O1.2 Life course and physical functioning
Chair: Gro Gujord Tangen
O1.2.1 Influence of healthy lifestyle activities in the incidence of frailty
Jenny Osa1, Miguel German Borda2, Mario Ulises Pérez-Zepeda3 , Camilo Gomez2, Carlos
1 Stavanger University Hospital, Norway, 2 Pontificia Universidad Javeriana, Colombia, 3 Instituto Nacional De Geriatría, Macedonia
Frailty is a clinical state defined as an increase in an individual's vulnerability for developing adverse outcomes when exposed to stressful events. Frailty can lead to a decline in functionality and an impairment in the quality of life, as well as higher morbidity and mortality. Determining targets such as healthy lifestyle activities to prevent this condition is important for decreasing the impact of these age-related conditions within society.
MHAS is a prospective study conducted in Mexico consisting of four waves, (2001, 2003, 2012 and 2015), that sequentially included and described a large and representative sample of Mexican adults that were 50 years and older. We used the surveys conducted in 2012 from which a subsample of 6087 subjects did not have frailty. We studied the incidence of frailty after 3 years, comparing the individuals who practiced healthy activities to those who did not.
From the wave of 2012, with a total sample of 6087 non-frail people, 55.2% were male, the mean age was 62.18 ± 8.48, and the mean of years of education was 6.83 ± 4.94. The incidence of frailty was 37.85 %. People that practiced exercise had a lower presence of frailty (48.88% vs. 42.23% p value < 0.0001) with an independent protective association in the logistic regression (OR 0.79 IC95% 0.71-0.88).
This work showed an independent association between exercise and a lower incidence of frailty after 3 years. More studies are needed.
O1.2.2 Early life determinants of frailty in old age: the Helsinki Birth Cohort Study
Markus Haapanen1, Mia Perälä2, Clive Osmond3,
Minna Salonen2, Eero Kajantie2, Taina Rantanen4,
Mika Simonen1, Pertti Pohjolainen5, Johan Eriksson1,
Mikaela von Bonsdorff4
1University of Helsinki, Finland, 2 National Institute for Health and Welfare, Finland, 3 University of Southampton, UK, 4 University of Jyväskylä, Finland, 5 Age Institute, Finland
Background: We investigated whether factors taking place early in life were associated with frailty in old age in the Helsinki Birth Cohort Study (HBCS).
Methods: 1,078 HBCS participants born in Helsinki in 1934-1944 were assessed for frailty according to the Fried criteria at a mean age of 71 years. Early life measurements (birth weight, length, mother’s body mass index [BMI], parity and measurements of body size from birth to 12 years of age) were obtained from birth, child welfare and school health records.
Research results: Weight, length and BMI at birth were all associated with frailty. A 1kg increase in birth weight was associated with a lower relative risk ratio (RRR) of frailty (age and sex adjusted RRR 0.40, 95% CI 0.19, 0.82) compared to non-frailty. The associations persisted after adjustment for confounders. Greater BMI gain between 2 and 11 years in boys was associated with frailty in old age (age-adjusted RRR 2.36, 95% CI 1.21, 4.63), but was attenuated when adjusted further.
Conclusions: Those who were small at birth, and the boys who experienced accelerated BMI gain in childhood, were at an increased risk of developing frailty in old age, suggesting that frailty is at least partly programmed in early life
O1.2.3 Midlife cardiovascular risk factors and physical functioning trajectories in old
Mikaela von Bonsdorff1, Timo Törmäkangas1, Sari Stenholm2, Kaisu Pitkälä3, Timo Strandberg3
1University of Jyväskylä, Finland, 2 University of Turku, Finland, 3 University of Helsinki, Finland
Background. Cardiovascular disease (CVD) risk factors have been shown to be associated with decreased physical functioning, however, less studies have used a longitudinal study design. We investigated whether midlife CVD risk factors were related to physical functioning trajectories in old age.
Methods. We studied Caucasian men born in 1919-1934 in the Helsinki Businessmen Study (HBS initial n=3313). The study cohort participated in a primary prevention trial in the 1970s in which they were assigned into CVD risk groups in 1974 based on body mass index, smoking, blood pressure, serum total cholesterol and triglycerides and 1-hour glucose tolerance test. The men were divided into a low risk (healthy no of the risk factors), high risk (healthy but had at least one risk factor), sick (had known CVD or used medication for it) and refused group (they did not take part in the primary prevention trial). Physical functioning trajectories using Short Form SF-36 survey assessments between 2000 and 2010 were constructed with latent class growth mixture models.
Results. Model fit statistics indicated that a five-class solution provided the optimal number of classes. Relative to those in the low CVD risk group in midlife, those in the high risk and sick group had an increased risk of a declining or consistently low physical functioning trajectory in old age. Adjustment for CVD in old age and mortality during the follow-up did not attenuate the associations. Conclusions. Among businessmen, a more favorable CVD risk profile was associated with better physical functioning in old age.
