Browsing by Subject "FRAILTY"

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  • Luyten, Walter; Antal, Peter; Braeckman, Bart P.; Bundy, Jake; Cirulli, Francesca; Fang-Yen, Christopher; Fuellen, Georg; Leroi, Armand; Liu, Qingfei; Martorell, Patricia; Metspalu, Andres; Perola, Markus; Ristow, Michael; Saul, Nadine; Schoofs, Liliane; Siems, Karsten; Temmerman, Liesbet; Smets, Tina; Wolk, Alicja; Rattan, Suresh I. S. (2016)
    Human longevity continues to increase world-wide, often accompanied by decreasing birth rates. As a larger fraction of the population thus gets older, the number of people suffering from disease or disability increases dramatically, presenting a major societal challenge. Healthy ageing has therefore been selected by EU policy makers as an important priority ; it benefits not only the elderly but also their direct environment and broader society, as well as the economy. The theme of healthy ageing figures prominently in the Horizon 2020 programme , which has launched several research and innovation actions (RIA), like "Understanding health, ageing and disease: determinants, risk factors and pathways" in the work programme on "Personalising healthcare". Here we present our research proposal entitled "ageing with elegans" (AwE), funded by this RIA, which aims for better understanding of the factors causing health and disease in ageing, and to develop evidence-based prevention, diagnostic, therapeutic and other strategies. The aim of this article, authored by the principal investigators of the 17 collaborating teams, is to describe briefly the rationale, aims, strategies and work packages of AwE for the purposes of sharing our ideas and plans with the biogerontological community in order to invite scientific feedback, suggestions, and criticism.
  • Björkman, Mikko P.; Suominen, Merja H.; Kautiainen, Hannu; Jyväkorpi, Satu K.; Finne-Soveri, Harriet U.; Strandberg, Timo E.; Pitkälä, Kaisu H.; Tilvis, Reijo S. (2020)
    Objectives: To test the long-term effects of whey-enriched protein supplementation on muscle and physical performance. Design: A 12-month randomized controlled double blind trial with a 43-month of post-trial follow-up. Setting: Porvoo, Finland. Participants: A total of 218 older (>74 years of age) community-dwelling people with sarcopenia. Intervention: (1) Control with no supplementation; (2) isocaloric placebo; and (3) 20 g x 2 whey-enriched protein supplementation. All participants were given instructions on home-based exercise, dietary protein, and vitamin D supplementation of 20 mu g/d. Measurements: Physical performance was assessed by short physical performance battery and continuous summary physical performance scores. Hand grip strength and calf intracellular resistance based skeletal muscle index were measured by bioimpedance spectroscopy. The measurements were performed at 0, 6, and 12 months. The post-trial follow-up was performed by a postal questionnaire and national census record data. Results: The participants were older (75-96 years of age) and mostly women (68%). The test supplements had no significant effects on physical performance; the 12-month changes for short physical performance battery were -0.55, -.05, and 0.03 points in control, isocaloric, and protein groups (P = .17), respectively. The changes in continuous summary physical performance scores were similar between the intervention groups (P = .76). The hand grip strength decreased significantly in all intervention groups, and the 12-month changes in calf intracellular resistance-based skeletal muscle index were minor and there were no differences between the intervention groups. One-half of the patients (56%) in both supplement groups reported mild gastrointestinal adverse effects. Differences were found neither in the all-cause mortality nor physical functioning in the post-trial follow-up. Conclusions: The whey-enriched protein supplementation in combination with low intensity home-based physical exercise did not attenuate the deterioration of muscle and physical performance in community-dwelling older people with sarcopenia. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
  • Robert, R.; Skrifvars, M. B.; Ranzani, O. T. (2017)
  • Pietiläinen, Laura; Hästbacka, Johanna; Bäcklund, Minna; Parviainen, Ilkka; Pettilä, Ville; Reinikainen, Matti (2018)
    We assessed the association between the premorbid functional status (PFS) and 1-year mortality and functional status of very old intensive care patients. Using a nationwide quality registry, we retrieved data on patients treated in Finnish intensive care units (ICUs) during the period May 2012aEuro'April 2013. Of 16,389 patients, 1827 (11.1%) were very old (aged 80 years or older). We defined a person with good functional status as someone independent in activities of daily living (ADL) and able to climb stairs without assistance; a person with poor functional status was defined as needing assistance for ADL or being unable to climb stairs. We adjusted for severity of illness and calculated the impact of PFS. Overall, hospital mortality was 21.3% and 1-year mortality was 38.2%. For emergency patients (73.5% of all), hospital mortality was 28% and 1-year mortality was 48%. The functional status at 1 year was comparable to the PFS in 78% of the survivors. PFS was poor for 43.3% of the patients. A poor PFS predicted an increased risk of in-hospital death, adjusted odds ratio (OR) 1.50 (95% confidence interval, 1.07-2.10), and of 1-year mortality, OR 2.18 (1.67-2.85). PFS data significantly improved the prediction of 1-year mortality. Of very old ICU patients, 62% were alive 1 year after ICU admission and 78% of the survivors had a functional status comparable to the premorbid situation. A poor PFS doubled the odds of death within a year. Knowledge of PFS improved the prediction of 1-year mortality.
