0000000000448670

AUTHOR

Erja Portegijs

Effects of a Rehabilitation Program on Perceived Environmental Barriers in Older Patients Recovering from Hip Fracture: A Randomized Controlled Trial

Objectives. To study effects of a one-year multicomponent intervention on perceived environmental barriers in hip fracture patients.Design. Randomized controlled trial of a 12-month home-based rehabilitation aiming to improve mobility and function (ISRCTN53680197); secondary analyses.Subjects. Community-dwelling hip fracture patients on average 70 days after trauma (n=81).Methods. Assessments at baseline, 3, 6, and 12 months later included perceived entrance-related barriers (e.g., indoor/outdoor stairs, lighting, floor surfaces, and storage for mobility devices) and perceived barriers in the outdoor environment (poor street condition, hilly terrain, long-distances, and lack of resting plac…

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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…

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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…

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Is Complexity of Daily Activity Associated with Physical Function and Life Space Mobility among Older Adults?

Purpose Information about mobility, and physical function may be encoded in the complexity of daily activity pattern. Therefore, daily activity pattern complexity metrics could provide novel insight regarding the relationship between daily activity behaviour and health. The purpose of the present study was to examine the association between the complexity of daily activity behaviour, and mobility and physical function among community-dwelling older adults aged 75, 80, and 85 years-of-age. Methods A total of 309 participants wore accelerometers concurrently on the thigh and the trunk for at least 3 consecutive days. Five activity states (lying, sitting, standing, walking, or activity other t…

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TENACIOUS GOAL PURSUIT AND LIFE-SPACE MOBILITY AMONG OLDER PEOPLE WITH WALKING DIFFICULTIES

Life-space mobility, defined as the spatial extent of movement in daily life, is strongly dependent on functional ability. However, active striving to reach one’s goals might inspire older people to move in a larger life-space regardless of their physical abilities. We aimed to study whether tenacious goal pursuit differs according to walking difficulties and whether it is associated with life-space mobility in old age.

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The Associations of Activity Fragmentation with Physical and Mental Fatigability among Community-Dwelling 75-, 80- and 85-Year-Old People

Abstract Background Fatigue related to task standardized by duration and intensity, termed fatigability, could manifest as shortening of activity bouts throughout the day causing daily activity to accumulate in a more fragmented pattern. Our purpose was to study the association of activity fragmentation with physical and mental dimensions of fatigability. Methods A cross-sectional study of 485 community-dwelling 75-, 80-, and 85-year-old people using a thigh-worn accelerometer for 3–7 days. Activity fragmentation was studied as Active-to-Sedentary Transition Probability for 2 operational definitions of physical activity: accelerations equivalent to at least light physical activity and for u…

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Birth cohort differences in cognitive performance in 75- and 80-year-olds: a comparison of two cohorts over 28 years.

Abstract Objective To evaluate cohort differences in cognitive performance in older men and women born and assessed 28 years apart. Methods Data in this study were drawn from two age-homogeneous cohorts measured in the same laboratory using the same standardized cognitive performance tests. Participants in the first cohort were born in 1910 and 1914 and assessed in 1989–1990 (Evergreen project, n = 500). Participants in the second cohort were born in 1938 or 1939 and 1942 or 1943 and assessed in 2017–2018 (Evergreen II, n = 726). Participants in both cohorts were assessed at age 75 and 80 years and were recruited from the population register. Cognitive performance was measured using the Dig…

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Individualized counselling for active aging: protocol of a single-blinded, randomized controlled trial among older people (the AGNES intervention study)

Background: Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person’s goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different aspects of well-being in older people. The aim of the present randomized controlled trial is to test the feasibility and effectiveness of a one-year community-based intervention on active aging. The AGNES intervention aims at increasing older peoples’ participation in self-selected valued activities. Methods: The proposed study is a two-arm single-…

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Association Between Free-Living Sit-to-Stand Transition Characteristics, and Lower-Extremity Performance, Fear of Falling, and Stair Negotiation Difficulties Among Community-Dwelling 75 to 85-Year-Old Adults

Abstract Background Good sit-to-stand (STS) performance is an important factor in maintaining functional independence. This study investigated whether free-living STS transition volume and intensity, assessed by a thigh-worn accelerometer, is associated with characteristics related to functional independence. Methods Free-living thigh-worn accelerometry was recorded continuously for 3–7 days in a population-based sample of 75-, 80-, and 85-year-old community-dwelling people (479 participants; women n = 287, men n = 192). The records were used to evaluate the number and intensity (angular velocity of the STS phase) of STS transitions. Associations with short physical performance battery (SPP…

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Physical activity compensates for increased mortality risk among older people with poor muscle strength

The aim of the study was to determine whether habitual physical activity can compensate for the increased mortality risk among older people with poor muscle strength. Mortality was followed up for 10 years after laboratory examination in 558 community dwelling 75- and 80-year-old men and women. Maximal isometric strength of five muscle groups was measured and tertile cut-off points were used to categorize participants. Participants, who reported moderate physical activity for at least 4 h a week, were categorized as physically active and the others as sedentary. High muscle strength and physical activity both protected from mortality, but their effect was not additive. Within each muscle st…

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Day-to-Day Variability and Year-to-Year Reproducibility of Accelerometer-Measured Free-Living Sit-to-Stand Transitions Volume and Intensity among Community-Dwelling Older Adults

(1) Background: The purpose of this study was to evaluate the day-to-day variability and year-to-year reproducibility of an accelerometer-based algorithm for sit-to-stand (STS) transitions in a free-living environment among community-dwelling older adults. (2) Methods: Free-living thigh-worn accelerometry was recorded for three to seven days in 86 (women n = 55) community-dwelling older adults, on two occasions separated by one year, to evaluate the long-term consistency of free-living behavior. (3) Results: Year-to-year intraclass correlation coefficients (ICC) for the number of STS transitions were 0.79 (95% confidence interval, 0.70-0.86, p < 0.001), for mean angular velocity-0.81 (95% c…

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Supplemental_figure_2 – Supplemental material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial

