Health literacy supports active aging.

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.

Do opposite ends of same factors underlie life satisfaction vs. depressive symptoms among older people?

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.

Psychometric properties of the 10-item Connor-Davidson resilience scale among Finnish older adults.

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.

The Scales of Psychological Well-Being - a validation, usability and test-retest study among community-dwelling older people in Finland.

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.

The role of personality traits in leisure time physical activity during COVID-19 pandemic.

The COVID-19 pandemic has affected everyday life, including physical activity behavior. This study examined the role of the five factor model of personality traits on leisure time physical activity during the pandemic in a sample (n = 168) of 61 year-old Finnish men and women, participating in a larger longitudinal study, between April 2020 and April 2021. Frequency of participation and changes in leisure time physical activity were self-reported. Personality traits and facets were assessed with the 181-item NEO-PI. Openness was the only factor positively associated with leisure time physical activity frequency. Participants scoring higher in extraversion (particularly the activity-facet) and lower in openness to values were more likely to report change in their physical activity. In conclusion, individual differences in traits appear to have played a role in physical activity behavior during the pandemic.

The effect of individualized, theory-based counselling intervention on active aging and quality of life among older people (the AGNES intervention study).

BACKGROUND: We define active aging as a striving for activities as per one's goals, capacities and opportunities. AIM: To test the 1-year counselling intervention effects on active aging. METHODS: In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active aging total score measured with the University of Jyväskylä Active Aging Scale (UJACAS, range 0-272, higher values indicate more activity) and secondary outcomes were its subscores for goals, ability, opportunity and activity (range 0-68) and a quality of life (QoL) score. Measures took place at pre-trial, mid-trial (6 months) and post-trial (12 months), except for QoL only pre and post-trial. Data were analyzed with intention-to-treat principles using GEE-models. RESULTS: The UJACAS total score increased in the intervention group slightly more than in the control group (group by time p-value = 0.050, effect size 0.011, net benefit 2%), but the group effect was not statistically significant. A small effect was observed for the activity subscore (p = 0.007). DISCUSSION: The individualized counselling supporting autonomous motivation for active life increased the UJACAS score slightly. CONCLUSIONS: It may be possible to promote active aging with individualized counselling, but the effect is small and it is unclear whether the change is meaningful.

Individualized counselling for active aging: protocol of a single-blinded, randomized controlled trial among older people (the AGNES intervention study).

BACKGROUND: Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person's goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different aspects of well-being in older people. The aim of the present randomized controlled trial is to test the feasibility and effectiveness of a one-year community-based intervention on active aging. The AGNES intervention aims at increasing older peoples' participation in self-selected valued activities. METHODS: The proposed study is a two-arm single-blinded randomized controlled trial. The intervention group receives individually tailored counselling for an active life (one face-to-face session, four phone calls and supportive written material) and the control group written general health information only. Two hundred older adults aged 75- and 80- year old, with intermediate mobility function and without cognitive impairment, living independently in the municipality of Jyväskylä, Finland, are recruited and randomized with a 1:1 allocation to the intervention and control group. Randomization is computer-generated stratified by sex and age. The primary outcome is active aging and secondary outcomes are well-being, depressive symptoms, quality of life, personal goals, mobility and physical activity. Measures are administered at pre-trial, mid-trial (at 6 months) and post-trial (12 months after baseline). DISCUSSION: The AGNES intervention study will provide new knowledge on the effects of individualized counselling on active aging and the potential of older people to promote their own well-being. TRIAL REGISTRATION: The trial is registered at ISRCTN - ISRCTN16172390 : Promoting well-being through active aging.

Assessing physical performance and physical activity in large population-based aging studies: home-based assessments or visits to the research center?

