PubMed Health⌕ Search

Biomedical subjects

Eino Heikkinen

Publications and source records attributed to Eino Heikkinen.

At least 19 recordsLinked to original sources
PubMed2006

Fall-related injuries among initially 75- and 80-year old people during a 10-year follow-up.

The aim of this study was to investigate the occurrence, type, scene and seasonal variation of fall related injuries, and the impact of socio-economic factors, mobility limitation, and the most common diseases on the risk of injurious falls over a 10-year follow-up. Elderly residents of Jyväskylä, Finland, aged initially 75 and 80 years, took part in the study in 1989-1990. The health and functional capacity assessments were carried out at the baseline. Injurious falls were monitored over a 10-year period. The rate of injurious falls per thousand person-years was 188 among women and 78 among men. Of all fall-related diagnoses, head injuries comprised 32%, upper limb injuries 27% and hip injuries 19%. Majority of injurious falls took place indoors and no seasonal variation in fall occurrence was observed. Recurring falls were more likely to take place in institutions. Osteoarthritis increased the risk of injurious falls but no effect was observed for coronary heart diseases or mobility limitation. All in all, intrinsic factors, such as chronic diseases and mobility limitation had only minor effect on risk of injurious falls among older people. The current results suggest that preventive interventions for injurious falls among older people should pay attention to the risk factors present indoors.

Accidental Falls↗
PubMed2006

Mobility limitations and cognitive deficits as predictors of institutionalization among community-dwelling older people.

PURPOSE: Mobility limitations and cognitive disorders have often been observed as risks for institutionalization. However, their combined effects on risk of institutionalization among initially community-dwelling older people have been less well reported. DESIGN: A prospective cohort study with 10-year surveillance on institutionalization. SUBJECTS: Study population (n = 476) consisted of 75- and 80-year-old people who were community-dwelling, had not been diagnosed with dementia, and participated in tests on walking speed and cognitive capacity at a research centre. MEASURES: Cognitive capacity was measured with three validated psychometric tests that were from the Wechsler Adult Intelligence Scale, Wechsler Memory Scale and Schaie-Thurstone Adult Mental Abilities Test. Mobility was measured with walking speed over a 10-m distance. Exclusive distribution based study groups were formed with cut-offs at the lowest third as follows: no limitation, solely mobility limitation, solely cognitive deficits, and combined mobility limitation and cognitive deficits. Cox proportional hazards model was used to determine the relative risks of institutionalization for the study groups. RESULTS: Eleven percent of the participants were institutionalized during the 10-year surveillance. The risk for institutionalization was 4.9 times greater (95% confidence interval: 2.1-11.2) for those who had co-existing mobility limitations and cognitive deficits than for those with no limitations. CONCLUSIONS: The findings show that the accumulation of limitations in physical and cognitive performance substantially decreases the possibility for a person remaining at home. This might be due to a decreased reserve capacity and ineffective compensatory strategies. Therefore, interventions targeted to improve even one limitation, or prevent accumulation of these risk factors, could significantly reduce the risk of institutionalization.

Aged↗
PubMed2006

Motor speed and lower extremity strength as predictors of fall-related bone fractures in elderly individuals.

BACKGROUND AND AIMS: The purpose of this prospective population-based study was to examine the combined effects of motor speed and knee extension strength on risk of fall-related bone fractures in elderly individuals over a 10-year period. METHODS: Participants were 307 men and women aged 75 or 80 years at baseline, who visited the research laboratory at the University of Jyväskylä, Finland. Multi-choice motor speed tests and maximal isometric knee extension strength tests were carried out at baseline. Information on fractures was collected from hospital and health center records. The presence of impairment was defined as a score in the lowest tertile of sex- and age-stratified distribution of results in each test. RESULTS: During the 10-year period, 93 participants had at least one fracture. In Cox proportional hazards models for motor speed and knee extension strength, the risk of fracture was almost double in the lowest vs the highest tertile of each test score. For those in the poorest speed and strength tertiles compared with the best speed and strength tertiles, the relative risk of fracture adjusted for age, sex and bone mineral density was 4.69 (95% confidence interval 1.72-12.81). CONCLUSIONS: Increased risk of fracture was observed for those with either slow motor speed or poor lower extremity strength; however, a combination of these impairments increased the fracture risk significantly when compared with those with no impairments. A co-impairment approach may prove useful in gaining better understanding of the risk of fall-related bone fractures and the development of effective interventions.