Supplemental material, Supplemental_figure_2 for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial by Katri M Turunen, Laura Aaltonen-Määttä, Timo Törmäkangas, Timo Rantalainen, Erja Portegijs, Sirkka Keikkala, Marja-Liisa Kinnunen, Taija Finni, Sarianna Sipilä and Riku Nikander in Clinical Rehabilitation

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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 …

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Health literacy supports active aging

From the individual viewpoint, active aging refers to the ability of older persons, depending on their goals, functional capacity and opportunities, to engage in desired activities. This study investigated the role of health literacy in active aging among persons differing in their number of chronic conditions. Data were collected from 948 individuals, 57% women, aged 75, 80 and 85 in 2017–2018 in the city of Jyväskylä in Central Finland. Health literacy was assessed with the 16-question version of the European Health Literacy Survey (HLS-EU-Q16), active aging with the University of Jyväskylä Active Aging Scale (UJACAS) and self-reported physician-diagnosed chronic conditions. Both health l…

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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…

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

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Self-rated resilience and mobility limitations as predictors of change in active aging during COVID-19 restrictions in Finland : a longitudinal study

AbstractSocial distancing during the COVID-19 pandemic decreased older people’s opportunities to lead an active life. The purpose of this study was to investigate whether walking difficulties predict changes in leading an active life during the COVID-19 social distancing recommendation compared to 2 years before, and whether self-rated resilience moderates this association among older people. Data were collected during social distancing recommendation in May and June 2020 and 2 years before (2017–18) among community-living AGNES study participants initially aged 75, 80, or 85 years (n = 809). Leading an active life was assessed with the University of Jyväskylä Active Aging Scale (UJACAS; to…

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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…

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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 &lt; 60). Those reporting one or more environmental barriers had more than double the odds for restricted life-space co…

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Neighborhood environment, social participation, and physical activity in older adults with lower limb osteoarthritis: A mediation analysis

Older adults with lower limb osteoarthritis (LLOA) are highly dependent on their physical and social environment for being physically active. Longitudinal data from 2286 older adults (M age = 73.8 years; 50.3% female) in six European countries were analyzed using cross-lagged Structural Equation Modeling (SEM) and multi-group SEM. In cross-sectional analyses, neighborhood resources were associated with physical activity (r = 0.26;p &lt;.001) and social participation (r = 0.13;p =.003). Physical activity at follow-up was associated with neighborhood resources, with this relationship mediated by social participation in people with LLOA (β = 0.018;p =.013). To promote future physical activity,…

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A tailored counseling and home-based rehabilitation program to increase physical activity and improve mobility among community-dwelling older people after hospitalization: protocol of a randomized controlled trial

Physical activity (PA) decreases during hospitalization. In particular, the amount of PA engaged in by older people who are hospitalized following musculoskeletal injury is likely to be limited for months after discharge home. Given the importance of an active lifestyle for their recovery and the prevention of future adverse outcomes, there is clearly a need for interventions to increase PA. This article describes the protocol of a randomized controlled trial set up to investigate the effects of a physical activity oriented home rehabilitation program (ProPA) on PA and the restoration of mobility in community-dwelling older people. Men and women aged 60 years or older hospitalized due to a …

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Environmental Features Associated With Older Adults' Physical Activity in Different Types of Urban Neighborhoods.

The authors studied associations of nature- and infrastructure-based features with physical activity (PA) in different urban neighborhood types; 848 community-dwelling people aged 75–90 years reported PA and three perceived nature-based destinations and seven infrastructure-based features as outdoor mobility facilitators. Neighborhood type was defined using a geographic information system based on proximity to central service areas and residential density (city center, subcenter, and dense and dispersed areas outside centers). PA was higher in dense areas and the city center. Binary logistic regression showed that perceiving nature-based destinations increased the odds for higher PA in the …

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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…

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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…

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ASYMMETRICAL LOWER EXTREMITY POWER DEFICIT AS A RISK FACTOR FOR INJURIOUS FALLS IN HEALTHY OLDER WOMEN

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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…

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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 …

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Supplemental_tables – Supplemental Material for Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study

Supplemental Material, Supplemental_tables for Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study by Heidi Skantz, Taina Rantanen, Timo Rantalainen, Kirsi E. Keskinen, Lotta Palmberg, Erja Portegijs, Johanna Eronen and Merja Rantakokko in Journal of Aging and Health

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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.…

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Hilliness and the Development of Walking Difficulties Among Community-Dwelling Older People

Objective: The objective of this study is to study the associations of objectively defined hilliness with the prevalence and incidence of walking difficulties among community-dwelling older adults, and to explore whether behavioral, health, or socioeconomic factors would fully or partially explain these associations. Method: Baseline interviews ( n = 848, 75-90 years) on difficulties in walking 500 m, frequency of moving through the neighborhood, and perceived hilliness as a barrier to outdoor mobility were conducted. Two-year follow-up interviews ( n = 551) on difficulties in walking 500 m were conducted among participants without baseline walking difficulties. Hilliness objectively defin…

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Associations Between Accelerometer-Based Free-Living Walking and Self-Reported Walking Capability Among Community-Dwelling Older People

The authors examined whether accelerometer-based free-living walking differs between those reporting walking modifications or perceiving walking difficulty versus those with no difficulty. Community-dwelling 75-, 80-, or 85-year-old people (N = 479) wore accelerometers continuously for 3–7 days, and reported whether they perceived no difficulties, used walking modifications, or perceived difficulties walking 2 km. Daily walking minutes, walking bouts, walking bout intensity and duration, and activity fragmentation were calculated from accelerometer recordings, and cut points for increased risk for perceiving walking difficulties were calculated using receiver operating characteristic analys…

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Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture

Aim The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. Methods The study included 115 community-dwelling older adults aged 60 years and older with previous femoral neck fracture, and 31 reference subjects without previous lower limb injuries. A total of 30 patients had internal fixation surgery, 70 had hemiarthroplasty and 15 had total hip replacement. All patients had surgery in the same hospital and received typical inpatient rehabilitation. From 1.6 months to 7.5 years after the fracture, the patients underwent examination inclu…

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Personal goals and changes in life-space mobility among older people

