Subclinical cognitive decline in middle-age is associated with reduced task-induced deactivation of the brain's default mode network.

Cognitive abilities decline with age, but with considerable individual variation. The neurobiological correlate of this variation is not well described. Functional brain imaging studies have demonstrated reduced task-induced deactivation (TID) of the brain's default mode network (DMN) in a wide range of neurodegenerative diseases involving cognitive symptoms, in conditions with increased risk of Alzheimer's disease, and even in advanced but healthy aging. Here, we investigated brain activation and deactivation during a visual-motor task in 185 clinically healthy males from a Danish birth cohort, whose cognitive function was assessed in youth and midlife. Using each individual as his own control, we defined a group with a large degree of cognitive decline, and a control group. When correcting for effects of total cerebral blood flow and hemoglobin level, we found reduced TID in the posterior region of the DMN in the cognitive decline group compared to the control group. Furthermore, increased visual activation response was found in the cognitive decline group, indicating that the TID reduction was not exclusively due to overall impaired vascular reactivity. These results suggest a neurobiological basis for subclinical cognitive decline in late midlife, which includes TID alterations similar to the pattern seen in patients with AD and mild cognitive impairment. Hence, TID reduction might be suggested as an early marker for subtle cognitive decline in aging.

Frailty and depression in older adults: a high-risk clinical population.

OBJECTIVE: To identify salient characteristics of frailty that increase risk of death in depressed elders. METHODS: Data were from the Nordic Research on Ageing Study from research sites in Denmark, Sweden, and Finland. Participants were 1,027 adults aged 75 years (436 men and 591 women). Time of death was obtained, providing a maximum survival time of 11.08 years (initial evaluation took place between 1988 and 1991). RESULTS: Depressed elders showed greater baseline impairments in each frailty characteristic (gait speed, grip strength, physical activity levels, and fatigue). Simultaneous models including all four frailty characteristics showed slow gait speed (hazard ratio: 1.84; 95% confidence interval: 1.05-3.21) and fatigue (hazard ratio: 1.94; 95% confidence interval: 1.11-3.40) associated with faster progression to death in depressed women; none of the frailty characteristics in the simultaneous model was associated with death in depressed men. In women, the effect of impaired gait speed on mortality rates nearly doubled when depression was present (nondepressed women: no gait impairment = 26%; slow gait = 40%; depressed women: no gait impairment = 32%; slow gait = 58%). A similar pattern was observed for fatigue. CONCLUSION: The confluence of specific characteristics of frailty (fatigue and slow gait speed) and depressive illness is associated with an increased risk of death in older adults; this association is particularly strong in older depressed women. Future research should investigate whether multimodal interventions targeting depressive illness, mobility deficits, and fatigue can decrease mortality and improve quality of life in older depressed individuals with characteristics of the syndrome of frailty.

Psychosocial factors at work and the development of mobility limitations among adults in Denmark.

AIM: Psychosocial factors in the working environment have been shown to be associated with mobility limitations, but this has not yet been confirmed in a Danish population. We aimed to examine how psychosocial factors at work are related to developing mobility limitations in Denmark. METHODS: This study is based on data from 2952 middle-aged men and women without mobility limitations in 2000. RESULTS: We found increased risk of incident mobility limitations during 6-year follow up among men who often perceived high work pace (OR 5.45, 95% CI 1.21-24.52) vs. never, who only sometimes or/never perceived the work to be meaningful (OR 6.54, 95% CI 1.55-27.55) vs. always, and who sometimes perceived high emotional demands at work (OR 7.85, 95% CI 1.78-34.65) vs. never. Among women, lower risk of incident mobility limitations was observed among those who in 2000 perceived high work pace sometimes (OR 0.46, 95% CI 0.24-0.87) or often (OR 0.43, 95% CI 0.22-0.85) vs. never in 2000. Also, women who always or often experienced high emotional demands had an increased risk. CONCLUSIONS: The most important finding was that high work pace was strongly associated with increased risk of mobility limitations among men, but associated with lower risk of mobility limitations among women. This knowledge may be used to better target interventions among men and women in midlife from physical deterioration later in life.

Educational intervention and functional decline among older people: the modifying effects of social capital.

