Tiina-Mari Lyyra

Factors affecting the increased risk of physical inactivity among older people with depressive symptoms

The purpose of this study was to investigate the association between depressive symptoms and physical inactivity, and whether motives for and barriers to exercise explain the potential association between depressive symptoms and physical inactivity in older people. The design of the study was cross‐sectional. The study population comprised 645 people born between 1922 and 1928 who were residents in a city‐center area of Jyväskylä in central Finland. Depressive symptoms were assessed using Center for the Epidemiologic Studies Depression Scale, physical activity using Grimbys (1986) validated scale, and motives for and barriers to exercise using a questionnaire and mobility limitation with a test of walking time over 10 m. The results demonstrated that the risk of physical inactivity was more than twofold among persons with depressive symptoms compared with non‐depressed people. A higher prevalence of perceived barriers to physical activity, such as poor health, fear and negative experiences, together with lack of knowledge, explained part of the increased risk of physical inactivity among those with depressive symptoms while differences in motives for physical activity did not have a material effect. Adjustment for walking time over 10 m attenuated the increased risk of inactivity further. When planning exercise promotion programs, finding ways to overcome fear and negative experiences and providing information may help to increase physical activity among people with depressive symptoms. Additionally, difficulties caused by poor mobility should not be ignored.

Does Social Activity Decrease Risk for Institutionalization and Mortality in Older People

OBJECTIVES Social inactivity predicts adverse health events, but less is known about how different dimensions of social activity are related to health. The aim of this study was to investigate collective (e.g., cultural and organizational activities) and productive (e.g., helping others) social activity as predictors of risk for mortality and institutionalization in old age. METHOD A total of 1,181 community-living people aged 65-84 years at baseline were interviewed face to face as part of the Evergreen project, in Jyväskylä, Finland in 1988. Time to institutionalization and mortality were analyzed in separate models for proportional hazard regression on mortality and competing risks analysis on institutionalization and mortality. RESULTS At follow-up, approximately 17 years later, 22% of persons were institutionalized and 71% had died. When sociodemographics, health, functioning, and intensity of physical activity were controlled for, collective social activity reduced risk for mortality and initially for institutionalization although this latter effect diminished over time. DISCUSSION Collective social activity may be associated with a reduced risk for mortality and institutionalization in older people. Further studies on the mechanisms underlying the association between social activity and health are needed.

Perceived constraints on physical exercise among obese and non-obese older people.

OBJECTIVE To examine what older obese people consider as constraints on their physical exercise and to determine whether these constraints can explain the differences in physical activity. METHODS Six hundred nineteen community-living people aged 75-81 years living in Jyväskylä, Central Finland, in 2003 were included in these cross-sectional analyses. Weight and height were measured at the research center, and physical activity and perceived constraints on physical exercise were assessed using validated questionnaires. Participants were categorized as non-obese (n=436), moderately obese (n=127) or severely obese (n=56). RESULTS The risk of physical inactivity was two times higher in the moderately obese group (OR 1.99, 95% CI 1.27-3.12) and over four times higher in the severely obese group (OR 4.58, 95% CI 2.55-8.24) compared to the non-obese group. Higher prevalence of comorbidities, pain, tiredness, fear of falling and injury, discomfort and feelings of insecurity when exercising explained almost half of the increased risk of physical inactivity of older severely obese people. CONCLUSIONS Results suggest that physical activity promotion among older obese people may be well received as long as it focuses on factors that enable participation in physical activity and takes into account their constraints on physical activity.

Cohort differences in health, functioning and physical activity in the young-old Finnish population

Background and aims: A mixed picture emerges from the international literature about secular and cohort changes in the health and functioning of older adults. We conducted a repeated population-based cross-sectional study to determine trends in health, functioning and physical activity in the young-old Finnish population. Methods: Representative samples of community-dwelling people aged 65–69 years in 1988 (n=362), 1996 (n=320) and 2004 (n=292) were compared in socio-economic status, self-rated health, chronic diseases, memory problems, ability to carry out instrumental activities of daily living, physical activity, and five-year mortality. Results: Significant improvement in all the investigated modalities, except that of chronic diseases, was observed in the newer cohorts. In logistic regression analysis, after controlling for socio-economic status and gender, cohort effects remained significant for memory problems, IADL difficulties and physical activity. Cox regression analyses showed significant improvement in survival when later cohorts were compared with the earlier ones. Conclusions: This study provides evidence of improving levels of socio-economic status, self-rated health, functioning, physical activity, and lower risk of mortality in the newer cohorts of the Finnish young-old, but this was not accompanied by a parallel diminution in chronic diseases.