Abstract Objective Life-space mobility – the spatial extent of mobility in daily life – is associated with quality of life and physical functioning but may also be influenced by future orientation expressed in personal goals. The aim of this study was to explore how different personal goals predict changes in older people's life-space mobility. Methods This prospective cohort study with a 2-year follow-up included 824 community-dwelling people aged 75 to 90 years from the municipalities of Jyvaskyla and Muurame in Central Finland. As part of the Life-Space Mobility in Old Age study (LISPE), which was conducted between 2012 and 2014, the participants responded to the Life-Space Assessment an…

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Map-based assessment of older adults’ life space: validity and reliability

Background Map-based tools have recently found their way into health-related research. They can potentially be used to quantify older adults’ life-space. This study aimed to evaluate the validity (vs. GPS) and the test-retest reliability of a map-based life-space assessment (MBA). Methods Life-space of one full week was assessed by GPS and by MBA. MBA was repeated after approximately 3 weeks. Distance-related (mean and maximum distance from home) and area-related (convex hull, standard deviational ellipse) life-space indicators were calculated. Intraclass correlations (MBA vs. GPS and test-retest) were calculated in addition to Bland-Altman analyses (MBA vs. GPS). Results Fifty-eight older …

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Individual Scaling of Accelerometry to Preferred Walking Speed in the Assessment of Physical Activity in Older Adults

Abstract Background Walking forms a large portion of physical activity (PA) of older adults. We assessed free-living PA using acceleration corresponding to preferred walking speed as a relative cut-point and studied how it relates to age. We compared the relative cut-point to a common absolute cut-point of moderate-to-vigorous physical activity (MVPA). Method Four hundred forty-four community-dwelling adults aged 75, 80, and 85 years wore an accelerometer on the thigh during a PA surveillance period and a modified 6-minute walking test (6MWT) at preferred speed. Each individual’s mean acceleration (g) during the 6MWT was used as a cut-point for relative PA. Acceleration corresponding to thr…

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Neighborhood walkability and older people's participation in leisure activities

Background The neighborhood environment may enhance or restrict older people's opportunities to participate in leisure activities, and thus impact quality of life. Walkability depicts the environment's suitability for walking to different destinations. Little is known concerning about the relation between environment walkability and participation in leisure activities. Our purpose was to study whether neighborhood's objective and perceived walkability were related to participation in various leisure activities outside the home. Methods Cross-sectional data of LISPE consisted of 848 community-dwelling people aged 75-90 living in the municipalities of Jyväskylä and Muurame, Finland. Participa…

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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…

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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)…

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Do opposite ends of same factors underlie life satisfaction vs. depressive symptoms among older people?

Abstract Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. Methods The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Phy…

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FLEXIBLE AND TENACIOUS GOAL PURSUIT IN RELATION TO OUTDOOR MOBILITY IN OLD AGE

Goal pursuit may affect older people’s outdoor mobility, a correlate of quality of life. This study investigated associations of flexible and tenacious goal pursuit with perceived autonomy in participation outdoors and life-space mobility. Participants were community-dwelling older people aged 79–93 years (n=185). Tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) were self-reported with separate scales (ranges 5–25). Perceived autonomy in participation was assessed with the Impact on Participation and Autonomy ‘outdoors’-subscale (range 0–20), and life-space mobility with the Life-Space Assessment (range 0–120). Two-step cluster analysis was used to create data-driven goal pur…

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Clustering of reported activity destinations and use of active transport among older adults

Background Conducting everyday activities out-of-home may accumulate a large share of older adults' daily physical, especially if active transportation is used. Environmental features in home neighborhood may motivate for higher physical activity, but the role of features around destinations is less known. Our goal was to study 1) clustering of older adults' reported activity destinations, and 2) whether transport mode to a destination was associated with characteristics of destination clusters. Methods Data comprise AGNES study participants (901 community-dwelling people aged 75-85 years living in city of Jyväskylä, Finland; 57% women) combined with geospatial data. Using digital mapping, …

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Maintenance of high quality of life as an indicator of resilience during COVID-19 social distancing among community-dwelling older adults in Finland

Abstract Purpose Social distancing during the COVID-19 pandemic reduced possibilities for activities of choice potentially threatening quality of life (QoL). We defined QoL resilience as maintaining high quality of life and studied whether walking speed, absence of loneliness, living arrangement, and stress-coping ability predict QoL resilience among older people. Methods Community-dwelling 75-, 80-, and 85-year-old persons (n = 685) were interviewed and examined in 2017–2018 and were followed up during COVID-19 social distancing in 2020. We assessed QoL using the OPQOL-brief scale and set a cut-off for ‘constant high’ based on staying in the highest baseline quartile over the follow-up and…

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Assimilative and Accommodative Coping and Older People’s Leisure Activities

Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation to leisure activities in old age. We investigated whether tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) influence the association between physical performance and participation in leisure activities. Methods: A cross-sectional analysis was conducted among 187 community-dwelling people aged 79 to 93 years. TGP, FGA, and leisure activity participation were asked with questionnaires. Physical performance was assessed with the Short Physical Performance Battery (SPPB). Results: TGP moderated the relationship between physical performance and leisure activity participation. Despite…

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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,…

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Life-Space Mobility and Active Aging as Factors Underlying Quality of Life Among Older People Before and During COVID-19 Lockdown in Finland—A Longitudinal Study

Abstract Background Social distancing, that is, avoiding places with other people and staying at home, was recommended to prevent viral transmission during the COVID-19 pandemic. Potentially, reduced out-of-home mobility and lower activity levels among older people may lower their quality of life (QOL). We studied cross-sectional and longitudinal associations of and changes in life-space mobility, active aging, and QOL during COVID-19 social distancing compared to 2 years before. Methods Altogether 809 community-living participants initially aged 75, 80, or 85 years of our active aging study (AGNES) conducted in 2017–2018 took part in the current AGNES-COVID-19 survey in May and June 2020. …

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Psychometric properties of the MOBITEC-GP mobile application for real-life mobility assessment in older adults

Aim of this study was to test the reliability and validity of the life-space measures and walking speed delivered by the MOBITEC-GP app. Participants underwent several supervised walking speed assessments as well as a 1-week life-space assessment during two assessment sessions 9 days apart. Fifty-seven older adults (47.4% male, mean age= 75.3 (±5.9) years) were included in the study. The MOBITEC-GP app showed moderate to excellent test-retest reliability (ICCs between 0.584 and 0.920) and validity (ICCs between 0.468 and 0.950) of walking speed measurements of 50 meters and above and of most 1-week life-space parameters, including life-space area, time spent out-of-home, and action range. T…

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Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds : A Comparison of Two Cohorts 28 Years Apart

Objectives To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989–1990 ( n = 617) and 2017–2018 ( n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the c…

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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…

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Impaired geometric properties of tibia in older women with hip fracture history.

