Factors affecting the increased risk of physical inactivity among older people with depressive symptoms.

The purpose of this study was to investigate the association between depressive symptoms and physical inactivity, and whether motives for and barriers to exercise explain the potential association between depressive symptoms and physical inactivity in older people. The design of the study was cross-sectional. The study population comprised 645 people born between 1922 and 1928 who were residents in a city-center area of Jyväskylä in central Finland. Depressive symptoms were assessed using Center for the Epidemiologic Studies Depression Scale, physical activity using Grimby's (1986) validated scale, and motives for and barriers to exercise using a questionnaire and mobility limitation with a…

Construct and predictive validity of a self-reported measure of preclinical mobility limitation.

Abstract Manty M, Heinonen A, Leinonen R, Tormakangas T, Sakari-Rantala R, Hirvensalo M, von Bonsdorff MB, Rantanen T. Construct and predictive validity of a self-reported measure of preclinical mobility limitation. Objectives To validate self-reported preclinical mobility limitation concept and self-report assessment method against muscle power and walking speed, and to study the predictive validity of preclinical mobility limitation with respect to future risk of manifest mobility limitation. Design Observational prospective cohort study and cross-sectional analysis. Setting Research laboratory and community. Participants A total of 632 community-living (age range, 75−81y) women and men t…

Quality of Life and Barriers in the Urban Outdoor Environment in Old Age

OBJECTIVES: To examine the association between barriers in the outdoor environment and perceived quality of life (QoL) in old age and to assess whether fear of moving outdoors and unmet physical activity need contribute to this association. DESIGN: Cross-sectional. SETTING: Community and research center. PARTICIPANTS: Five hundred eighty-nine, community-dwelling people aged 75 to 81 took part in face-to-face home-interviews and examinations in the research center. MEASUREMENTS: QoL was assessed using the LEIPAD questionnaire. Environmental barriers were studied based on self-reports of lack of resting places or long distances (distances), noisy traffic or dangerous crossroads (traffic), and…

Multidimensional health assessment of 75- and 80-year-old men and women: a five-year prospective study.

Background and aims: There are no earlier reports of regular multidimensional health check programs in elderly people. The aim of this study was to establish the number and type of previously unrecognized health conditions in two cohorts of elderly people examined twice during a 5-year period, and to determine how these conditions were subsequently evaluated and treated. Methods: This population-based study, carried out at a university research center in Finland, consisted of a multidimensional and multiphased health assessment including interviews, health questionnaires and medical examinations and tests, and follow-up of subsequent examinations and treatment. Participants were all 75- (N=…

EFFECT OF PHYSICAL ACTIVITY COUNSELING ON HOME CARE USE IN OLDER PEOPLE

Self-rated health and self-assessed change in health in elderly men and women — A five-year longitudinal study

The purpose of the present investigation was two fold: (1) to examine how men and women self-rate their health as they age from 75 to 80 yr and how they assess the change in their health over the five year period; and (2) to ascertain how self-assessed change in health over the follow-up period corresponded to the difference in self-ratings of health between the assessments performed at baseline and at follow-up. The study was part of the Evergreen-project with the study group comprising all inhabitants born in 1914 (N = 388) living in Jyväskylä, central Finland. At baseline, 93.4%, and at follow-up, 93.3%, of those who were eligible participated in the interview. Self-rated health, when as…

The Relationship Between Generalized Resistance Resources, Sense of Coherence, and Health Among Finnish People Aged 65-69

Abstract. The present study investigated the appropriateness of Antonovsky's model, in which generalized resistance resources (GRRs) facilitate an individual's sense of coherence (SOC); which in turn is assumed to sustain health. The proposed model was tested using a sample of 320 Finnish persons (132 of them were men and 188 women) aged 65-69 years. The GRRs investigated were family income, cognitive functioning, years of formal education, marital status, and physical exercise. Health was measured by means of a multidimensional indicator composed of physical, social and mental health. Structural Equation Modelling (SEM) within the framework of LISREL models were used to test the hypothesi…

Factors associated with maximal walking speed among older community-living adults.

Background and aims: The relative contribution of different domains on walking speed is largely unknown. This study investigated the central factors associated with maximal walking speed among older people. Methods: Cross-sectional analyses of baseline data from the SCAMOB study (ISRCTN 07330512) involving 605 community-living ambulatory adults aged 75–81 years. Maximal walking speed, leg extensor power, standing balance and body mass index were measured at the research center. Physical activity, smoking, use of alcohol, chronic diseases and depressive symptoms were self-reported by standard questionnaires. Results: The mean maximal walking speed was 1.4 m/s (range 0.3–2.9). In linear regre…

A path analysis model of self-rated health among older people.

