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BACKGROUND AND AIMS: Active aging is the process through which people strive to maintain wellbeing when growing old. Addressing the lack of research on active aging in the context of housing, the aim was to describe active aging among people aged 55 and older considering relocation and investigate whether perceived housing moderates the relationship between functional limitations and active aging. METHODS: We utilized cross-sectional data from a sub-sample (N = 820; mean age = 69.7; 54% women) of the Prospective RELOC-AGE. Functional limitations were reported using 10 dichotomous questions. Active aging was assessed with the University of Jyvaskyla Active Aging Scale (UJACAS; 17 items, self-rated for four perspectives). Perceived housing was self-rated with four usability questions and meaning of home (MOH; 28 items). Cross-sectional associations and interactions were analysed using linear regression models, adjusting for gender and educational level. RESULTS: Each functional limitation decreased the active aging score by almost five points (p < 0.001). Usability did not moderate that relationship while MOH significantly attenuated the association between functional limitations and active aging (p = 0.039). Those with high MOH had two points less decrease in active aging score compared to those with low MOH. DISCUSSION AND CONCLUSIONS: Having a home with more personal meaning attached to it seems to provide more ability and opportunity for meaningful activities, thus supporting active aging despite functional limitations. This sheds new light on the known association between MOH and different aspects of wellbeing in old age and has relevance for theory development, housing policies and housing counselling targeting younger older adults.
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Envelhecimento , Humanos , Feminino , Idoso , Masculino , Estudos Transversais , Pessoa de Meia-Idade , Envelhecimento/fisiologia , Envelhecimento/psicologia , Habitação , Atividades Cotidianas , Idoso de 80 Anos ou mais , Estudos ProspectivosRESUMO
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.
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COVID-19 , Vida Independente , Humanos , Idoso , Pandemias , Finlândia/epidemiologia , Envelhecimento , COVID-19/epidemiologia , Limitação da MobilidadeRESUMO
OBJECTIVES: We investigated the association of social participation with mental well-being among older people and whether purpose in life mediates the potential association. METHOD: Cross-sectional (n = 1014) and longitudinal (n = 660, four-year follow-up) data comprised of three age cohorts (75, 80, and 85 years) of community-dwelling people. Life satisfaction was measured with the Satisfaction with Life Scale, depressive symptoms with the Centre for Epidemiologic Studies Depression Scale, and purpose in life with the Scales of Psychological Well-Being purpose in life subscale. Social participation was assessed with questions concerning the frequency of meeting close friends and acquaintances, and volunteering. The data were analyzed using structural equation modeling. RESULTS: Higher social participation was associated with higher life satisfaction and fewer depressive symptoms both cross-sectionally and after a four-year follow-up. Higher purpose in life mediated the associations of more social participation with higher life satisfaction and fewer depressive symptoms cross-sectionally. In the longitudinal data, the mediation effect was not observed. CONCLUSION: Older people with frequent social participation who had a sense of purpose in their lives will likely have higher mental well-being than those with less social participation. Enabling and supporting them to conduct purposeful actions in social contexts may help maintain their mental well-being.
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This study aimed to compare community-dwelling older adults' physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2 years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants' (n = 809, initial age 75-85 years) self-reported PA was assessed at baseline in 2017-2018 and May/June 2020 as total weekly minutes of walking and vigorous PA. Physical performance was assessed at baseline using the maximal handgrip strength and Short Physical Performance Battery tests. During the first wave of the COVID-19 pandemic, a median change in total weekly minutes of walking and vigorous PA among all participants was + 20.0 (interquartile range: -60.0 to 120.0, p < .001) min per week compared with 2 years earlier. Higher baseline Short Physical Performance Battery total scores were associated with higher total weekly minutes of walking and vigorous PA over the follow-up in men and women, and better handgrip strength in women.