BACKGROUND: The current study aims to compare correlations between a range of measures of physical performance and physical activity assessing the same underlying construct in different settings, that is, in a home versus a highly standardized setting of the research center or accelerometer recording. We also evaluated the selective attrition of participants related to these different settings and how selective attrition affects the associations between variables and indicators of health, functioning and overall activity. METHODS: Cross-sectional analyses comprising population-based samples of people aged 75, 80, and 85 years living independently in Jyväskylä, Finland. The AGNES study protocol involved the following phases: 1) phone interview (n = 1886), 2) face-to-face at-home interview (n = 1018), 3) assessments in the research center (n = 910), and 4) accelerometry (n = 496). Phase 2 and 3 included walking and handgrip strength tests, and phase 4 a chest-worn and thigh-worn accelerometer estimating physical activity and assessing posture, respectively, for 3-10 days in free-living conditions. RESULTS: Older people with poorer health and functioning more likely refrained from subsequent study phases, each requiring more effort or commitment from participants. Paired measures of walking speed (R = 0.69), handgrip strength (R = 0.85), time in physical activity of at least moderate intensity (R = 0.42), and time in upright posture (R = 0.30) assessed in different settings correlated with each other, and they correlated with indicators of health, functioning and overall activity. Associations were robust regardless of limitations in health and functioning, and low overall activity. CONCLUSIONS: Correlational analyses did not clearly reveal one superior setting for assessing physical performance or physical activity. Inclusion of older people with early declines in health, functioning and overall activity in studies on physical performance and physical activity is feasible in terms of study outcomes, but challenging for recruitment.

Assessment of health literacy among older Finns.

AIMS: This study examined the feasibility of the HLS-EU-Q16 (in Finnish) for use among older Finns and whether the health literacy score correlates with indicators of health and functioning. METHODS: To determine the feasibility of the instrument, we first conducted a focus group discussion with nine participants. For the quantitative analyses, we used data from the AGNES cohort study, collected between October 2017 and April 2018 at the University of Jyväskylä in Finland. 292 75-year-old Finnish men and women were interviewed face-to-face in their homes. Health literacy was measured with the HLS-EU-Q16 and health literacy score, ranging from 0 to 50, computed. The reproducibility of the instrument was test-retested. Chi-square tests were used to compare health literacy scores between participants by different socioeconomic variables, and Spearman correlation coefficients were calculated to study the associations of health literacy with cognition, depressive symptoms, chronic conditions, life-space mobility and physical performance. RESULTS: The mean health literacy score for all participants was 35.05 (SD 6.32). Participants who rated their financial situation and self-rated health as very good had the highest health literacy scores (38.85, SD 5.09 and 39.22, SD 6.77, respectively). Better health literacy was associated with better cognitive status, fewer depressive symptoms and chronic conditions, higher life-space mobility and better physical performance. CONCLUSIONS: The HLS-EU-Q16 is a feasible measure for research purposes among older Finns. The associations between health literacy and indicators of health and functioning need to be more closely investigated in larger samples with a wider age-range.

Association of tenacious goal pursuit and flexible goal adjustment with out-of-home mobility among community-dwelling older people.

BACKGROUND: As people age, functional losses may limit the potential to get outside the home and participate in desired activities and community life. Coping with age-related losses has been reported to be important for psychological well-being. Hitherto is not known whether active use of coping strategies also helps maintain out-of-home mobility. AIMS: We investigated how two coping strategies, tenacious goal pursuit (TGP; persistency in reaching one's goals) and flexible goal adjustment (FGA; adjusting one's goals to changed circumstances), are associated with life-space mobility and perceived autonomy in participation outdoors among community-dwelling older people. METHODS: Participants (n = 186) were aged 79-93 years. TGP and FGA were self-reported using separate scales. Perceived autonomy in participation was assessed with the Impact on Participation and Autonomy Outdoors-subscale, and life-space mobility with the Life-Space Assessment. Two-step cluster analysis was used to create data-driven coping profiles of TGP and FGA. RESULTS: General linear model analyses showed that the profile including highly tenacious and flexible older people had the highest life-space mobility and perceived autonomy outdoors, whereas the profile including people with low TGP and low FGA showed the lowest scores. Depressive symptoms attenuated the associations. CONCLUSIONS: Active use of both TGP and FGA is favorable for out-of-home mobility and enables more active participation in society in later life.

Active aging - resilience and external support as modifiers of the disablement outcome: AGNES cohort study protocol.