AIM: To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples' functional decline, but how social capital might modify this effect is still unknown. METHODS: We used the Danish Intervention Study on Preventive Home Visits - a prospective cohort study including 2863 75-year-olds and 1171 80-year-olds in 34 Danish municipalities - to analyse the modifying effect of different aspects of social capital on the effect of educational intervention of home visitors on functional decline. The three measures of social capital (bonding, bridging, and linking) were measured at contextual level. Data was analysed with multivariate linear regression model using generalised estimating equations to account for repeated measurements. RESULTS: We found that 80-year-olds living in municipalities with high bonding (B=0.089, p=0.0279) and high linking (B=0.0929; p=0.0217) had significant better mobility disability in average at 3-year follow up if their municipality had received intervention. CONCLUSIONS: With the unique design of the Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability.

Indoor mobility-related fatigue and muscle strength in nonagenarians: a prospective longitudinal study.

BACKGROUND AND AIMS: Mobility-related fatigue is an important indicator of functional decline in old age, however, very little is known about fatigue in the oldest old population segment. The aim of this study was to examine the association between indoor mobility-related fatigue and muscle strength decline in nonagenarians. METHODS: The study is based on a prospective longitudinal study of all Danes born in 1905 and assessed in 1998, 2000 and 2003, and includes 92- to 93-year-old persons who were independent of help in basic indoor mobility at baseline (n = 1,353). Fatigue was assessed at baseline and defined as a subjective feeling of fatigue when transferring or walking indoors. The outcome measure, maximum grip strength, was measured at each measurement point. RESULTS: Grip strength declined throughout the study in participants with and without fatigue, but those reporting fatigue had significantly (P < .001) lower muscle strength during the entire study period. Longitudinal analyses indicated slightly slower decline in muscle strength among participants with fatigue compared to those without; however, observed selective dropout of participants with fatigue and poor performance at baseline needs to be considered when interpreting the results. Accordingly, participants without fatigue had significantly higher chances of being alive and having muscle strength above gender-specific median at first (RR 1.32, 95 % CI 1.07-1.58), second (RR 1.51, 1.06-1.96) and third (RR 1.39, 1.01-1.97) measurement points. CONCLUSIONS: Indoor mobility-related fatigue in advanced later life should not merely be considered as an unpleasant symptom, but rather an indicator of physical impairment, and consequently declined physiological reserve.

Intakes of calcium, vitamin D, and dairy servings and dental plaque in older Danish adults.

BACKGROUND: To investigate whether intakes of calcium and dairy-servings within-recommendations were associated with plaque score when allowing for vitamin D intakes. METHODS: In this cross-sectional study, including 606 older Danish adults, total dietary calcium intake (mg/day) was classified as below vs. within-recommendations and dairy intake as <3 vs. ≥3 servings/ d. Dental plaque, defined as the percentage of tooth surfaces exhibiting plaque, was classified as < median vs. ≥median value (9.5%). Analyses were stratified by lower and higher (≥6.8 µg/d) vitamin D intake. FINDINGS: Intakes of calcium (OR = 0.53; 95% CI = 0.31-0.92) and dairy servings (OR = 0.54; 95% CI = 0.33-0.89) within-recommendations were significantly associated with lower plaque score after adjustments for age, gender, education, intakes of alcohol, sucrose and mineral supplements, smoking, diseases, number of teeth, visits to the dentist, use of dental floss/tooth pick and salivary flow, among those with higher, but not lower, vitamin D intake. CONCLUSION: Intakes of calcium dairy-servings within-recommendations were inversely associated with plaque, among those with higher, but not lower, vitamin D intakes. Due to the cross-sectional nature of the study, it is not possible to infer that this association is causal.

Socio-economic position early in life, cognitive development and cognitive change from young adulthood to middle age.