Accidental Falls↗
PubMed2006

Absent pedal pulse and impaired balance in older people: a cross-sectional and longitudinal study.

BACKGROUND AND AIMS: The purpose of this study was to determine the relationship between abnormal pedal pulse status and postural balance in older people. METHODS: Prospective, population-based cohort study of older residents in the city of Jyväskylä, Finland. A total of 419 individuals aged 75 or 80 at baseline, with known lower extremity pulse status and balance tests performed on a force platform, were eligible for analysis. RESULTS: Cross-sectionally, persons with both dorsal pedal artery pulses absent were found to sway more (p=0.047 anteroposterior velocity, normal standing eyes-open position). The risk of being unable to do the full tandem stance was twofold (OR=2.20, 95% CI 1.29-3.78) for persons without palpable dorsal pedal arteries compared with those with normal pulse status. Balance deterioration was observed at five years (p<0.001 for time) but without group-by-time interaction. At ten years, however, the interaction term became significant for the normal standing eyes-closed position (p=0.025 for anteroposterior velocity and p=0.026 for mediolateral velocity), indicating greater balance deterioration among those with both dorsal pedal artery pulses absent. CONCLUSIONS: According to our study, the absence of both dorsal pedal artery pulses is associated with impaired balance in older people. The association was observed both cross-sectionally and longitudinally. In addition, as diminished pedal pulses are frequently associated with impaired lower extremity circulation, our results have also produced information on the possible pathophysiological mechanisms of balance deterioration in older people, which warrant further study.

Aged↗
PubMed2006

Endogenous hormones, muscle strength, and risk of fall-related fractures in older women.

BACKGROUND: Among older people, fracture-causing fall often leads to health deterioration. The role of endogenous hormone status and muscle strength on fall-related fracture risk is unclear. This study investigates if, after adjustment for bone density, endogenous hormones and muscle strength would predict fall-related limb fracture incidence in older community-dwelling women followed-up over 10 years. METHODS: As a part of a prospective population-based study, 187 75-year-old women were investigated. Serum estradiol, testosterone, sex hormone binding globulin, and dehydroepiandrosterone sulfate concentrations were analyzed, and isometric muscle strength and bone mineral density were assessed. Fall-related limb fractures were gathered from patient records. RESULTS: Serum estradiol concentration was a significant predictor of fall-related limb fractures. Women with serum estradiol concentrations less than 0.022 nmol/L had a 3-fold risk (relative risk 3.05; 95% confidence interval, 1.26-7.36), and women with estradiol concentrations between 0.022 and 0.066 nmol/L doubled the risk (relative risk 2.24; 95% confidence interval, 0.97-5.19) of fall-related limb fracture compared to the women with estradiol concentrations ()above 0.066 nmol/L. Adjustment for muscle strength and bone mineral density did not materially change the risk estimates. High muscle strength was associated with a low incidence of fall-related limb fractures. CONCLUSIONS: This study showed that in 75-year-old women higher serum estradiol concentration and greater muscle strength were independently associated with a low incidence of fall-related limb fractures even after adjustment for bone density. Our results suggest that hormonal status and muscle strength have their own separate mechanisms protecting from fall-related fractures. This finding is of importance in developing preventive strategies, but calls for further study.

Accidental Falls↗
PubMed2005

Self-rated health and mortality: could clinical and performance-based measures of health and functioning explain the association?

It is well established that self-rated health (SRH) predicts mortality even when other indicators of health status are taken into account. It has been suggested that SRH measures a wide array of mortality-related physiological and pathological characteristics not captured by the covariates included in the analyses. Our aim was to test this hypothesis by examining the predictive value of SRH on mortality controlling for different measurements of body structure, performance-based functioning and diagnosed diseases with a population-based, prospective study over an 18-year follow-up. Subjects consisted of 257 male residents of the city of Jyväskylä, central Finland, aged 51-55 and 71-75 years. Among the 71-75-year-olds the association between SRH and mortality was weaker over the longer compared to shorter follow-up period. In the multivariate Cox regression models with an 18-year follow-up time for middle-aged and a10-year follow-up time for older men, SRH predicted mortality even when the anthropometrics, clinical chemistry and performance-based measures of functioning were controlled for, but not when the number of chronic diseases was included. Although our results confirm the hypothesis that the predictive value of SRH can be explained by diagnosed diseases, its predictive power remained, when the clinical and performance-based measures of health and functioning were controlled.