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COVID-19 , Vida Independente , Masculino , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Força da Mão , Finlândia/epidemiologia , Pandemias , Inquéritos e Questionários , Exercício FísicoRESUMO
We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 (n = 441) wore triaxial accelerometers for 3-7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait bouts for men and women. Associations with physical capacity and life-space mobility were examined using age-adjusted general linear models. Three profiles emerged: "Exercisers" and "actives" accumulated relatively high PA minutes, with actives engaging in lighter intensity PA. "Inactives" had the highest activity fragmentation and lowest PA volume, intensity, and gait bouts. Inactives showed lower scores in physical capacity and life-space mobility compared with exercisers and actives. Exercisers and actives had similar physical capacity and life-space mobility, except female exercisers had higher walking speed in the 6-min walk test. Our findings demonstrate the importance of assessing PA as multidimensional behavior rather than focusing on a single metric.
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Acelerometria , Exercício Físico , Humanos , Feminino , Masculino , Idoso , Idoso de 80 Anos ou mais , Exercício Físico/fisiologia , Caminhada/fisiologia , Limitação da Mobilidade , Velocidade de Caminhada/fisiologiaRESUMO
The objectives were to translate the University of Jyvaskyla Active Aging Scale (UJACAS) to Swedish, to establish semantic equivalence and evaluate psychometric properties for use among persons 55 years and older in Sweden. The UJACAS contains 17 items to be self-assessed regarding goals, abilities, opportunity, and activity. Psychometric properties content validity, data quality including floor and ceiling effects, test-retest reliability, internal consistency, and construct validity were evaluated with different samples in three phases, using state-of-the-art statistics. After translating and establishing semantic equivalence, content validity was assessed as high. With ICC = 0.88 (95% CI 0.80-0.93) test-retest reliability was moderate. Internal consistency was high (Cronbach alpha = 0.84-0.91), and 84% of the questions reached the cut-off value of 0.3 for corrected item-total correlation. Construct validity hypotheses were confirmed. Results indicate that the UJACAS is reliable and valid for use among persons 55 and older in Sweden.
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Envelhecimento , Humanos , Suécia , Reprodutibilidade dos Testes , Psicometria , Inquéritos e QuestionáriosRESUMO
Little is known about older adults' physical exercise destinations. We studied associations between physical activity (PA) level and physical exercise destinations (total number and surrounding environment) in community-dwelling 75- to 85-year-old adults living in Central Finland. Participants (N = 901) reported the amount of at least moderate-intensity PA and physical exercise destinations. Distance from home, land use, and locations of sport facilities were defined using a geographic information system. A general linear model showed that older adults with higher PA reported higher numbers of physical exercise destinations and destinations further away from home than those reporting lower PA. Binary logistic regression showed that higher PA increased the odds of reporting a distant destination identified as a sports facility and of reporting destinations located in residential, service, forest, and water body areas, respectively. Physical exercise destinations in different environments may attract older people to go out and be more physically active.
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Características de Residência , Caminhada , Humanos , Idoso , Idoso de 80 Anos ou mais , Autorrelato , Planejamento Ambiental , Exercício FísicoRESUMO
PURPOSE: Social distancing during the COVID-19 pandemic reduced possibilities for activities of choice potentially threatening quality of life (QoL). We defined QoL resilience as maintaining high quality of life and studied whether walking speed, absence of loneliness, living arrangement, and stress-coping ability predict QoL resilience among older people. METHODS: Community-dwelling 75-, 80-, and 85-year-old persons (n = 685) were interviewed and examined in 2017-2018 and were followed up during COVID-19 social distancing in 2020. We assessed QoL using the OPQOL-brief scale and set a cut-off for 'constant high' based on staying in the highest baseline quartile over the follow-up and categorized all others as having 'low/moderate'. Perceived restrictiveness of the social distancing recommendations was examined with one item and was categorized as 'yes' or 'no' restrictiveness. RESULTS: Better stress-coping ability (OR 1.21, 95% CI 1.14-1.28) and not being lonely (OR 2.67, 95% CI 1.48-4.63) increased the odds for constant high QoL from before to amid social distancing, and the odds did not differ according to the perceived restrictiveness of the social distancing recommendations. Higher walking speed predicted constant high QoL only among those perceiving restrictiveness (OR 1.16, 95% CI 1.07-1.27). Living arrangement did not predict constant high QoL. CONCLUSION: During social distancing, psychosocial resources helped to maintain good QoL regardless how restrictive the social distancing recommendations were perceived to be. Better physical capacity was important for constant high QoL only among those perceiving restrictiveness presumably because it enabled replacing blocked activities with open outdoor physical activities.