BACKGROUND: We examine the influence of social circumstances early in life on changes in cognitive function from young adulthood to middle age, and we explore the impact of birth characteristics, childhood activities, education and adult social class on the expected relationship. METHODS: A cohort of 11 532 men born in Copenhagen, Denmark in 1953-7906, 10 246 and 2483 participants-had completed assessments of cognitive function at ages 12, 18 and 57 years, respectively. Linear regression was used to investigate the association of early-life characteristics with cognitive test scores at these ages and with score changes from early to mid-adulthood. RESULTS: The cognitive scores at age 57 years had high correlations with scores at ages 12 (r = 0.67) and 18 years (r = 0.70), and these two scores also showed bivariate correlation (r = 0.69). Having a father from the working class at birth was associated with lower cognitive function at ages 12, 18 and 57 years. The latter relation was attenuated when educational status at age 18 years and adult social class were adjusted for, while birth characteristics and childhood activities had minor influence. Having an unskilled father at birth, low education, few intellectual and many social activities in childhood as well as low adult social class were associated with decline in cognitive function. CONCLUSION: Adverse social circumstances early in life were associated with lower cognitive function at ages 12, 18 and 57 years, as well as with a decline between these ages. Educational status at age 18 years and adult social class seemed to account for most of the associations, whereas childhood activities were independent predictors that did not explain the social inequality.

The predictive value of fatigue for nonfatal ischemic heart disease and all-cause mortality.

OBJECTIVE: To investigate whether fatigue predicts nonfatal ischemic heart disease (IHD) and all-cause mortality in middle-aged men. METHODS: The study population consisted of 5216 middle-aged men born in the Copenhagen metropolitan area in 1953. At baseline, men free of angina pectoris and previous IHD were asked if they felt fatigued. Information on IHD diagnosis and all-cause mortality was register based. The Cox proportional hazard model was used to test the association at 4-year follow-up. RESULTS: Fatigue was associated with hospitalization for nonfatal IHD (hazard ratio [HR] = 1.98, 95% confidence interval [CI] = 1.09-3.61) and all-cause mortality (HR = 3.99, 95% CI = 2.27-7.02). These associations became nonsignificant in multivariable-adjusted models (HR = 1.57, 95% CI = 0.82-3.01 and HR = 1.90, 95% CI = 0.95-3.80). Imputation of missing data did not modify conclusions. Fatigue was a strong independent predictor of first hospitalization for nonfatal IHD among nonsmoking men (HR = 6.00, 95% CI = 2.00-18.04), and the fatigue-by-smoking status interaction was significant (p = .04). Findings should be interpreted with caution because of the small number of participants with IHD (n = 21, 1.5%). Compared to nonfatigued nonsmokers, both fatigued nonsmokers and fatigued smokers had higher hazard of dying (HR = 4.99, 95% CI = 1.31-19.09 and HR = 3.74, 95% CI = 1.32-10.57, respectively), although the fatigue-by-smoking status interaction was not significant (p = .12). CONCLUSIONS: Fatigue is a potential risk indicator for IHD and mortality. Further research is needed to establish the role of smoking and other life-style characteristics.

Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark.

BACKGROUND: Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association. METHODS: The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender. RESULTS: Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0)). However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals. CONCLUSION: High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.

Differential associations between white blood cell counts and fatigue in young and older adults.

BACKGROUND AND AIMS: The aims of this exploratory study were to study whether fatigue might be related to the cellular immune system by 1) analysing if the number of white blood cell subsets are related to fatigue and 2) if possible relationships vary in younger and older community-dwelling individuals. METHODS: The participants were recruited from nine general practitioners in Aarhus County, Denmark and included 196 individuals aged 20-35 years and 314 individuals aged 70-85 years. The white blood cell counts included number of total leukocytes, lymphocytes, monocytes, neutrophils, eosinophils, and basophils. General fatigue was measured by a question from the SF-12 Vitality-Scale and mobility-related fatigue by the Avlund Mob-T Scale. RESULTS: Total number of lymphocytes was associated with fatigue in the old sample, both in the crude and adjusted analyses. Total number of leukocytes and netrophils were associated with fatigue in both age groups in the crude analyses. In the old sample the estimates were attenuated to non-significance when adjusting for physical activity and disability. In the young sample the estimates stayed statistically significant in the fully adjusted analyses regarding number of neutrophils, while the associations between fatigue and number of leukocytes were attenuated to non-significance when adjusting for depressive mood. CONCLUSION: Total number of leukocytes, lymphocytes and neutrophils were associated with fatigue in both age groups, while the explanatory factors for the associations differed by age group, in that the associations were partly explained by physical activity and disability in the old sample and partly by depressive mood in the young sample. The findings provide initial insight into the potential role of leukocyte, neutrophil and lymphocyte counts in the development of fatigue.

Onset of mobility limitations in old age: the combined effect of socioeconomic position and social relations.

