Older women's personal goals and exercise activity: an 8-year follow-up.

This study investigated the associations of personal goals with exercise activity, as well as the relationships between exercise-related and other personal goals, among older women. Both cross-sectional and longitudinal designs were used with a sample of 308 women ages 66–79 at baseline. Women who reported exercise-related personal goals were 4 times as likely to report high exercise activity at baseline than those who did not report exercise-related goals. Longitudinal results were parallel. Goals related to cultural activities, as well as to busying oneself around the home, coincided with exercise-related goals, whereas goals related to own and other people’s health and independent living…

Individual and environmental factors underlying life space of older people – study protocol and design of a cohort study on life-space mobility in old age (LISPE)

Abstract Background A crucial issue for the sustainability of societies is how to maintain health and functioning in older people. With increasing age, losses in vision, hearing, balance, mobility and cognitive capacity render older people particularly exposed to environmental barriers. A central building block of human functioning is walking. Walking difficulties may start to develop in midlife and become increasingly prevalent with age. Life-space mobility reflects actual mobility performance by taking into account the balance between older adults internal physiologic capacity and the external challenges they encounter in daily life. The aim of the Life-Space Mobility in Old Age (LISPE) p…

The Association Between Transportation and Life-Space Mobility in Community-Dwelling Older People With or Without Walking Difficulties.

Objective: The aim of this study is to examine whether a persons’ most frequently used mode of transportation is associated with life-space mobility and whether the association differs between persons with or without walking difficulties. Method: Life-space mobility was measured with the Life-Space Assessment in 848 community-dwelling men and women aged 75 to 90 years. Six separate mobility groups were formed according to the most frequently used mode of transportation (car driver, car passenger, public transportation) combined with the presence or absence of difficulties walking 2 km. Results: Car drivers without walking difficulties had the highest life-space mobility scores, and car pas…

Hearing as a Predictor of Falls and Postural Balance in Older Female Twins

BACKGROUND: The purpose of the present study was to examine, first, whether hearing acuity predicts falls and whether the potential association is explained by postural balance and, second, to examine whether shared genetic or environmental effects underlie these associations. METHODS: Hearing was measured using a clinical audiometer as a part of the Finnish Twin Study on Aging in 103 monozygotic and 114 dizygotic female twin pairs aged 63-76 years. Postural balance was indicated as a center of pressure (COP) movement in semitandem stance, and participants filled in a fall-calendar daily for an average of 345 days after the baseline. RESULTS: Mean hearing acuity (better ear hearing threshol…

Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study

Background Environmental barriers increase risk for mobility difficulties in old age. Mobility difficulty is preceded by a phase where people try to postpone a difficulty through mobility modification. We studied whether perceived environmental mobility barriers outdoors correlate with mobility modification and mobility difficulty, predict development of mobility difficulty over a two-year follow-up, and whether mobility modification alleviates the risk for difficulty. Methods At baseline, 848 people aged 75–90 were interviewed face-to-face. Telephone follow-up interviews were conducted one (n = 816) and two years (n = 761) later. Environmental barriers to mobility were self-reported using …

Mobility Limitation and Changes in Personal Goals Among Older Women.

Objectives. Several theoretical viewpoints suggest that older adults need to modify their personal goals in the face of functional decline. The aim of this study was to investigate longitudinally the association of mobility limitation with changes in personal goals among older women. Method. Eight-year follow-up of 205 women aged 66–78 years at baseline. Results. Health-related goals were the most common at both measurements. Goals related to independent living almost doubled and goals related to exercise and to cultural activities substantially decreased during the follow-up. Higher age decreased the likelihood for engaging in new goals related to cultural activities and disengaging from g…

Additional file 3: of Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults

Table on the associations between self-reported hearing difficulty and health service use in older adults when accounting for missing data with maximum likelihood. Multivariable adjusted odds ratios (OR) for self-reported hearing difficulty explaining use of health services when accounting for missing data with maximum likelihood method (N = 2144). (PDF 6 kb)

Do Associations Between Perceived Environmental and Individual Characteristics and Walking Limitations Depend on Lower Extremity Performance Level?

Objective: The aim of this study was to analyze whether the associations between perceived environmental and individual characteristics and perceived walking limitations in older people differ between those with intact and those with poorer lower extremity performance. Method: Persons aged 75 to 90 ( N = 834) participated in interviews and performance tests in their homes. Standard questionnaires were used to obtain walking difficulties; environmental barriers to and, facilitators of, mobility; and perceived individual hindrances to outdoor mobility. Lower extremity performance was tested using Short Physical Performance Battery (SPPB). Results: Among those with poorer lower extremity perf…

Life-space mobility and quality of life in community-dwelling older people

Genetic effects on life-space mobility in older women.