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COVID-19 , Qualidade de Vida , Idoso , COVID-19/epidemiologia , Finlândia , Humanos , Vida Independente , Pandemias , Distanciamento Físico , Qualidade de Vida/psicologia , SARS-CoV-2RESUMO
Aim of this study was to test the reliability and validity of the life-space measures and walking speed delivered by the MOBITEC-GP app. Participants underwent several supervised walking speed assessments as well as a 1-week life-space assessment during two assessment sessions 9 days apart. Fifty-seven older adults (47.4% male, mean age= 75.3 (±5.9) years) were included in the study. The MOBITEC-GP app showed moderate to excellent test-retest reliability (ICCs between 0.584 and 0.920) and validity (ICCs between 0.468 and 0.950) of walking speed measurements of 50 meters and above and of most 1-week life-space parameters, including life-space area, time spent out-of-home, and action range. The MOBITEC-GP app for Android is a reliable and valid tool for the assessment of real-life walking speed (at distances of 50 metres and above) and life-space parameters of older adults. Future studies should look into technical issues more systematically in order to avoid invalid measurements.
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Aplicativos Móveis , Humanos , Masculino , Idoso , Feminino , Reprodutibilidade dos Testes , Velocidade de Caminhada , Psicometria , Caminhada , MarchaRESUMO
From the individual viewpoint, active aging refers to the ability of older persons, depending on their goals, functional capacity and opportunities, to engage in desired activities. This study investigated the role of health literacy in active aging among persons differing in their number of chronic conditions. Data were collected from 948 individuals, 57% women, aged 75, 80 and 85 in 2017-2018 in the city of Jyväskylä in Central Finland. Health literacy was assessed with the 16-question version of the European Health Literacy Survey (HLS-EU-Q16), active aging with the University of Jyväskylä Active Aging Scale (UJACAS) and self-reported physician-diagnosed chronic conditions. Both health literacy (r = 0.40) and number of chronic conditions (r = -0.21) correlated with the active aging score. Linear regression models revealed that health literacy was a stronger predictor than chronic conditions of active aging (ß 0.18, p < 0.001 vs. ß -0.06, p = 0.030) and that its predictive value remained statistically significant after adjustment for cognitive capacity, number of depressive symptoms, physical performance and length of education. Higher health literacy can enable older persons, including those with multiple chronic conditions, to maintain higher levels of active aging. As more people are projected to live with chronic conditions to older ages, health literacy may help them to cope with illnesses and functional limitations and lead a fulfilling life. These cross-sectional findings lay a foundation for future prospective and experimental studies on health literacy and active aging.
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Letramento em Saúde , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Estudos Transversais , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12-month physical and cognitive training (PTCT) on gait speed, dual-task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community-dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2-3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the PT and computer training (CT) on EFs 15-20 min, 3-4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6-min walking distance, dual-task cost in gait speed, and EF (Stroop and Trail Making B-A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59%-72% in PT and 62%-77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT-PT, 0.02; 95%CI -0.03, 0.08), walking distance (-3.8; -16.9, 9.3) or dual-task cost (-0.22; -1.74, 1.30). Stroop improvement was greater after PTCT than PT (-6.9; -13.0, -0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF's, complementing physical training with targeted cognitive training provides additional benefit.
