Longitudinal changes in life-space mobility and autonomy in participation outdoors among Finnish community-dwelling older adults from pre-COVID-19 to through the pandemic.

BACKGROUND: Among older people, community mobility was reduced at the beginning of the COVID-19 pandemic, but the longer-term changes are unclear. AIMS: To study lower extremity performance and car driving as predictors of changes in older adults' life-space mobility, autonomy in participation outdoors, and the risk of developing restricted life-space mobility from 2017 to 2022. METHODS: Life-space mobility (scoring range 0-120) and autonomy in participation outdoors (scoring range 0-20) were assessed in community-dwelling individuals (n = 657) in 2017-2018 (baseline age 75, 80, or 85 years), during the first wave of COVID-19 in 2020, and in 2021-2022. Lower extremity performance was assessed using the Short Physical Performance Battery, and car driving was self-reported at baseline. Data were analysed using generalized estimating equations and Cox regression. RESULTS: During the first wave of COVID-19 in 2020, life-space mobility decreased on average by 10.3 (SD 21.6) points and partially recovered in 2021-2022 (+ 2.7, SD 21.8). The same pattern was observed for autonomy in participation outdoors. Non-drivers and those with impaired lower extremity performance had a 2.4-to-3.6-fold adjusted risk of developing restricted life-space mobility over the follow-up period compared to drivers with intact lower extremity performance. CONCLUSIONS: For older people, the recovery of community mobility was incomplete after the restrictions stemming from the pandemic were lifted. Older adults with impaired lower extremity performance and who did not drive were particularly vulnerable to developing restricted life-space mobility, a situation that could lead to social isolation and reduced well-being.

Genome-Wide Polygenic Score for Muscle Strength Predicts Risk for Common Diseases and Lifespan: A Prospective Cohort Study.

BACKGROUND: We used a polygenic score for hand grip strength (PGS HGS) to investigate whether genetic predisposition for higher muscle strength predicts age-related noncommunicable diseases, survival from acute adverse health events, and mortality. METHODS: This study consisted of 342 443 Finnish biobank participants from FinnGen Data Freeze 10 (53% women) aged 40-108 with combined genotype and health registry data. Associations between PGS HGS and a total of 27 clinical endpoints were explored with linear or Cox regression models. RESULTS: A higher PGS HGS was associated with a reduced risk of selected common noncommunicable diseases and mortality by 2%-10%. The risk for these medical conditions decreased by 5%-23% for participants in the highest PGS HGS quintile compared to those in the lowest PGS HGS quintile. A 1 standard deviation (SD) increase in the PGS HGS predicted a lower body mass index (ß = -0.112 kg/m2, standard error [SE] = 0.017, p = 1.69E-11) in women but not in men (ß = 0.004 kg/m2, p = .768). PGS HGS was not associated with better survival after acute adverse health events compared to the nondiseased period. CONCLUSIONS: The genotype that supports higher muscle strength appears to protect against future health adversities, albeit with modest effect sizes. Further research is needed to investigate whether or how a favorable lifestyle modifies this intrinsic capacity to resist diseases, and if the impacts of lifestyle behavior on health differs due to genetic predisposition for muscle strength.

Investigating resilience through intrinsic capacity networks in older adults.

BACKGROUND: The network approach may provide a framework for understanding intrinsic capacity (IC) as a system underlying functioning. The system's resilience to resist functional decline may arise from the interrelationships among system components, i.e., body functions or capacities. We applied network analysis to investigate whether the interplay between different intrinsic capacities differs according to age and self-rated health (SRH) in older adults. METHODS: The study sample consisted of a population-based cohort of community-dwelling older adults aged 75, 80, and 85 years (men n=356 and women n=469). We quantified five IC domains: vitality, locomotion, cognition, psychology, and sensory, using performance-based measurements and questionnaires, and estimated IC networks for two age (75- vs. 80- and 85-years) and SRH (higher vs. lower) groups separately for sexes. Differences in global network properties (e.g., density, overall connectivity) and centrality indices were compared between the groups. RESULTS: IC network density (i.e., the number of edges) was higher in the 80- and 85-olds compared to the 75-year-olds, and in the worse compared to the better SRH group in both sexes. However, the differences in edge weights and global strength of the networks were statistically non-significant. Walking speed was the most central node in the estimated networks. CONCLUSIONS: With increasing age and health decline, the IC network seems to become more denser, which may indicate a loss of system resilience. Walking is a more complex activity than the others requiring the functioning of many subsystems, which may explain why it connects multiple domains in the IC network.