Tobacco Use Documenting Policy and Its Association With Pupils’ Smoking and Their Perception of the Enforcement of School Smoking Bans in Finland

Finnish national data sets on schools (N = 496) and pupils (N = 74,143; 14–16 years) were used to study whether a systematic documenting policy for the violations of school smoking bans was associated with pupils’ smoking and their perceptions on the enforcement of smoking bans. Attending a school with a systematic documenting policy was associated with perceptions that smoking is prohibited and restrictions monitored, with lower levels of smoking in the vicinity of the school during the school day, but not with smoking prevalence. Findings suggest that a consistent documenting policy could be an effective tool for reducing pupils’ smoking in schools.

Visual acuity in relation to functional performance, falls and mortality in old age

Association between mid- to late life physical fitness and dementia: Evidence from the CAIDE study

Objectives. This study investigated the association between perceived physical fitness at midlife, changes in perceived fitness during the three decades from mid-to late life and dementia risk. Design. Prospective cohort study. Setting. Cardiovascular risk factors, ageing and incidence of dementia (CAIDE) study. Subjects. Subjects were selected from four independent, random samples of population-based cardiovascular surveys and were first examined in 1972, 1977, 1982 or 1987, when they were on average 50 years old. The CAIDE target population included 3559 individuals. A random sample of 2000 individuals still alive in 1997 was drawn for re-examinations (performed in 1998 and 2005-2008) tha…

Promoting safe walking among older people : the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial

Abstract Background Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70–85-year-old community-dwelling sedentary or…

Associations Between Physical and Executive Functions Among Community-Dwelling Older Men and Women

Walking is a complex task requiring the interplay of neuromuscular, sensory, and cognitive functions. Owing to the age-related decline in cognitive and physical functions, walking may be compromised in older adults, for cognitive functions, especially poor performance in executive functions, is associated with slow walking speed. Hence, the aim of this study was to investigate the associations between different subdomains of executive functions and physical functions and whether the associations found differ between men and women. Multiple linear regression analysis was performed on data collected from 314 community-dwelling older adults who did not meet physical activity guidelines but had…

Health and Cognition in Old Age

Occupational Gerontology: Work-Related Determinants of Old Age Health and Functioning

Work is one of the essential functions during the human life span. We spend almost half of our lives occupationally active. Therefore, several different work-related determinants are affecting our lives. In recent years, there has been an increasing knowledge about work-related factors and their effect on health and functioning. Both cross-sectional and longitudinal studies have provided strong evidence that both positive and negative exposures in work influence our well-being. This chapter gives an overview of recent literature about the associations between work, working conditions, and health. Within this chapter, we summarize the current knowledge on the association between work-related…

Leisure-time physical activity from mid- to late life, body mass index, and risk of dementia

Abstract Background Physical activity may be beneficial for cognition, but the effect may vary depending on personal characteristics. Methods We investigated the associations between leisure-time physical activity (LTPA) from mid- to late life, the risk of dementia, and the role of body mass index, sex, and APOE in the CAIDE study during 28-year follow-up. Cognitive function of a random subsample was assessed at a mean age of 78.8 years (n = 1511), and dementia/Alzheimer's disease (AD) diagnoses were identified from national registers for the entire target population (n = 3559). Results Moderate (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.08–1.99) and low levels of midlife LTP…

Job strain in the public sector and hospital in-patient care use in old age : a 28-year prospective follow-up

Background: high job strain increases the risk of health decline, but little is known about the specific consequences and long-term effects of job strain on old age health. Objectives: purpose was to investigate whether physical and mental job strain in midlife was associated with hospital care use in old age. Methods: study population included 5,625 Finnish public sector employees aged 44–58 years who worked in blue- and white-collar professions in 1981. The number of in-patient hospital care days was collected from the Finnish Hospital Discharge Register for the 28-year follow-up period. Results: rates of hospital care days per 1,000 person-years for men were 7.78 (95% confidence interval…

Participant characteristics associated with the effects of a physical and cognitive training program on executive functions

Background: Physical and cognitive interventions have been shown to induce positive effects on older adults’ executive functioning. However, since participants with different background characteristics may respond differently to such interventions, we investigated whether training effects on executive functions were associated with sex, training compliance, and age. We also investigated if change in global cognition was associated with physical and cognitive training intervention-induced changes in executive functions. Methods: Exploratory data from a randomized controlled trial were analyzed. Participants were 70–85-year-old men and women who received a 12-month physical (PT) or physical a…

