0000000000307498
AUTHOR
Kaisu H. Pitkälä
Effects of a 12‐month home‐based exercise program on functioning after hip fracture – Secondary analyses of an RCT
Background Long-term functional limitations are common after hip fractures. Exercise may alleviate these negative consequences but there is no consensus on an optimal training program. The objective was to study the effects of a 12-month home-based supervised, progressive exercise program on functioning, physical performance, and physical activity. Methods Secondary analysis of a randomized controlled trial targeting patients with surgical repair of a hip fracture, aged >= 60 years, Mini-Mental State Examination (MMSE) score of >= 12. The participants were randomized into Exercise (n = 61) or Usual care (n = 60). Assessments at baseline, 3, 6, and 12 months included Lawton's Instrumental Ac…
Effects of home-based physical exercise on days at home, healthcare utilization and functional independence among patients with hip fractures : a randomized controlled trial
Objective To evaluate the effects of a physical exercise program on days lived at home, the use and costs of healthcare and social services mortality and functional independence among patients with hip fractures. Design Randomized controlled trial with parallel two-group design, consisting of a 12-month intervention and 12-month registry follow-up. Setting Home-based intervention. Participants Patients with operated hip fracture, living at home, aged ≥60 years, randomized into physical-exercise (n=61) or usual-care (n=60) groups. Intervention Supervised physical exercise twice a week. Main Outcome Measures The primary outcome was the number of days lived at home over 24 months. Secondary ou…
Recommendations on Physical Activity and Exercise for Older Adults Living in Long-Term Care Facilities: A Taskforce Report.
A taskforce, under the auspices of The International Association of Gerontology and Geriatrics-Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics, met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCFs). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established 2 sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and r…
Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons: Randomized Controlled Trial.
Objectives: Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored. Design: Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization. Setting and Participants: A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: >65 years, meeti…
Prevention of Functional Decline by Reframing the Role of Nursing Homes?
Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of t…
Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen
Background long working hours and short sleep duration are associated with a range of adverse health consequences. However, the combined effect of these two exposures on health-related quality of life (HRQoL) has not been investigated. Methods we studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3,490). Data on clinical variables, self-rated health (SRH), working hours and sleep duration in 1974, and RAND-36 (SF-36) HRQoL survey in the year 2000 were available for 1,527 men. Follow-up time was 26 years. By combining working hours and sleep duration, four categories were formed: (i) normal work (≤50 hours/week) and normal sleep (>47 hours/week);…
Older persons with signs of frailty in a home-based physical exercise intervention : baseline characteristics of an RCT
Background Increasing the level of physical activity among persons with signs of frailty improves physical functioning. There is a lack of long-term supervised physical exercise intervention studies including a validated definition of frailty. Aims To present baseline characteristics of persons with signs of frailty participating in a randomized long-term home-based physical exercise trial (HIPFRA), and to study associations between the severity of frailty, functional independence and health-related quality-of-life (HRQoL). Methods Three hundred persons, ≥ 65 years old and with signs of frailty (assessed by Fried´s phenotype criteria) were recruited from South Karelia, Finland and randomize…
Effects of Home-Based Physical Exercise on Days at Home, Health Care Utilization, and Functional Independence Among Patients With Hip Fractures: A Randomized Controlled Trial.
Abstract Objective To evaluate the effects of a physical exercise program on days lived at home, the use and costs of health care and social services, mortality, and functional independence among patients with hip fractures. Design Randomized controlled trial with a parallel 2-group design consisting of a 12-month intervention and 12-month registry follow-up. Setting Home-based intervention. Participants Patients aged ≥60 years (N=121) with operated hip fracture and who were living at home were randomized into physical exercise (n=61) and usual care (n=60) groups. Interventions Supervised physical exercise twice a week. Main Outcome Measures The primary outcome was the number of days lived …
Associations of vacation time with lifestyle, long-term mortality and health-related quality of life in old age: The Helsinki Businessmen Study
Abstract Introduction There are few longitudinal studies of relationships between vacation and later health outcomes. We studied these during a 26-year follow-up of the Helsinki Businessmen Study. Methods In 1974, at mean age of 47 years, 2741 members of a cohort of executives and businessmen born 1919–1934 were clinically examined and reported their annual vacation time (dichotomized >21 [n = 2001] vs. ≤21 days [n = 740]), self-rated health (SRH) and perceived physical fitness using a five-step scale. In old age in 2000 (mean age 73 years), the survivors filled in the RAND-36/SF-36 health-related quality of life (HRQoL) questionnaire. Mortality between 1974 and 2000 was retrieved from nati…
Effect of 12-Month Supervised, Home-Based Physical Exercise on Functioning Among Persons With Signs of Frailty: A Randomized Controlled Trial
To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty.A randomized controlled trial with a 1:1 allocation.Home-based.Home-dwelling persons aged 65 years or older meeting at least 1 frailty phenotype criteria (N=300). The mean age of the participants was 82.2±6.3 years, 75% were women, 61% met 1-2 frailty criteria, and 39% met ≥3 criteria.A 12-month, individually tailored, progressive, and physiotherapist-supervised physical exercise twice a week (n=150) vs usual care (n=149).FIM, Short Physical Performance Battery (SPPB), handgrip strength, instrumental activities of daily living (IADL), and self-reported falls and …
Midlife Cardiovascular Status and Old Age Physical Functioning Trajectories in Older Businessmen
Objectives The associations between cardiovascular disease (CVD) risk and later physical functioning have been observed, but only a few studies with follow-up into old age are available. We investigated the association between cardiovascular status in midlife and physical functioning trajectories in old age. Design Prospective cohort study. Setting Helsinki Businessmen Study. Participants We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3490). Measurements Three CVD status groups were formed based on clinical measurements carried out in 1974: signs of CVD (diagnosed clinically or with changes in ECG, chronic disease present or used medicati…
Long-term home-based physiotherapy for persons with signs of frailty–RCT (NCT02305433)
Introduction/Background Frailty is a multidimensional condition, which can lead to disability. To postpone long-term care, one alternative is home-based physiotherapy. We study the effects of a 12-month home-based physiotherapy program on functional capacity, and applying successive 12-month register follow-up, on the use and costs of social and health care services, and on the duration of living at home during 24 months (the primary outcome). Here we report about feasibility of the intervention and baseline characteristics. Material and method Three hundred home-dwelling persons (>65 y) with signs of frailty were recruited by September, 2016. Frailty was screened by Morley's FRAIL question…