BACKGROUND: Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual's striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of health, health behaviors, health literacy and functional abilities, environmental and social support with active aging and wellbeing. We will develop and validate assessment methods for physical activity and physical resilience suitable for research on older people, and examine their associations with active aging and wellbeing. We will examine cohort effects on functional phenotypes underlying active aging and disability. METHODS: For this population-based study, we plan to recruit 1000 participants aged 75, 80 or 85 years living in central Finland, by drawing personal details from the population register. Participants are interviewed on active aging, wellbeing, disability, environmental and social support, mobility, health behavior and health literacy. Physical activity and heart rate are monitored for 7 days with wearable sensors. Functional tests include hearing, vision, muscle strength, reaction time, exercise tolerance, mobility, and cognitive performance. Clinical examination by a nurse and physician includes an electrocardiogram, tests of blood pressure, orthostatic regulation, arterial stiffness, and lung function, as well as a review of chronic and acute conditions and prescribed medications. C-reactive protein, small blood count, cholesterol and vitamin D are analyzed from blood samples. Associations of factors potentially underlying active aging and wellbeing will be studied using multivariate methods. Cohort effects will be studied by comparing test results of physical and cognitive functioning with results of a cohort examined in 1989-90. CONCLUSIONS: The current study will renew research on positive gerontology through the novel approach to active aging and by suggesting new biomarkers of resilience and active aging. Therefore, high interdisciplinary impact is expected. This cross-sectional study will not provide knowledge on temporal order of events or causality, but an innovative cross-sectional dataset provides opportunities for emergence of novel creative hypotheses and theories.

Associations Between Reasons to Go Outdoors and Objectively-Measured Walking Activity in Various Life-Space Areas Among Older People.

This cross-sectional study investigated associations between reasons to go outdoors and objectively-measured walking activity in various life-space areas among older people. During the study, 174 community-dwelling older people aged 75-90 from central Finland wore an accelerometer over seven days and recorded their reasons to go outdoors in an activity diary. The most common reasons for going outdoors were shopping, walking for exercise, social visits, and running errands. Activities done in multiple life-space areas contributed more to daily step counts than those done in the neighborhood or town and beyond. Those who went shopping or walked for exercise accumulated higher daily step counts than those who did not go outdoors for these reasons. These results show that shopping and walking for exercise are common reasons to go outdoors for community-dwelling older people and may facilitate walking activity in older age. Future studies on how individual trips contribute to the accumulation of steps are warranted.

Personal goals and changes in life-space mobility among older people.

OBJECTIVE: Life-space mobility - the spatial extent of mobility in daily life - is associated with quality of life and physical functioning but may also be influenced by future orientation expressed in personal goals. The aim of this study was to explore how different personal goals predict changes in older people's life-space mobility. METHODS: This prospective cohort study with a 2-year follow-up included 824 community-dwelling people aged 75 to 90 years from the municipalities of Jyväskylä and Muurame in Central Finland. As part of the Life-Space Mobility in Old Age study (LISPE), which was conducted between 2012 and 2014, the participants responded to the Life-Space Assessment and Personal Project Analysis in addition to questions on socio-demographics and health. Data were analyzed using generalized estimation equation models. RESULTS: The results showed that goals indicating a desire to be active in daily life, to stay mentally alert, and to exercise were associated with higher life-space mobility, and that the associations remained over the follow-up years. Goals related to maintaining functioning predicted higher life-space mobility at the 2-year follow-up. In contrast, goals reflecting improvement of poor physical functioning predicted lower life-space mobility. The results remained significant even when adjusted for indicators of health and functioning. CONCLUSIONS: This study indicates that supporting older people in striving for relevant personal goals in their lives might contribute to a larger life-space and thus also to improved quality of life in old age.

Older women's personal goals and exercise activity: an 8-year follow-up.

This study investigated the associations of personal goals with exercise activity, as well as the relationships between exercise-related and other personal goals, among older women. Both cross-sectional and longitudinal designs were used with a sample of 308 women ages 66-79 at baseline. Women who reported exercise-related personal goals were 4 times as likely to report high exercise activity at baseline than those who did not report exercise-related goals. Longitudinal results were parallel. Goals related to cultural activities, as well as to busying oneself around the home, coincided with exercise-related goals, whereas goals related to own and other people's health and independent living lowered the odds of having exercise-related goals. Helping older adults to set realistic exercise-related goals that are compatible with their other life goals may yield an increase in their exercise activity, but this should be evaluated in a controlled trial.

Stability in health behavior patterns in middle adulthood: a 19-year follow-up study.

