0000000000273034
AUTHOR
Miia Kivipelto
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…
Lymphocytic Mitochondrial Aconitase Activity is Reduced in Alzheimer's Disease and Mild Cognitive Impairment
Background: Specific mechanisms behind the role of oxidative/nitrosative stress and mitochondrial dysfunction in Alzheimer's disease (AD) pathogenesis remain elusive. Mitochondrial aconitase (ACO2) is a Krebs cycle enzyme sensitive to free radicalmediated damage. Objective: We assessed activity and expression of ACO2 extracted from blood lymphocytes of subjects with AD, mild cognitive impairment (MCI), older adults with normal cognition (OCN, age >= 65 years), and younger adults with normal cognition (YCN, age < 65 years). Plasma levels and activities of antioxidants were also measured. Methods: Blood samples were collected from 28 subjects with AD, 22 with MCI, 21 OCN, and 19 YCN. ACO2 act…
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…
New Strategy to Reduce the Global Burden of Stroke
The socioeconomic and health effect of stroke and other noncommunicable disorders (NCDs) that share many of the same risk factors with stroke, such as heart attack, dementia, and diabetes mellitus, is huge and increasing.1–4 Collectively, NCDs account for 34.5 million deaths (66% of deaths from all causes)3 and 1344 million disability-adjusted life years lost worldwide in 2010.2 The burden of NCDs is likely to burgeon given the aging of the world’s population and the epidemiological transition currently observed in many low- to middle-income countries (LMICs).5,6 In addition, there is low awareness in the population about these NCDs and their risk factors,7–10 particularly in LMICs.11 These…
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…
The effects of a physical and cognitive training intervention vs. physical training alone on older adults' physical activity : A randomized controlled trial with extended follow-up during COVID-19
BackgroundExecutive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown.MethodsData from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70-85 years old community-dwel…
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…
Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015
BACKGROUND: Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. METHODS: Drawing from ana…
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…
Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013
Summary Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic develo…
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…
Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
BACKGROUND: In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015.METHODS: We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underl…
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
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 …
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included…
The Stroke Riskometer (TM) App: Validation of a data collection tool and stroke risk predictor
Background The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the ‘mass’ approach), the ‘high risk’ approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer™, has been developed. We aim to explore the validity of the app fo…
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013
Summary Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2…
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…
Effects of Physical and Cognitive Training on Falls and Concern About Falling in Older Adults : Results From a Randomized Controlled Trial
Abstract Background The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cogniti…
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…