Browsing by Subject "OLDER-ADULTS"

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  • MacKay, C.; Webster, F.; Venkataramanan, Natarajan S.; Bytautas, J.; Perruccio, A. V.; Wong, R.; Carlesso, L.; Davis, A. M. (2017)
    Objectives: Studies show limited improvement in the frequency of engaging in life activities after joint replacement. However, there is a paucity of research that has examined factors, including other life events, which influence engagement following total hip replacement (THR). This research sought to identify factors associated with engaging in life activities following THR. Methods: A prospective cohort study was conducted with 376 people who had a THR for osteoarthritis (OA). Data were collected pre-surgery and 1 year post-surgery. The primary outcome was change in frequency in engagement in life activities (Late Life Disability Index (LLDI): higher scores indicate higher frequency of engagement (range 0e80)). Analyses included multivariable regression. Factors considered included: positive/negative life events, a new comorbidity, another joint replacement and complications post-surgery. Results: Participants' mean age was 64 years; 46% were male. 68% of participants had at least one comorbidity pre-surgery; 36% reported at least one new comorbidity after surgery. The mean change in LLDI frequency was an increase of 6.29 (+/- 8.10). 36% reported one or more positive impact life events in the year following surgery; 63% reported one or more negative life events. The number of positive life events (beta=1.24; 95% CI: 0.49, 1.99) was significantly associated with change in LLDI frequency after adjusting for age, sex, education, body mass index (BMI), comorbidities pre-surgery, number of symptomatic joints and pre-surgery pain and function, LLDI limitations and depression. Conclusions: These findings highlight the significant influence of social factors and life circumstances on engagement in life activities following THR. (C) 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
  • HATICE Grp; FINGER Grp; MAPT DSA Grp; Coley, Nicola; Ngandu, Tiia; Lehtisalo, Jenni; Soininen, Hilkka; Vellas, Bruno; Richard, Edo; Kivipelto, Miia; Andrieu, Sandrine; Laatikainen, Tiina; Strandberg, Timo (2019)
    Introduction: Multidomain interventions, targeting multiple risk factors simultaneously, could be effective dementia prevention strategies, but may be burdensome and not universally acceptable. Methods: We studied adherence rates and predictors in the Finnish Geriatric Intervevntion Study to Prevent Cognitive Impairment and Disability and Multidomain Alzheimer Preventive Trial prevention trials, for all intervention components (separately and simultaneously). Finnish Geriatric Intervevntion Study to Prevent Cognitive Impairment and Disability participants received a 2-year multidomain lifestyle intervention (physical training, cognitive training, nutritional counseling, and cardiovascular monitoring). Multidomain Alzheimer Preventive Trial participants received a 3-year multidomain lifestyle intervention (cognitive training, physical activity counseling, and nutritional counseling) with either an omega-3 supplement or placebo. Results: Adherence decreased with increasing intervention complexity and intensity: it was highest for cardiovascular monitoring, nutritional counseling, and the omega-3 supplement, and lowest for unsupervised computer-based cognitive training. The most consistent baseline predictors of adherence were smoking and depressive symptoms. Discussion: Reducing participant burden, while ensuring that technological tools are suitable for older individuals, maintaining face-to-face contacts, and taking into account participant characteristics may increase adherence in future trials. (C) 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
  • Lehtisalo, J.; Lindstrom, J.; Ngandu, T.; Kivipelto, M.; Ahtiluoto, S.; Ilanne-Parikka, P.; Keinanen-Kiukaanniemi, S.; Eriksson, J. G.; Uusitupa, M.; Tuomilehto, J.; Luchsinger, J.; Finnish Diabet Prevention Study DP (2016)
    Objectives: To investigate associations of long-term nutrient intake, physical activity and obesity with later cognitive function among the participants in the Finnish Diabetes Prevention Study, in which a lifestyle intervention was successful in diabetes prevention. Design: An active lifestyle intervention phase during middle age (mean duration 4 years) and extended follow-up (additional 9 years) with annual lifestyle measurements, followed by an ancillary cognition assessment. Setting: 5 research centers in Finland. Participants: Of the 522 middle-aged, overweight participants with impaired glucose tolerance recruited to the study, 364 (70%) participated in the cognition assessment (mean age 68 years). Measurements: A cognitive assessment was executed with the CERAD test battery and the Trail Making Test A on average 13 years after baseline. Lifestyle measurements included annual clinical measurements, food records, and exercise questionnaires during both the intervention and follow-up phase. Results: Lower intake of total fat (p=0.021) and saturated fatty acids (p=0.010), and frequent physical activity (p=0.040) during the whole study period were associated with better cognitive performance. Higher BMI (p= 0.012) and waist circumference (p= 0.012) were also associated with worse performance, but weight reduction prior to the cognition assessment predicted worse performance as well (decrease vs. increase, p= 0.008 for BMI and p= 0.002 for waist). Conclusions: Long-term dietary fat intake, BMI, and waist circumference have an inverse association with cognitive function in later life among people with IGT. However, decreases in BMI and waist prior to cognitive assessment are associated with worse cognitive performance, which could be explained by reverse causality.