Objective: This study investigated subgroups of adults with particular health behavior patterns, their stability over 19 years, and the role of sociodemographic and personality characteristics in these.Methods and Measures: Data on smoking, alcohol consumption, and physical activity were collected at ages 42, 50, and 61 in the Jyväskylä Longitudinal Study of Personality and Social Development (n = 205-302). Latent class, latent transition, and logistic regression analyses were used.Results: Four similar classes of health behaviors were identified at each age. A class named low alcohol consumption (AC)-high physical activity (PA) included individuals with the lowest levels of alcohol consumption and the highest levels of physical activity, and a class named high AC-low PA vice versa. Classes between these extremes of alcohol consumption and physical activity levels were nonsmokers with the lowest proportion of smokers, and smokers vice versa. Although transitions emerged, class memberships were relatively stable. Women, those who were married, held a degree, had higher occupational status, and certain personality traits at age 42 were more likely to belong continuously to healthier classes compared to a stable membership in high AC-low PA.Conclusion: Health behaviors exist in patterns, are relatively stable across adulthood, and associated with sociodemographic and personality characteristics.

Environmental mobility barriers and walking for errands among older people who live alone vs. with others.

BACKGROUND: Walking is the most popular form of physical activity among older people and for community-dwelling older people walking for errands is especially important. The aim of this study is to examine the association between self-reported environmental mobility barriers and amount of walking for errands among older people who live alone compared to those who live with others. METHODS: This observational study is based on cross-sectional data on 657 people aged 75-81 living in Jyväskylä, Central Finland. Self-reports of environmental mobility barriers were collected under four categories: Traffic, Terrain, Distances and Entrance. Persons who reported walking for errands ≤ 1.5 km/week or at most once a week were categorized as having low amount of walking for errands (LOWER). High walking for errands (HIGWER) was defined as the highest quartile of kilometers walked per week (cut-off 8.5 km, referent). The rest were defined as having moderate amount of walking for errands (MODWER). Multinominal regression analysis was used to compare the odds for LOWER vs. HIGWER and MODWER vs. HIGWER, which were formed for each environmental mobility barrier separately. RESULTS: Participants walked on average 6.5 km (SD 5.2) and 4.0 times (SD 2.2) per week and 14% reported LOWER. Persons living alone (57% of the participants) reported environmental mobility barriers more often than those living with others. LOWER was more common among those living with others. Among those living with others, all the environmental mobility barriers increased the odds for LOWER. In turn, among those living alone, only Distance- and Entrance- related environmental mobility barriers increased the odds for LOWER. People living alone typically run errands by themselves and become better aware of the barriers to environmental mobility, while those living with others have less exposure to environmental mobility barriers, as their walking for errands is more likely to be low. CONCLUSIONS: These findings emphasize the need to take living arrangements into account when analyzing the association between environmental mobility barriers and walking for errands. Future longitudinal studies are warranted to better understand the temporal order of events and to find ways to enhance walking for errands among older people.

Longitudinal associations between emotional well-being and subjective health from middle adulthood to the beginning of late adulthood.

OBJECTIVE: Emotional well-being may predict future health and vice versa. We examined the reciprocal associations between emotional well-being and subjective health from age 36 to 61. METHODS AND MEASURES: The data were drawn from the Jyväskylä Longitudinal Study of Personality and Social Development and included information from 36-, 42-, 50- and 61-year-olds (N = 336). The emotional well-being indicators included life satisfaction and negative and positive mood. The subjective health indicators were self-rated health and psychosomatic symptoms. The analyses were conducted with random intercept cross-lagged panel models. RESULTS: Within-person cross-lagged associations were found between emotional well-being and subjective health. Fewer psychosomatic symptoms at ages 36 and 50 predicted higher life satisfaction at ages 42 and 61, respectively. A lower negative mood at age 42 and a higher positive mood at age 50 predicted fewer psychosomatic symptoms at 50 and 61, respectively. Conversely, a higher negative mood at ages 36 and 50 predicted better self-rated health at ages 42 and 61, respectively. CONCLUSION: The relationship between emotional well-being and subjective health appears to be reciprocal. Both emotional well-being and subjective health predicted each other even 6-11 years later. However, associations may depend on the variables and age periods investigated.