Type of retirement as a determinant of pre- and post-retirement hospital in-patient care use: a prospective study

Background We examined prospectively the use of all-cause hospital in-patient care among public sector employees by using a 3-year pre- and post-retirement study window. Methods A total of 5269 participants of the Finnish Longitudinal Study of Municipal Employees had retired during January 1984 and July 2000. They had register-based data on retirement (non-disability retirement n = 3411, men 40%, and diagnose-specific disability retirement n = 1858, men 50%) and all-cause hospital in-patient admissions and discharges. Analyses were conducted using Generalized Estimating Equation model. Results The prevalence of hospital care use for non-disability retirees remained stable during the 6-year …

Perspectives on health and cognition in old age: Why we need multidisciplinary investigations

Maintaining health and cognition is vital to ensure that individuals can live autonomously up to and including old age. One of the most pressing topics in today’s aging societies is how to delay impairments in health and cognition in old age for as long as possible, with a particular focus on cognitive and physical functioning as these are of particular importance to maintain autonomy. This edited volume presents four different perspectives on developments in current aging research relating to health and cognition in old age. Using health as overarching concept, the volume addresses different components of health such as physical functioning, cognitive health, mental well-being, self-regula…

Association between Frailty and Dementia: A Population-Based Study

<b><i>Background:</i></b> Frailty is commonly considered as a syndrome with several symptoms, including weight loss, exhaustion, weakness, slow walking speed and physical inactivity. It has been suggested that cognitive impairment should be included in the frailty index, however the association between frailty and cognition has not yet been fully established. <b><i>Objective:</i></b> To investigate cross-sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people. <b><i>Methods:</i></b> The study included a total of<b> </b>654 persons aged 76-100 years…

Personal Social Networks of Community-Dwelling Oldest Old During the Covid-19 Pandemic—A Qualitative Study

The COVID-19 pandemic and its related restrictions have affected the everyday life of older people. Advanced age is a significant predisposing factor for a more severe COVID-19 infection, increasing the risk for hospitalization and mortality. Even though restrictions have been, thus, well-grounded, they may also have had detrimental effects on the social well-being of older people. Personal networks and social activity are known protective factors against the premature decline in health and functioning, and it is widely acknowledged that social isolation increases feelings of loneliness, poor quality of life, and even the risk for diseases and disabilities among older adults. This qualitati…

Fear of falling and coexisting sensory difficulties as predictors of mobility decline in older women.

BACKGROUND: Mobility decline, the coexistence of several sensory difficulties and fear of falling (FOF) are all common concerns in older people; however, knowledge about the combined effect of FOF and coexisting sensory difficulties on mobility is lacking. METHODS: Data on self-reported FOF, difficulties in hearing, vision, balance, and walking 2 km were gathered with a structured questionnaire among 434 women aged 63-76 years at baseline and after a 3-year follow-up. Logistic regression models were used for analyses. RESULTS: Every third participant reported difficulties in walking 2 km at baseline. In cross-sectional analysis, the odds ratio for difficulties in walking 2 km was higher amo…

Accumulation of sensory difficulties predicts fear of falling in older women

Objectives: To explore whether the accumulation of sensory difficulties predicts fear of falling (FOF), and whether the traits correlate with each other regardless of familial factors. Methods: Self-reported hearing, vision and balance difficulties, and FOF were assessed using structured questionnaires at the baseline and after a 3-year follow-up in 63- to 76-year-old women (n = 434). Results: Among the women without FOF at baseline (n = 245), 41% reported FOF at follow-up. Increasing numbers of sensory difficulties at baseline predicted higher incidence of FOF. The relationship between accumulated sensory difficulties and FOF was not mediated by familial factors. Discussion: The accumulati…

P3‐315: MID‐LIFE WORK‐RELATED STRESS INCREASES DEMENTIA RISK IN LATE‐LIFE: THE CAIDE 30‐YEAR STUDY

Background: The associations between work-related stress and various health outcomes in mid-life are well documented, yet less is known about the effects on late-life cognitive process and dementia. The current study investigated the associations between work-related stress in mid-life and the development of cognitive impairment and Alzheimer’s disease in late-life. Methods: The data was derived from the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) study; a prospective cohort study. Participants were randomly selected from four independent population-based samples that completed cardiovascular surveys. First baseline examinations occurred when participants were 50 y…