Social relations in older adults: Secular trends and longitudinal changes over a 16-year follow-up

Drawing on population studies in Finland, we investigated secular trends and longitudinal changes in social relations. The cohort comparison data comprised on 974 persons aged 65-69 years from three cohorts born between 1919 and 1939 and interviewed in 1988, 1996 and 2004. Longitudinal analyses were conducted for 635 persons aged 65-74 years over a 16-year follow-up at three measurement points. Social relations were studied on the basis of frequency seeing ones offspring, perceptions of the sufficiency of these contacts, and by asking whom the participants considered as their closest person and how often and in how many tasks they helped someone. The cohort comparisons showed that the frequency of seeing ones offspring had decreased in the most recent cohort and that the number of contacts was considered more inadequate. Longitudinal analyses showed that although the proportion of children as the closest persons increased, meetings with them became fewer. Helping others was more common in the last cohort, but in the longitudinal analyses it decreased with age. Finnish people at retirement help others more than before, but they do not meet their offspring as often as they would like. Measures are needed for action to promote intergenerational exchange in older adults on both individual and societal level.

Do negative life events promote gerotranscendence in the second half of life

Objectives: Gerotranscendence has been defined as a developmental shift in meta-perspective from a materialistic and pragmatic view to a more cosmic and transcendent view. Although gerotranscendence has been argued to increase with age and life experiences, the results have been mixed and based on cross-sectional studies. We use a longitudinal setting to investigate the role of negative life events, age, and gender on change in one dimension of gerotranscendence, cosmic transcendence. Method: 1569 individuals (ages 58–89) answered a questionnaire on cosmic transcendence in two cycles of the Longitudinal Aging Study Amsterdam in 1995–1996 (time 1) and 1998–1999 (time 2). Controlling for education, marital status, religious affiliation, chronic diseases, functional limitations, depressive symptoms, and social support, change models based on structural equation modeling were fitted to the data to test whether negative life events, age, and gender were associated with change in cosmic transcendence. Results: A higher number of negative life events, especially negative life events other than deaths of others, were associated with increased cosmic transcendence, whereas experiencing no negative life events was associated with decreased cosmic transcendence. The level of cosmic dimension was higher at older than younger ages. Cosmic transcendence decreased over time among the older participants and women, whereas it increased among the younger participants and men. Conclusion: Experiencing negative life events has the potential to promote the development of cosmic transcendence, even when controlling for age and gender. In the absence of negative life events, however, cosmic transcendence was observed to decline with aging.

Experienced health in older women with rheumatoid arthritis.

ABSTRACT This study explored how older women with chronic illness and disability experience their own health. Data were collected in in-depth interviews with ten older women with rheumatoid arthritis. Data analysis and interpretation was carried out within a phenomenological-hermeneutic frame of understanding, which revealed five major themes: health as coping with everyday life, health as freedom, health as absence of inconvenience, health as togetherness and health as mental well-being. For older people with chronic illness and disability, good health found expression in general well-being. It was perceived as a state of equilibrium that the respondents sought to maintain through their own active choices.

Social engagement from childhood to middle age and the effect of childhood socio-economic status on middle age social engagement: results from the National Child Development study

ABSTRACT Social engagement has powerful effects on wellbeing, but variation in individual engagement throughout the lifecourse is wide. The trajectories may differ by gender and be affected by socio-economic status (SES). However, long-term development of social engagement is little studied and the effect of childhood SES on later-life social engagement remains obscure. We aimed to describe the social engagement development from childhood to middle age by gender and test the effect of childhood SES on middle age social engagement. Data (N=16,440, 51.3% male) are drawn from the on-going National Child Development Study, following British babies born in 1958. Social engagement was measured by social activities, voluntary work and social contacts, with follow-ups at age 11, 16, 23 and 50. SES was measured by fathers occupational social class and tenure status. Structural equation modelling suggested inter-individual stability in social engagement, showing that development of social engagement started in childhood and increased social engagement in middle age through adolescence and early adulthood. Longitudinal effects were detected within and across the social engagement domains. Lower childhood SES was significantly related to a lower level of voluntary work and social activity in middle age, but to higher levels of social contacts. Although stability in social engagement is moderate over the lifecourse, variation within and across the different social engagement domains is shaped by differences in childhood SES.

The Current State and Developments in Higher Education in Gerontology in the Nordic Countries

The growing size of the older population challenges not only researchers but also higher education in gerontology. On the basis of an online survey the authors describe the situation of Nordic higher education in gerontology in 2008 and 2009 and also give some good examples of Nordic- and European-level collaboration. The survey results showed that gerontological education was given in every Nordic country, in 31 universities and 60 other higher education institutions. Although separate aging-related courses and modules were relatively numerous, programs for majors were relatively few. Networking in the Nordic region offers a good example on how to further develop higher education in gerontology. Emphasis should be put on strengthening networking on the European and trans-Atlantic levels.