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Sex differences in physical performance by age, educational level, ethnic groups and birth cohort: The Longitudinal Aging Study Amsterdam. PLoS One 2019; 14:e0226342. [PMID: 31851709 PMCID: PMC6919600 DOI: 10.1371/journal.pone.0226342] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/24/2019] [Indexed: 11/20/2022] Open
Abstract
Background Older women perform consistently poorer on physical performance tests compared to men. Risk groups for this “female disadvantage” in physical performance and it’s development over successive birth cohorts are unknown. This is important information for preventive strategies aimed to enhance healthy aging in all older women. This study aims to longitudinal investigate whether there are risk groups for a more apparent female disadvantage and study its trend over successive birth cohorts. Methods Data of the Longitudinal Aging Study Amsterdam (LASA) were used. All participants were aged 55–65 years at baseline. Longitudinal data of two birth cohorts with baseline measurements in 1992/1993 (n = 966, 24 year follow-up) and 2002/2003 (n = 1002, 12 year follow-up) were included. Follow-up measurements were repeated every three/four years. Cross-sectional data of two additional cohorts were included to compare ethnic groups: a Dutch cohort (2012/2013, n = 1023) and a Migration cohort (2013/2014, n = 478) consisting of migrants with a Turkish/Moroccan ethnicity. Results Mixed model analysis showed that women aged 55 years and older had a lower age- and height-adjusted gait speed (-0.03 m/s; -0.063–0.001), chair stand speed (-0.05 stand/s; -0.071–-0.033), handgrip strength (-14,8 kg; -15.69–-13.84) and balance (OR = 0.71; 0.547–0.916) compared to men. The sex difference in handgrip strength diminished with increasing age, but remained stable for gait speed, chair stand speed and balance. In general, results were consistent across different, educational levels and Turkish/Moroccan ethnic groups and birth cohorts. Conclusions There is a consistent “female disadvantage” in physical performance among older adults, which remains stable with increasing age (except for handgrip strength) and is consistent across different educational levels, ethnic groups and successive birth cohorts. So, no specific risk groups for the female disadvantage in physical performance were identified. Preventive strategies aimed to enhance healthy aging in older women are needed and should target all older women.
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Age, aging and physiological dysregulation in safety-critical work: a retrospective longitudinal study of helicopter emergency medical services pilots. Int Arch Occup Environ Health 2019; 93:301-314. [PMID: 31696315 DOI: 10.1007/s00420-019-01482-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Concurrent progressive physiological dysregulation in different organ systems may be a driver of phenotypical frailty and is associated with morbidity and performance declines. In aging societies, health and performance of older workers are given increased scrutiny. However, there are few studies researching the effect of age on physiological dysregulation specifically in the working population and none for high-risk occupations with close medical supervision. Here, we aim to investigate this association cross-sectionally and longitudinally in a healthy sample of European helicopter emergency medical services pilots. METHODS Using a retrospective cohort design, we constructed indices of (a) physiological dysregulation state (N = 52 participants) and (b) pace of change (N = 41 participants, average follow-up 7.9 years) based on measurements of 18 health risk-associated biomarkers, as documented in the participating pilots' aeromedical examination records. The relationship of these two indices with average age (range 27.9-60.6 years) and average baseline age (29.3-57.2 years), respectively, was modeled by weighted least squares regression, adjusting for region of origin, smoking, and medication. RESULTS Longitudinally, dysregulation significantly increased over the follow-up period, but the pace of change did not increase with baseline age. Cross-sectionally, we observed a significant negative quadratic effect of age on physiological dysregulation state, with maximum estimated physiological dysregulation at ages 45-50. CONCLUSIONS As hypothesized, progression of dysregulation over approximately 8 years is observable in a healthy occupational sample but it does not accelerate (i.e., does not increase with baseline age). Increases in dysregulation are counteracted by what appears to be a strong healthy worker survivor effect. The study shows that the development of physiological dysregulation in high-risk occupations differs from that in the general population and that physiological dysregulation indices may be helpful in reconciling safety concerns and fair treatment of aging workers in safety-critical jobs.
