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The outdoor mobility and leisure activities of older people in five European countries
- Authors:
- GAGLIARDI Christina, et al
- Journal article citation:
- Ageing and Society, 27(5), September 2007, pp.683-700.
- Publisher:
- Cambridge University Press
Many gerontological studies have dealt with the leisure activities of older people and they have generated many important theories. Although outdoor activities and mobility promote good health in old age, both decrease with increasing age as people lose physical and mental functions. This paper examines the outdoor and indoor leisure activities of 3,950 older adults and their variations by personal and environmental characteristics in Germany, Finland, Hungary, The Netherlands and Italy. The main dimensions of activity were established by factor analysis, and in all countries four factors were found: home activities, hobbies, social activities, and sports activities. Both similar and distinctive pursuits characterised each dimension among the five countries. ‘Home activities’ mainly comprised indoor activities, but the other three dimensions involved more physical mobility. The scores of various socio-environmental characteristics on the factors enabled the attributes of the participants to be profiled. Sports activities and hobbies were performed more often by younger men, by those with good physical functioning and by those who drove cars. Social activities were performed more by women and those who used public transport. Home activities were more frequently performed by those with low physical function and women.
Trends in severe disability among elderly people: assessing the evidence in 12 OECD countries and the future implications
- Authors:
- LAFORTUNE Gaetan, et al
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2007
- Pagination:
- 78p., bibliog.
- Place of publication:
- Paris
As the population aged 65 and over will continue to grow steadily in OECD countries over the next decades, improvements in the functional status of elderly people could help mitigate the rise in the demand for, and hence expenditure on, long-term care. This paper assesses the most recent evidence on trends in disability among the population aged 65 and over in 12 OECD countries: Australia, Belgium, Canada, Denmark, Finland, France, Italy, Japan, the Netherlands, Sweden, the United Kingdom and the United States. One of the principal findings from this review is that there is clear evidence of a decline in disability among elderly people in only five of the twelve countries studied (Denmark, Finland, Italy, the Netherlands and the United States). Three countries (Belgium, Japan and Sweden) report an increasing rate of severe disability among people aged 65 and over during the past five to ten years, and two countries (Australia, Canada) report a stable rate. In France and the United Kingdom, data from different surveys show different trends in ADL disability rates among elderly people, making it impossible to reach any definitive conclusion on the direction of the trend. One of the main policy implications that can be drawn from the findings of this study is that it would not be prudent for policymakers to count on future reductions in the prevalence of severe disability among elderly people to offset completely the rising demand for long-term care that will result from population ageing.
Stronger symptoms of depression predict high coronary heart disease mortality in older men and women
- Authors:
- AHTO Merja, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.757-763.
- Publisher:
- Wiley
This study aimed to describe associations between stronger symptoms of depression and the risk of death from coronary heart disease (CHD) or myocardial infarction (MI) in elderly Finnish subjects free of CHD at the baseline. This study is a prospective population-based epidemiological and clinical twelve-year follow-up study in Lieto Health Centre, Finland. The basic population consisted of 1196 elderly (64 years of age or older) persons who lived in the municipality of Lieto in southwestern Finland in 1990. The occurrence of CHD was determined on the basis of electrocardiographic (ECG) findings, Rose questionnaire and the diagnoses in medical records. The persons with CHD were excluded from the study population. Symptoms of depression at the baseline were measured with the Zung Self-rating Depression Scale (ZSDS). Mortality was followed up for about 12 years. The Kaplan-Meier survival curves showed stronger symptoms of depression to be related to high risks of mortality from CHD or MI among men and women. According to the Cox model for men significant predictors for higher risk of CHD or MI mortality were stronger symptoms of depression, higher age and a large number of medications in use. When women were examined, significant predictors were stronger symptoms of depression and a large number of medications in use. Stronger symptoms of depression are an independent risk factor for high CHD or MI mortality in aged Finnish men and women free of CHD at baseline.
Length of gestation and depressive symptoms at age 60 years
- Authors:
- RAIKKONEN Katri, et al
- Journal article citation:
- British Journal of Psychiatry, 190(6), June 2007, pp.469-474.