This study evaluated side-to-side differences in tibial mineral mass and geometry in women with previous hip fracture sustained on average 3.5 years earlier. Both tibial mineral mass and geometry were found to be reduced in the fractured leg. INTRODUCTION: The purpose of this study was to evaluate side-to-side differences in tibial mineral mass and geometry after hip fracture and to assess the determinants of such differences. METHODS: Thirty-eight 60- to 85-year-old women with a previous hip fracture and 22 same-aged control women without fractures participated in the study. Bone characteristics of the distal tibia and tibial shaft of both legs were assessed using pQCT in order to compare …

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Effects of resistance training on lower-extremity impairments in older people with hip fracture

Abstract Portegijs E, Kallinen M, Rantanen T, Heinonen A, Sihvonen S, Alen M, Kiviranta I, Sipila S. Effects of resistance training on lower-extremity impairments in older people with hip fracture. Objective To study the effects of resistance training on muscle strength parameters, mobility, and balance. Design Randomized controlled trial. Setting Research laboratory and senior gym. Participants Population-based sample of eligible 60- to 85-year-old community-dwelling men and women 0.5 to 7.0 years after hip fracture. Forty-six people had no contraindications and were willing to participate in the exercise trial. Intervention Twelve-week intensive progressive strength-power training (n=24),…

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Impact of mobility restrictions on active aging; cross-sectional associations and longitudinal changes parallel to COVID-19 restrictions

Background: Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. Methods: AGNES cohort data were collected in 2017-2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, comp…

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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…

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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…

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The effect of individualized, theory-based counselling intervention on active aging and quality of life among older people (the AGNES intervention study)

Abstract Background We define active aging as a striving for activities as per one’s goals, capacities and opportunities. Aim To test the 1-year counselling intervention effects on active aging. Methods In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active agi…

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Assessing physical performance and physical activity in large population-based aging studies: home-based assessments or visits to the research center?

Abstract Background The current study aims to compare correlations between a range of measures of physical performance and physical activity assessing the same underlying construct in different settings, that is, in a home versus a highly standardized setting of the research center or accelerometer recording. We also evaluated the selective attrition of participants related to these different settings and how selective attrition affects the associations between variables and indicators of health, functioning and overall activity. Methods Cross-sectional analyses comprising population-based samples of people aged 75, 80, and 85 years living independently in Jyväskylä, Finland. The AGNES stud…

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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.

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Nature diversity and well-being in old age

Background The research aim was to study the associations of nature diversity with quality of life (QoL) and depressive symptoms among older people, and whether physical activity explains the associations. Methods Community-dwelling people aged 75–90 years (n = 848) living in Central Finland were interviewed in their homes. QoL was assessed with a short version of the World Health Organization Quality-of-Life Assessment (range 0–130, higher score indicates better QoL) and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (range 0–30, higher scores indicate more depressive symptoms). Self-reported physical activity was assessed by intensity and duration using a s…

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The effects of muscle strength and power training on mobility among older hip fracture patients

The incidence of hip fractures is growing in all Western societies. The mobility of hip fracture patients does not return to the pre-fracture level even 2 years after fracture. One reason for mobility limitation may be the persistent muscle weakness on the fractured leg. The purpose of this randomized controlled study was to examine whether 12-week muscle strength and power training twice a week has an effect on mobility in 60–85-year-old hip fracture patients. Forty-three persons were randomly assigned to an intervention (n=23) and a control (n=20) group. The intervention comprised 12-week supervised intensive progressive strength–power training twice per week. All the measurers were blind…

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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…

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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…

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Association of tenacious goal pursuit and flexible goal adjustment with out-of-home mobility among community-dwelling older people

Background As people age, functional losses may limit the potential to get outside the home and participate in desired activities and community life. Coping with age-related losses has been reported to be important for psychological well-being. Hitherto is not known whether active use of coping strategies also helps maintain out-of-home mobility. Aims We investigated how two coping strategies, tenacious goal pursuit (TGP; persistency in reaching one’s goals) and flexible goal adjustment (FGA; adjusting one’s goals to changed circumstances), are associated with life-space mobility and perceived autonomy in participation outdoors among community-dwelling older people. Methods Participants (n …

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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 (…

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Developing an Assessment Method of Active Aging: University of Jyvaskyla Active Aging Scale

Objective: To develop an assessment method of active aging for research on older people. Method: A multiphase process that included drafting by an expert panel, a pilot study for item analysis and scale validity, a feedback study with focus groups and questionnaire respondents, and a test–retest study. Altogether 235 people aged 60 to 94 years provided responses and/or feedback. Results: We developed a 17-item University of Jyvaskyla Active Aging Scale with four aspects in each item (goals, ability, opportunity, and activity; range 0-272). The psychometric and item properties are good and the scale assesses a unidimensional latent construct of active aging. Discussion: Our scale assesses ol…

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Associations of Environmental Features With Outdoor Physical Activity on Weekdays and Weekend Days: A Cross-Sectional Study Among Older People

Background: Physical activity (PA) of higher intensity and longer duration mainly accumulates from older adults' out-of-home activities. Outdoor PA is influenced by environmental features; however, the day-to-day variability of PA and its associations with environmental features have not been widely studied. This study focused on the associations of environmental features with accelerometer-measured PA in older people on weekdays and weekend days. Methods: The study population comprised 167 community-dwelling older people aged 75–90 years. Accelerometers were worn on 7 consecutive days and a structured interview on physical functioning, health, and socioeconomic factors was administered. A …

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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…

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Supplemental Material - Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds: A Comparison of Two Cohorts 28 Years Apart

Supplemental Material for Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds: A Comparison of Two Cohorts 28 Years Apart by Tiia Kekäläinen, Kaisa Koivunen, Katja Pynnönen, Erja Portegijs, and Taina Rantanen in Journal of Aging and Health.