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Rantanen T, Pynnönen K, Saajanaho M, Siltanen S, Karavirta L, Kokko K, Karvonen A, Kauppinen M, Rantalainen T, Rantakokko M, Portegijs E, Hassandra M. Individualized counselling for active aging: protocol of a single-blinded, randomized controlled trial among older people (the AGNES intervention study). BMC Geriatr 2019; 19:5. [PMID: 30616537 PMCID: PMC6323746 DOI: 10.1186/s12877-018-1012-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/11/2018] [Indexed: 12/02/2022] Open
Abstract
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-blinded randomized controlled trial. The intervention group receives individually tailored counselling for an active life (one face-to-face session, four phone calls and supportive written material) and the control group written general health information only. Two hundred older adults aged 75- and 80- year old, with intermediate mobility function and without cognitive impairment, living independently in the municipality of Jyväskylä, Finland, are recruited and randomized with a 1:1 allocation to the intervention and control group. Randomization is computer-generated stratified by sex and age. The primary outcome is active aging and secondary outcomes are well-being, depressive symptoms, quality of life, personal goals, mobility and physical activity. Measures are administered at pre-trial, mid-trial (at 6 months) and post-trial (12 months after baseline). DISCUSSION The AGNES intervention study will provide new knowledge on the effects of individualized counselling on active aging and the potential of older people to promote their own well-being. TRIAL REGISTRATION The trial is registered at ISRCTN - ISRCTN16172390 : Promoting well-being through active aging.
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Affiliation(s)
- Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Katja Pynnönen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Sini Siltanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Laura Karavirta
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Anu Karvonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Markku Kauppinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Timo Rantalainen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Mary Hassandra
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
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Rantanen T, Saajanaho M, Karavirta L, Siltanen S, Rantakokko M, Viljanen A, Rantalainen T, Pynnönen K, Karvonen A, Lisko I, Palmberg L, Eronen J, Palonen EM, Hinrichs T, Kauppinen M, Kokko K, Portegijs E. Active aging - resilience and external support as modifiers of the disablement outcome: AGNES cohort study protocol. BMC Public Health 2018; 18:565. [PMID: 29716566 PMCID: PMC5930766 DOI: 10.1186/s12889-018-5487-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 04/19/2018] [Indexed: 01/07/2023] Open
Abstract
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 cohort effects on functional phenotypes underlying active aging and disability. Methods For this population-based study, we plan to recruit 1000 participants aged 75, 80 or 85 years living in central Finland, by drawing personal details from the population register. Participants are interviewed on active aging, wellbeing, disability, environmental and social support, mobility, health behavior and health literacy. Physical activity and heart rate are monitored for 7 days with wearable sensors. Functional tests include hearing, vision, muscle strength, reaction time, exercise tolerance, mobility, and cognitive performance. Clinical examination by a nurse and physician includes an electrocardiogram, tests of blood pressure, orthostatic regulation, arterial stiffness, and lung function, as well as a review of chronic and acute conditions and prescribed medications. C-reactive protein, small blood count, cholesterol and vitamin D are analyzed from blood samples. Associations of factors potentially underlying active aging and wellbeing will be studied using multivariate methods. Cohort effects will be studied by comparing test results of physical and cognitive functioning with results of a cohort examined in 1989–90. Conclusions The current study will renew research on positive gerontology through the novel approach to active aging and by suggesting new biomarkers of resilience and active aging. Therefore, high interdisciplinary impact is expected. This cross-sectional study will not provide knowledge on temporal order of events or causality, but an innovative cross-sectional dataset provides opportunities for emergence of novel creative hypotheses and theories.
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Affiliation(s)
- Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland.
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Laura Karavirta
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Sini Siltanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Anne Viljanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Timo Rantalainen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Katja Pynnönen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Anu Karvonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Inna Lisko
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Lotta Palmberg
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Johanna Eronen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Eeva-Maija Palonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markku Kauppinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, Univerisity of Jyvaskyla, P.O. Box 35 (viv 149), 40014, Jyväskylä, Finland.
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Jagger C, Matthews FE, Wohland P, Fouweather T, Stephan BCM, Robinson L, Arthur A, Brayne C. A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II. Lancet 2016; 387:779-86. [PMID: 26680218 PMCID: PMC4761658 DOI: 10.1016/s0140-6736(15)00947-2] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Whether rises in life expectancy are increases in good-quality years is of profound importance worldwide, with population ageing. We investigate how various health expectancies have changed in England between 1991 and 2011, with identical study design and methods in each decade. METHODS Baseline data from the Cognitive Function and Ageing Studies in populations aged 65 years or older in three geographically defined centres in England (Cambridgeshire, Newcastle, and Nottingham) provided prevalence estimates for three health measures: self-perceived health (defined as excellent-good, fair, or poor); cognitive impairment (defined as moderate-severe, mild, or none, as assessed by Mini-Mental State Examination score); and disability in activities of daily living (defined as none, mild, or moderate-severe). Health expectancies for the three regions combined were calculated by the Sullivan method, which applies the age-specific and sex-specific prevalence of the health measure to a standard life table for the same period. FINDINGS Between 1991 and 2011, gains in life expectancy at age 65 years (4·5 years for men and 3·6 years for women) were accompanied by equivalent gains in years free of any cognitive impairment (4·2 years [95% CI 4·2-4·3] for men and 4·4 years [4·3-4·5] for women) and decreased years with mild or moderate-severe cognitive impairment. Gains were also identified in years in excellent or good self-perceived health (3·8 years [95% CI 3·5-4·1] for men and 3·1 years [2·7-3·4] for women). Gains in disability-free years were much smaller than those in excellent-good self-perceived health or those free from cognitive impairment, especially for women (0·5 years [0·2-0·9] compared with 2·6 years [2·3-2·9] for men), mostly because of increased mild disability. INTERPRETATION During the past two decades in England, we report an absolute compression (ie, reduction) of cognitive impairment, a relative compression of self-perceived health (ie, proportion of life spent healthy is increasing), and dynamic equilibrium of disability (ie, less severe disability is increasing but more severe disability is not). Reasons for these patterns are unknown but might include increasing obesity during previous decades. Our findings have wide-ranging implications for health services and for extension of working life. FUNDING UK Medical Research Council.