O1.2.4 A capabilities approach to unequal trajectories of healthy ageing: The
importance of the environment
Christine Stephens, Agnes Szabo, Joanne Allen, Fiona Alpass
Massey University, New Zealand
Background and Objectives: Sen’s Capabilities Approach provides a framework that answers many of the critiques of ‘successful ageing’ models and focuses on the environment for the promotion of wellbeing among all older people. Based on this framework we predicted that standard of living, and quality of housing and neighbourhoods would be related to physical, mental and social health trajectories.
Methods: We analysed longitudinal data from 2483 New Zealanders (55-70 years of age in 2006) surveyed biennially for ten years.
Results: Growth mixture modelling revealed five profiles: those with robust health; average good health; declining physical health; limitations in mental health and social wellbeing or vulnerable health. After accounting for the effects of gender, ethnicity, and age, MANOVA revealed that health profile membership was significantly related to standard of living, satisfaction with housing, quality of neighbourhood, and social cohesion of neighbourhood (in 2016). These environmental resources were significantly inter-correlated.
Discussion and Implications: The findings support our argument that inequalities in health may be more usefully explained by inequalities in capabilities, rather than by individual abilities or choices. Policies to offset such inequalities would focus on social and physical environmental support for individuals’ abilities to meet their valued practical, social and participatory needs. Although these findings support others from recent growth in interest in the environment and health, further research to support the importance of the environment for healthy ageing is required.
O1.2.5 Health status and health care utilization patterns in exceptionally long-lived
Debora Rizzuto, Davide Liborio Vetrano, Giulia Grande, Amaia Calderon-Larrañaga, Laura Fratiglioni
Aging Research Centre, Karolinska Institutet, Stockholm, Sweden
Background: According to the compression of morbidity hypothesis, long-lived individuals delay or even escape diseases lethal at younger age. We aimed to assess the health status and health care utilization of individuals dying as centenarians (95+ years) as compared with those dying at younger age.
Methods: 1569 participants from the SNAC-K were analyzed. Extensive information on health status based on clinical assessment and administrative data (National Patient and Cause of Death Registers) was gathered for an average period of five years prior to death. Participants were categorized as follows: those who died as centenarians (n=447), those who died between 80−94 years (n= 846), and those who died before age 79 (n=276).
Research results: The likelihood of overall morbidity in centenarians was not different from younger participants (OR=1.0; 95%CI=0.5−1.8). When analyzing those diseases deemed as lethal in older adults, we found that more than 80% of the centenarians escaped cancer and diabetes but not dementia, ischemic heart disease, cerebrovascular disease and atrial fibrillation (OR ranging between 1.6 and 5.7). Finally, centenarians were found to be more dependent (on average 1.1 ADL more; p-value<0.01) and higher users of social care services (on average 7.9 and 13.2 monthly-hours more of formal and informal care, p-values<0.02) as compared with people who died at younger ages.
Conclusions: Centenarians are an ideal model for the study of protective factors of specific diseases such as diabetes and cancer. Still, longevity pays a toll to dementia and other burdensome diseases with worrisome consequences at individual and societal levels.
O1.2.6 The influence of psychosocial working conditions on late-life mobility in Sweden
Charlotta Nilsen1, Alexander Darin-Mattsson1,2, Ross Andel3, Ingemar Kåreholt1, 2, 4
1 Aging Research Centre, Karolinska Institutet, Stockholm, Sweden, 2 Stockholm University/Karolinska
institutet, Sweden, 3 School of Aging Studies, University of South Florida and International Clinical Research Center, USA, 4 Institute of Gerontology, Sweden
Work dominates much of our adult lives, which makes it likely that the workplace is important to health and aging. Stressful working conditions have been associated with limitations in physical functioning in old age. Active jobs (high demands, high control) are considered to increase learning, which may reduce the perception of situations as stressful and instead be viewed as challenges and opportunities for personal growth. This will, in turn, lead to feelings of self-efficacy that may encourage an active leisure-time, such as physical activity. We investigated the long-term association between active jobs and mobility in old age. Two individually linked Swedish surveys were used (n = 775). A psychosocial job exposure matrix was used to measure active jobs four times in midlife (age 40-65). Data were analyzed with ordered logistic regressions. Having an active job was associated with significantly better mobility in old age compared to people in non-active jobs, after adjustments at baseline for age, sex, educational attainment, social class, physical working conditions, and smoking. However, the accumulated score of active jobs over working life were not more strongly associated with mobility in old age than the score of active job in 1991, which may indicate that the conditions of a person’s most recent job mattered the most. Active job conditions in midlife are important predictors of mobility in old age. Promoting active job conditions may be used to improve midlife interventions aimed at preventing physical deterioration later in life.