Heritability of Lung Function: A Twin Study Among Never-Smoking Elderly Women

Most studies on lung function heritability have been conducted in smokers and non-smokers using cross-sectional study design. Smoking patterns may, however, confound the contribution of genetic factors. We investigated heritability of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio longitudinally, excluding the effects of smoking. A sample of never smoking female twins (n = 374), aged 63–76 at baseline, answered health questionnaires and attended spirometry in years 2000 and 2003. Bivariate structural equation modeling, restricted to adequate spirometry performances (baseline n = 339, follow-up n = 252), was used to estimate genetic and environ…

Life-space mobility assessment in older people in Finland; measurement properties in winter and spring.

Background: Life-space mobility refers to the spatial area an individual moves through, the frequency and need for assistance. Based on the assumption that measurement scale properties are context-specific, we tested the scale distribution, responsiveness, and reproducibility of the 15-item University of Alabama at Birmingham Study of Aging Life-Space Assessment in older people in Finland, specifically accounting for season. Methods: Community-dwelling older men and women in cent ral Finland aged 75-90 y ears were interviewed to determine life-space mobility (score range 0-120). Baseline (January-June 2012) and one-year follow-up data (January-June 2013; n = 806) from the cohort study “ Lif…

Associations Between Environmental Characteristics and Life-Space Mobility in Community-Dwelling Older People

Objective: To examine the association between perceived environmental barriers to and facilitators for outdoor mobility with life-space among older people. Methods: Community-dwelling, 75- to 90-year-old people ( n = 848) were interviewed face-to-face using standard questionnaires. The Life-Space Assessment (LSA), indicating distance and frequency of moving and assistance needed in moving (range 0-120), was used. Environmental barriers and facilitators outdoors were self-reported. Results: Altogether, 41% ( n = 348) of the participants had restricted life-space (LSA score < 60). Those reporting one or more environmental barriers had more than double the odds for restricted life-space co…

Additional file 2: of Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults

Table on health service use in older adults with (pure-tone hearing level > 25 dB) and without hearing loss. Age-sex adjusted proportions person with (N = 787) and without hearing loss (better-ear hearing level at frequencies 0.5–2 kHz >25 dB, N = 893) and multivariable-adjusted odds ratios for hearing loss explaining use of health services. (PDF 234 kb)

Associations Between Reasons to Go Outdoors and Objectively-Measured Walking Activity in Various Life-Space Areas Among Older People.

This cross-sectional study investigated associations between reasons to go outdoors and objectively-measured walking activity in various life-space areas among older people. During the study, 174 community-dwelling older people aged 75–90 from central Finland wore an accelerometer over seven days and recorded their reasons to go outdoors in an activity diary. The most common reasons for going outdoors were shopping, walking for exercise, social visits, and running errands. Activities done in multiple life-space areas contributed more to daily step counts than those done in the neighborhood or town and beyond. Those who went shopping or walked for exercise accumulated higher daily step count…

Environmental mobility barriers and walking for errands among older people who live alone vs. with others

Background. Walking is the most popular form of physical activity among older people and for community-dwelling older people walking for errands is especially important. The aim of this study is to examine the association between self-reported environmental mobility barriers and amount of walking for errands among older people who live alone compared to those who live with others. Methods. This observational study is based on cross-sectional data on 657 people aged 75–81 living in Jyväskylä, Central Finland. Self-reports of environmental mobility barriers were collected under four categories: Traffic, Terrain, Distances and Entrance. Persons who reported walking for errands ≤ 1.5 km/week or…

Outdoor Mobility and Use of Adaptive or Maladaptive Walking Modifications among Older People

Background. In old age, decline in functioning may cause changes in walking ability. Our aim was to study whether older people who report adaptive, maladaptive or no walking modifications differ in outdoor mobility. Methods. Community-dwelling people aged 75–90 years (N=848) were interviewed at baseline, of whom 761 participated in the 2-year follow-up. Walking modifications were assessed by asking the participants whether they had modified their way of walking 2 kilometers due to their health. Based on the responses, three categories were formed: no walking modifications (reference), adaptive (e.g., walking more slowly, using an aid) and maladaptive walking modifications (reduced frequency…

Dual sensory loss and social participation in older Europeans

The purpose of the study was to describe the prevalence of hearing difficulties, vision difficulties and dual sensory difficulties in 11 European countries, and to study whether sensory difficulties are associated with social inactivity in older Europeans. This cross-sectional study is based on the 2004 data collection of the Survey of Health, Ageing and Retirement in Europe comprising 27,536 men and women aged 50 years and older. Hearing and vision difficulties, as well as participation in seven different social activities were assessed using a structured computer-assisted personal interview. Logistic regression models were used for analyses. Altogether, 5.9 % of the participants reported …

Objectively Measured Physical Activity and Changes in Life-Space Mobility Among Older People