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Capacitação de Usuário de Computador , Função Executiva , Terapia por Exercício , Velocidade de Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Capacitação de Usuário de Computador/estatística & dados numéricos , Terapia por Exercício/estatística & dados numéricos , Feminino , Humanos , Vida Independente , Masculino , Equilíbrio Postural , Treinamento Resistido , Teste de Stroop , Fatores de Tempo , Teste de Sequência Alfanumérica , Teste de Caminhada , CaminhadaRESUMO
BACKGROUND: Older people with limited health literacy may encounter difficulties in finding relevant information on COVID-19, understanding its relevance, and complying with recommended protective measures. Complying with such recommendations has required older as well as younger persons to change their daily lives in ways that have reduced their opportunities for engaging in many activities meaningful to them. AIMS: To find out from what sources older people have obtained information on protective measures, the level of their coronavirus-related health literacy (CHL), and whether CHL is associated with their perceptions of the restrictiveness of coronavirus-related protective measures. METHODS: 696 Finnish men and women aged over 77 answered a mailed questionnaire on their CHL, sources of information and perceptions of the restrictiveness of the recommended protective measures. The association of CHL with perceived restrictiveness was studied using multinomial logistic regression analysis. RESULTS: Television and newspapers were the most frequently reported sources of information. Reporting high confidence in the ability to assess how one's behavior influences coronavirus infection risk was associated with higher odds of perceiving the protective measures to be highly restrictive, when controlling for age, gender, and difficulty in using digital devices (OR 3.21, 95% CI 1.09, 9.46). DISCUSSION: Participants who reported being highly confident about their ability to appraise the influence of their behavior on their susceptibility to coronavirus infection were more likely to perceive that the recommended protective measures had restricted their daily lives. CONCLUSIONS: Health literacy plays a role in complying with recommended restrictions.
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COVID-19 , Letramento em Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Finlândia , Humanos , Vida Independente , Masculino , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. AIM: To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. METHODS: The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants' life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one's life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling. RESULTS: Better physical performance, not perceiving loneliness, having special interests in one's life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes. DISCUSSION: The opposite ends of the same factors underlie positive and negative dimensions of mental well-being. CONCLUSION: Further studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.
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Depressão , Satisfação Pessoal , Idoso , Envelhecimento , Estudos Transversais , Depressão/epidemiologia , Humanos , SolidãoRESUMO
BACKGROUND: Outdoor mobility enables participation in essential out-of-home activities in old age. AIM: To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported walking. METHODS: Community-dwelling participants of AGNES study (2017-2018, initial age 75-85) responded to AGNES-COVID-19 postal survey in spring 2020 (N = 809). Life-space mobility, autonomy in participation outdoors, and self-reported physical activity were assessed at both time points and differences according to self-reported walking modifications and difficulty vs. intact walking at baseline were analyzed. RESULTS: Life-space mobility and autonomy in participation outdoors had declined (mean changes -11.4, SD 21.3; and 6.7, SD 5.3, respectively), whereas physical activity had increased (5.5 min/day, SD 25.1) at follow-up. Participants perceiving walking difficulty reported the poorest baseline outdoor mobility, a steeper decline in life-space mobility (p = 0.001), a smaller increase in physical activity (p < 0.001), and a smaller decline in autonomy in participation outdoors (p = 0.017) than those with intact walking. Those with walking modifications also reported lower baseline life-space mobility and physical activity, a steeper decline in life-space mobility and a smaller increase in physical activity those with intact walking (p < 0.001 for both). DISCUSSION: Participants reporting walking modifications remained the intermediate group in outdoor mobility over time, whereas those with walking difficulty showed the steepest decline in outdoor mobility and hence potential risk for accelerated further functional decline. CONCLUSION: Interventions should target older people perceiving walking difficulty, as they may be at the risk for becoming homebound when environmental facilitators for outdoor mobility are removed.
