical study.

https://arctichealth.org/en/permalink/ahliterature282167
Source
Scand J Prim Health Care. 2016 Jun;34(2):159-64
Publication Type
Article
Date
Jun-2016
Author
Susanna Rapo-Pylkkö
Maija Haanpää
Helena Liira
Source
Scand J Prim Health Care. 2016 Jun;34(2):159-64
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Aged
Aged, 80 and over
Analgesics, Non-Narcotic - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Chronic Disease - epidemiology
Chronic Pain - drug therapy - epidemiology - etiology - psychology
Cross-Sectional Studies
Fatigue - psychology
Female
Finland - epidemiology
House Calls
Humans
Independent living
Loneliness - psychology
Male
Neuralgia - complications
Quality of Life
Sex Distribution
Surveys and Questionnaires
Abstract
To present the occurrence, characteristics, etiology, interference, and medication of chronic pain among the elderly living independently at home.
A total of 460 subjects in three cohorts aged 75, 80 and 85 years respectively received visits by communal home-care department nurses for a cross-sectional survey. Of them, 175 had chronic (duration = 3 months) pain with an average intensity of = 4/10 and/or = moderate interference in daily life.
Clinical assessment was performed for consenting subjects to define the location, intensity, etiology, type, interference and medications of chronic pain.
According to home visits, elderly people with chronic pain rated their health and mobility worse and felt sadder, lonelier and more tired than those without chronic pain. A geriatrician made clinical assessments for 106 patients with chronic pain in 2009-2013. Of them, 66 had three, 35 had two and 5 had one pain condition. The worst pain was musculoskeletal in 88 (83%) of patients. Pain was pure nociceptive in 61 (58%), pure neuropathic in 9 (8%), combined nociceptive and neuropathic pain in 34 (32%), and idiopathic in 2 (2%) patients. On a numerical rating scale from 0 to 10, the mean and maximal intensity of the worst pain was 5.7 and 7.7, respectively, while the mean pain interference was 5.9. Mean pain intensity and maximal pain intensity decreased by age. Duration of pain was longer than 5 years in 51 (48%) patients. Regular pain medication was used by 82 (77%) patients, most commonly paracetamol or NSAIDs. Although pain limited the lives of the elderly with chronic pain, they were as satisfied with their lives as those without chronic pain.
Elderly people in our study often suffered from chronic pain, mostly musculoskeletal pain, and the origin of pain was neuropathic in up to 40% of these cases. However, elderly people with chronic pain rarely used the medications specifically for neuropathic pain. Based on increased loneliness, sadness and tiredness, as well as decreased subjective health and mobility, the quality of life was decreased among those with chronic pain compared with those without pain. KEY POINTS It is known that chronic pain is one of the most common reasons for general practice consultations and is more common in women than men. In our study using detailed clinical examinations, up to 40% of patients with chronic pain in cohorts aged 75, 80 and 85 years suffered from neuropathic pain. However, only a few elderly people with chronic pain used medications specifically for chronic pain, which may be due to side effects or non-willingness to experiment with these drugs. Elderly people with chronic pain rated their health and mobility to be worse and felt sadder, lonelier and more tired but were not less satisfied with their lives than those without chronic pain.
Notes
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PubMed ID
27065337 View in PubMed
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Concurrent validity of the Swedish version of the life-space assessment questionnaire.

https://arctichealth.org/en/permalink/ahliterature282982
Source
BMC Geriatr. 2016 11 08;16(1):181
Publication Type
Article
Date
11-08-2016
Author
Sofi Fristedt
Ann-Sofi Kammerlind
Marie Ernsth Bravell
Eleonor I Fransson
Source
BMC Geriatr. 2016 11 08;16(1):181
Date
11-08-2016
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Architectural Accessibility - methods - standards
Female
Humans
Independent Living - standards
Male
Mobility Limitation
Reproducibility of Results
Social Support
Surveys and Questionnaires
Sweden - epidemiology
Translating
Abstract
The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one's hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility.
The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated.
Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r?=?0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual's own physical function.
LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.
Notes
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Cites: Phys Ther. 2002 Feb;82(2):128-3711856064
PubMed ID
27821138 View in PubMed
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Do personal assistance activities promote participation for persons with disabilities in Sweden?