PURPOSE: to examine the combined effect of cohabitation status and social participation, respectively, and socioeconomic position on onset of mobility limitations in a prospective study among older Danes. DESIGN AND METHODS: logistic regression analyses with combined exposure variables were performed in a study population of 2,839 older men and women from the Danish Intervention Study on Preventive Home Visits. RESULTS: among men low financial assets, living alone or having low social participation significantly increased the odds ratios (OR) for onset of mobility limitations. Among women only low financial assets and low social participation significantly increased the ORs for onset of mobility limitations. Analyses with combined exposure variables showed that simultaneous exposure to low financial assets and poor social relations significantly increased the ORs for onset of mobility limitations among both genders, yet the tendencies appeared stronger for males. In particular, men with simultaneous exposure to low financial assets and low social participation had increased odds ratios for onset of mobility limitations, OR = 5.36 (2.51-11.47), compared with the non-exposed. CONCLUSION: the study suggests that future interventions to increase social participation might alleviate the negative effects on mobility experienced by older people in low socioeconomic position, perhaps especially among older males.

Childhood social circumstances and body mass index in adult life: the Metropolit 1953 Danish male birth cohort.

AIMS: To examine whether father's social class was associated with body mass index (BMI) at age 20 and 50 years in a cohort of men born in 1953 and to explore the role of birth weight, cognitive function (IQ), and educational status in these relationships. METHODS: We used data from the Metropolit cohort which includes 11,532 Danish men born in 1953 with information on father's socioeconomic position (SEP) at participant's birth and assessments of height, weight, cognitive performance, and education at age 20. In 2004, 6292 of these men participated in a follow-up survey on health and behaviour. Linear and logistic regression were used to investigate the association of father's social class with BMI among the 5117 men with complete information on all variables. RESULTS: Between age 20 and 50, mean BMI increased from 21.4 to 26.1 kg/m(2), while the prevalence of overweight (BMI ≥25 kg/m(2)) increased from 8.1 to 57.8%. Men of fathers who were skilled or unskilled workers had higher odds of being overweight (OR = 1.32, 95% CI 1.13-1.53) or often obese (OR = 1.28, 95% CI 1.03-1.60) at age 50 years compared to those with fathers being self-employed, employee, or civil servants when adjusted for the other socially correlated indicators of impaired childhood development. In the linear regression analyses, mean BMI at both age 20 and 50 were around 0.3 kg/m(2) higher in men with fathers from working class compared to those self-employed, employee, or civil servants. CONCLUSIONS: This study supports that among men, father's SEP influences the development of obesity later in adult life.

Amount and type of alcohol consumption and missing teeth among community-dwelling older adults: findings from the Copenhagen Oral Health Senior study.

OBJECTIVES: To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists. METHODS: A cross-sectional study including a total of 783 community-dwelling men and women aged 65-95 years who were interviewed about alcohol drinking habits and underwent a clinical oral and dental examination. Multiple regression analyses were applied for studying the association between total weekly alcohol consumption, beverage-specific alcohol consumption, beverage preference (defined as the highest intake of one beverage type compared with two other types), and the number of remaining teeth (≤ 20 versus >20 remaining teeth). RESULTS: The odds ratio (OR) of having a low number of teeth decreased with the total intake of alcohol in women, with ORs for a low number of teeth of 0.40 [95 percent confidence interval (CI) 0.22-0.76] in women drinking 1-14 drinks per week and 0.34 (95 percent CI 0.16-0.74) in women with an intake of more than 14 drinks per week compared with abstainers. Similar relations could also be obtained for type-specific alcohol intake of wine and for wine and spirits preference among women. Men who preferred beer showed a decreased risk for a low number of teeth compared with men with other alcohol preferences. CONCLUSION: In this study, alcohol consumption, wine drinking, and wine and spirits preference among women were associated with a higher number of teeth compared with abstainers. Among men, those who preferred beer also had a higher number of teeth.

The Copenhagen Oral Health Senior Cohort: design, population and dental health.