Background Our aim was to study the relationship between objectively measured physical activity and subsequent changes in life-space mobility over 2 years among older people. Life-space mobility refers to the area a person moves through in daily life, taking into account frequency, and need of assistance. Life-space mobility and physical activity correlate, but whether different intensities of objectively assessed physical activity predicts decline in life-space mobility is not known. Methods Prospective cohort study of the "Life-space Mobility in Old Age" (LISPE) project accelerometer substudy. Participants were community-dwelling older people aged 75-90 (n = 164). Life-space mobility was …

Association between physical performance and sense of autonomy in outdoor activities and life-space mobility in community-dwelling older people

Objectives. To study the relationship between physical performance and sense of autonomy in outdoor activities with life-space mobility—the spatial area a person purposefully moves through in daily life—in community-dwelling older people. Design. Cross-sectional analyses of baseline data of the Life-Space Mobility in Old Age cohort study. Setting. Structured interviews in participants' homes. Participants. Community-dwelling people aged 75 to 90 (N = 848). Measurements. Sense of autonomy outdoors (Impact on Participation and Autonomy questionnaire subscale), life-space mobility (Life-Space Assessment; University of Alabama, Birmingham Study of Aging), and Short Physical Performance Battery.…

Genetic and environmental effects on hearing acuity and the association between hearing acuity, mobility and falls in older women

The Association Between Epigenetic Clocks and Physical Functioning in Older Women: A 3-Year Follow-up

Abstract Background Epigenetic clocks are composite markers developed to predict chronological age or mortality risk from DNA methylation (DNAm) data. The present study investigated the associations between 4 epigenetic clocks (Horvath’s and Hannum’s DNAmAge and DNAm GrimAge and PhenoAge) and physical functioning during a 3-year follow-up. Method We studied 63- to 76-year-old women (N = 413) from the Finnish Twin Study on Aging. DNAm was measured from blood samples at baseline. Age acceleration (AgeAccel), that is, discrepancy between chronological age and DNAm age, was determined as residuals from linear model. Physical functioning was assessed under standardized laboratory conditions at b…

Short telomere length is associated with impaired cognitive performance in European ancestry cohorts

AbstractThe association between telomere length (TL) dynamics on cognitive performance over the life-course is not well understood. This study meta-analyses observational and causal associations between TL and six cognitive traits, with stratifications on APOE genotype, in a Mendelian Randomization (MR) framework. Twelve European cohorts (N=17 052; mean age=59.2±8.8 years) provided results for associations between qPCR-measured TL (T/S-ratio scale) and general cognitive function, mini-mental state exam (MMSE), processing speed by digit symbol substitution test (DSST), visuospatial functioning, memory and executive functioning (STROOP). In addition, a genetic risk score (GRS) for TL includin…

Neighborhood Mobility and Unmet Physical Activity Need in Old Age: A 2-Year Follow-Up

Background: Many older people report a willingness to increase outdoor physical activity (PA), but no opportunities for it, a situation termed as unmet PA need. The authors studied whether lower neighborhood mobility and PA precede the development of unmet PA need. Methods: Community-dwelling 75- to 90-year-old people (n = 700) were interviewed annually for 2 years. Unmet PA need, neighborhood mobility, and PA were self-reported. In addition, accelerometer-based step counts were assessed among a subgroup (n = 156). Results: Logistic regression analyses revealed that lower baseline neighborhood mobility (odds ratio 3.02, 95% confidence interval [1.86, 4.90] vs. daily) and PA (odds ratio 4.37…

Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? A longitudinal study

Background: essential aspects of independence in community mobility among older people concern the control over where, when and how to participate (perceived autonomy), and actual mobility (life-space mobility; frequency, distance and need of assistance). We studied relationships between frailty and life-space mobility and perceived autonomy in participation outdoors among community-dwelling 75–90 years old people. Methods: longitudinal analyses of the ‘Life-space mobility in old age’ cohort study (n = 753). Life-space mobility (Life-Space Assessment, range 0–120) and perceived autonomy in participation outdoors (Impact on Participation and Autonomy subscale ‘autonomy outdoors’, range 0–20)…

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…

The Older Finnish Twin Cohort : 45 Years of Follow-up

AbstractThe older Finnish Twin Cohort (FTC) was established in 1974. The baseline survey was in 1975, with two follow-up health surveys in 1981 and 1990. The fourth wave of assessments was done in three parts, with a questionnaire study of twins born during 1945–1957 in 2011–2012, while older twins were interviewed and screened for dementia in two time periods, between 1999 and 2007 for twins born before 1938 and between 2013 and 2017 for twins born in 1938–1944. The content of these wave 4 assessments is described and some initial results are described. In addition, we have invited twin-pairs, based on response to the cohortwide surveys, to participate in detailed in-person studies; these …

Socioeconomic Status and Life-Space Mobility in Old Age.