  • Salonen, Anne; Alho, Hannu; Castren, Sari (2017)
    Background: Information about public gambling attitudes and gambling participation is crucial for the effective prevention of gambling-related harm. This study investigates female and male attitudes towards gambling, gambling participation, and gambling-related harm in the Finnish population aged 15-74. Methods: Cross-sectional random sample data were collected in 2011 (n = 4484) and 2015 (n = 4515). The data were weighted based on gender, age and region of residence. Attitudes were measured using the Attitudes Towards Gambling Scale (ATGS-8). Gambling-related harms were studied using the Problem Gambling Severity Index and the South Oaks Gambling Screen. Results: Attitudes towards gambling became more positive from 2011 to 2015. Female attitudes were generally negative, but nonetheless moved in a positive direction except in age groups under 25. Occasional gambling increased among women aged 18-24. Women aged 18-24 and 45-54 experienced more harms in 2015 than in 2011. Both land and online gambling increased among women aged 65-74. Male attitudes towards gambling were generally positive, and became more positive from 2011 to 2015 in all age groups except 15-17. Weekly gambling decreased among males aged 15-17. Gambling overall increased among males aged 18-24. Gambling several times a week decreased among men aged 35-44 and 45-54, and gambling 1-3 times a month increased in the latter age group. Online gambling increased only among men aged 55-64. Conclusions: Attitudes towards gambling became more positive in all except the youngest age groups. Under-age male gambling continued to decrease. We need to make decision-makers better aware of the continuing growth of online gambling among older people and women's increasing experiences of gambling-related harm. This is vital to ensure more effective prevention.
  • Engberg, Elina; Koivusalo, Saila B.; Huvinen, Emilia; Viljakainen, Heli T. (2020)
    Introduction Type 2 diabetes is associated with an increased risk of bone fractures. However, bone health of women with a history of gestational diabetes (GDM) has received little attention. This cross-sectional study compares bone health between premenopausal women with and without a history of GDM, and examines factors associated with bone health in women with a history of GDM or obesity. Material and methods We measured areal bone mineral density for total hip, lumbar spine and whole body, and total body fat percentage (fat%) with dual-energy X-ray absorptiometry in 224 women. In addition, we measured bone characteristics of radius and tibia with peripheral quantitative computed tomography. Results When compared with women without a history of GDM (mean age 39 years [SD 5], body mass index [BMI] 35 kg/m(2) [SD 6], fat% 48 [SD 7]), women with a history of GDM (age 41 years [SD 4], BMI 31 kg/m(2) [SD 7], fat% 43 [SD 10]) had lower hip and whole body bone mineral densities, and inferior tibia outcomes. However, the differences in bone characteristics disappeared after controlling for age, height, BMI and fat%. After controlling for age, height, BMI and smoking, physical activity and healthier diet were positively associated with bone outcomes, whereas fat%, HbA(1c) and screen time were negatively associated with bone outcomes. Particularly, fat% showed independent negative associations with whole body bone mineral density and several tibia and radius characteristics. Conclusions Fat% is associated with adverse bone health, independently of BMI, in women with a history of GDM or obesity. Promoting healthy lifestyle and reducing fat% in high-risk women could improve bone health and prevent future fractures.