Activities of Daily Living↗
PubMed2005

Associations of socio-economic position and disability among older women in Britain and Jyväskylä, Finland.

The aim was to compare the pattern of associations in measures of socio-economic position and disability among British and Finnish older women. In Britain data from the British Women's Heart and Health Study was used. Women from 23 towns took part in a nurse-assessed medical examination and postal questionnaire (n = 4286). In Finland, data from the Evergreen study was used. Eight hundred and four women from the city of Jyväskylä were interviewed at home. Socio-economic position was measured according to social class in childhood, education, use of a car, home ownership and previous occupation. Disability measures included questions on difficulties in washing/dressing and climbing stairs. Logistic regression analyses were conducted to examine the relationship between disability and socio-economic position. In the age-adjusted analysis of both samples increasing disability in washing/dressing and climbing stairs was associated with at least one of the measures of deprivation. The relationship between socio-economic position and disability was more distinct in the British than Finnish women. Despite adjustment for a range of confounders, the relationship between socio-economic position and disability was not much attenuated, particularly in the British women. The associations in the measures of socio-economic position and disability showed a slightly different pattern between the British and Finnish women.

Age Factors↗
PubMed2005

Socio-economic position and its relationship to physical capacity among elderly people living in Jyväskylä, Finland: five- and ten-year follow-up studies.

Socio-economic differences in self-reported disability are well described but much less is known about their associations with more objective measures of physical capacity. The aim was to study socio-economic differences in performance-based physical capacity in 75-year-old persons, examining changes in performance at five- and ten-year follow-up intervals. At the baseline 350 residents of the city of Jyväskylä, Finland, aged 75 were interviewed and 295 of them took part in clinical examinations. The corresponding figures at the five-year follow-up were 234 and 191 and at the ten-year follow-up 139 and 103. The statistical significance of differences in physical capacity between the socio-economic groups and genders were tested using ANOVA in univariate and repeated measures models and ANCOVA, with confounders added to the models. Generally, higher education and income were separately related to better maximal walking speed and vital capacity at every measurement point. In addition, higher income was related to better maximal isometric hand grip strength at both follow-ups. When education and income were in the same model, only income was related to physical capacity, almost without exception. Similarly, in the five- and ten-year follow-up periods, both education and income groups showed a parallel decline in physical capacity. The association between income and physical capacity remained even after adjusting for smoking, physical activity and number of chronic diseases. The results indicate that elderly people in disadvantaged socio-economic groups show lower levels of performance in almost all domains of physical capacity, but change in capacity over time does not differ significantly between either markers of socio-economic position.

Activities of Daily Living↗
PubMed2005

A cohort study found good respiratory, sensory and motor functions decreased mortality risk in older people.

BACKGROUND AND OBJECTIVE: The main aims of this study were to evaluate the separate and joint effects of respiratory, sensory, and psychomotor function, muscle strength, and mobility in predicting mortality in older men and women, and to find a way to control multicollinearity in a multivariate Cox regression model. METHODS: Mortality was followed for 10 years (1990-2000) in an entire cohort of 75-year-old residents of the city of Jyvaskyla, Finland (born in 1914; N=388). Cox regression models and principal component estimation were employed to study the association between the covariates and mortality. RESULTS: The study indicated that, after adjustment for fatal diseases and cognitive capacity, vital capacity, tapping rate, muscle strength, and walking speed predict mortality in elderly men and women to a similar extent. The hazard ratio for mortality for those in the lowest tertile of the principal component representing all the significant physiological functions was from three to four times higher than for those in the highest tertile. CONCLUSION: Our results suggest that a poor level in any of the measured functions has a similar impact on the risk for mortality, which is further increased by combining the different results. No single, dominant predictor of mortality emerged.

Aged↗
PubMed2005

Hearing among 75-year-old people in three Nordic localities: a comparative study.