Life-space mobility describes the extent of community mobility of older persons. The aim of this cross-sectional study was to examine the relationship between socioeconomic status (SES) and life-space mobility and to investigate whether associations might be explained by SES-related disparities in health and functioning. The participants (n = 848) were community-dwelling adults aged 75–90. Education and occupation were used to indicate SES. Life-space assessment (range 0–120) was used to indicate distance and frequency of moving and assistance needed in moving. People with low education had lower life-space mobility scores than those with intermediate or high education: marginal means 63.5,…

Outdoor and indoor falls as predictors of mobility limitation in older women

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…

Genetic effects on life-space mobility in older women

Self-reported hearing difficulties and changes in life-space mobility among community-dwelling older adults: a Two-year follow-Up study

Background Life-space mobility reflects individuals’ actual mobility and engagement with society. Difficulty in hearing is common among older adults and can complicate participation in everyday activities, thus restricting life-space mobility. The aim of this study was to examine whether self-reported hearing predicts changes in life-space mobility among older adults. Methods We conducted a prospective cohort study of community-dwelling older adults aged 75–90 years (n = 848). At-home face-to-face interviews at baseline and telephone follow-up were used. Participants responded to standardized questions on perceived hearing at baseline. Life-space mobility (the University of Alabama at Birmi…

Does the epigenetic clock GrimAge predict mortality independent of genetic influences : an 18 year follow-up study in older female twin pairs

Background: Epigenetic clocks are based on DNA methylation (DNAm). It has been suggested that these clocks are useable markers of biological aging and premature mortality. Because genetic factors explain variations in both epigenetic aging and mortality, this association could also be explained by shared genetic factors. We investigated the infuence of genetic and lifestyle factors (smoking, alcohol consumption, physical activity, chronic diseases, body mass index) and education on the association of accelerated epigenetic aging with mortality using a longitudinal twin design. Utilizing a publicly available online tool, we calculated the epigenetic age using two epigenetic clocks, Horvath D…

Perceived and objective entrance-related environmental barriers and daily out-of-home mobility in community-dwelling older people

Abstract Purpose We studied whether entrance-related environmental barriers, perceived and objectively recorded, were associated with moving out-of-home daily in older people with and without limitations in lower extremity performance. Methods Cross-sectional analyses of the “Life-space mobility in old age” cohort including 848 community-dwelling 75–90-year-old of central Finland. Participants reported their frequency of moving out-of-home (daily vs. 0–6 times/week) and perceived entrance-related environmental barriers (yes/no). Lower extremity performance was assessed (Short Physical Performance Battery) and categorized as poorer (score 0–9) or good (score 10–12). Environmental barriers at…

Barriers to outdoor physical activity and unmet physical activity need in older adults

Abstract Objective To profile participants based on reported outdoor physical activity barriers using a data-driven approach, describe the profiles and study their association with unmet physical activity need. Method Cross-sectional analyses of 848 community-dwelling men and women aged 75–90 living in Central Finland in 2012. Barriers to outdoor physical activity and unmet physical activity need were enquired with a questionnaire. The latent profiles were identified by profiling participants into latent groups using a mixture modeling technique on the multivariate set of indicators of outdoor physical activity barriers. A path model was used to study the associations of the profiles with u…

Astigmatism among myopics and its changes from childhood to adult age: a 23‐year follow‐up study

Purpose To study the prevalence of and changes in astigmatism from the onset of myopia at school age. Methods Two hundred and forty myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983–1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Three annual examinations with subjective cycloplegic refraction were performed for 237–238 subjects. Subsequent examinations were performed at the mean ages of 23.2 and 33.9 years for 178 and 163 subjects, and the last examination, including data from prescriptions of different ophthalmologists, for 32 subjects. Corneal topography was studied at baseline, at the 3-year follow-up and at t…

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…

Additional file 1: of Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults

Table on the associations between hearing loss and health service use in older adults when accounting for missing data with maximum likelihood. Multivariable adjusted odds ratios (OR) for hearing loss explaining use of health services when accounting for missing data with maximum likelihood method (N = 2144). (PDF 211 kb)

EXECUTIVE FUNCTION AND LIFE-SPACE MOBILITY IN OLD AGE

Mobility is important for maintaining independence and active participation in old age. Life-space mobility assessment incorporates the extent of mobility in terms of the distance from home, the frequency of mobility and the need of assistance for mobility. Executive function (EF) is one of the most important higher-order cognitive abilities that control and guide goal-directed actions. The aim of the study was to examine the association between EF and life-space mobility.