Fear of falling and coexisting sensory difficulties as predictors of mobility decline in older women

Background. Mobility decline, the coexistence of several sensory difficulties and fear of falling (FOF) are all common concerns in older people; however, knowledge about the combined effect of FOF and coexisting sensory difficulties on mobility is lacking. Methods. Data on self-reported FOF, difficulties in hearing, vision, balance, and walking 2 km were gathered with a structured questionnaire among 434 women aged 63–76 years at baseline and after a 3-year follow-up. Logistic regression models were used for analyses. Results. Every third participant reported difficulties in walking 2 km at baseline. In cross-sectional analysis, the odds ratio for difficulties in walking 2 km was higher amo…

Perceived stress symptoms in midlife predict disability in old age: a 28-year prospective cohort study.

Background Stress has damaging effects on individual's health. However, information about the long-term consequences of mental stress is scarce. Methods This 28-year prospective cohort study examined on the associations between midlife stress and old age disability among 2,994 Finnish municipal professionals aged 44-58 years at baseline. Self-reported stress symptoms were assessed at baseline in 1981 and 4 years later in 1985 and perceived disability in 2009. For the baseline data, principal component analysis was used for differentiation into stress symptom profiles. The regression coefficient estimates for self-care disability (activities of daily living) and instrumental activities of da…

Accumulation of sensory difficulties predicts fear of falling in older women

Objectives: To explore whether the accumulation of sensory difficulties predicts fear of falling (FOF), and whether the traits correlate with each other regardless of familial factors. Methods: Self-reported hearing, vision and balance difficulties, and FOF were assessed using structured questionnaires at the baseline and after a 3-year follow-up in 63- to 76-year-old women ( n = 434). Results: Among the women without FOF at baseline ( n = 245), 41% reported FOF at follow-up. Increasing numbers of sensory difficulties at baseline predicted higher incidence of FOF. The relationship between accumulated sensory difficulties and FOF was not mediated by familial factors. Discussion: The accumul…

How can dementia and disability be prevented in older adults: where are we today and where are we going?

Abstract Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age‐related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, phy…

P2‐310: MIDLIFE SELF‐RATED HEALTH AND FITNESS IN RELATION TO WHITE MATTER LESIONS AND GREY MATTER VOLUME 20 YEARS LATER

Midlife self-rated health and fitness in relation to white matter lesions and grey matter volume 20 years later

Lowered vision as a risk factor for injurious accidents in older people

Poor vision in older people is often related to increased fall risk. However, the association of the severity between visual deficit and risk for all kind of injurious accidents has not been widely studied. The aim of this study was to examine whether visual loss is associated with higher incidence of injurious accidents and whether walking speed or physical activity play a mediating role in the association.416 persons aged 75 and 80 years at baseline underwent visual acuity measurements. Visual acuity (VA)0.3 in the better eye, with spectacle correction when necessary, was defined as visual impairment, VAor=0.3 butor=0.5 as lowered vision, and VA0.5 as normal VA. Hospital records of accide…

Effects of Physical and Cognitive Training on Gait Speed and Cognition in Older Adults : A Randomized Controlled Trial

Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12‐month physical and cognitive training (PTCT) on gait speed, dual‐task cost in gait speed, and executive functions (EFs) compared to physical training (PT) (ISRCTN52388040). Community‐dwelling older adults, who did not meet physical activity recommendations, were recruited (n=314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2‐3 times weekly) and moderate aerobic activity 150 minutes/week in bouts of >10 minutes. PTCT included …

Frailty as a predictor of all-cause mortality in older men and women

Aims To investigate the modifying effect of sex on the association between frailty and all-cause mortality, and to determine the effects of changes in frailty status on mortality. Methods This population-based study comprised 654 persons aged 76–100 years (mean age 82 ± 4.6 years). Frailty status was assessed at baseline in 2005, and reassessed in 2007 (n = 546) using the Cardiovascular Health Study criteria. Death dates were received from the official register until the end of 2009. The associations between frailty, changes in frailty and mortality were investigated using Cox regression models. Results At baseline, 93 (14%) participants were classified as frail, and 311 (48%) as pre-frail.…