  • Stenholm, Sari; Solovieva, Svetlana; Viikari-Juntura, Eira; Aalto, Ville; Kivimaki, Mika; Vahtera, Jussi (2017)
    Background: Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics. Methods: A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000-2011 and who reported their body weight one to three times prior to (w(-3), w(-2), w(-1)), and one to three times after (w(+1), w(+2), w(+3)) retirement. Results: During the 4-year retirement transition (w(+1), vs. w(-1)) men showed decline in BMI, which was most marked among men with sedentary work (-0.18 kg/m(2), 95% CI -.30 to -0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m(2), 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m(2), 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition. Conclusions: In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.
  • Sjosten, Noora; Kivimaki, Mika; Singh-Manoux, Archana; Ferrie, Jane E.; Goldberg, Marcel; Zins, Marie; Pentti, Jaana; Westerlund, Hugo; Vahtera, Jussi (2012)
    Objectives: To examine the trajectories of physical activity from preretirement to postretirement and to further clarify whether the changes in physical activity are associated with changes in body weight. Design: Prospective. Setting: French national gas and electricity company (GAZEL cohort). Participants: From the original sample of 20 625 employees, only those retiring between 2001 and 2008 on a statutory basis were selected for the analyses (analysis 1: n = 2711, 63% men; analysis 2: n = 3812, 75% men). Persons with data on at least one preretirement and postretirement measurement of the outcome were selected. Primary and secondary outcome measures: All outcome data were gathered by questionnaires. In analysis 1, the annual prevalence of higher physical activity (walking >= 5 km/week) 4 years before and after retirement was analysed. In analysis 2, changes in leisure-time sport activities (engagement, frequency and manner) from preretirement to postretirement were analysed with simultaneous changes in body weight (kilogram). Results: In analysis 1 (n = 2711), prevalence estimates for 4 years before and 4 years after retirement showed that higher leisure-time physical activity (walking at least 5 km/week) increased by 36% in men and 61% in women during the transition to retirement. This increase was also observed among people at a higher risk of physical inactivity, such as smokers and those with elevated depressive symptoms. In a separate sample (analysis 2, n = 3812), change in weight as a function of preretirement and postretirement physical activity was analysed. Weight gain preretirement to postretirement was 0.85 (95% CI 0.48 to 1.21) to 1.35 (0.79 to 1.90) kg greater among physically inactive persons (decrease in activity or inactive) compared with those physically active (p Conclusions: Retirement transition may be associated with beneficial changes in lifestyle and may thus be a good starting point to preventive interventions in various groups of individuals in order to maintain long-term changes.