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COVID-19 , Caminhada , Idoso , Idoso de 80 Anos ou mais , Humanos , Vida Independente , Limitação da Mobilidade , SARS-CoV-2RESUMO
OBJECTIVE: To evaluate cohort differences in cognitive performance in older men and women born and assessed 28 years apart. METHODS: Data in this study were drawn from two age-homogeneous cohorts measured in the same laboratory using the same standardized cognitive performance tests. Participants in the first cohort were born in 1910 and 1914 and assessed in 1989-1990 (Evergreen project, n = 500). Participants in the second cohort were born in 1938 or 1939 and 1942 or 1943 and assessed in 2017-2018 (Evergreen II, n = 726). Participants in both cohorts were assessed at age 75 and 80 years and were recruited from the population register. Cognitive performance was measured using the Digit Span test from the Wechsler Memory Scale (WMS), Digit Symbol test from the Wechsler Adult Intelligence Scale (WAIS) and phonemic Verbal Fluency test from the Schaie-Thurstone Adult Mental Abilities Test. Reaction time assessing motor and mental responses was measured with a simple finger movement task, followed by a complex finger movement task. T-tests were used to study cohort differences and linear regression models to study possible factors underlying differences. RESULTS: We found statistically significant cohort differences in all the cognitive performance tests, except for the digit span test and simple movement task in men, the later-born cohort performing better in all the measured outcomes. CONCLUSIONS: The results of this study provide strong evidence that cognitive performance is better in more recent cohorts of older people compared to their counterparts measured 28 years earlier.
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Transtornos Cognitivos , Cognição , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Testes de Inteligência , Masculino , Testes NeuropsicológicosRESUMO
OBJECTIVES: Resilience, the ability to bounce back after adverse events may be an important factor in active aging. The 10-item version of the Connor-Davidson Resilience Scale (CD-RISC10) seems suitable for aging research owing to its low participant burden; however, its psychometric properties have not been comprehensively reported for older people. For example, no estimate exists of the test-retest reliability of the scale when used with older adults. Hence, this study evaluated the psychometric properties of the CD-RISC10 in a large population-based sample of community-dwelling older people. METHOD: The scale's internal consistency, factor structure, construct validity, test-retest reliability, and user experience were analyzed among 1018 Finnish older adults (57% women) aged 75 (45%), 80 (33%) and 85 years (22%). RESULTS: The internal consistency of the CD-RISC10 was good (Cronbach's α = 0.85), test-retest reliability moderate (ICC = 0.61), and the scale was unidimensional. However, a two-factor solution was found among the 75-year-olds, where the ability to deal positively with change (e.g. using humor) explained an additional part of resilience. While no differences by gender, age, or education were observed in total scores, very good perceived financial situation was associated with higher resilience. The scale showed good construct validity, and user feedback indicated that administering the scale in research is quick and easy. CONCLUSION: In general, the CD-RISC10 is a valid method to study older adults' psychological resilience. However, the present test-retest reliability values suggest caution in using the scale as an outcome measure in intervention studies.
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Resiliência Psicológica , Idoso , Análise Fatorial , Feminino , Finlândia , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Objectives: To validate the Finnish version of the 42-item Scales of Psychological Well-Being among community-dwelling older people. The study also examined the test-retest reliability and usability, i.e. user experience, of the scales in this age group.Method: The 42-item version of the SPWB was administered as part of a face-to-face interview among 968 men and women aged 75, 80 or 85 years. The subsample for test-retest analyses comprised 42 participants, who in addition to 11 interviewers also answered questions concerning the usability of the scales. Exploratory and confirmatory factor analyses, Cronbach's alpha coefficients, Pearson and intra-class correlation coefficients, and Kendal's Tau B were used in the analyses.Results: The factor analyses did not support the theory-based six-factor structure of the scales. The Cronbach's alphas showed high internal consistency reliability for the total scale, but modest for the subscales. The intercorrelations between the subscales were moderate. The total score and the subscale scores of the SPWB correlated positively with quality of life and life satisfaction, and negatively with depressive symptoms. The interviewers reported that while most of the participants responded to the scales without marked difficulties, others could only answer after clarifications of some statements.Discussion: The reliability of the 42-item version of the SPWB was modest. The factor structure was inconsistent among the three age groups studied, but the scales were feasible to use. The current results call for further methodological consideration to optimize assessment of eudaimonic well-being in old age.
