Erkki Alanen

Social capital as a determinant of self-rated health and psychological well-being

ObjectiveTo examine whether specific dimensions of social capital are related to self-rated health and psychological well-being.MethodsCross-sectional data from a health survey representing the adult Finnish population (Nxa0=xa08,028) were used. Logistic regression analysis was used to reveal and quantify the possible associations between three dimensions of social capital (social support; social participation and networks; trust and reciprocity) and two general health indicators (self-rated health and psychological well-being). The roles of age, gender, education, living arrangements, income, type of region, functional capacity, and long-standing illness were also assessed.ResultsGood self-rated health was associated with high levels of social participation and networks and trust and reciprocity, but social support did not remain statistically significant after adjustment for socio-demographic factors, long-standing illness, and functional capacity. The association between social support and psychological well-being was explained by the other two dimensions of social capital. The strong positive association between trust and psychological well-being persisted after controlling for all the other factors in our model.ConclusionsOur findings suggest that trust and reciprocity and social participation and networks contribute to good self-rated health and psychological well-being.

Obesity History as a Predictor of Walking Limitation at Old Age

Objective: To study whether walking limitation at old age is determined by obesity history.

Social capital, health behaviours and health: a population-based associational study

BackgroundSocial capital is associated with health behaviours and health. Our objective was to explore how different dimensions of social capital and health-related behaviours are associated, and whether health behaviours mediate this association between social capital and self-rated health and psychological well-being.MethodsWe used data from the Health 2000 Survey (n=8028) of the adult population in Finland. The response rate varied between 87% (interview) and 77% (the last self-administered questionnaire). Due to item non-response, missing values were replaced using multiple imputation. The associations between three dimensions of social capital (social support, social participation and networks, trust and reciprocity) and five health behaviours (smoking, alcohol use, physical activity, vegetable consumption, sleep) were examined by using logistic regression and controlling for age, gender, education, income and living arrangements. The possible mediating role of health behaviours in the association between social capital and self-rated health and psychological well-being was also analysed with a logistic regression model.ResultsSocial participation and networks were associated with all of the health behaviours. High levels of trust and reciprocity were associated with non-smoking and adequate duration of sleep, and high levels of social support with adequate duration of sleep and daily consumption of vegetables. Social support and trust and reciprocity were independently associated with self-rated health and psychological well-being. Part of the association between social participation and networks and health was explained by physical activity.ConclusionsIrrespective of their social status, people with higher levels of social capital – especially in terms of social participation and networks – engage in healthier behaviours and feel healthier both physically and psychologically.

Effect of co-morbidity on the association of high body mass index with walking limitation among men and women aged 55 years and older

Background and aims: Obesity among older persons is rapidly increasing, thus affecting their mobility negatively. The aim of this study was to examine the association of high body mass index (BMI) with walking limitation, and the effect of obesity-related diseases on this association. Methods: In a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, chronic diseases, and BMI were ascertained in a health examination. Walking limitation was defined as maximal walking speed of less than 1.2 m/s or difficulty in walking 500 meters. To analyze the effects of chronic conditions, smoking, marital status, and education on BMI class differences in walking limitation, covariates were sequentially adjusted in logistic regression analyses. Results: In women, an increasing gradient in the age-adjusted risk of walking limitation was observed with higher BMI: overweight (OR 1.47, 95% CI 1.10–1.96), obese (OR 2.77, 95% CI 2.01–3.82), and severely obese (OR 5.80, 95% CI 3.52–9.54). In men, the risk was significantly increased among the obese (OR 1.63, 95% CI 1.04–2.55) and severely obese (OR 4.33, 95% CI 2.20–8.53). After adjustment of multiple covariates, the association remained significant among the obese (OR 1.99, 95% CI 1.38–2.86) and severely obese women (OR 3.64, 95% CI 2.12–6.26), as well as severely obese men (OR 2.78, 95% CI 1.30–5.95). Knee osteoarthritis in women and diabetes in men contributed most to the excess risk of walking limitation among obese persons, 18 and 32% respectively. Conclusions: Obesity increases the risk of walking limitation, independent of obesity-related diseases, smoking, marital status, and education, especially in older women. The results of this study emphasize the importance of maintaining normal body weight, in order to prevent obesity-related health risks and loss of functioning in older age.

SLEEP MOVEMENTS AND POOR SLEEP IN PATIENTS WITH NON-SPECIFIC SOMATIC COMPLAINTS - I. NO FIRST-NIGHT EFFECT IN POOR AND GOOD SLEEPERS

To evaluate the possible first-night effect on the nocturnal motor activity 25 poor sleepers and 12 good sleepers slept on the Static Charge Sensitive Bed (SCSB) during two consecutive nights. The frequency of body movements in poor sleepers was almost two times higher than in good sleepers. The method itself was reproducible across two nights. There were no statistically significant and systemic level differences between the nights in the movements in bed (MIB). The difference t-test did not either reveal group differences in the magnitude or direction of changes from night to night. Results are consistent with the view that the level of motor activity is one of the determinants of sleep quality. No first-night effect exists in terms of psychomotor activity.

Hip fractures and femoral bone mineral density in male former elite athletes.

INTRODUCTIONnWe studied whether vigorous physical activity in young adulthood is associated with higher femoral bone density and lower risk of hip fracture at older age in men.nnnMATERIALSnA cohort of former male elite athletes (n=2147) and matched control subjects (n=1467) were studied for their leisure physical activity, and for fragility fractures at the hip (proximal femur) by Cox regression. Areal bone mineral densities (aBMD) at femoral neck and trochanter region were measured using dual-energy X-ray absorptiometry in a subgroup of the former athletes (n=87; median age 59 years) and in a population-based control group (n=194) and compared by general linear models.nnnRESULTSnAfter their active sporting careers, the former athletes participated in leisure physical activity more than the matched control subjects (p<0.0001). The hazard ratio (HR) of osteoporotic hip fracture adjusted for the occupational group was 0.77 (95% CI 0.45 to 1.32, p=0.34) in the athletes compared with the control subjects. The mean age at the time of the fracture event was 76.9 years (95% CI 73.2 to 78.8) for the athletes and 70.6 years (95% CI 67.1 to 72.9) for the matched control subjects (p=0.005). Adjusted for age and body mass index, aBMD at the proximal femur was significantly higher in the former athletes compared with the population-based control group (p<0.0001 for both measurement sites).nnnCONCLUSIONSnOsteoporotic hip fractures were sustained at a significantly older age among former athletes compared with control subjects. Clear skeletal benefits of long-term physical loading were also observed in comparative DXA measurements of aBMD.

Everything all right in method comparison studies

Researchers and clinicians often need to know whether a new method of measurement is equivalent to an established one that is already in use. For this problem, the estimation of limits of agreement advocated by Bland and Altman is a widely used solution. However, this approach ignores two vital issues in method comparisons. First, does the appropriate re-scaling of the test method bring the methods into agreement? Second, independent of lying ‘adequately’ between the limits of agreement or not, it is important to know whether one method is equal to or better than another. This article proposes an approach and a model, where both these questions will be addressed simultaneously. In this model, the error variation of the standard method stands for ‘acceptable’ precision in measurements. Accordingly, the between-subject component of the measurements by the standard method will be used as a ‘gold standard’ against which the properties of the test method will be evaluated. Application of the model is demonstrated using the peak expiratory flow rate data of Bland and Altman.