  • Jokanovic, Natali; Kautiainen, Hannu; Bell, J. Simon; Tan, Edwin C. K.; Pitkälä, Kaisu H. (2019)
    BackgroundOne quarter of residents in long-term care facilities (LTCFs) have a diagnosis of CHD or stroke and over half use at least one preventative cardiovascular medication. There have been no studies that have investigated the longitudinal change in secondary preventative cardiovascular medication use in residents in LTCFs over time.ObjectiveThe aim of this study was to investigate the change in cardiovascular medication use among residents with coronary heart disease (CHD) and prior stroke in nursing homes (NHs) and assisted living facilities (ALFs) in Finland over time, and whether this change differs according to dementia status.MethodsThree comparable cross-sectional audits of cardiovascular medication use among residents aged 65years and over with CHD or prior stroke in NHs in 2003 and 2011 and ALFs in 2007 and 2011 were compared. Logistic regression analyses adjusted for gender, age, mobility, cancer and length of stay were performed to examine the effect of study year, dementia and their interaction on medication use.ResultsCardiovascular medication use among residents with CHD (NHs: 89% vs 70%; ALFs: 89% vs 84%) and antithrombotic medication use among residents with stroke (NHs: 72% vs 63%; ALFs: 78% vs 69%) declined between 2003 and 2011 in NHs and 2007 and 2011 in ALFs.Decline in the use of diuretics, nitrates and digoxin were found in both groups and settings. Cardiovascular medication use among residents with CHD and dementia declined in NHs (88% [95% CI 85-91] in 2003 vs 70% [95% CI 64-75] in 2011) whereas there was no change among people without dementia. There was no change in cardiovascular medication use among residents with CHD in ALFs with or without dementia over time. Antithrombotic use was lower in residents with dementia compared with residents without dementia in NHs (p
  • Karppinen, Helena; Pitkala, Kaisu H.; Kautiainen, Hannu; Tilvis, Reijo S.; Valvanne, Jaakko; Yoder, Kathe; Strandberg, Timo E. (2017)
    Objective: To explore changes in self-reported disabilities, health, comorbidities and psychological wellbeing (PWB) in aged cohorts over two decades. Design, setting and subjects: Cross-sectional cohort studies with postal surveys were conducted among community-dwelling people aged 75, 80, 85, 90 and 95 years in 1989 (n = 660), 1999 (n = 2598) and 2009 (n = 1637) in Helsinki, Finland. Main outcome measures: Self-reported items on disability, self-rated health (SRH), diagnoses and PWB were compared between cohorts of the same age. Standardized mortality ratios (SMRs) were calculated for each study year to explore the representativeness of the samples compared to general population of same age. Results: A significantly lower proportion of the 75-85-year-olds of the later study years reported going outdoors daily, although this group had improvements in both SRH and PWB scores. The number of comorbidities increased over time among 75-85-year-olds. The only significant change that could be verified among 90- and 95-year-olds between 1999 and 2009, was the lower proportion of participants going outdoors daily. The trend of leveling-off in disabilities was not explained by the SMRs (0.90, 0.71 and 0.60 for 1989, 1999 and 2009). Conclusions: The latest older people's cohorts showed an end to previously reported improvements in disabilities, despite having favorable trends in SRH and PWB. Primary care may be faced with increasing need of appropriate services for their senior members.
  • Ali-Kovero, Kirsi; Pietilainen, Olli; Mauramo, Elina; Jäppinen, Sauli; Rahkonen, Ossi; Lallukka, Tea; Kanerva, Noora (2020)
    Retirement is a major life transition affecting health and health behaviour, but evidence on how this transition contributes to changes in healthy food habits is scarce. We examined whether the consumption of fruit and vegetables as well as fish changes after transition into statutory retirement. The data were derived from the prospective Helsinki Health Study. At phase 1 in 2000-2002, all participants were 40- to 60-year-old employees of the City of Helsinki, Finland (n 8960, response rate 67 %). Follow-up surveys were conducted in 2007, 2012 and 2017 (response rates 79-83 %). Using the four phases, we formed three nested cohorts in which the participants either continued working or moved to statutory retirement. The final analytical sample consisted of 6887 participants (14 357 observations). Frequency of fruit, vegetable and fish consumption was calculated from a twenty-two-item FFQ. Analyses of repeated measures of food consumption before and after retirement transition were conducted with a negative binomial mixed model, adjusting for age, marital status, limiting long-standing illness and household income. During the follow-up, altogether 3526 participants retired. Transition to retirement was associated with a decrease in vegetable consumption among women and, contrarily, with an increase in fruit consumption among men (P <0 center dot 05 for interaction between time and employment status). Fish consumption did not differ by the change in employment status. Statutory retirement can have mixed effects on healthy food habits, and these can differ between food groups and sex. Healthy food habits should be promoted among employees transitioning to retirement.