Genetic and environmental influences on hearing at different frequencies separately for the better and worse hearing ear in older women

The purpose of the present study was to examine the relative contribution of genetic and environmental effects on the air-conducted hearing threshold levels at low (0.125-0.5 kHz), mid (1-2 kHz), and high (4-8 kHz) frequencies separately for the better and worse hearing ear in older women. We also examined the distribution of audiogram configurations. Data was analysed using quantitative genetic modelling. As part of the Finnish twin study on aging (FITSA), hearing was measured in 103 monozygotic and 114 dizygotic female twin pairs aged 63-76 years. Approximately every third subject had a flat type, and two-thirds a descending type of audiogram configuration. No significant difference was o…

Executive function and life-space mobility in old age

Life-space assessment incorporates all movements in terms of the distance from home, the frequency of movement and the need of assistance for movement. Executive function (EF) is an important higher order cognitive ability that controls and guides people’s goal-directed actions. We examined the cross-sectional and longitudinal associations between EF and life-space mobility, and investigated if perceived walking difficulties, lower extremity performance, and transportation difficulties explain the association. Methods 157 community-dwelling persons aged 76–91 years participated in the study at the baseline, and 103 of them in 2-year follow-up study. Based on the distribution on the Trail Ma…

Task Modifications in Walking Postpone Decline in Life-Space Mobility Among Community-Dwelling Older People: A 2-year Follow-up Study

Background Task modification refers to performing a task differently than before. While task modification in walking may be a sign of looming walking difficulty, it may also be adaptive in and postpone the decline in life-space mobility. However, this has not been studied. This study examined whether changes in life-space mobility over a 2-year period differ between people who at baseline report no walking difficulty and no task modification, those who report no walking difficulty but task modification, and those who report walking difficulty. Methods Community-dwelling people aged 75–90 years were interviewed face-to-face at baseline (N = 848), and over phone one (n = 816) and two (n = 761…

Perceived Benefit From Hearing Aid Use and Life-Space Mobility Among Community-Dwelling Older Adults

Objectives: To examine the association between perceived benefit from hearing aid (HA) use and life-space mobility among older adults. Method: Cross-sectional analysis of 76- to 91-year-old community-dwelling adults ( n = 702). Data on perceived hearing with and without a HA were obtained via postal questionnaire and data on life-space mobility (Life-Space Assessment, range = 0-120) via phone interview. Results: Participants who perceived more benefit from HA use, had a better life-space mobility score ( M = 65, SD = 2.6) than participants who had less benefit from using a HA ( M = 55, SD = 3.2). Participants who benefitted more from HA use did not differ from those who did not have a HA (…

Life-space mobility and dimensions of depressive symptoms among community-dwelling older adults

Objectives: To examine the association between life-space mobility and different dimensions of depressive symptoms among older community-dwelling people. Methods: Cross-sectional analyses of baseline data of the ‘Life-Space Mobility in Old Age’ cohort study were carried out. The participants were community-dwelling women and men aged 75–90 years (N = 848). Data were gathered via structured interviews in participants’ home. Life-space mobility (the University of Alabama at Birmingham (UAB) Life-Space Assessment – questionnaire) and depressive symptoms (Centre for Epidemiological Studies Depression Scale, CES-D) were assessed. Other factors examined included sociodemographic factors, difficul…

Self-reported hearing is associated with time spent out-of-home and withdrawal from leisure activities in older community-dwelling adults.

Background Hearing difficulties are prevalent among older people and can lead to difficulties in social interaction. These difficulties may increase the tendency to remain at home and withdraw from leisure activities. Aims To investigate whether self-reported hearing problems are associated with time spent out-of-home and withdrawal from a leisure activity among older persons. Methods Cross-sectional and longitudinal data on 75- to 90-year-old community-dwelling men and women (n = 767) was used. Self-reports of hearing, diseases, and difficulty walking 2 km were obtained via home interviews at baseline, and withdrawal from a leisure activity via 1- and 2-year follow-up telephone interviews.…

Perceived environmental barriers to outdoor mobility and feelings of loneliness among community-dwelling older people

We examined the association between perceived environmental barriers to outdoor mobility and loneliness among community-dwelling older people. In addition, we studied whether walking difficulties and autonomy in participation outdoors affected this association.Cross-sectional analyses of face-to-face home interview data with 848 people aged 75-90 years (mean age: 80.1 years; 62% women) gathered within the "Life-Space Mobility in Old Age" (LISPE) project. Self-reports of loneliness, environmental barriers to outdoor mobility, and difficulties in walking 2 km were obtained with structured questionnaires. Autonomy in participation outdoors was assessed with the "Impact on Participation and Aut…

Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

Objective: 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. Methods: 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 …

The association between objectively measured physical activity and life-space mobility among older people

The purpose of this cross-sectional study was to investigate the association between objectively measured physical activity and life-space mobility in community-dwelling older people. Life-space refers to the spatial area a person purposefully moves through in daily life (bedroom, home, yard, neighborhood, town, and beyond) and life-space mobility to the frequency of travel and the help needed when moving through different life-space areas. The study population comprised community-living 75- to 90-year-old people {n = 174; median age 79.7 [interquartile range (IQR) 7.1]}, participating in the accelerometer substudy of Life-Space Mobility in Old Age (LISPE) project. Step counts and activity …