BACKGROUND: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. OBJECTIVES: To describe the design, measurement procedures, and baseline values for COHS including spatial distribution of restorations and dental caries as well as reasons for non-participation. MATERIALS AND METHODS: Seven hundred and eighty-three individuals aged 65 years or older, from a total of 1918 invited elderly people, underwent an interview regarding oral health-related behaviour and a clinical oral examination including measurement of unstimulated whole saliva flow rate. RESULTS: Twelve percent of the COHS was edentulous. The number of dental restorations was higher for women compared to men; however, men had more caries than women. Coronal caries was most frequent on mesial and distal surfaces and on the maxillary incisors and canines; root caries was most frequent on labial surfaces and evenly distributed within the dentition. Only 41% of all invited elderly people accepted the invitation, with old age and poor health being the primary reasons for non-participation. CONCLUSION: The baseline values for COHS show that a substantial proportion of the participants had retained a natural dentition and that dental caries was prevalent with the anterior maxillary teeth being most affected.

Can the higher risk of disability onset among older people who live alone be alleviated by strong social relations? A longitudinal study of non-disabled men and women.

PURPOSE: to investigate if the increased risk of disability onset among older people who live alone could possibly be moderated by either high social participation or by being satisfied with the social relations. DESIGN AND METHODS: logistic regression models were tested using two waves in a study population of 2,697 non-disabled older men and women from The Danish Longitudinal Study on Preventive Home Visits. RESULTS: living alone and low social participation were significant risk factors for later male disability onset. Not being satisfied with the social relations was significantly associated with onset of disability for both genders. Among men who lived alone low social participation was a significant predictor of disability onset [odds ratio, OR = 2.30 (1.00-5.29)]; for cohabiting men social participation was not associated with disability onset, [adjusted OR = 0.91 (0.49-1.71)]. Similar results were present concerning satisfaction with the social relations among men. There was no significant interaction for women. CONCLUSIONS: the study suggests that men who live alone can possibly alleviate their risk of disability onset by being socially active and by having access to satisfactory social relations. Women do not seem to benefit as much from cohabitation as men, although women who live alone and who are not satisfied with their social relations also constitute a significant risk category.

Do childhood and adult socioeconomic circumstances influence health and physical function in middle-age?

This study examines the joint and separate contribution of social class in early and adult life to differences in health and physical function in middle-aged men. We use data from the Metropolit project which includes men born in 1953 in Copenhagen and a study of middle-aged Danish twins (MADT). In total 6292 Metropolit participants in a follow-up survey on health in 2004 were included in the study together with 2198 male twins of which 1294 were part of a male twin pair (N=647 pairs). Logistic regression was used to investigate the association between social class in early and adult life, respectively and health in midlife, measured as limitations in running 100 m, poor dental status, poor self-rated health, and fatigue. In both datasets, men with low childhood or adult social class had a higher risk of being unable to run 100 m, having poor dental status, having poor self-rated health and fatigue than men from the highest social classes. When childhood and adult social class were mutually adjusted, the estimates for both measures were attenuated. Adjustment for living without a partner, body mass index (BMI) and smoking in midlife, which were also related to the four outcomes, had marginal effects on the estimates for childhood social class, but attenuated the effect of adult social class somewhat. Among male twin pairs discordant on adult social class, the twin in the lowest class seemed to be unable to run 100 m, rate own health poorer and being fatigued more often than the high class co-twin, while there seemed to be no twin pair difference in dental status. This suggests that the associations of adult social class with functional limitations, poor self-rated health and fatigue may partly be due to causal effects related to adult social class exposures, while social class differences in dental status might be consistent with an effect of factors mainly operating early in life.

Aging-from molecules to populations.

The mean age of the human population is steadily increasing in many areas around the globe, a phenomenon with large social, political, economic and biological/medical implications. Inevitably, this phenomenon is stimulating great interest in understanding and potentially modulating the process of human aging. To foster interactions and collaboration between diverse scientists interested in the biochemical, physiological, epidemiological and psychosocial aspects of aging, The University of Copenhagen Faculty of Health Sciences recently organized and co-sponsored a workshop entitled Aging-From Molecules to Populations. The following questions about human aging were discussed at the workshop: What is the limit of human life expectancy? What are the key indicators of human aging? What are the key drivers of human aging? Which genes have the greatest impact on human aging? How similar is aging-related cognitive decline to pathological cognitive decline associated with neurological disease? Are human progeriod diseases, characterized by premature aging, good models for "normal" human aging? Is delayed or "elite" aging informative about "normal" human aging? To what extent and by what mechanisms do early life environmental factors influence aging-associated physical and cognitive decline? To what extent and by what mechanism does the social environment influence life course outcomes? What physiological factors underlie the timing and extent of aging-associated physical and cognitive decline? How do cultural stereotypes and perceptions of aging influence the process and experience of aging? One of the primary outcomes of the workshop was a recognition that cross-disciplinary studies and "out-of-the-box" approaches, especially those that adopt an integrated life course perspective on human health status, are needed to expedite advances in aging research. This and other outcomes of the workshop are summarized and discussed in this report.