  • Leskinen, Tuija; Pulakka, Anna; Heinonen, Olli J.; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi; Stenholm, Sari (2018)
    Background Retirement is a major life transition which may influence health behaviours and time use. Little is known about how sedentary behaviour changes as a result of increased time availability after retirement. The aim of this study was to examine changes in nonoccupational sedentary behaviours across the retirement transition. In addition, we examined which preretirement characteristics were associated with these changes. Methods The study population consisted of 2011 participants from the Finnish Retirement and Aging Study. Repeated postal survey including questions on sedentary behaviour domains (television viewing, computer use at home, sitting in a vehicle and other sitting) were conducted once a year across the retirement transition, covering on average 3.4 study waves. Linear regression with generalised estimating equations was used for the analyses. Results Total sedentary time increased by 73 (95% CI 66 to 80) min/day during the retirement transition. Of the domain-specific sedentary behaviours, television viewing time increased by 28 (95% CI 25 to 32) min/day, computer use at home by 19 (95% CI 17 to 22) min/day and other sitting time by 37 (95% CI 33 to 41) min/day, while time sitting in a vehicle decreased by 6 (95% CI 4 to 9) min/day. Highest increase in total sedentary time was among women and persons who had high occupational sitting time, low physical activity level, sleep difficulties, mental disorders or poor health before retirement (all p values for interaction <0.03). Conclusion Total and domain-specific sedentary time, except sitting in a vehicle, increased during the retirement transition.
  • Suorsa, Kristin; Pulakka, Anna; Leskinen, Tuija; Pentti, Jaana; Vahtera, Jussi; Stenholm, Sari (2021)
    Background Prolonged sedentary behaviour is associated with a higher risk of cardiometabolic diseases. This longitudinal study examined changes in daily total, prolonged (>= 30 min) and highly prolonged (>= 60 min) sedentary time across the transition to retirement by gender and occupational status. Methods We included 689 aging workers (mean (SD) age before retirement 63.2 (1.6) years, 85% women) from the Finnish Retirement and Aging Study (FIREA). Sedentary time was measured annually using a wrist-worn triaxial ActiGraph accelerometer before and after retirement with on average 3.4 (range 2-4) measurement points. Results Women increased daily total sedentary time by 22 min (95% CI 13 to 31), prolonged sedentary time by 34 min (95% CI 27 to 42) and highly prolonged sedentary time by 15 min (95% CI 11 to 20) in the transition to retirement, and remained at the higher level of sedentary time years after retirement. The highest increase in total and prolonged sedentary time was observed among women retiring from manual occupations. Men had more total and prolonged sedentary time compared with women before and after retirement. Although no changes in men's sedentary time were observed during the retirement transition, there was a gradual increase of 33 min (95% CI 6 to 60) in prolonged sedentary time from pre-retirement years to post-retirement years. Conclusion The transition to retirement was accompanied by an abrupt increase in prolonged sedentary time in women but a more gradual increase in men. The retirement transition may be a suitable time period for interventions aiming to decrease sedentary behaviour.
  • Kujala, Urho M.; Hautasaari, Pekka; Vähä-Ypyä, Henri; Waller, Katja; Lindgren, Noora; Iso-Markku, Paula; Heikkilä, Kauko; Rinne, Juha; Kaprio, Jaakko; Sievänen, Harri (2019)
    Introduction: High physical activity (PA) at old age indicates good functional capacity enabling independent living. We investigated how different disease conditions are associated with measured PA indicators in old women and men, and whether they recognize this association. Materials and methods: This cross-sectional twin cohort study in Finland comprised 779 individuals (276 complete twin pairs, including 117 monozygotic pairs), who participated in hip-worn accelerometer monitoring of PA and responded to questions on diseases and mobility limitations at mean age of 73 (range 71-75). Results: Of the participants, 23.2% reported having a disease restricting mobility. With sex and age in the regression model, the reported disease restricting mobility explained 11.8% of the variation in moderate-to-vigorous PA (MVPA) and 10.4% of the variation in daily steps. Adding stepwise other self-reported diseases and body mass index to the model increased the explanatory power for MVPA up to 18.5% and 25.5%, and for daily steps up to 16.0% and 20.7%, respectively. In the co-twin control analysis the PA differences were smaller in disease-discordant monozygotic than dizygotic pairs. Conclusions: Chronic disease conditions are associated with low PA, which individuals may not always recognize. Shared genetic factors may explain part of the associations.Key messages Among community-dwelling older men and women one-fourth of the variation in objectively measured moderate-to-vigorous physical activity is accounted for by age, sex, body mass index and self-reported diseases. Occurrence of chronic diseases is associated with low physical activity and individuals do not always recognize this. Healthcare professionals should pay attention to the low physical activity and mobility of individuals with chronic disease conditions before these result in limitations in independent living.
