Marti G. Parker

LEISURE ACTIVITIES AND QUALITY OF LIFE AMONG THE OLDEST OLD IN SWEDEN

Drawing on Rowe and Kahn’s (1998) notion that “engagement with life” is a critical component of successful aging, this study tested whether change in leisure activities over a ten year period was associated with retrospectively assessed change in quality of life among older people in Sweden. Hypotheses were tested using a nationally rep resentative sample of 324 older Swedes living in the community, surveyed in 1981 and 1992. Fifteen leisure activities were divided into six domains: culture-entertainment, productive-personal growth, outdoor-physical, recreation-expressive, friendship, and formal-group. Ordered logit analysis revealed that those increasing their activity participation across domains tended to perceive an improvement in their life conditions. This effect was particularly strong among older adults who became widowed, developed functional impairments, and had relatively low contact with family. The results suggest that maximizing activity participation is an adaptive strategy taken by older adults to compensate for social and physical deficits in later life.

The prevalence of pain among the oldest old in Sweden

&NA; Although there is information available about pain in elderly persons, there have been very few studies about pain among the oldest old. In Sweden, 8% of the population is older than 74 years, and 2% is older than 84 years. It is the group over 74 which is growing fastest in proportion to the entire population. The aims of the present study are (a) to analyze if pain increases or decreases with age in the oldest age groups and (b) to study gender differences regarding pain. The present study of a random sample (n = 537) of the oldest old in Sweden shows that there is some evidence of decreased musculoskeletal pain with age. Among women, total reported pain decreases with age. Among men, there is an increase of reported severe pain with age. Including the results from another Swedish population survey of individuals aged 18–84, there is evidence that the prevalence of pain among the older elderly is comparable to the prevalence of pain among the middle‐aged (45–64) and is higher than the prevalence among the younger elderly (65–75). Musculoskeletal pain is more common among old women than old men but for chest pain and abdominal pain there is no difference. The sex difference is more pronounced for multiple and severe pain complaints. The prevalence of mild or severe pain in any of the studied locations in the whole study group (77+) was 73% and for individuals over 85 years, 68%. For multiple pain, the figures were 47% for all older elderly (77+) and 46% for individuals over 85 years of age. For severe pain in at least one location, corresponding figures were 33% and 35%.

Mentally Stimulating Activities at Work During Midlife and Dementia Risk After Age 75: Follow-Up Study From the Kungsholmen Project

OBJECTIVES Previous research has suggested that mental stimulation in different life periods may protect against dementia or delay disease onset. This study aimed to explore the association between work complexity factors at midlife and dementia risk in late life under the hypothesis that high work complexity may modulate the increased dementia risk due to low education. DESIGN Population-based follow-up study. SETTING Urban. PARTICIPANTS A cohort of 931 nondemented subjects, aged 75+ years from the Kungsholmen Project, Stockholm, examined twice over 6 years. MEASUREMENTS Incident dementia cases were identified using Diagnostic and Statistical Manual of Mental Disorders, 3rd-Edition Revised criteria. Primary occupations were assigned into categories according to the Nordic Occupational Classification and matched to the 1970 U.S. Census to score the level of work complexity with data, people, and things by using a preformed matrix. RESULTS Lower dementia risk was associated with complexity of work with both data (age and gender adjusted relative risk [aRR]: 0.85, 95% confidence interval [CI]: 0.75-0.95) and with people (aRR: 0.88, 95% CI: 0.80-0.97). Adjusting for education led to similar results, although no longer statistically significant. Further, the highest degrees of complexity of work with data that involves analyzing, coordinating, and synthesizing data were associated with lower dementia risk even among lower educated subjects (relative risk: 0.52, 95% CI: 0.29-0.95). No gender differences were detected. CONCLUSIONS This study suggests that work complexity with data and people is related to lower risk of dementia and that the highest levels of work complexity may modulate the higher dementia risk due to low education.

Are today's older people more active than their predecessors? Participation in leisure-time activities in Sweden in 1992 and 2002

For the older individual, leisure activities are a resource that helps to maintain health and engagement with lire. This article investigates change over 10 years ill the level of participation of older people in leisure activities in Sweden, and the factors associated with these changes. The data are from nationally representative samples of the Swedish population aged 77 or more years in 1992 and 2002. The level of participation was higher at the later date, and among four major groups of activities, social and Cultural activities increased the most, while physical and intellectual activities increased only among women. Ordered logistic regressions enable variations in the level of participation by age, gender, level of education, disability and fatigue to be described. Participation in most kinds of activities, including the overall level, was more common at the younger ages (the late seventies and early eighties) and among those with full mobility and more education. Since average health was worse in 2002 than in 1992, it cannot explain the higher level of participation. Other possible explanations, Such as cohort differences, improved accessibility, and changing gender roles, and the implications for health promotion programmes are discussed.