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HEALTH AND PHYSICAL FUNCTIONING AS DETERMINANTS OF PURPOSE IN LIFE IN OLD AGE

AbstractPurpose in life reflects the feeling of having goals and meaning in life. Higher purpose in life has been shown to predict better health outcomes in old age and even buffer against mortality. However, it is not known how current health and functional status reflect on the possibilities of older people to live a meaningful life. Therefore, this study aimed to explore associations of health and physical functioning with purpose in life. The participants were 273 community-dwelling 75-year-old men and women from the AGNES study. Purpose in life was assessed with the subscale of the Scales of Psychological well-being (range 7–42). Current health situation and walking ability were self-r…

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Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland

The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75–90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-reported physical activity one or two years later (n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score ≤9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was …

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Moving through Life-Space Areas and Objectively Measured Physical Activity of Older People

Objectives Physical activity–an important determinant of health and function in old age–may vary according to the life-space area reached. Our aim was to study how moving through greater life-space areas is associated with greater physical activity of community-dwelling older people. The association between objectively measured physical activity and life-space area reached on different days by the same individual was studied using one-week longitudinal data, to provide insight in causal relationships. Methods One-week surveillance of objectively assessed physical activity of community-dwelling 70–90-year-old people in central Finland from the “Life-space mobility in old age” cohort substudy…

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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.…

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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…

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Effects of intensive strength-power training on sense of coherence among 60-85-year-old people with hip fracture: A randomized controlled trial

Background and aims: Older people with disabilities are at increased risk of psychological health decline. There are no earlier studies on the effects of resistance training on sense of coherence (SOC) among older people with a history of hip fracture. The aim of this study is to test the effects of intensive 12-week strength-power training on SOC among older adults after hip fracture. Methods: A clinical sample of 60-85-year-old community-dwelling men and women was studied, 0.5. to 7.0 years after hip fracture. Forty-six had no contraindications for participation and were randomized into training (n=24) and control groups (n=22). The training group participated in a 12-week, individually t…

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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 …

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Older adults’ activity destinations before and during COVID-19 restrictions: From a variety of activities to mostly physical exercise close to home

The aim was to study various types of older adult's activity destinations (counts, frequency of visitation, and distance from home) in the pre-COVID-19 era, and to study prospectively how COVID-19-related regulations limiting mobility affected these. Using a map-based questionnaire, 75-85-year-old participants reported activity destinations, that is, any destinations for physical exercise, destinations facilitating one's outdoor mobility, and destinations for other activities, which they had visited several times during the past month. At baseline, a variety of activity destinations was reported, but during COVID-19, destinations reported markedly declined in number, they were reported pred…

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Neighborhood resources associated with active travel in older adults: A cohort study in six European Countries

Objectives: To study associations between perceived neighborhood resources and time spent by older adults in active travel. Methods: Respondents in six European countries, aged 65–85 years, reported on the perceived presence of neighborhood resources (parks, places to sit, public transportation, and facilities) with response options “a lot,” “some,” and “not at all.” Daily active travel time (total minutes of transport-related walking and cycling) was self-reported at the baseline (n = 2,695) and 12–18 months later (n = 2,189). Results: Reporting a lot of any of the separate resources (range B’s = 0.19–0.29) and some or a lot for all four resources (B = 0.22, 95% confidence interval [0.09, …

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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 …

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Leg extension power deficit and mobility limitation in women recovering from hip fracture.

OBJECTIVE: After hip fracture, muscle strength and power remain persistently poor, especially in the fractured leg. This study explores whether asymmetrical leg extension power (LEP) deficit affects mobility in women after proximal femoral fracture (PFF). DESIGN: In this observational study, LEP of both legs, 10- and 50-foot walking speed, and stair-climbing speed were measured in 43 women, aged 73-96, at 1 and 13 wks after surgical repair of PFF. Asymmetrical LEP deficit was calculated as (fractured/(sum both legs)) x 100%. RESULTS: Between weeks 1 and 13 after PFF surgery, LEP increased in the fractured and nonfractured legs by 100% and 30%, respectively. Asymmetrical deficit was reduced …

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ROAD NETWORK HILLINESS AND DEVELOPMENT OF WALKING DIFFICULTIES AMONG COMMUNITY-DWELLING OLDER PEOPLE

Aims: To study associations between objective road network hilliness and development of walking difficulties (WD) within two years, and to examine how hilliness as a perceived barrier and frequency of moving through the neighborhood affect to this.

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Use of walking modifications, perceived walking difficulty and changes in outdoor mobility among community-dwelling older people during COVID-19 restrictions

Abstract Background Outdoor mobility enables participation in essential out-of-home activities in old age. Aim To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported walking. Methods Community-dwelling participants of AGNES study (2017–2018, initial age 75–85) responded to AGNES-COVID-19 postal survey in spring 2020 (N = 809). Life-space mobility, autonomy in participation outdoors, and self-reported physical activity were assessed at both time points and differences according to self-reported walking modifications and difficulty vs. intact walking at baseline were analyzed. Results Life-space mobility and …

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Barriers to and facilitators of participation of older adults in a placebo-controlled randomized clinical trial

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Balance confidence and functional balance are associated with physical disability after hip fracture.