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Affiliation(s)
- Carol Jagger
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK.
| | - Fiona E Matthews
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK; Medical Research Council (MRC) Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK
| | - Pia Wohland
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK
| | - Tony Fouweather
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK
| | - Louise Robinson
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK
| | - Antony Arthur
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge University, Cambridge, UK
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Population Aging at Cross-Roads: Diverging Secular Trends in Average Cognitive Functioning and Physical Health in the Older Population of Germany. PLoS One 2015; 10:e0136583. [PMID: 26323093 PMCID: PMC4556449 DOI: 10.1371/journal.pone.0136583] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/05/2015] [Indexed: 11/19/2022] Open
Abstract
This paper uses individual-level data from the German Socio-Economic Panel to model trends in population health in terms of cognition, physical fitness, and mental health between 2006 and 2012. The focus is on the population aged 50–90. We use a repeated population-based cross-sectional design. As outcome measures, we use SF-12 measures of physical and mental health and the Symbol-Digit Test (SDT) that captures cognitive processing speed. In line with previous research we find a highly significant Flynn effect on cognition; i.e., SDT scores are higher among those who were tested more recently (at the same age). This result holds for men and women, all age groups, and across all levels of education. While we observe a secular improvement in terms of cognitive functioning, at the same time, average physical and mental health has declined. The decline in average physical health is shown to be stronger for men than for women and found to be strongest for low-educated, young-old men aged 50–64: the decline over the 6-year interval in average physical health is estimated to amount to about 0.37 SD, whereas average fluid cognition improved by about 0.29 SD. This pattern of results at the population-level (trends in average population health) stands in interesting contrast to the positive association of physical health and cognitive functioning at the individual-level. The findings underscore the multi-dimensionality of health and the aging process.
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Szanton SL, Walker RK, Roberts L, Thorpe RJ, Wolff J, Agree E, Roth DL, Gitlin LN, Seplaki C. Older adults' favorite activities are resoundingly active: findings from the NHATS study. Geriatr Nurs 2015; 36:131-5. [PMID: 25619566 PMCID: PMC4775165 DOI: 10.1016/j.gerinurse.2014.12.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 11/24/2014] [Accepted: 12/01/2014] [Indexed: 11/26/2022]
Abstract
Activity is associated with health among older adults yet older adults' favorite activities have rarely been investigated. We analyzed the community dwelling, cognitively-intact sample of NHATS, a nationally representative sample of adults ≥ 65, who had named their favorite activities (N = 5247). Logistic regression models estimated the odds of choosing a physical activity controlling for demographics, self-rated health, and disability. For all ages, four of the top five most common favorite activities were active: walking/jogging (14%), outdoor maintenance (13%), playing sports (8.9%), and other physical activity (8.7%). These findings sustain in 65-75 year olds. Even in 80-84 year olds, 3 of the top five activities are active. These findings vary by self-rated health (OR = 0.71, p < 0.001), disability (OR = 0.72, p < 0.001) and gender (OR = 0.52, p < 0.001). Policy makers, clinicians, and urban planners can use these results in their work.
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Affiliation(s)
- Sarah L Szanton
- Johns Hopkins University, School of Nursing, USA; Johns Hopkins University Bloomberg School of Public Health, USA.
| | | | | | - Roland J Thorpe
- Johns Hopkins University Bloomberg School of Public Health, USA
| | | | - Emily Agree
- University of Massachusetts Amherst, USA; Johns Hopkins University Bloomberg School of Public Health, USA
| | - David L Roth
- Department of Sociology, Johns Hopkins University, USA
| | - Laura N Gitlin
- Johns Hopkins University, School of Nursing, USA; Department of Sociology, Johns Hopkins University, USA
| | - Christopher Seplaki
- Johns Hopkins University Bloomberg School of Public Health, USA; University of Rochester, USA
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