Individual and environmental factors underlying life space of older people - study protocol and design of a cohort study on life-space mobility in old age (LISPE).

BACKGROUND: A crucial issue for the sustainability of societies is how to maintain health and functioning in older people. With increasing age, losses in vision, hearing, balance, mobility and cognitive capacity render older people particularly exposed to environmental barriers. A central building block of human functioning is walking. Walking difficulties may start to develop in midlife and become increasingly prevalent with age. Life-space mobility reflects actual mobility performance by taking into account the balance between older adults internal physiologic capacity and the external challenges they encounter in daily life. The aim of the Life-Space Mobility in Old Age (LISPE) project is to examine how home and neighborhood characteristics influence people's health, functioning, disability, quality of life and life-space mobility in the context of aging. In addition, examine whether a person's health and function influence life-space mobility. DESIGN: This paper describes the study protocol of the LISPE project, which is a 2-year prospective cohort study of community-dwelling older people aged 75 to 90 (n = 848). The data consists of a baseline survey including face-to-face interviews, objective observation of the home environment and a physical performance test in the participant's home. All the baseline participants will be interviewed over the phone one and two years after baseline to collect data on life-space mobility, disability and participation restriction. Additional home interviews and environmental evaluations will be conducted for those who relocate during the study period. Data on mortality and health service use will be collected from national registers. In a substudy on walking activity and life space, 358 participants kept a 7-day diary and, in addition, 176 participants also wore an accelerometer. DISCUSSION: Our study, which includes extensive data collection with a large sample, provides a unique opportunity to study topics of importance for aging societies. A novel approach is employed which enables us to study the interactions of environmental features and individual characteristics underlying the life-space of older people. Potentially, the results of this study will contribute to improvements in strategies to postpone or prevent progression to disability and loss of independence.

Impact of mobility restrictions on active aging; cross-sectional associations and longitudinal changes parallel to COVID-19 restrictions.

BACKGROUND: Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. METHODS: AGNES cohort data were collected in 2017-2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, composite and sub-scores of active aging were computed. Neighborhood mobility was assessed as frequency of moving in or beyond own neighborhood (limited, regular, daily=reference). Associations were studied using Generalized Linear Models (cross-sectionally, n = 1007) and General Estimating Equations (prospectively, n = 774). RESULTS: Participants with limited baseline neighborhood mobility had lower active aging scores than those with daily mobility, but the decline over time was similar. Some item scores on opportunity to act and extent of doing, e.g. for making one's day more interesting and advancing matters of faith or worldview, were better retained amid COVID-19 by those with limited mobility, attenuating group differences. CONCLUSIONS: Active aging scores were somewhat compromised in individuals with limited neighborhood mobility, but opportunities for and engagement in several activities seemed to be better retained amid COVID-19 than for those with daily mobility. Thus, active aging may be possible despite mobility restriction.

Self-rated resilience and mobility limitations as predictors of change in active aging during COVID-19 restrictions in Finland: a longitudinal study.

Social distancing during the COVID-19 pandemic decreased older people's opportunities to lead an active life. The purpose of this study was to investigate whether walking difficulties predict changes in leading an active life during the COVID-19 social distancing recommendation compared to 2 years before, and whether self-rated resilience moderates this association among older people. Data were collected during social distancing recommendation in May and June 2020 and 2 years before (2017-18) among community-living AGNES study participants initially aged 75, 80, or 85 years (n = 809). Leading an active life was assessed with the University of Jyväskylä Active Aging Scale (UJACAS; total score range 0-272) and resilience with the 10-item Connor-Davidson Resilience Scale (0-40). Self-reported walking difficulties over a 2 km distance were categorized into no difficulty, difficulty, and unable to walk. The total UJACAS score declined 24.9 points (SD 23.5) among those without walking difficulty, 27.0 (SD 25.0) among those reporting walking difficulty and 19.5 (SD 31.2) among those unable to walk 2 km. When adjusted for baseline UJACAS score, those unable to walk 2 km demonstrated the greatest decline. Baseline resilience moderated this association: Higher resilience was associated with less declines in UJACAS scores among persons with or without walking difficulty, and with more declines among persons unable to walk 2 km. When opportunities for leading an active life are compromised, those with less physical and psychological resources become particularly vulnerable to further declines in activity.