Abstract Background This cross-sectional study investigated the associations between balance confidence, functional balance, and physical disability among older people after hip fracture. Material and methods The study utilizes baseline data of two randomized controlled trials (ISRCTN34271567 and ISRCTN53680197). The participants were 159 community-dwelling over 60-year-old people. Health, fracture status, the date and type of surgery, and contraindications for participation were assessed in a clinical examination. Balance confidence was assessed by the Activities-specific Balance Confidence Scale (ABC) and functional balance by the Berg Balance Scale. Physical disability was assessed by a …

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Association between arterial stiffness and walking capacity in older adults

Background and aim: Arterial stiffening – a process that is largely due to intimal thickening, collagen disposition or elastin fragmentation – significantly contributes to cardiovascular events and mortality. There is also some evidence that it may negatively affect physical function. This study aimed to evaluate whether arterial stiffness was associated with measures of walking capacity in a large, population-based sample of highly aged older adults.Methods: A population-based sample of 910 community-dwelling adults (aged 75, 80, or 85 years) were investigated in a cross-sectional observational study. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, was estimated based …

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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…

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Comment on “Fatigability: A Prognostic Indicator of Phenotypic Aging”

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Coronavirus-related health literacy and perceived restrictiveness of protective measures among community-dwelling older persons in Finland

Abstract Background Older people with limited health literacy may encounter difficulties in finding relevant information on COVID-19, understanding its relevance, and complying with recommended protective measures. Complying with such recommendations has required older as well as younger persons to change their daily lives in ways that have reduced their opportunities for engaging in many activities meaningful to them. Aims To find out from what sources older people have obtained information on protective measures, the level of their coronavirus-related health literacy (CHL), and whether CHL is associated with their perceptions of the restrictiveness of coronavirus-related protective measur…

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Physical activity compensates for increased mortality risk among oder people with poor muscle strength

The aim of the study was to determine whether habitual physical activity can compensate for the increased mortality risk among older people with poor muscle strength. Mortality was followed up for 10 years after laboratory examination in 558 community dwelling 75- and 80-year-old men and women. Maximal isometric strength of five muscle groups was measured and tertile cut-off points were used to categorize participants. Participants, who reported moderate physical activity for at least 4 h a week, were categorized as physically active and the others as sedentary. High muscle strength and physical activity both protected from mortality, but their effect was not additive. Within each muscle st…

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Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study

Objectives: To examine associations of perceived outdoor environment with the prevalence and development of adaptive (e.g., slower pace) and maladaptive (e.g., avoiding walking) modifications in walking 2 km among older people. Methods: Community-dwelling 75–90 -year-old persons ( N = 848) reported environmental outdoor mobility facilitators and barriers at baseline. Modifications in walking 2 km (adaptive, maladaptive, or no) were assessed at baseline and one and two years later. Results: Outdoor mobility facilitators were more often reported by those not using modifications or using adaptive versus maladaptive walking modifications. Differences in health and physical capacity explained m…

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Assessment of health literacy among older Finns

Aims: This study examined the feasibility of the HLS-EU-Q16 (in Finnish) for use among older Finns and whether the health literacy score correlates with indicators of health and functioning. Methods: To determine the feasibility of the instrument, we first conducted a focus group discussion with nine participants. For the quantitative analyses, we used data from the AGNES cohort study, collected between October 2017 and April 2018 at the University of Jyväskylä in Finland. 292 75-year-old Finnish men and women were interviewed face-to-face in their homes. Health literacy was measured with the HLS-EU-Q16 and health literacy score, ranging from 0 to 50, computed. The reproducibility of the in…

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supplement_material – Supplemental material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial

Supplemental material, supplement_material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial by Katri M Turunen, Laura Aaltonen-Määttä, Timo Törmäkangas, Timo Rantalainen, Erja Portegijs, Sirkka Keikkala, Marja-Liisa Kinnunen, Taija Finni, Sarianna Sipilä and Riku Nikander in Clinical Rehabilitation

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Psychological resilience and active aging among older people with mobility limitations.

Active aging refers to striving for well-being through preferred activity and may be restricted with declining mobility. We investigated whether psychological resilience, i.e., the ability to tolerate hardship, can aid older people in being active despite mobility limitations. Participants were 961 community-dwelling persons aged 75, 80, or 85 years living in Jyväskylä, Central Finland. Mobility limitations were indicated as self-reported difficulty in walking 2 km. Categories were no difficulty (reference), difficulty, and unable to walk. Resilience was assessed with the 10-item Connor–Davidson Resilience Scale and active aging with the University of Jyvaskyla Active Aging scale. Data were…

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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…

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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…

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FREE-LIVING AND LABORATORY-BASED GAIT ASSESSMENTS PROVIDE CONGRUENT RESULTS AMONG 75-YEAR-OLD MEN AND WOMEN

It is often wondered how representative laboratory-based assessments are of the free-living condition. Indeed, free-living gait is more predictive of self-reported falls history compared to laboratory-based gait. However, explicit explorations of the relationship between laboratory-based and free-living based gait parameters remain scarce. Therefore, this association was studied using a trunk-worn accelerometer during a laboratory-based 6-min walking test, and in free-living conditions (6 days) in a sample of 75-year-old men and women (N=77). Gait quantity (minutes of walking per day, distance covered for free-living and laboratory, respectively) and quality (assessed with multiscale entrop…

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Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial.

Objectives: The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital. Design: Randomized controlled trial. Setting: Home and community. Participants: Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention ( n = 59) or a control (standard care, n = 58) group. Intervention: The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive hom…

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Vesialueiden ja suurten luontoalueiden monimuotoisuuden yhteys iäkkäiden ihmisten fyysiseen aktiivisuuteen

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Nature as a facilitator for physical activity : Defining relationships between the objective and perceived environment and physical activity among community-dwelling older people

The aim was to study the correspondence between the objective and perceived environment and to assess their associations with physical activity (PA) in older people. 848 community-dwelling older people aged 75–90 were interviewed on their difficulties in walking 500 m, perceiving nature as a facilitator for outdoor mobility, and PA. The presence of water and landscape diversity were objectively assessed inside 500 m and 1000 m circular buffers around participants’ homes. Using logistic regression, participant data were analyzed together with the objectively assessed environmental features. Our results indicate that higher habitat diversity within natural areas correlates with higher PA amon…

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Effects of a Home-Based Physical Rehabilitation Program on Physical Disability After Hip Fracture: A Randomized Controlled Trial