  • Lavonius, Sirkku; Salminen, Marika; Vahlberg, Tero; Isoaho, Raimo; Kivelä, Sirkka-Liisa; Wuorela, Maarit; Lopponen, Minna; Viitanen, Matti; Viikari, Laura (2020)
    Purpose Psychosocial resources have been considered to be associated with survival among frail older adults but the evidence is scarce. The aim was to investigate whether psychosocial resources are related to survival among non-robust community-dwelling older people. Methods This is a prospective study with 10- and 18-year follow-ups. Participants were 909 non-robust (according to Rockwood's Frailty Index) older community-dwellers in Finland. Psychosocial resources were measured with living circumstances, education, satisfaction with friendship and life, visiting other people, being visited by other people, having someone to talk to, having someone who helps, self-rated health (SRH) and hopefulness about the future. To assess the association of psychosocial resources for survival, Cox regression analyses was used. Results Visiting other people more often than once a week compared to that of less than once a week (hazard ratio 0.61 [95% confidence interval 0.44-0.85], p = 0.003 in 10-year follow-up; 0.77 [0.62-0.95], p = 0.014 in 18-year follow-up) and good SRH compared to poor SRH (0.65 [0.44-0.97], p = 0.032; 0.68 [0.52-0.90], p = 0.007, respectively) were associated with better survival in both follow-ups. Visiting other people once a week (compared to that of less than once a week) (0.77 [0.62-0.95], p = 0.014) was only associated with better 18-year survival. Conclusions Psychosocial resources, such as regularly visiting other people and good self-rated health, seem to be associated with better survival among non-robust community-dwelling Finnish older people. This underlines the importance of focusing also on psychosocial well-being of frail older subjects to remain or promote their resilience. Key summary pointsAim To investigate whether psychosocial resources are associated with survival among non-robust community-dwelling older Finnish people during an 18-year follow-up. Findings Psychosocial resources, such as good self-rated health and regularly visiting other people, were significantly associated with better survival of non-robust older people. Message It is important to focus also on psychological well-being, together with physical activity and nutrition, of frail older people to remain or promoting their capacity.
  • Wuorela, Maarit; Lavonius, Sirkku; Salminen, Marika; Vahlberg, Tero; Viitanen, Matti; Viikari, Laura (2020)
    BackgroundDespite a non-specific nature of self-rated health (SRH), it seems to be a strong predictor of mortality. The aim of this study is to assess the association of SRH and objective health status (OH) with all-cause mortality in 70-year-old community-dwelling older people in Finland.MethodsA prospective study with 5-, 10- and 27-year follow-ups. SRH (n=1008) was assessed with a single question and OH (n=962) by the Rockwood's Frailty Index (FI). To assess the association of SRH and OH with mortality, Cox regression model was used.ResultsOf the 1008 participants, 138 (13.7%), 319 (31.6%), and 932 deceased (86.3%) during the 5-, 10- and 27-year follow-ups, respectively. In unadjusted models, subjects with poor SRH had almost eightfold risk for mortality compared to those with good SRH during the 5-year follow-up; among those with poor OH, the risk was fourfold compared to those with good OH. In the 10-year-follow up, both poor SRH and poor OH predicted about fourfold risk for mortality compared to those with good health. During the 27-year follow-up, OH was a stronger predictor of mortality than SRH. Poor SRH, compared to good SRH, showed 95% sensitivity and 34% specificity for 5-year mortality; corresponding figures for OH were 54 and 80%, respectively.ConclusionsSingle-item SRH seems to be able to capture almost the same as OH in predicting a short-term (less than 10years) mortality risk among older adults in clinical settings. The use of SHR may also enhance the focus on patient-centered care.