- Publisher:
- Cambridge University Press
A non-optimal foetal environment, reflected in smaller birth size and shorter duration of gestation, is a risk factor for compromised health later in life. A total of 1371 members of a cohort born between 1934 and 1944 at term (259–294 days’ gestation) in Helsinki, Finland, completed the Beck Depression Inventory (BDI) and the Center for Epidemiological Studies Depression scale (CES–D) at an average age of 61.5 years (BDI) and 63.4 years (BDI and CES–D). Gestational length predicted depressive symptoms linearly and independently of gender and birth weight: per day decrease in gestational length, depressive symptoms scores increased by 0.8–0.9%. Weight, length and head circumference at birth showed no linear association with depression, adjusted for gender and gestational length. The results did not change when further controlled for socio-economic characteristics at birth and in adulthood, age and body mass index in adulthood. Susceptibility to depressive symptoms may relate to shorter length of gestation.
Rates and previous disease history in old age suicide
- Authors:
- KOPONEN Hannu J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(1), January 2007, pp.38-46.
- Publisher:
- Wiley
Suicide rates in persons over 65 have been reported to be higher than those of younger age groups. Since the absolute number of suicides in the elderly is expected to rise, more precise ways to identify potential risk factors for elderly suicides are needed. On the basis of forensic examinations suicide rates and methods in elderly Finns of northern Finland were compared with those of adults aged 18-64 years. Data from earlier illnesses of the suicide victims were scrutinized for records of multiple physical disorders. Over the 15-year period the mean annual suicide rate per population of 100 000 was significantly lower in the elderly (22.5) than adults aged 18-64 years (38.4). A decrease in suicide rates over time occurred in both groups. Suicide methods among elderly were more often violent, and they were seldom under the influence of alcohol. They also had a high prevalence of previous hospital-treated depressive episodes and hospital-treated physical illnesses. A lifetime history of hospital-treated depression was more common among elderly victims who had received hospital treatment for genitourinary diseases, injuries or poisonings after their 50th birthday. These results from elderly suicide victims suggest an association between multiple physical illnesses and a history of depression. Especially, genitourinary diseases as well as hospital treatment due to injuries or poisonings were shown to associate with depression. Elderly Northern Finns showed lower suicide rates, and they decreased during the study period suggesting that active preventive measures against suicide are also feasible in the elderly.
The effects of integrated home care and discharge practice on functional ability and health-related quality of life: a cluster-randomised trial among home care patients
- Authors:
- HAMMAR Teija, PERALA Marja-Leena, RISSANEN Pekka
- Journal article citation:
- International Journal of Integrated Care, 7(3), 2007, Online only
- Publisher:
- International Foundation for Integrated Care
The aim of this study was to evaluate the effects of integrated home care and discharge practice on the functional ability (FA) and health-related quality of life (HRQoL) of home care patients. A cluster randomised trial (CRT) with 22 Finnish municipalities as the units of randomisation. At baseline the sample included 669 patients aged 65 years or over. Data consisted of interviews (at discharge, and at 3-week and 6-month follow-up), medical records and care registers. The intervention was a generic prototype of care/case management-practice. The aim of the intervention was to standardize practices and make written agreements between hospitals and home care administrations, and also within home care and to name a care/case manager pair for each home care patient. The main outcomes were HRQoL and also Activities of Daily Living (ADL). All analyses were based on intention-to-treat. At baseline over half of the patient population perceived their FA and HRQoL as poor. At the 6-month follow-up there were no improvements in FA or in EQ-5D scores, and no differences between groups. In energy, sleep, and pain the NHP improved significantly in both groups at the 3-week and at 6-month follow-up with no differences between groups. In the 3-week follow-up, physical mobility was higher in the trial group. Although the effects of the new practice did not improve the patients' FA and HRQoL, except for physical mobility at the 3-week follow-up, the workers thought that the intervention worked in practice. The intervention standardised practices and helped to integrate services.