The aim of this study was to examine the structure of self-rated health among 75-year-old men and women. The study was part of the Evergreen project, comprising all the 75-year-old residents (N = 382) of Jyväskylä, in central Finland, in 1989. The data were collected by interviews, questionnaires and laboratory examinations, focusing on different domains of health and functional capacity. Of the target group, 91.6% (119 men and 231 women) participated in the interview, and 77.2% (104 men and 191 women) took part in the clinical and laboratory examinations. Path analysis models (LISREL 8) were used to examine the structure of self-rated health. About half the participants self-rated their he…

Effect of Physical Activity Counseling on Disability in Older People: A 2-Year Randomized Controlled Trial

OBJECTIVES: To study the effect of a physical activitycounseling intervention on instrumental activity of dailyliving (IADL) disability.DESIGN: Primary care–based, single-blind, randomizedcontrolled trial.SETTING: City of Jyva¨skyla¨, central Finland.PARTICIPANTS: Six hundred thirty-two people aged 75to 81 who were able to walk 500 meters without assistance,were at most moderately physically active, had a Mini-Mental State Examination score greater than 21, had nomedical contraindications for physical activity, and gaveinformed consent for participation.INTERVENTION: A single individualized physical activitycounseling session with supportive phone calls from a physio-therapist every 4 month…

Perceived barriers in the outdoor environment and development of walking difficulties in older people

SIR—Older people with mobility limitations often report more barriers in their outdoor environment than people with intact mobility [1]. However, it is uncertain whether older people perceive their environment as problematic because of their mobility limitations or whether the environmental barriers precede incident mobility limitation, as most studies have been limited to cross-sectional analyses [2–5]. Only a few longitudinal studies have shown that barriers in the outdoor environment, such as poor street conditions, poor lighting and heavy traffic, increase the risk for overall functional loss [6, 7] and decrease physical activity participation [8]. More knowledge is needed about the cha…

Underlying Factors in the Association between Depressed Mood and Mobility Limitation in Older People

<i>Background:</i> Depressed mood may either precede mobility limitation or follow from mobility limitation. <i>Objective:</i> To compare mood status among people with manifestmobility limitation, those with preclinical mobility limitation and those without mobility limitation and investigate factors explaining the association between depressed mood and mobility limitation. <i>Design:</i> Cross-sectional. Subjects: 645 community-living 75- to 81-year-old people. <i>Methods:</i> Depressed mood was assessed using the Centre for Epidemiologic Studies Depression Scale (CES-D, cut-off score 16); difficulty walking 500 m was assessed by self-report.…

Perceived constraints on physical exercise among obese and non-obese older people.

Abstract Objective To examine what older obese people consider as constraints on their physical exercise and to determine whether these constraints can explain the differences in physical activity. Methods Six hundred nineteen community-living people aged 75–81 years living in Jyvaskyla, Central Finland, in 2003 were included in these cross-sectional analyses. Weight and height were measured at the research center, and physical activity and perceived constraints on physical exercise were assessed using validated questionnaires. Participants were categorized as non-obese ( n  =   436), moderately obese ( n  =   127) or severely obese ( n  =   56). Results The risk of physical inactivity was …

Self-rated health in old age : a follow-up study of changes and determinants

The purpose of the study was to examine how older people rate their health with increase-ing age and how they assess change in their health over a 5-year follow-up period. Further, the aim was to study the individual-related factors underlying self-rated health, as well as to explore whether self-rated health takes the form of a continuum in relation to different indicators of health status, functional performance, and physical and social activity.This study was part of the Evergreen project and used data on the inhabitants of Jyväskylä, Finland, born in 1914. The baseline data were collected in 1989, the 5-year follow-up was conducted in 1994, and the 10-year follow-up in 1999. The data we…

Fear of Moving Outdoors and Development of Outdoor Walking Difficulty in Older People

OBJECTIVES: To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation. DESIGN: Observational prospective cohort study and cross-sectional analyses. SETTING: Community and research center. PARTICIPANTS: Seven hundred twenty-seven community-living people aged 75 to 81 were interviewed at baseline, of whom 314 took part in a 3.5-year follow-up. MEASUREMENTS: Fear of moving outdoors and its potential individual and environmental correlates were assessed at baseline. Perceived difficulties in walking 0.5 km and 2 km were assessed twice a year over a 3.5-year period. RE…

Motives for and barriers to physical activity among older adults with mobility limitations

The purpose of this study was to investigate what older adults with severe, moderate, or no mobility limitation consider motives for and barriers to engaging in physical exercise. Community-dwelling adults (N = 645) age 75–81 years completed a questionnaire about their motives for and barriers to physical exercise and answered interview questions on mobility limitation. Those with severely limited mobility more often reported poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise than did those with no mobility limitation. They also accentuated disease management as a motive for exercise, whereas those with no or moderate mobility …

Long-term effect of physical activity counseling on mobility limitation among older people: a randomized controlled study.

Background. Physical activity counseling increases physical activity among older people, but its effectiveness on mobility, that is, maintaining the ability to move independently, is unknown. We studied the effect of physical activity counseling on mobility among older people and evaluated whether counseling-induced benefi ts persist after cessation of the intervention. Methods. In a 2-year, single-blinded, randomized controlled study, 632 sedentary participants aged 75 – 81 years were randomly assigned into the intervention ( n = 318) or control ( n = 314) group. The intervention group received a single individualized physical activity counseling session with a supportive telephone contact…

Effect of physical activity counseling on physical activity of older people in Finland (ISRCTN 07330512).