  • Strandberg, Timo E.; Urtamo, Annele; Kähärä, Juuso; Strandberg, Arto Y.; Pitkälä, Kaisu H.; Kautiainen, Hannu (2018)
    Background: Statin treatment is common among 80+ people, but little is known about statin effects on health-related quality of life (HRQoL) in this oldest age group. Methods: In the Helsinki Businessmen Study (HBS), men born from 1919 to 1934 (original n = 3,490), have been followed-up since the 1960s. In 2015, a questionnaire about lifestyle, diseases, and medications, and including RAND-36/SF-36 HRQoL instrument was mailed to survivors. About 612 men (72.6%) responded, 530 of them reporting their medications (98% community-living). Propensity score analysis was used to compare statin users and nonusers for HRQoL. Results: We compared 229 current statin users (median age 85 years, interquartile range 84-88 years) with 301 nonusers (86; 84-89 years). Current statin users had had significantly higher serum cholesterol level in midlife (p <.001), but current lifestyle-related characteristics were similar in users and nonusers. Statin users reported more hypertension (61.1%, p <.001), diabetes (23.6%, p Conclusions: Our study suggests that statin treatment has no significant effect on health-related quality of life among octogenarian, community-dwelling men. The results contradict concerns about statin treatment in the oldest-old, and may caution against deprescribing of statins due to old age alone.
  • Niemeläinen, Susanna; Huhtala, Heini; Ehrlich, Anu; Kössi, Jyrki; Jämsen, Esa; Hyöty, Marja (2021)
    BackgroundThe number of colorectal cancer patients increases with age. The decision to go through major surgery can be challenging for the aged patient and the surgeon because of the heterogeneity within the older population. Differences in preoperative physical and cognitive status can affect postoperative outcomes and functional recovery, and impact on patients' quality of life.Methods / designA prospective, observational, multicentre study including nine hospitals to analyse the impact of colon cancer surgery on functional ability, short-term outcomes (complications and mortality), and their predictors in patients aged >= 80years. The catchment area of the study hospitals is 3.88 million people, representing 70% of the population of Finland. The data will be gathered from patient baseline characteristics, surgical interventional data, and pre- and postoperative patient-questionnaires, to an electronic database (REDCap) especially dedicated to the study.DiscussionThis multicentre study provides information about colon cancer surgery's operative and functional outcomes on older patients. A further aim is to find prognostic factors which could help to predict adverse outcomes of surgery.Trial (NCT03904121). Registered on 1 April 2019.
  • Åström, Max J.; von Bonsdorff, Mikaela B.; Perälä, Mia-Maria; Salonen, Minna K.; Rantanen, Taina; Kajantie, Eero; Simonen, Mika; Pohjolainen, Pertti; Haapanen, Markus J.; Guzzardi, Maria A.; Iozzo, Patricia; Kautiainen, Hannu; Eriksson, Johan G. (2019)
    Telomere length has been suggested a biomarker of aging and is associated with several chronic diseases. However, the association between telomere length and physical performance is not well known. Using both cross-sectional and longitudinal data, we studied 582 women and 453 men from the Helsinki Birth Cohort Study at two time-points; a baseline examination in 2001-2004 at a mean age of 61 years and a follow-up examination approximately 10 years later in 2011-2013. Telomere length was measured both at baseline and at follow-up using real-time quantitative polymerase chain reaction. Physical performance was evaluated only at follow-up using the Senior Fitness Test (SFT), which assesses strength, flexibility and endurance. In women, shorter telomere length at follow-up (p = 0.044) and greater telomere attrition during follow-up time (p = 0.022) were associated with poorer physical performance after adjusting for covariates (age at baseline, smoking status, body mass index at baseline, follow-up time and educational attainment). No similar associations were found for men. This indicates that, at least in women, telomere length could potentially be used as a biomarker for physical performance, however, more longitudinal studies are needed to confirm this association.