Socioeconomic status, marital status and hip fracture risk : A population-based case-control study

Abstract: Socioeconomic status and social support have been identified as important determinants of several diseases and overall mortality, but these factors have not been adequately examined in relation to hip fracture risk. The aim of this study was to determine the relationship of socioeconomic status and marital status to hip fracture risk. We used data from a population-based case–control study in postmenopausal women aged 50–81 years during 1993–1995 who resided in six counties in Sweden. The analysis was based on 1327 incident cases of hip fracture and 3262 randomly selected controls. Socioeconomic and marital status were obtained by record linkage with census data in 1960, 1970, 1980 and 1990. Information on other possible risk factors for hip fracture was collected by a mailed questionnaire. Women who were gainfully employed in 1990 had an odds ratio (OR) of 0.74 [95% confidence interval (CI) 0.56–0.96] compared with those not gainfully employed; those in the highest tertile of household income had an OR of 0.74 (95% CI 0.60–0.90) compared with those in the lowest tertile of income. Women who lived in a one-family house had an OR of 0.85 (95% CI 0.72–0.99) compared with those living in an apartment. Divorced, widowed or unmarried women had a higher risk of hip fracture than married or cohabiting women; the OR was 1.40 (95% CI 1.06–1.85). Married women who were both gainfully employed and were living in a one-family house had a substantially decreased risk of hip fracture compared with unemployed women living without a partner in an apartment (OR 0.39; 95% CI 0.22–0.71). Occupational affiliation among women ever employed, and educational level, were not associated with hip fracture risk. We conclude that employment, household income, type of housing and marital status seem to be risk indicators of hip fracture risk independent of known osteoporotic risk factors.

A longitudinal study of pain: reported pain from middle age to old age.

OBJECTIVE Describe patterns of pain reporting over a span of 24 years. DESIGN Individuals were interviewed on four occasions (1968, 1974, 1981, 1992). PARTICIPANTS Representative sample (n = 321) of the Swedish population aged 53-63 at baseline. MEASURES Self-reported pain in the chest, abdomen, and musculoskeletal system (back or hips, shoulders, hands, elbows, legs, or knees). RESULTS Less than 1% reported chest or abdominal pain on all four occasions. Whereas 21.8% of the sample reported musculoskeletal pain on all four occasions. More than half of the sample reported some kind of pain on three or four occasions. Women reported more severe and more persistent pain compared with men. There were more people who developed pain during the 24-year period than there were who became pain free. An increase in pain was equally common for chest and musculoskeletal pain, but a decrease in pain was much more common for musculoskeletal pain than chest pain. CONCLUSIONS Cross-sectional studies have shown differing age patterns in pain. This longitudinal study demonstrates different patterns for men and women and for different pain localities.

Leisure activities and mortality: does gender matter?

Objectives: This study examines the association between participation in leisure activities and mortality risk among older men and women. Methods: A representative sample of 1,246 men and women ages 65 to 95, interviewed in 1991-1992, were followed for 12 years. Cox regressions analyzed mortality risk. Results : Participating in only a few activities doubled mortality risk compared to those with the highest participation levels, even after controlling for age, education, walking ability, and other health indicators. Women had a dose-response relationship between overall participation and survival. Strong associations with survival were found for engagement in organizational activities and study circles among women and hobby activities and gardening among men. Discussion: Results suggest gender differences in the association between leisure activities and mortality. Women display a decreasing mortality risk for each additional activity. Social activities have the strongest effects on survival among women, whereas men seem to benefit from solitary activities.

Complexity of Primary Lifetime Occupation and Cognition in Advanced Old Age

Objectives: The authors explored the association between complexity of primary lifetime occupation and cognition in older adulthood. Method: The study included 386 participants from the Swedish Panel Study of Living Conditions of the Oldest Old, a nationally representative sample aged 77 years or older. The authors examined complexity of work with data, people, and things in relation to cognitive functioning, measured with a shortened version of Mini-Mental State Examination (MMSE) and cognitive impairment based on MMSE score cutoff. Results: Complexity of work with data and people were associated with better MMSE scores, controlling for age, sex, childhood socioeconomic status, and education. The association between complexity of work with data and MMSE remained statistically significant when adult occupational status was substituted for education as a covariate. Discussion: Complexity of primary lifetime occupation may be reflected in cognitive functioning even in advanced old age. This effect may be independent of education or occupational status.

Chewing Ability and Tooth Loss: Association with Cognitive Impairment in an Elderly Population Study

To determine whether there is an association between tooth loss, chewing ability, and cognitive function in a general elderly population.

Mobility limitations in the Swedish population from 1968 to 1992: Age, gender and social class differences

Mobility limitations are closely related to disability in old age. The study of mobility limitations in the population may improve the understanding of the development of disability, as well as gender and class patterns in disability in old age. Representative samples of the Swedish population between the ages of 18 and 75 years were interviewed in 1968, 1974, 1981, and 1991. A further sample of people aged 76+ years was interviewed in 1992. The questionnaire included the ability to walk 100 meters, to walk up and down stairs, and to run 100 meters. Mobility limitations begin to appear around age 40 years, and increase with age. In 1992 nearly none in the oldest age group (85+) could run 100 meters, and less than half could walk 100 meters, or go up and down stairs without difficulty. Between 1968 and 1991, the proportion of people with mobility limitations was reduced by one third, with the most prominent reduction among the oldest age groups. Women were more likely to report mobility limitations compared to men at all waves; however, the gender difference decreased between 1968 and 1991. Blue-collar workers had more mobility limitations than white-collar workers, and this discrepancy did not decrease over time. Mobility limitations often begin early in life, and differences between cohorts, men and women, and social classes can be seen well before the age of 50. The results suggest that gender differences in functional limitations among elderly people may decrease in the future, while social class inequalities are likely to persist.