https://arctichealth.org/en/permalink/ahliterature294940
Source
Disabil Rehabil. 2017 12; 39(24):2512-2521
Publication Type
Journal Article
Date
12-2017
Author
Heléne von Granitz
Ieva Reine
Karin Sonnander
Ulrika Winblad
Author Affiliation
a Department of Public Health and Caring Sciences , Uppsala University , Uppsala , Sweden.
Source
Disabil Rehabil. 2017 12; 39(24):2512-2521
Date
12-2017
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Child
Disabled Persons - psychology - rehabilitation - statistics & numerical data
Female
Healthcare Disparities
Human Rights - standards
Humans
Independent Living - standards
Interpersonal Relations
Male
Middle Aged
Needs Assessment
Public Policy
Social Participation
Social Security - standards
Surveys and Questionnaires
Sweden - epidemiology
Abstract
To examine how the right to participation according to Article 19 of the United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD) is promoted by personal assistance use in Sweden across age, gender and eligible person categories.
Register data and data from a questionnaire were used (N?=?15,289). Principal component analysis was performed and the internal consistency was tested. Descriptive statistics (?2 test) were used across age, gender and eligible person categories and components.
An uneven distribution of personal assistance across the components Health and Care; Home, Leisure and Social Interaction; and Daily Occupation was found. Significant differences in personal assistance reported were found between children and adults, men and women and between the three eligible person categories.
The discrepancy between reported and expected outcome of personal assistance indicates that Article 19 of the UNCRPD has not been met. The unequal access to participation across age, gender and eligible person categories would seem to further signify that the Act concerning Support and Service for Persons with Certain Functional Impairments is promoting activities of a caring nature rather than fulfilling Article 19 of the UNCRPD, i.e. ensuring full participation in society. IMPLICATIONS FOR REHABILITATION Government assistance allowance were granted for predominantly health and care, i.e. basic needs presenting risk of undermining the intention of participation in society. Men reported more personal assistance use for activities promoting participation than women. The discrepancy found between reported and expected outcome of personal assistance underlines the importance of service providers and administrative officials being sensitive to policy intentions. There is a need of guidelines for service providers and administrative officials to promote disability rights of participation for persons eligible for personal assistance.
PubMed ID
27796138 View in PubMed
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Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture - protocol of a randomized controlled trial (HIPFRA study).

https://arctichealth.org/en/permalink/ahliterature301757
Source
BMC Geriatr. 2018 10 01; 18(1):232
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
10-01-2018
Author
Paula Soukkio
Sara Suikkanen
Sanna Kääriä
Hannu Kautiainen
Sarianna Sipilä
Katriina Kukkonen-Harjula
Markku Hupli
Author Affiliation
Rehabilitation, South Karelia Social and Health Care District, Valto Käkelän katu 3, FI-53130, Lappeenranta, Finland. paula.soukkio@eksote.fi.
Source
BMC Geriatr. 2018 10 01; 18(1):232
Date
10-01-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Female
Finland - epidemiology
Frail Elderly - psychology
Hip Fractures - epidemiology - psychology - rehabilitation
Home Care Services - trends
Humans
Independent Living - psychology - trends
Male
Nutrition Assessment
Physical Therapy Modalities - psychology - trends
Quality of Life - psychology
Surveys and Questionnaires
Time Factors
Treatment Outcome
Abstract
Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture.
This is a non-blinded, parallel group, randomized controlled trial performed in South Karelia Social and Health Care District, Finland (population 131,000). Three hundred community-dwelling older persons with signs of frailty (age?=?65) and 300 persons with a recent hip fracture (age?=?60) will be recruited. Frailty is screened by FRAIL questionnaire and verified by modified Fried's frailty criteria. Both patient groups will be randomized separately to a physiotherapy and a usual care arm. Individualized, structured and progressive physiotherapy will be carried out for 60 min, twice a week for 12 months at the participant's home. The primary outcome at 24 months is duration of living at home. Our hypothesis is that persons assigned to the physiotherapy arm will live at home for six months longer than those in the usual care arm. Secondary outcomes are functional capacity, frailty status, health-related quality-of-life, falls, use and costs of social and health care services, and mortality. Assessments, among others Short Physical Performance Battery, Functional Independence Measure, Mini Nutritional Assessment, and Mini-Mental State Examination will be performed at the participant's home at baseline, 3, 6, and 12 months. Register data on the use and costs of social and health care services, and mortality will be monitored for 24 months.
Our trial will provide new knowledge on the potential of intensive, long-term home-based physiotherapy among older persons at risk for disabilities, to enhance functional capacity and thereby to postpone the need for institutional care, and diminish the use of social and health care services.
ClinicalTrials.gov Identifier: NCT02305433 , Registered Nov 28, 2014.
PubMed ID
30285645 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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Frequent pain in older people with and without diabetes - Finnish community based study.