Erratum to: Dual sensory loss and social participation in older Europeans

The purpose of the study was to describe the prevalence of hearing difficulties, vision difficulties and dual sensory difficulties in 11 European countries, and to study whether sensory difficulties are associated with social inactivity in older Europeans. This cross-sectional study is based on the 2004 data collection of the Survey of Health, Ageing and Retirement in Europe comprising 27,536 men and women aged 50 years and older. Hearing and vision difficulties, as well as participation in seven different social activities were assessed using a structured computer-assisted personal interview. Logistic regression models were used for analyses. Altogether, 5.9 % of the participants reported …

Aistien heikkeneminen rajoittaa ikäihmisten sosiaalista elämää

Hearing loss and use of health services : a population-based cross-sectional study among Finnish older adults

Background Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Methods Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, he…

Self-Reported Hearing Status Is Associated with Lower Limb Physical Performance, Perceived Mobility, and Activities of Daily Living in Older Community-Dwelling Men and Women

BACKGROUND: Poor hearing is common in older adults and it may have negative consequences which extend beyond communication. OBJECTIVES: To explore the associations of self-reported hearing problems with physical performance and self-reported difficulties in mobility and activities of daily living (ADL) in community-dwelling older adults. DESIGN: Cross-sectional cohort study SETTING: Community PARTICIPANTS: 848 men and women aged 75-90 years MEASUREMENTS: Structured face-to-face interviews to assess perceived hearing problems in the presence of noise, mobility difficulties (moving indoors, stair-climbing, 0.5 km walk and 2 km walk) and difficulties in ADLs and instrumental ADLs. The Short Ph…

Lukiolaisen nuoren minäkäsityksen ja itsetunnon tukeminen ohjauksen avulla

Mortality associations with DNA methylation-based biological aging and physical functioning measures across a 20-year follow-up period

Background Measures of biological aging range from DNA methylation (DNAm)-based estimates to measures of physical abilities. The purpose of this study was to compare DNAm- and physical functioning-based measures of biological aging in predicting mortality. Methods We studied 63- to 76-year-old women (N = 395) from the Finnish Twin Study on Aging (FITSA). Participants’ biological age (epigenetic clocks DNAm GrimAge and DunedinPACE) was estimated using blood DNAm data. Tests of physical functioning conducted under standardized laboratory conditions included the Timed Up and Go (TUG) test and 10-m walk test. Mortality hazard ratios (HRs) were calculated per every one standard deviation (SD) in…

Effective communication as a fundamental aspect of active aging and well-being: paying attention to the challenges older adults face in noisy environments

Successful communication is vital to active aging and well-being, yet virtually all older adults find it challenging to communicate effectively in noisy environments. The resulting discomfort and frustration can prompt withdrawal or avoidance of social situations, which, in turn, can severely limit the range of activities available to older adults and lead to a less active and satisfying lifestyle, and, in some cases, depression. Using the International Classification of Functioning, Disability and Health’s (ICF) multifactorial model (WHO, 2001), we review the wider aspects of functioning and disability as they relate to hearing difficulties and communication, placing a particular emphasis …

Iäkäs autoilija : autoilusta luopumiseen yhteydessä olevia terveydellisiä tekijöitä

Changes in life-space mobility and quality of life among community-dwelling older people: a 2-year follow-up study

Purpose Life-space mobility refers to the spatial area in which a person moves in daily life, taking into account distance, frequency and assistance needed. The aim was to examine how changes in life-space mobility are associated with changes in quality of life (QOL) over a 2-year period. Methods Community-dwelling people aged 75–90 years (n = 848) were interviewed face-to-face in their homes and followed up annually for 2 years. QOL was assessed with the short version of the World Health Organization QOL assessment (range 0–130, higher scores indicate better QOL). Life-space mobility was assessed with the Life-Space Assessment (range 0–120, higher scores indicate better life-space mobility…

Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment : A Longitudinal Cohort Study

Abstract Objectives Life-space mobility, assessed with the Life-Space Assessment (LSA), reflects an individual's mobility in terms of the spatial area, frequency, and need for assistance. The aims were to study associations between life-space mobility and disability status in activities of daily living (ADL), and to define cutoff scores for baseline LSA and LSA change over time identifying individuals who developed ADL inability during 2 years of follow-up. Robustness of the cutoff scores was tested accounting for potential confounders. Design Longitudinal analyses of the “Life-space mobility in old age” cohort study. Setting Home-based interviews at baseline and phone interviews 2 years la…

Genetic and environmental influences on hearing in older women.