Abstract Objective Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture. Design Randomized, controlled, parallel-group trial. Setting Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital. Participants Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups. Intervention The year-long intervent…

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Life-space mobility and active ageing

This chapter highlights research on the concepts of life-space mobility and active ageing. With age, the life-space of older people becomes more restricted and they spend more and more time in or around their home, a situation that increases the risk of social isolation, physical inactivity, and poor quality of life. Optimal mobility is the result of a good balance between the environmental demands and affordances, on the one hand, and the personal resources and capacity of the individual, on the other hand. This chapter describes a new tool developed by the authors and their colleagues to assess active ageing at the level of the individual, rather than at the policy level. This chapter dis…

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Effects of progressive resistance training on physical disability among older community-dwelling people with history of hip fracture

Background and aims: Hip fracture is a common trauma in older people, and often leads to decreased muscle strength and increased physical disability. This randomized controlled trial examined whether three months of progressive resistance training (PRT) can reduce physical disability among older people with a history of hip fracture. Methods: A population-based sample of 60-85-year-old community-dwelling persons, with hip fractures sustained on average three years earlier, were enrolled in the study. Of 78 people participating in laboratory assessments, those without contraindications for participation in resistance training were randomly assigned to a training group (TG, n=22) or a control…

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Physical inactivity and pain in older men and women with hip fracture history

Hip fracture patients often suffer from pain for several months after surgery. This may lead to physical inactivity and subsequent mobility limitation and disability. The purpose of this study was to investigate the association between severe musculoskeletal pain and the level of physical activity in older people with a history of hip fracture. Data were collected from 60- to 85-year-old (n = 78) community-dwelling people, 0.7–7.5 years after hip fracture. Physical activity was assessed with the Yale Physical Activity Survey (YPAS). According to the YPAS summary index distribution, the participants were divided into the physically inactive and physically active groups. Musculoskeletal pain …

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Balance Confidence Was Associated With Mobility and Balance Performance in Older People With Fall-Related Hip Fracture: A Cross-Sectional Study

Abstract Portegijs E, Edgren J, Salpakoski A, Kallinen M, Rantanen T, Alen M, Kiviranta I, Sihvonen S, Sipila S. Balance confidence was associated with mobility and balance performance in older people with fall-related hip fracture: a cross-sectional study. Objective To study the relationship between balance confidence, a concept closely related to fear of falling, mobility and balance performance, and perceived mobility limitation in older people after a fall-related hip fracture. Design Cross-sectional analyses of pretrial data of 2 randomized controlled trials of physical rehabilitation. Setting University research center. Participants Community-dwelling people aged over 60 years, 6 week…

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Editorial: Healthy Aging and the Community Environment

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Asymmetrical lower-limb muscle strenght deficit in older people

The aim was to study causes and consequences of asymmetrical strength deficit, i.e. difference in muscle strength between the lower-limbs, and the effects of progressive resistance training in clinical and non-clinical populations of older people.Data of three larger studies were used. Healthy 63-75-year-old women (n=403-419), 73-96-year-old women 1-13 weeks after hip fracture (n=43), and 60-85-year-old men and women ½-7 years after hip fracture (n=79) were studied. A randomized controlled trial of strength-power training aiming to reduce the lower-limb side-to-side difference was performed (n=46). Leg extension power, isometric knee extension torque, rate of force development, walking and …

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Physical Activity Scaled to Preferred Walking Speed as a Predictor of Walking Difficulty in Older Adults: A 2-Year Follow-up

Abstract Background The usual accelerometry-based measures of physical activity (PA) are dependent on physical performance. We investigated the associations between PA relative to walking performance and the prevalence and incidence of early and advanced walking difficulties compared to generally used measures of PA. Methods Perceived walking difficulty was evaluated in 994 community-dwelling participants at baseline (age 75, 80, or 85 years) and 2 years later over 2 km (early difficulty) and 500 m (advanced difficulty). We used a thigh-mounted accelerometer to assess moderate-to-vigorous PA, daily mean acceleration, and relative PA as movement beyond the intensity of preferred walking spee…

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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…

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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…

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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% …

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Cohort Differences in Maximal Physical Performance: A Comparison of 75- and 80-Year-Old Men and Women Born 28 Years Apart

Abstract Background Whether increased life expectancy is accompanied by increased functional capacity in older people at specific ages is unclear. We compared similar validated measures of maximal physical performance in 2 population-based older cohorts born and assessed 28 years apart. Method Participants in the first cohort were born in 1910 and 1914 and were assessed at age 75 and 80 years, respectively (N = 500, participation rate 77%). Participants in the second cohort were born in 1938 or 1939 and 1942 or 1943 and were assessed at age 75 and 80 years, respectively (N = 726, participation rate 40%). Participants were recruited using a population register and all community-dwelling pers…

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Self-reported life-space mobility in the first year after ischemic stroke: longitudinal findings from the MOBITEC-Stroke project

Abstract Background Life-space mobility is defined as the size of the area in which a person moves about within a specified period of time. Our study aimed to characterize life-space mobility, identify factors associated with its course, and detect typical trajectories in the first year after ischemic stroke. Methods MOBITEC-Stroke (ISRCTN85999967; 13/08/2020) was a cohort study with assessments performed 3, 6, 9 and 12 months after stroke onset. We applied linear mixed effects models (LMMs) with life-space mobility (Life-Space Assessment; LSA) as outcome and time point, sex, age, pre-stroke mobility limitation, stroke severity (National Institutes of Health Stroke Scale; NIHSS), modified R…

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Leg extension power asymmetry and mobility limitation in healthy older women

Objective To investigate the association of asymmetry in leg extension power (LEP) with walking and standing balance. Design Cross-sectional analysis. Setting Research laboratory. Participants Healthy female twins (N=419), ages 63 to 75 years. Interventions Not applicable. Main Outcome Measures The LEP difference between the stronger and the weaker leg, measured with the Nottingham power rig, was calculated. Ten-meter maximal walking velocity was assessed in a laboratory corridor on a wide (170cm) and narrow (35cm) track, and the ability to maintain tandem stance for 20 seconds was recorded. Results The mean LEP difference ± standard deviation between the legs was 15%±9% (P<.001). Those wit…