https://arctichealth.org/en/permalink/ahliterature294408
Source
BMC Geriatr. 2018 03 15; 18(1):73
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
03-15-2018
Author
M Karjalainen
J Saltevo
M Tiihonen
M Haanpää
H Kautiainen
P Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland.
Source
BMC Geriatr. 2018 03 15; 18(1):73
Date
03-15-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Comorbidity
Cross-Sectional Studies
Depression - diagnosis - epidemiology - psychology
Diabetes Mellitus - diagnosis - epidemiology - psychology
Female
Finland - epidemiology
Humans
Independent Living - psychology
Male
Pain - diagnosis - epidemiology - psychology
Pain Measurement - methods - psychology
Primary Health Care - methods
Surveys and Questionnaires
Abstract
The association between pain and diabetes in older people has been largely unexplored. The aim of this survey was to analyze the prevalence and characteristics of pain among Finnish men and women 65 or older with and without diabetes in primary care.
All home-dwelling persons 65 years or older with diabetes (N?=?527) and age and gender matched controls (N?=?890) were identified from electronic patient records. Frequent pain was regarded as any pain experienced more often than once a week, and it was divided into pain experienced several times a week but not daily and pain experienced daily or continuously. The Numeric Rating Scale (0-10) (NRS) was used to assess the intensity and interference of the pain.
The number of subjects who returned the questionnaire was 1084 (76.5%). The prevalence of frequent pain in the preceding week was 50% among women without diabetes and 63% among women with diabetes (adjusted, p?=?0.22). In men, the corresponding proportions were 42% without diabetes and 47% with diabetes (adjusted, p?=?0.58). In both genders, depressive symptoms and the number of comorbidities were associated with pain experienced more often than once a week and with daily pain. Diabetes was not associated with pain intensity or pain interference in either women or men.
Pain in older adults is associated with depressive symptoms and the number of comorbidities more than with diabetes itself.
Notes
Cites: Med Sci Sports Exerc. 2000 Feb;32(2):531-9 PMID 10694143
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PubMed ID
29544464 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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Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men.

https://arctichealth.org/en/permalink/ahliterature286089
Source
J Am Geriatr Soc. 2017 Sep;65(9):1953-1960
Publication Type
Article
Date
Sep-2017
Author
Kristin Franzon
Liisa Byberg
Per Sjögren
Björn Zethelius
Tommy Cederholm
Lena Kilander
Source
J Am Geriatr Soc. 2017 Sep;65(9):1953-1960
Date
Sep-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases - prevention & control
Diet, Mediterranean
Exercise
Follow-Up Studies
Health Behavior
Humans
Independent living
Longitudinal Studies
Male
Risk factors
Surveys and Questionnaires
Sweden
Abstract
To examine the longitudinal associations between aging with preserved functionality, i.e. independent aging and survival, and lifestyle variables, dietary pattern and cardiovascular risk factors.
Cohort study.
Uppsala Longitudinal Study of Adult Men, Sweden.
Swedish men (n = 1,104) at a mean age of 71 (range 69.4-74.1) were investigated, 369 of whom were evaluated for independent aging 16 years later, at a mean age of 87 (range 84.8-88.9).
A questionnaire was used to obtain information on lifestyle, including education, living conditions, and physical activity. Adherence to a Mediterranean-like diet was assessed according to a modified Mediterranean Diet Score derived from 7-day food records. Cardiovascular risk factors were measured. Independent aging at a mean age of 87 was defined as lack of diagnosed dementia, a Mini-Mental State Examination score of 25 or greater, not institutionalized, independence in personal activities of daily living, and ability to walk outdoors alone. Complete survival data at age 85 were obtained from the Swedish Cause of Death Register.
Fifty-seven percent of the men survived to age 85, and 75% of the participants at a mean age of 87 displayed independent aging. Independent aging was associated with never smoking (vs current) (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.05-4.60) and high (vs low) adherence to a Mediterranean-like diet (OR = 2.69, 95% CI = 1.14-6.80). Normal weight or overweight and waist circumference of 102 cm or less were also associated with independent aging. Similar associations were observed with survival.
Lifestyle factors such as never smoking, maintaining a healthy diet, and not being obese at age 71 were associated with survival and independent aging at age 85 and older in men.
PubMed ID
28685810 View in PubMed
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