The aim of this study was to compare auditory functions and to analyse the prevalence of hearing impairment and the relationship of self-reported hearing disability with audiometric test results among 75-year-old people in three Nordic localities. The representative samples came from Glostrup, Denmark (n = 571), Göteborg, Sweden (n =450), and Jyväskylä, Finland (n =388). The median pure-tone thresholds were rather similar in all three populations. The prevalence of moderate hearing impairment varied between 26% and 34% in men, and between 17% and 23% in women. The corresponding figures in the prevalence of self-reported hearing difficulties were 41%-57%, and 28%-37%. The self-reported difficulties were broadly in accordance with the audiometric test results, but there also were individuals with conflicting results. It is concluded that the prevalence of hearing impairment in the three Nordic localities is fairly similar. To assess hearing disorders in elderly people, both audiometry and self-report data are needed.

Aged↗
PubMed2005

Genetic influences underlying self-rated health in older female twins.

OBJECTIVES: To examine the genetic and environmental sources of variation in self-rated health (SRH) in older female twins and to explore the roles of morbidity, functional limitation, and psychological well-being as mediators of genetic and environmental effects on SRH. DESIGN: Cross-sectional analysis of twin data. SETTING: Research laboratory. PARTICIPANTS: One hundred two monozygotic and 115 dizygotic female twin pairs aged 63 to 76. MEASUREMENTS: SRH was categorized as good, average, or poor. Morbidity was described using a physician-assessed disease-severity scale together with information about the presence of diabetes mellitus and cancer. Maximal walking speed measured over 10 m was used to assess physical functional limitation; the Mini-Mental State Examination and the Center for Epidemiologic Studies Depression Scale were used to characterize psychological well-being. The contributions of genetic and environmental (defined as familial (shared by siblings) or nonshared (unique to each sibling)) effects were assessed using univariate and multivariate structural equation modeling of twin data. RESULTS: SRH did not have its own specific genetic effect but shared a genetic component in common with the genetic components underlying liability to disease severity, maximal walking speed, and depressive symptoms. It accounted for 64% of the variation in SRH, with environmental effects accounting for the remaining variation. CONCLUSION: The current results suggest that there are no specific genetic effects on SRH but rather that genetic influences on SRH are mediated through genetic influences affecting chronic diseases, functional limitation, and mood.

Activities of Daily Living↗
PubMed2005

Shared genetic and environmental effects on strength and power in older female twins.

PURPOSE: This study examined the relative contribution of genetic and environmental effects on maximal leg extensor power and also investigated whether leg extensor power and maximum voluntary isometric knee extensor strength share a genetic component. METHODS: Muscle functions were measured as part of the Finnish Twin Study on Aging in 101 monozygotic (MZ) and 116 dizygotic (DZ) female twin pairs aged 63-76 yr. Leg extensor power was measured using the Nottingham Leg Extensor Power Rig and maximum voluntary isometric knee extensor strength using an adjustable dynamometer chair. The analyses were carried out using the maximum likelihood method in Mx-program on the raw data set. RESULTS: A bivariate Cholesky decomposition model showed that leg extensor power and isometric knee extensor strength shared a genetic component in common, which accounted for 32% of the total variance in leg extensor power and 48% in isometric knee extensor strength. In addition, power and strength had a nonshared environmental effect in common accounting for four percent of the variance in power and 52% in strength. Remaining variance for leg extensor power was due to trait-specific shared and nonshared environmental effects. CONCLUSION: Observed genetic effect in common for leg extensor power and maximum voluntary isometric knee extensor strength indicated that these two traits are regulated by the same genes. However, also environmental effects have a significant role in explaining the variability in power and strength.

Aged↗
PubMed2004

Changes in hearing in 80-year-old people: a 10-year follow-up study.

The aims of this prospective 10-year longitudinal population study were to report changes in hearing in people aged 80 years at baseline, and to assess such changes by comparing results from both cross-sectional and longitudinal analyses. The study population comprised all residents of the city of Jyväskylä born in 1910 (n = 291). The subjects' hearing was tested on three occasions at 5-year intervals with the use of pure-tone audiometry, speech audiometry, and self-report on hearing difficulties. The results showed a significant deterioration in hearing sensitivity in both the longitudinal and cross-sectional assessments over the 10-year follow-up. However, the change in self-assessed hearing difficulties was not significant. Hearing aids were not used by over 75%, of those who had moderate hearing impairment. Self-assessed hearing difficulties at baseline were associated with increased mortality. Hearing deterioration in elderly people and their low level of use of hearing aids deserve closer attention in the healthcare system.