Visual Acuity and Mortality in Older People and Factors on the Pathway

To examine vision as a predictor of mortality in older people and the role of mobility, depressed mood, chronic diseases, body mass index, physical activity and injurious accidents in this possible association.223 persons aged 75 and 193 persons aged 80 years at the baseline participated in visual acuity measurements. Visual acuity (VA) of0.3 in the better eye was defined as visual impairment, VA ofor = 0.3 butor = 0.5 as lowered vision and VA0.5 as normal VA. Death dates were received from the official register. Cox regression models were used to determine the relative risks of mortality and to study what factors lie on the pathway from poor vision to mortality.Over the 10-year follow-up, …

Midlife work ability and mobility limitation in old age among non-disability and disability retirees - a prospective study

Little is known about the wellbeing and mobility limitation of older disability retirees. Personal and environmental factors, such as time spent in working life, may either exacerbate or mitigate the onset of mobility limitation in general population. We aimed to study perceived midlife work ability as a determinant of self-reported mobility limitation in old age among municipal employees who transitioned into non-disability and disability retirement. METHODS: 4329 participants of the Finnish Longitudinal Study of Municipal Employees (FLAME) had retired during January 1985 and July 2000. They had data on retirement, perceived work ability in 1985, and self-reported mobility limitation (non-…

Poor vision accompanied with other sensory impairments as a predictor of falls in older women

Objectives:we studied visual acuity (VA) and co-existing hearing impairment and poor standing balance as predictors of falls. Design: prospective study with 1-year follow-up. Setting: research laboratory and residential environment. Participants: 428 women aged 63‐76 years from the Finnish Twin Study on Aging. Measurements: participants were followed up for incidence of falls over 1 year. VA, hearing ability and standing balance were assessed at the baseline. The incidence rate ratios (IRR) for falls were computed using the negative binomial regression model. Results: during the follow-up, 47% of participants experienced a fall. After adjusting for age and interdependence of twin sisters, p…

Balance Confidence and Functional Balance in Relation to Falls in Older Persons with Hip Fracture History

PURPOSE: To investigate whether self-assessed balance confidence and functional balance are associated with falls in older persons with hip fracture history. METHODS: This study is a part of a larger study on functional capacity and exercise rehabilitation in hip fracture patients. Seventy-nine patients, operated at the local hospital for collum or trochanter fracture within one-half to 7 years, participated in the laboratory measurements. Balance confidence was assessed with Activities-specific Balance Confidence scale (ABC) and functional balance using the Berg Balance Scale (BBS). According to self-reported number of falls during the previous 6 months participants were classified as thos…

Effects of physical and cognitive training on gait speed and cognition in older adults: A randomized controlled trial

Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12-month physical and cognitive training (PTCT) on gait speed, dual-task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community-dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2-3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the…

Inverse Effects of Midlife Occupational and Leisure Time Physical Activity on Mobility Limitation in Old Age-A 28-Year Prospective Follow-Up Study

Objectives: To evaluate in a sample of initially middle-aged municipal employees whether leisure time (LPA) or occupational physical activity (OPA) was associated with mobility limitation (ML) in old age. Design: Prospective population-based follow-up. Setting: Municipalities in Finland. Participants: Public sector employees from the Finnish Longitudinal Study on Municipal Employees (FLAME) initially aged 44 to 58 (N = 5,200). Measurements: Baseline data were collected in 1981, including LPA (average exercise within previous year: inactive (no exercise), moderate (some form of exercise ?1 time per week), vigorous (brisk exercise ?1 time per week)) and OPA (usual activities at work within pr…

Liikkumisen kannustimet muistisairauksien riskiryhmään kuuluvilla ikääntyneillä

Liikunnallisesti aktiivinen elämäntapa ylläpitää tehokkaasti ikääntyneiden terveyttä ja toimintakykyä. Liikunnan harrastamiseen vaikuttavat kuitenkin monet yksilölliset tekijät, jotka tulisi huomioida kannustettaessa ikääntyneitä henkilöitä liikkumaan. Tämän tutkimuksen tarkoituksena oli selvittää, minkälaiset liikkumisen kannustimet ovat yhteydessä aktiiviseen liikunnan harrastamiseen ikääntyneillä ihmisillä, joilla riski muistisairauteen sairastumiseen on kohonnut. Tämä poikkileikkaustutkimus on osa laajempaa FINGER-tutkimusta (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability), johon osallistui 1 260 keski-iältään 69-vuotiasta henkilöä. Tutkittavien fyys…