  • Kallio, Eeva-Liisa; Öhman, Hanna; Kautiainen, Hannu; Hietanen, Marja; Pitkala, Kaisu (2017)
    Background: Cognitive training (CT) refers to guided cognitive exercises designed to improve specific cognitive functions, as well as enhance performance in untrained cognitive tasks. Positive effects of CT on cognitive functions in healthy elderly people and persons with mild cognitive impairment have been reported, but data regarding the effects of CT in patients with dementia is unclear. Objective: We systematically reviewed the current evidence from randomized controlled trials (RCTs) to find out if CT improves or stabilizes cognition and/or everyday functioning in patients with mild and moderate Alzheimer's disease. Results: Altogether, 31 RCTs with CT as either the primary intervention or part of a broader cognitive or multi-component intervention were found. A positive effect was reported in 24 trials, mainly on global cognition and training-specific tasks, particularly when more intensive or more specific CT programs were used. Little evidence of improved everyday functioning was found. Conclusions: Despite some positive findings, the inaccurate definitions of CT, inadequate sample sizes, unclear randomization methods, incomplete datasets at follow-up and multiple testing may have inflated the results in many trials. Future high quality RCTs with appropriate classification and specification of cognitive interventions are necessary to confirm CT as an effective treatment option in Alzheimer's disease.
  • Sarkamo, Teppo (2018)
    Music has the capacity to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and is relatively preserved in aging and dementia. Thus, music is a promising tool in the rehabilitation of aging-related neurological illnesses, such as stroke and Alzheimer disease. As the population ages and the incidence and prevalence of these illnesses rapidly increases, music-based interventions that are enjoyable and effective in the everyday care of the patients are needed. In addition to formal music therapy, musical leisure activities, such as music listening and singing, which patients can do on their own or with a caregiver, are a promising way to support psychological well-being during aging and in neurological rehabilitation. This review article provides an overview of current evidence on the cognitive, emotional, and neural effects of musical leisure activities both during normal aging and in the rehabilitation and care of stroke patients and people with dementia. (C) 2017 Elsevier Masson SAS. All rights reserved.
  • Adebayo, Folasade A.; Itkonen, Suvi T.; Koponen, Päivikki; Prättälä, Ritva; Härkänen, Tommi; Lamberg-Allardt, Christel; Erkkola, Maijaliisa (2017)
    Aims: We evaluated the consumption of healthy foods among Russian, Somali and Kurdish immigrants in Finland, and examined the relationship between socio-demographic factors and food consumption. Methods: We used data from the Migrant Health and Wellbeing Study (Maamu), a population-based health interview and examination survey in six different municipalities in Finland between 2010 and 2012. Altogether, 635 men and 737 women, aged 18-64 years, of Russian (n = 527), Somali (n = 337) and Kurdish (n = 508) origin were included. The important socio-demographic determinants of healthy food consumption - sex, age, education, place of residence and household size - were assessed by logistic regression. Results: Based on the consumption frequencies of recommended healthy foods - fruits, berries, vegetables, fish and rye bread - immigrants of Russian origin had higher consumption of healthy foods than their peers of Kurdish and Somali origin. Low consumption of fresh vegetables, fruits and berries was found among Somali immigrants. Sex and age were the most important determinants of healthy food consumption, as women and older age groups had diets closer to the national nutrition recommendations. High educational level was also positively associated with healthy food consumption. Conclusions: We found ethnic differences in the consumption of healthy foods among the immigrant groups of Russian, Somali and Kurdish origin in Finland. Socio-demographic factors, especially age, sex and education, seem to also play an important role in immigrants' food consumption. Further studies examining the consumption of fruits, berries and fresh vegetables among Somali immigrants in Finland are needed.