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Vida Independente , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Finlândia , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
(1) Background: The purpose of this study was to evaluate the day-to-day variability and year-to-year reproducibility of an accelerometer-based algorithm for sit-to-stand (STS) transitions in a free-living environment among community-dwelling older adults. (2) Methods: Free-living thigh-worn accelerometry was recorded for three to seven days in 86 (women n = 55) community-dwelling older adults, on two occasions separated by one year, to evaluate the long-term consistency of free-living behavior. (3) Results: Year-to-year intraclass correlation coefficients (ICC) for the number of STS transitions were 0.79 (95% confidence interval, 0.70-0.86, p < 0.001), for mean angular velocity-0.81 (95% ci, 0.72-0.87, p < 0.001), and maximal angular velocity-0.73 (95% ci, 0.61-0.82, p < 0.001), respectively. Day-to-day ICCs were 0.63-0.72 for number of STS transitions (95% ci, 0.49-0.81, p < 0.001) and for mean angular velocity-0.75-0.80 (95% ci, 0.64-0.87, p < 0.001). Minimum detectable change (MDC) was 20.1 transitions/day for volume, 9.7°/s for mean intensity, and 31.7°/s for maximal intensity. (4) Conclusions: The volume and intensity of STS transitions monitored by a thigh-worn accelerometer and a sit-to-stand transitions algorithm are reproducible from day to day and year to year. The accelerometer can be used to reliably study STS transitions in free-living environments, which could add value to identifying individuals at increased risk for functional disability.
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Acelerometria , Vida Independente , Idoso , Feminino , Humanos , Reprodutibilidade dos Testes , Coxa da PernaRESUMO
The authors examined whether accelerometer-based free-living walking differs between those reporting walking modifications or perceiving walking difficulty versus those with no difficulty. Community-dwelling 75-, 80-, or 85-year-old people (N = 479) wore accelerometers continuously for 3-7 days, and reported whether they perceived no difficulties, used walking modifications, or perceived difficulties walking 2 km. Daily walking minutes, walking bouts, walking bout intensity and duration, and activity fragmentation were calculated from accelerometer recordings, and cut points for increased risk for perceiving walking difficulties were calculated using receiver operating characteristic analysis. The authors' analyses showed that accumulating ≤83.1 daily walking minutes and walking bouts duration ≤47.8 s increased the likelihood of reporting walking modifications and difficulties. Accumulating walking bouts ≤99.4 per day, having walking bouts ≤0.119 g intensity, and ≥0.257 active to sedentary transition probability fragmented activity pattern were associated only with perceiving walking difficulties. The findings suggest that older people's accelerometer-based free-living walking reflects their self-reported walking capability.
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Vida Independente , Caminhada , Acelerometria , Idoso , Idoso de 80 Anos ou mais , Humanos , Limitação da Mobilidade , AutorrelatoRESUMO
BACKGROUND: Living alone is a risk factor for health decline in old age, especially when facing adverse events increasing vulnerability. AIM: We examined whether living alone is associated with higher post-fracture mortality risk. METHODS: Participants were 190 men and 409 women aged 75 or 80 years at baseline. Subsequent fracture incidence and mortality were followed up for 15 years. Extended Cox regression analysis was used to compare the associations between living arrangements and mortality risk during the first post-fracture year and during the non-fracture time. All participants contributed to the non-fracture state until a fracture occurred or until death/end of follow-up if they did not sustain a fracture. Participants who sustained a fracture during the follow-up returned to the non-fracture state 1 year after the fracture unless they died or were censored due to end of follow-up. RESULTS: Altogether, 22% of men and 40% of women sustained a fracture. During the first post-fracture year, mortality risk was over threefold compared to non-fracture time but did not differ by living arrangement. In women, living alone was associated with lower mortality risk during non-fracture time, but the association attenuated after adjustment for self-rated health. In men, living alone was associated with increased mortality risk during non-fracture time, although not significantly. CONCLUSION: The results suggest that living alone is not associated with pronounced mortality risk after a fracture compared to living with someone.