Eino Heikkinen

Handgrip strength and cause-specific and total mortality in older disabled women: Exploring the mechanism

OBJECTIVES: To examine the association between muscle strength and total and cause‐specific mortality and the plausible contributing factors to this association, such as presence of diseases commonly underlying mortality, inflammation, nutritional deficiency, physical inactivity, smoking, and depression.

Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population.

OBJECTIVE: In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality.

Physical Activity and the Changes in Maximal Isometric Strength in Men and Women from the Age of 75 to 80 Years

OBJECTIVE: To research the natural changes in maximal isometric strength, over a period of 5 years, in men and women aged 75 at baseline, and to study the effect of everyday physical activity on strength alterations.

Predictors of decline in self-assessments of health among older people -- a 5-year longitudinal study

Within the framework of the Evergreen project we examined how changes in several indicators of health and functioning and physical activity predicted a decline in self-assessments of health evaluated over a 5-year period in older people by two different measurements: self-rated health (SRH) and self-assessed change in health (SACH). The study group comprised all 75-year-old persons born in 1914 (N = 382) and living in Jyväskylä, a town in central Finland. At baseline in 1989, 91.6%, and at follow-up 5 years later in 1994, 87.3% of those eligible participated in the interview and 77.2 and 71.3%, respectively, in the examinations in the study centre, focusing on different domains of health and functional capacity. One-fifth of the subjects reported a deterioration in and one-fifth an improvement in SRH over the 5 years. The rest gave identical self-assessments of their health at baseline and at follow-up in response to the same question. Decline in SRH was associated with a decrease in physical activity and cognitive capacity. When asked directly about changes in their health (SACH), however, half the subjects said their health had declined. Negative SACH over the 5-year period was related to an increased number of chronic conditions, deterioration in functional performance and physical activity, and to the number of chronic conditions at baseline. We suggest that ageing people adapt to changes in their objective health and functional performance: the majority tend to assess their health as similar to or even better with increasing age despite an increase in chronic diseases and decline in functional performance. However, a negative SACH indicates that older people are realistic about these negative changes. These results support the assumption that the two subjective measurements of change in health are based on different criteria: assessment of current general health status tends to be based on inter-individual comparison, whereas assessment of change in health over a given time period may be based on intra-individual comparison. Physical activity seems to be an important factor when older people assess their health.

Activity as a predictor of mental well-being among older adults

This eight-year follow-up study examines the roles of physical and leisure activity as predictors of mental well-being among older adults born in 1904–1923. As part of the Evergreen project, 1224 (80%) persons aged 65–84 years were interviewed at baseline (1988), and 663 (90%) persons in the follow-up (1996). Mental well-being factors including depressive symptoms, anxiety, loneliness, self-rated mental vigour and meaning in life were constructed using factor analysis. The predictors of mental well-being included physical and leisure activity, mobility status and number of chronic illnesses. We used a path analysis model to examine the predictors of mental well-being. At baseline, low number of chronic illnesses, better mobility status and leisure activity were associated with mental well-being. Baseline mental well-being, better mobility status and younger age predicted mental well-being in the follow-up. Explanatory power of the path analysis model for the mental well-being factor at baseline was 19% and 35% in the follow-up. These findings suggest that mental well-being in later life is associated with activity, better health and mobility status, which should become targets for preventive measures.

Mechanical properties of fast and slow skeletal muscle with special reference to collagen and endurance training.

The mechanical properties of the slow soleus and the fast rectus femoris muscle under passive stretching were studied in endurance trained, untrained and lathyritic rats, aged 3 months. The soleus muscle with more abundant and cross-linked collagen had higher ultimate tensile strength and tangent modulus compared to the fast rectus femoris muscle which, on the other hand, had higher maximum strain. The inhibition of collagen cross-linking by lathyrism resulted in decreased tensile strength and stiffness, especially in the soleus muscle, whereas endurance training showed the opposite effects. It is supposed that the properties of collagen partly explain the capacity of slow muscles to maintain posture and to perform prolonged dynamic work. The effects of training on the tensile properties further indicate the close relationship between intramuscular collagen and the endurance capacity of muscles.

Fear of moving outdoors and development of outdoor walking difficulty in older people

OBJECTIVES: To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation.

Self-rated health and self-assessed change in health in elderly men and women — A five-year longitudinal study

The purpose of the present investigation was two fold: (1) to examine how men and women self-rate their health as they age from 75 to 80 yr and how they assess the change in their health over the five year period; and (2) to ascertain how self-assessed change in health over the follow-up period corresponded to the difference in self-ratings of health between the assessments performed at baseline and at follow-up. The study was part of the Evergreen-project with the study group comprising all inhabitants born in 1914 (N = 388) living in Jyväskylä, central Finland. At baseline, 93.4%, and at follow-up, 93.3%, of those who were eligible participated in the interview. Self-rated health, when asked using the same questions, did not change at follow-up compared to baseline. However, nearly half of the follow-up group reported that their health had become worse over the five year period. Gender differences in self-rated health were not found, although women reported more often than men that their health had become worse and some of the men said their health had become better. It is concluded that self-rated health seems to be age-adjusted; elderly people who say their health has become worse as they age actually self-rate their health as the same or better than before.

Postural balance and self-reported functional ability in 75-year-old men and women: a cross-national comparative study

OBJECTIVE: To study postural balance in relation to selfreported functional ability (mobility and ADL) and general physical activity in elderly men and women living in three different Nordic environments.

Mobility limitations and cognitive deficits as predictors of institutionalization among community-dwelling older people.

Purpose: Mobility limitations and cognitive disorders have often been observed as risks for institutionalization. However, their combined effects on risk of institutionalization among initially community-dwelling older people have been less well reported. Design: A prospective cohort study with 10-year surveillance on institutionalization. Subjects: Study population (n = 476) consisted of 75- and 80-year-old people who were community-dwelling, had not been diagnosed with dementia, and participated in tests on walking speed and cognitive capacity at a research centre. Measures: Cognitive capacity was measured with three validated psychometric tests that were from the Wechsler Adult Intelligence Scale, Wechsler Memory Scale and Schaie- Thurstone Adult Mental Abilities Test. Mobility was measured with walking speed over a 10-m distance. Exclusive distribution based study groups were formed with cut-offs at the lowest third as follows: no limitation, solely mobility limitation, solely cognitive deficits, and combined mobility limitation and cognitive deficits. Cox proportional hazards model was used to determine the relative risks of institutionalization for the study groups. Results: Eleven percent of the participants were institutionalized during the 10-year surveillance. The risk for institutionalization was 4.9 times greater (95% confidence interval: 2.1–11.2) for those who had co-existing mobility limitations and cognitive deficits than for those with no limitations. Conclusions: The findings show that the accumulation of limitations in physical and cognitive performance substantially decreases the possibility for a person remaining at home. This might be due to a decreased reserve capacity and ineffective compensatory strategies. Therefore, interventions targeted to improve even one limitation, or prevent accumulation of these risk factors, could significantly reduce the risk of institutionalization.