  • Strandberg, Timo E. (2016)
  • Lehtisalo, Jenni; Lindstrom, Jaana; Ngandu, Tiia; Kivipelto, Miia; Ahtiluoto, Satu; Ilanne-Parikka, Pirjo; Keinanen-Kiukaanniemi, Sirkka; Eriksson, Johan G.; Uusitupa, Matti; Tuomilehto, Jaakko; Luchsinger, Jose A.; Finnish Diabet Prevention Study DP (2016)
    BackgroundType 2 diabetes is linked with cognitive dysfunction and dementia in epidemiological studies, but these observations are limited by lack of data on the exact timing of diabetes onset. We investigated diabetes, dysglycaemia, and cognition in the Finnish Diabetes Prevention Study, in which the timing and duration of diabetes are well documented. MethodsThe Finnish Diabetes Prevention Study comprised middle-aged, overweight participants with impaired glucose tolerance but no diabetes at baseline (n=522), randomized to lifestyle intervention or a control group. After an intervention period (mean duration 4years) and follow-up (additional 9years), cognitive assessment with the CERAD test battery and Trail Making Test A (TMT) was executed twice within a 2-year interval. Of the 364 (70%) participants with cognitive assessments, 171 (47%) had developed diabetes. ResultsCognitive function did not differ between those who developed diabetes and those who did not. Lower mean 2-h glucose at an oral glucose tolerance test (OGTT) and HbA(1C) during the intervention period predicted better performance in the TMT (p=0.012 and 0.024, respectively). Those without diabetes or with short duration of diabetes improved in CERAD total score between the two assessments (p=0.001) whereas those with long duration of diabetes did not (p=0.844). ConclusionsBetter glycemic control among persons with baseline impaired glucose tolerance predicted better cognitive performance 9years later in this secondary analysis of the Finnish Diabetes Prevention Study population. In addition, learning effects in cognitive testing were not evident in people with long diabetes duration. Copyright (c) 2015 John Wiley & Sons, Ltd.
  • Knaster, Peter; Estlander, Ann-Mari; Karlsson, Hasse; Kaprio, Jaakko; Kalso, Eija (2016)
    Background Diagnosing depression in chronic pain is challenging due to overlapping somatic symptoms. In questionnaires, such as the Beck Depression Inventory (BDI), responses may be influenced more by pain than by the severity of depression. In addition, previous studies have suggested that symptoms of negative self-image, a key element in depression, are uncommon in chronic pain-related depression. The object of this study is to assess the relationship of the somatic and cognitive-emotional items of BDI with the diagnosis of depression, pain intensity, and disability. Methods One hundred consecutive chronic pain patients completed the Structured Clinical Interview for DSM Disorders (SCID) for the diagnosis of major depressive disorder (MDD) according to DSM-IV. Two subscales of BDI (negative view of self and somatic-physical function) were created according to the factor model presented by Morley. Results In the regression analysis, the somatic-physical function factor associated with MDD, while the negative view of self factor did not. Patients with MDD had higher scores in several of the BDI items when analysed separately. Insomnia and weight loss were not dependent on the depression diagnosis. Limitations The relatively small sample size and the selected patient sample limit the generalisability of the results. Conclusions Somatic symptoms of depression are also common in chronic pain and should not be excluded when diagnosing depression in pain patients. Regardless of the assessment method, diagnosing depression in chronic pain remains a challenge and requires careful interpretation of symptoms.
  • Lehtisalo, Jenni; Levälahti, Esko; Lindström, Jaana; Hänninen, Tuomo; Paajanen, Teemu; Peltonen, Markku; Antikainen, Riitta; Laatikainen, Tiina; Strandberg, Timo; Soininen, Hilkka; Tuomilehto, Jaakko; Kivipelto, Miia; Ngandu, Tiia (2019)
    Introduction: Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. Methods: We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60-77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. Results: Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). Discussion: Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition. (C) 2018 The Authors. Published by Elsevier Inc.