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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…

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The Scales of Psychological Well-Being – a validation, usability and test–retest study among community-dwelling older people in Finland

Objectives: To validate the Finnish version of the 42-item Scales of Psychological Well-Being among community-dwelling older people. The study also examined the test–retest reliability and usability, i.e. user experience, of the scales in this age group. Method: The 42-item version of the SPWB was administered as part of a face-to-face interview among 968 men and women aged 75, 80 or 85 years. The subsample for test–retest analyses comprised 42 participants, who in addition to 11 interviewers also answered questions concerning the usability of the scales. Exploratory and confirmatory factor analyses, Cronbach’s alpha coefficients, Pearson and intra-class correlation coefficients, and Kendal…

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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-…

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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…

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Timed up-and-go performance is associated with objectively measured life space in patients 3 months after ischemic stroke: a cross-sectional observational study

Background Stroke is a common cause of mobility limitation, including a reduction in life space. Life space is defined as the spatial extent in which a person moves within a specified period of time. We aimed to analyze patients' objective and self-reported life space and clinical stroke characteristics. Methods MOBITEC-Stroke is a prospective observational cohort study addressing poststroke mobility. This cross-sectional analysis refers to 3-month data. Life space was assessed by a portable tracking device (7 consecutive days) and by self-report (Life-Space Assessment; LSA). We analysed the timed up-and-go (TUG) test, stroke severity (National Institutes of Health Stroke Scale; NIHSS), and…

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Lower-Limb Pain, Disease, and Injury Burden as Determinants of Muscle Strength Deficit After Hip Fracture

Background: Hip fracture may result in an asymmetrical lower-limb strength deficit. The deficit may be related to the trauma, surgical treatment, pain, or disuse of the fractured limb. However, disease and injury burden or musculoskeletal pain in the other limb may reduce muscle strength on that side, reducing the asymmetrical deficit. The aim of our study was to explore the asymmetrical strength deficit and to determine the potential underlying factors in patients from six months to seven years after a hip fracture. Methods: The asymmetrical deficit was calculated ([fractured limb/sum of both lower limbs] x 100%) for isometric knee extension torque, rate of force development during isometr…

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Associations of Environmental Features With Outdoor Physical Activity on Weekdays and Weekend Days: A Cross-Sectional Study Among Older People

Background: Physical activity (PA) of higher intensity and longer duration mainly accumulates from older adults' out-of-home activities. Outdoor PA is influenced by environmental features; however, the day-to-day variability of PA and its associations with environmental features have not been widely studied. This study focused on the associations of environmental features with accelerometer-measured PA in older people on weekdays and weekend days.Methods: The study population comprised 167 community-dwelling older people aged 75–90 years. Accelerometers were worn on 7 consecutive days and a structured interview on physical functioning, health, and socioeconomic factors was administered. A g…

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Sense of coherence: effect on adherence and response to resistance training in older people with hip fracture history.

Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5–7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), …

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MOBIlity assessment with modern TEChnology in older patients’ real-life by the General Practitioner: the MOBITEC-GP study protocol

Abstract Background Mobility limitations in older adults are associated with poor clinical outcomes including higher mortality and disability rates. A decline in mobility (including physical function and life-space) is detectable and should be discovered as early as possible, as it can still be stabilized or even reversed in early stages by targeted interventions. General practitioners (GPs) would be in the ideal position to monitor the mobility of their older patients. However, easy-to-use and valid instruments for GPs to conduct mobility assessment in the real-life practice setting are missing. Modern technologies such as the global positioning system (GPS) and inertial measurement units …

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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…

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Daily Physical Activity and Sedentary Time Assessed by Acceleration Based on Mean Amplitude Deviation among Older People

Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an unmet PA need, which is defined as the desire to engage in more PA but without the opportunity to act on the desire. This study examined the intensity of daily PA and sedentary behavior measured with accelerometers among older people, and whether PA differs between weekdays and weekends and those with and without the experience of unmet PA need, measured with self-reports. A total of 174 comm…

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Effects of an Individualized Active Aging Counseling Intervention on Mobility and Physical Activity: Secondary Analyses of a Randomized Controlled Trial

Objectives: The aim of this study was to report preplanned secondary analyses of the effects of a 12-month individualized active aging counseling intervention on six mobility and physical activity outcomes. Methods: A two-arm, single-blinded randomized controlled trial was conducted among 75- and 80-year-old community-dwelling people. The intervention group (IG, n = 101) received counseling aimed at increasing self-selected, primarily out-of-home activity. The control group (CG, n = 103) received general health information. Data were analyzed with generalized estimating equations. Results: Physical performance improved in the IG more than that in the CG (group by time p = .022), self-repor…

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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…

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HAND GRIP STRENGTH, LOWER EXTREMITY PERFORMANCE AND ACTIVE AGING AMONG 75-YEAR-OLD PEOPLE

Active aging is an endorsed policy goal, which we defined and quantified at the individual level as a striving for activities as per one’s goals, abilities and opportunities. This study examines the association of physical functioning with active aging. Participants were 127 men and 167 women aged 75 years randomly drawn from the population register as part of the AGNES study. The validated University of Jyväskylä Active Aging Scale (UJACAS) assesses 17 meaningful activities from four aspects: goals, ability, opportunity and activity. Each dimension forms a sub-scale and their sum forms a total score ranging from 0 to 272 (higher scores indicate more active agency). Maximal handgrip strengt…

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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…

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Maantieteelliset piirteet ja iäkkäiden henkilöiden liikkuminen ulkona (GEOage)

This dataset is part of the “Geographic characteristics, outdoor mobility and physical activity of older people” (GEOage) project, in which freely available geographic information characterizing the environment is linked to participant data of the “Life-space mobility in old age” (LISPE) cohort comprising 75–90-years-old community-dwelling people living in Jyväskylä and Muurame in Central Finland (n=848). The GEOage dataset contains variables of environmental characteristics of participants' environment within 500 or 1000 m from home. The dataset comprises variables related to characteristics of nature (hilliness, nature and green areas, waterside areas) and built environment (land use, nei…

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