Physical functioning and use of health services in a young and old sample. The influence of fatigue.

INTRODUCTION: The purpose was to analyse 1) whether fatigue is related to physical functioning and utilization of health services at one-year follow-up in a young and old sample and 2) to compare the results of two different measures of fatigue. METHODOLOGY: The study is a longitudinal cohort study based on 182 young (age 20-35) and 199 older (age 70-85) community-dwelling individuals recruited from nine general practitioners in Aarhus, Denmark. Physical functioning was measured by the physical health scale from the SF-12-questionnaire. Data on health care utilization were extracted from the county's central register during one year. Fatigue was measured as Vitality-Tiredness by a question from the SF-12 questionnaire and Mobility-Tiredness by the Avlund Mobility-Tiredness Scale on fatigue in six daily activities. RESULTS: The predictive value of the two measures varied by the age of the participants. The Vitality-Tiredness Scale was related to the outcome measures in both samples, while the Mobility-Tiredness Scale was only predictive in the old population. In the young sample the associations were attenuated by the covariates, while the estimates in the old sample remained strong and significant in the adjusted analyses. CONCLUSION: Fatigue is related to subsequent physical functioning and use of health services at one year follow-up, both in young and old individuals.

Cohabitation status and onset of disability among older Danes: is social participation a possible mediator?

OBJECTIVE: To investigate the effect of cohabitation status in older men and women on (a) onset of disability at 3- and 4.5-year follow-up and (b) changes in functional ability between 3- and 4.5-year follow-up, and to analyze whether this effect was mediated by social participation. METHOD: A total of 2,533 nondisabled older men and women enrolled in the Danish Intervention Study on Preventive Home Visits constituted the study population. Data were collected by mailed questionnaires in 1998-1999, 2000, 2001-2002, and 2003. RESULTS: Living alone significantly increased the risk of onset of disability (T3 OR = 1.60[1.06-2.43], T4 OR = 1.74[1.22-2.47]) and the risk of sustained poor functional ability (OR = 2.35[1.44-3.84]) among men, but not among single-living women. Social participation mediated only a small part of the effect of cohabitation status on functional ability. DISCUSSION: Our results underline the importance of cohabitation/marriage for maintaining a high functional ability among older men.

The overtime effect of social position on dental caries experience in a group of old-aged Danes born in 1914.

OBJECTIVES: The purpose of this study was to analyze the life-course effects of education, occupation, and income at ages 70, 75, 80, and 85 years, respectively, on dental caries experience of 85-year-olds. METHODS: The present study includes follow-up data from a population-based study, which comprised a sample of 176 individuals aged 85 years. Data on social position were collected at ages 70, 75, 80, and 85 years by means of structured personal interviews. Clinical oral health examinations were conducted to obtain data on dental caries at age 85. Dental caries was recorded at tooth surface level and caries experience was expressed by the DMF Index: the decayed tooth surfaces (D component), missing tooth surfaces (M component), and filled tooth surfaces (F component). RESULTS: The participants in the present study demonstrated a high level of dental caries experience; the prevalence rate for active dental caries (D-S) was 80 percent. Older adults with low education, low occupational status, and poor income tended to have more active dental caries compared to their counterparts. In contrast, individuals with high education (F-S = 35.5) and high occupational status (F-S = 36.0) had significantly more filled surfaces than persons with low education (F-S = 24.0) and low occupational status (F-S = 25.6). Individuals with high income at ages 75, 80, and 85 years had more filled surfaces (F-S = 31.9, 33.2, 34.1) compared to persons with low income (F-S = 25.5, 23.5, 22.8). CONCLUSION: The study identified social inequalities across age among the very old individuals in relation to dental caries experience.