Background. This study examined the relative contribution of genetic and environmental effects on the air-conducted hearing threshold level (0.5‐4 kHz) and speech recognition threshold level of the better ear as well as self-reported hearing in older women. Methods. Hearing was measured as a part of the Finnish Twin Study on Aging in 103 monozygotic (MZ) and 114 dizygotic (DZ) female twin pairs aged 63‐76 years. Audiometric measured hearing was tested using standardized methods in soundproof conditions. Self-reported hearing was assessed by a structured question. Quantitative genetic modeling was used for data analyses. Results. No significant differences in age, exposure to noise, hearing-…

Genetic Factors and Susceptibility to Falls in Older Women

OBJECTIVES: To determine whether genetic influences account for individual differences in susceptibility to falls in older women. DESIGN: Prospective twin cohort study. SETTING: Research laboratory and residential environment. PARTICIPANTS: Ninety-nine monozygotic (MZ) and 114 dizygotic (DZ) female twin pairs aged 63 to 76 from the Finnish Twin Cohort study. MEASUREMENTS: The participants recorded their falls on a calendar for an average+/-standard deviation of 344+/-41 days. Reported falls were verified via telephone interview, and circumstances, causes, and consequences of the fall were asked about. RESULTS: The total number of falls was 434, of which 188 were injurious; 91 participants h…

The progression of myopia from its onset at age 8-12 to adulthood and the influence of heredity and external factors on myopic progression. A 23-year follow-up study

Purpose To examine myopic progression and factors connected with myopic progression. Methods Myopic schoolchildren, with no previous spectacles, 119 boys and 121 girls, were recruited during 1983–1984 to a randomized 3-year clinical trial of bifocal treatment of myopia with a subsequent 20-year follow-up. Participants' mean age at Baseline was 10.9, ranging from 8.7 to 12.8 years. An ophthalmological examination was carried out annually for 3 years and twice thereafter at ca. 10-year intervals. Additional refraction values were received from prescriptions issued by different ophthalmologists and opticians. Altogether, 1915 refraction values were available. Reading distance and accommodation…

Genome-wide association analysis on normal hearing function identifies PCDH20 and SLC28A3 as candidates for hearing function and loss.

Hearing loss and individual differences in normal hearing both have a substantial genetic basis. Although many new genes contributing to deafness have been identified, very little is known about genes/variants modulating the normal range of hearing ability. To fill this gap, we performed a two-stage meta-analysis on hearing thresholds (tested at 0.25, 0.5, 1, 2, 4, 8 kHz) and on pure-tone averages (low-, medium-and high-frequency thresholds grouped) in several isolated populations from Italy and Central Asia (total N = 2636). Here, we detected two genome-wide significant loci close to PCDH20 and SLC28A3 (top hits: rs78043697, P = 4.71E-10 and rs7032430, P = 2.39E-09, respectively). For both…

Hearing and Quality of Life Among Community-Dwelling Older Adults

Objectives Hearing loss is a common health concern in older people, and the prevalence of hearing loss increases with aging. Poor hearing may cause difficulties in everyday life situations and reduce quality of life (QoL). The aim of this study was to assess the associations between different domains of QoL (physical, psychological, social, and environmental), perceived hearing difficulties in various everyday situations, and audiometrically measured hearing level among community-dwelling older adults. Method Cross-sectional analysis of 76- to 91-year-old community-dwelling adults. Data on QoL (WHO Quality of Life Assessment short version) and perceived hearing difficulties were gathered vi…

The combined effect of lower extremity function and cognitive performance on perceived walking ability among older people : a 2-year follow-up study

Background We studied the combined effects of cognitive performance and lower extremity function on self-reported walking modifications and walking difficulty and on self-reported walking difficulty incidence over a 2-year follow-up. Methods A total of 848 community-dwelling older people aged 75-90 years participated at baseline, 816 at the 1-year follow-up, and 761 at the 2-year follow-up. Baseline lower extremity function was measured with the Short Physical Performance Battery (<10 vs. ≥10) and cognitive performance with the Mini-Mental State Examination (<24 vs. ≥24). Difficulty in walking 2 km was self-reported and categorized into no difficulties, no difficulties but walking modificat…

Perceived Opportunities for Physical Activity and Willingness to Be More Active in Older Adults with Different Physical Activity Levels

This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% …

Hearing in Real-Life Environments (HERE) : Structure and Reliability of a Questionnaire on Perceived Hearing for Older Adults

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Comment on: A critical analysis of the internal logic in the Life-Space Assessment (LSA) composite score and suggested solutions

Background:An individual’s ability to live independently is commonly measured in health research interested in identifying risk factors associated with disablement processes. In order to inform clinical practice, population research has attempted to identify the contraction of “lived-space” by using various survey instruments.Problem:Studies assessing habitual movements over the environment with the Life-Space Assessment (LSA) survey instrument should carefully consider how the LSA Composite Score (LSA-CS) is computed. Until now, no publication has carefully delineated the assumptions guiding the internal logic used in the computation of the LSA-CS.Core argument:Because the internal logic o…

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…

Validity of a single question to assess habitual physical activity of community-dwelling older people