SUMMARY The aim of this study was to describe the underlying theory and the implementation of a 2-year individualized physical activity counseling intervention and to evaluate whether benefits persisted 1.5 years after the intervention. The sample included 632 sedentary 75- to 81-year-old participants. Data were collected in 2003 –2005. The participants were randomly assigned to an intervention group and a control group. The intervention consisted of an individualized face-to-face meeting followed by telephone contacts every 4 months for 2 years, with the aim to increase participation in specific physical activities as well as to increase habitual physical activity. At the 2-year follow-up,…

Customer-oriented counseling for physical activity in older people: study protocol and selected baseline results of a randomized-controlled trial (ISRCTN 07330512)

The objective of this study is to describe the rationale, design and selected baseline results of a 2-year randomized-controlled trial (RCT) on the effects of physical activity counseling in community-living older people. After a four-phase screening and data-collection process targeting all independently living people in the city center of Jyvaskyla, Finland, six hundred and thirty-two 75–81-year-old cognitively intact, sedentary persons who were able to move independently outdoors at least minimally and willing to take part in the RCT were randomized into intervention and control groups. At baseline, over half of the subjects exercised less than two to three times a month and two-thirds w…

Effect of physical activity councelling on disability in older people: A 2-year randomized controlled trial.

OBJECTIVES: To study the effect of a physical activity counseling intervention on instrumental activity of daily living (IADL) disability. DESIGN: Primary care–based, single-blind, randomized controlled trial. SETTING: City of Jyväskylä, central Finland. PARTICIPANTS: Six hundred thirty-two people aged 75 to 81 who were able to walk 500 meters without assistance, were at most moderately physically active, had a Mini-Mental State Examination score greater than 21, had no medical contraindications for physical activity, and gave informed consent for participation. INTERVENTION: A single individualized physical activity counseling session with supportive phone calls from a physiotherapist ever…

Physical activity history and end-of-life hospital and long-term care

Background: Little is known about the early predictors of need for care in late life. The purpose of this study was to investigate whether physical activity from midlife onward was associated with hospital and long-term care in the last year of life. Methods: We studied a decedent population of 846 persons aged 66–98 years at death, who, on average 5.8 years prior to death, had participated in an interview about their current and earlier physical activity. Data on the use of care in the last year of life are register-based data and complete. Results: Men needed on average 96 days (SD 7.0) and women 138 days (SD 6.2) of inpatient care in the last year of life. Among men, the risk for all-cau…

Effect of physical activity counseling on home care use in older people

Changes in health, functional performance and activity predict changes in self-rated health: a 10-year follow-up study in older people.

Abstract The purpose was to examine changes in self-rated health (SRH) in older people and associations between these changes and various self-reported and objectively measured indicators of health status, functional performance and activity at three time-points 5 years apart. Further, our aim was to examine whether SRH takes the form of a continuum. The study group comprised all the baseline 75-year-old inhabitants of the City of Jyvaskyla, Finland (N=382). Four groups were formed according to change/stability in SRH: ‘good–good’, ‘good–bad’, ‘bad–good’ and ‘bad–bad’. Cross-tabulation and one-way analysis of variance (ANOVA) was used to examine the cross-sectional differences, and GLM Repe…

Predictors of decline in self-assessments of health among older people--a 5-year longitudinal study.

Within the framework of the Evergreen project we examined how changes in several indicators of health and functioning and physical activity predicted a decline in self-assessments of health evaluated over a 5-year period in older people by two different measurements: self-rated health (SRH) and self-assessed change in health (SACH). The study group comprised all 75-year-old persons born in 1914 (N = 382) and living in Jyvaskyla, a town in central Finland. At baseline in 1989, 91.6%, and at follow-up 5 years later in 1994, 87.3% of those eligible participated in the interview and 77.2 and 71.3%, respectively, in the examinations in the study centre, focusing on different domains of health an…

The effects of physical activity counseling on mood among 75- to 81-year-old people: a randomized controlled trial.

Abstract Objectives. To examine the effects of physical activity counseling on mood among older people unselected for their depressive symptomatology. Methods. Data are from “Screening and Counseling for Physical Activity and Mobility in Older People” project (SCAMOB), conducted in Finland during 2003–2005. SCAMOB was a 2-year single-blinded randomized controlled trial among 624 participants 75 years and older randomized into physical activity counseling group and control group. Depressive symptoms were assessed at baseline and after 24 months using Center for the Epidemiologic Studies Depression Scale. Results. Among all the study participants, no effect of intervention was observed. Howev…

Unmet Physical Activity Need in Old Age

OBJECTIVES To examine which individual and environmental factors correlate with unmet physical activity need in old age and predict development of unmet physical activity need (the feeling that one's level of physical activity is inadequate and thus distinct from the recommended amount of physical activity) over a 2-year follow-up. DESIGN Observational prospective cohort study and cross-sectional analyses. SETTING Community and research center. PARTICIPANTS A total of 643 community-living ambulatory people aged 75 to 81 took part in face-to-face interviews and examinations at baseline and 314 at the 2-year follow-up. MEASUREMENTS Unmet physical activity need and its potential individual and…