Kirsten Avlund

Social relations: network, support and relational strain

We introduce a conceptual framework with social relations as the main concept and the structure and the function of social relations as subconcepts. The structure of social relations covers aspects of formal relations and social network. The function of social relations covers social support, social anchorage and relational strain. We use this conceptual framework to describe social relations in the Danish population, with questionnaire data from the Danish Longitudinal Health Behaviour Study including a random sample of each of the age groups 25-, 50-, 60-and 70-year olds, N = 2,011. The postal questionnaires were answered by a random sample in each of the age groups. The results show marked age and gender differences in both the structure and the function of social relations. The social network, measured as weekly contacts, weakens with age and so does instrumental support. Emotional support is unrelated to this decline in contact frequency and appears to be at the same level for younger and older individuals. Relational strain, measured as conflicts, declines with age for all kinds of social relations. The weakening of the social network with age does not seem to affect the level of emotional support and in turn seems to be partly compensated for by a simultaneous decline in relational strain.

Maximal isometric muscle strength and functional ability in daily activities among 75‐year‐old men and women

The purpose of this study was to analyze whether functional ability in daily activities among 75‐year‐old men and women is predicted by physical activity, isometric muscle strength and simple function tests. In this representative sample of a general population of 405 75‐year‐olds, isometric muscle strength and functional ability in daily activities were closely related (odds ratio of disability 1.2–2.1), stressing the importance of strength in the truncus, proximal and distal muscle groups for daily activities. There were strong correlations between physical activity, isometric muscle strength as well as simple function tests and ability to manage daily activities. Those with even light physical activities at least 2–4 h a week had significantly better functional ability than those with sedentary activities. Those with heavy physical activities further improved their functional abilities.

Tiredness in daily activities among nondisabled old people as determinant of onset of disability.

The purpose of this article was to examine whether self-reported tiredness in daily activities at age 75 is an independent determinant of onset of disability at 5-year follow-up. The investigation is based on two subgroups of nondisabled participants of 75 year olds who survived and participated in the follow-up study 5 years later (n = 510 and 429). Persons who felt tired in their daily activities had a larger risk of becoming disabled in mobility (OR = 3.2, 95% CI = 1.4-7.6) and in daily activities (OR = 2.1, 95% CI = 1.0-4.2) compared to persons without tiredness. In addition, persons with poor cognitive function, little diversity in social relations and no physical activity had an independent risk of onset of disability. The results indicate that it is important to take it seriously when older people complain about tiredness in daily activities, as these people are at higher risk of becoming disabled than others.

Tooth loss and subsequent disability and mortality in old age.

OBJECTIVES: To examine whether tooth loss at age 70 is associated with onset of disability at 5‐, 10‐, 15‐, and 20‐year follow‐up and to mortality at 21‐year follow‐up.

Functional Ability and Oral Health Among Older People: A Longitudinal Study from Age 75 to 80

OBJECTIVE: To examine whether functional ability at age 75 and age 80 is associated with oral health and use of dental services cross‐sectionally and whether changes in functional ability from age 75 to age 80 are associated with oral health and regular use of dental services at age 80.

SOCIAL RELATIONS AND MORTALITY. AN ELEVEN YEAR FOLLOW-UP STUDY OF 70-YEAR-OLD MEN AND WOMEN IN DENMARK.

PURPOSE To identify which aspects of social relations among 70-year-old men and women are predictive of mortality 11 years later. METHODS The baseline study in 1984 included 734 70-year-old men and women in Glostrup (county of Copenhagen). The variables comprised the structure and the function of the social network, education, income and functional ability. Eleven years later, in November 1995, information about deaths was obtained from the Central National Register. RESULTS The study showed an independent association between social relations and mortality. Men who did not help others with repairs and who lived alone and women with no social support to other tasks had increased risk of dying during the follow-up period. CONCLUSIONS This study supports (1) that there is an association between social relations and mortality, (2) that two aspects of the function of social relations matters: (a) to receive support for small or larger tasks needed, (b) to help others with different tasks, and (3) that social relations may serve different functions for men and women.

Tiredness in Daily Activities at Age 70 as a Predictor of Mortality During the Next 10 Years

This study examined whether self-reported tiredness in mobility and activities of daily living is predictive of mortality, when controlled for global self-rated health, smoking, and socio-demographic factors. The investigation is part of the 1984 longitudinal study of the residents of Glostrup, Denmark, born in 1914, and included 734 men and women who were interviewed about mobility, activities of daily living, self-rated health, smoking, and socio-demographic factors, when they were 70 years old. Ten years later, in November 1994, information about deaths was obtained from the Central National Register. When controlled for the other variables tiredness in mobility was an independent predictor of mortality during the next 10 years among both women and men. The finding persisted when the analysis was performed on a restricted sample of non-disabled 70-year-old people. The results in the present study indicate that we have identified a subgroup of independent elderly people who are at risk of dying earlier than others.

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.

Fatigue in older adults: an early indicator of the aging process?

The aim of this paper is to give an overview of research on fatigue in older adults, with a focus on fatigue as an early indicator of the aging process. Fatigue is a strong predictor of functional limitations, disability, mortality, and other adverse outcomes in young-old and old-old populations, between men and women, and in different geographic localities. Several biological, physiological and social explanations are proposed: fatigue may be seen not only as a self-reported indicator of frailty, defined as a physiologic state of increased vulnerability to stressors, which results from decreased physiologic reserves and even dysregulation of multiple physiologic systems, but also this state may be accelerated because of the cumulative impact of social, mental and biological factors throughout life.

Construct validation and the Rasch model: functional ability of healthy elderly people.

The purpose of this study was to test the construct validity of a measure of functional ability, developed with the intention of achieving a high degree of variability and capacity for discriminating among a group of healthy elderly people. Data were collected from 734 70-year-old people in Denmark in the county of Copenhagen. Functional ability was measured with the traditional activities of daily living and with a classification system developed specially for healthy elderly people. Construct validity was tested by the Rasch model for item analysis, addressing specifically the internal validity by assessing the homogeneity of items under different conditions. The results show that the proposed measure of functional ability is a combination of six different dimensions, divided into 3 types: mobility function, lower limb function and upper limb function. With regard to these three types decreased functional ability can appear by either tiredness or reduced speed.