The aim is to determine concurrent validity of a single self-report habitual physical activity (PA) question against accelerometer-based PA and mobility variables, and corresponding changes in self-reported PA and mobility. Cross-sectional and longitudinal data of the "Life-space mobility in old age" (LISPE) cohort and its substudy on PA were utilized. At baseline, 848 community-dwelling, 75- to 90-year-old people living independently in central Finland participated in home-based interviews. One and 2 years later, 816 and 761 of them were reassessed by phone, respectively. Tri-axial accelerometer data over 7 days were collected following the baseline assessments in a subsample of 174. Self-…

The temporal association between executive function and life-space mobility in old age

Background Life-space mobility, an indicator of community mobility, describes person’s movements in terms of the distance from home, the frequency of movement, and the need of assistance for movement. Executive function (EF) is a higher-order cognitive function that supervises motor control and plays a key role in a person’s ability to function independently. Cognitive impairment often co-occurs with restricted life-space mobility; however, the direction of the longitudinal associations between EF and life-space mobility is unclear. The aim of this study was to investigate the temporal associations between EF and life-space mobility among community-dwelling older people. Methods One hundred…

Association of Self-Reported Hearing Difficulty to Objective and Perceived Participation Outside the Home in Older Community-Dwelling Adults

Objective: To investigate whether hearing difficulty is associated with objective and perceived participation in social and leisure activities outside the home in older adults. Method: Self-reported hearing difficulty, frequency of participation, perceived participation and Mini-Mental State Examination (MMSE) were obtained from 848 community-dwelling men and women aged 75 to 90. Results: Among persons with MMSE ≤ 24, hearing was not associated with participation. In persons with MMSE &gt; 24, relative to persons who reported no difficulty hearing, participants with major hearing difficulty had a higher odds ratio [OR] for infrequent participation in group activities (OR 2.1, 95% confidenc…

The Relationship Between Sleep Characteristics and Unmet Physical Activity Need in Older Women

Objective: We examined among older women the association of sleep quality, daytime tiredness, and sleep duration with unmet physical activity need, that is, wishing to be more physically active but perceiving no opportunity for it. Method: Cross-sectional logistic regression analyses among women aged 74 to 86 years (Finnish Twin Study on Aging, third wave, n = 302). Results: Thirty-one participants reported unmet physical activity need. Short sleepers had fivefold and long sleepers threefold odds for unmet physical activity need compared with normative sleepers, while for daytime tiredness the odds were double. Presence of daytime tiredness and unmet physical activity coincided with higher…

Genome-wide association analysis identifies six new loci associated with forced vital capacity

Forced vital capacity (FVC), a spirometric measure of pulmonary function, reflects lung volume and is used to diagnose and monitor lung diseases. We performed genome-wide association study meta-analysis of FVC in 52,253 individuals from 26 studies and followed up the top associations in 32,917 additional individuals of European ancestry. We found six new regions associated at genome-wide significance (P &lt;5 x 10(-8)) with FVC in or near EFEMP1, BMP6, MIR129-2-HSD17B12, PRDM11, WWOX and KCNJ2. Two loci previously associated with spirometric measures (GSTCD and PTCH1) were related to FVC. Newly implicated regions were followed up in samples from African-American, Korean, Chinese and Hispani…

Active aging – resilience and external support as modifiers of the disablement outcome: AGNES cohort study protocol

Background: Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual’s striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of health, health behaviors, health literacy and functional abilities, environmental and social support with active aging and wellbeing. We will develop and validate assessment methods for physical activity and physical resilience suitable for research on older people, and examine their associations with active aging and wellbeing. We will examine coho…

A Polygenic Risk Score for Hand Grip Strength Predicts Muscle Strength and Proximal and Distal Functional Outcomes among Older Women

Purpose Hand grip strength (HGS) is a widely used indicator of overall muscle strength and general health. We computed a polygenic risk score (PRS) for HGS, and examined, whether it predicted muscle strength, functional capacity and disability outcomes. Methods Genome-wide association study summary statistics for HGS from the Pan-UK Biobank was utilized. PRSs were calculated in the Finnish Twin Study on Aging (N = 429 women, 63–76 years). Strength tests included HGS, isometric knee extension, and ankle plantar flexion strength. Functional capacity was examined with the Timed Up and Go, six-minute and 10-meter walk tests, and dual-task tests. Disabilities in the basic (ADL) and instrumental …

The effect of body mass index, lower extremity performance, and use of a private car on incident life-space restriction: a two-year follow-up study

Background: The purpose of the study was to explore the single and combined contributions of body mass index (BMI) and lower extremity performance as modifiable physical factors, and the influence of use of a private car as an environmental factor on prevalent and incident life-space restriction in community-dwelling older people. Methods: Community-dwelling people aged 75–90 years (n = 823) participated in the Life-Space Mobility in Old Age (LISPE) two-year follow-up study. Participants who reported that the largest life-space area they had attained, without aid from any device or another person, was the neighborhood or less were considered to have life-space restriction. Incident life-spa…