Age Factors↗
PubMed2004

Changes in dental status over 10 years in 80-year-old people: a prospective cohort study.

OBJECTIVES: The aim of the present study was to follow-up the condition of the teeth over a sufficiently long period. METHODS: Dental examinations were a part of a multidisciplinary 10-year cohort study on the elderly. These examinations were made in 1990 (n = 226), 1995 (n = 90) and 2000 (n = 65) for the entire population born in 1910 and living in Jyväskylä, Finland. The subjects were divided into two categories, dentate (one tooth or more) and edentulous. RESULTS: The results showed that men had more intact teeth and lower DMF scores than women, but the differences diminished during the follow-up period. The number of remaining and filled teeth of those women who took part in all three phases of the present study was higher than that of those who died during the follow-up. In men the DMF scores showed the opposite trend. The most significant deterioration during the 10-year follow-up was found in the number of teeth and DMF scores in men and in the number of remaining and filled teeth in women. CONCLUSION: Among men, in particular, significant changes in oral health status could be seen even between 80 and 90 years of age. Hence, regardless of advanced age, a subject should be motivated by the oral health care team to seek regular dental treatment.

Age Factors↗
PubMed2003

Heritability of maximal isometric muscle strength in older female twins.

The purpose of the present study was to examine genetic and environmental effects on maximal isometric handgrip, knee extension, and ankle plantar flexion strength. In addition, we wanted to investigate whether the strength of these three muscle groups shares a genetic component or whether the genetic effect is specific for each muscle group. Muscle strength was measured as part of the Finnish Twin Study on Aging in 97 monozygotic (MZ) and 102 dizygotic (DZ) female twin pairs, aged 63-76 yr. The MZ and DZ individuals did not differ from each other in age, body height, weight, or self-related health. The age-adjusted pairwise (intraclass) correlations of the MZ and DZ twins were, respectively, 0.462 and 0.242 in knee extension, 0.435 and 0.345 in handgrip, and 0.512 and 0.435 in ankle plantar flexion strength. The multivariate genetic analysis showed that handgrip and knee extension strength shared a genetic component, which accounted for 14% (95% confidence interval: 4-28%) of the variance in handgrip strength and 31% (95% confidence interval: 18-45%) in knee extension strength. The influence of genetic effects on ankle plantar flexion strength was minor and not significant. Furthermore, these three muscle groups had a nongenetic familial effect in common and nonshared environmental effects in common. The results suggested that muscle strength is under a genetic regulation, but also environmental effects have a significant role in explaining the variability in the muscle strength.

Aged↗
PubMed2003

Contribution of genetic and environmental effects to postural balance in older female twins.

The aim of the present study was to determine the relative roles of genetic and environmental influences on postural balance in older women. The participants were 97 monozygotic (MZ) and 102 dizygotic (DZ) female twins, aged 64-76 yr. Postural sway was measured during side-by-side stance with eyes open and eyes closed, and during semitandem stance with eyes open on a force platform. Sway data were condensed into four first-order and one second-order latent factors. The second-order factor, named balance, incorporates sway data from multiple tests and thus best describes the phenotype of postural balance. The contribution of genetic and environmental influences on the variability of the latent factors was assessed by using structural equation modeling. Additive genetic influences accounted for 35% and shared environmental influences accounted for 24% of the total variance in the balance factor. In the present study, postural balance in older women had a moderate genetic component. Genetic influences on postural balance may be mediated through gene variation in the systems that control posture. The finding that individual environmental influences accounted for almost one-half of the variance in postural balance points to the potential of targeted interventions to maintain and improve balance control in older persons.

Aged↗
PubMed2003

Reduced mobility and physical activity as predictors of depressive symptoms among community-dwelling older adults: an eight-year follow-up study.

BACKGROUND AND AIMS: Epidemiological research suggests that reduced physical activity and mobility may be associated with depressive symptoms. The present study examines the relative roles of mobility status and physical activity as predictors of depressive symptoms among community-dwelling older adults. METHODS: The subjects comprised randomly selected, non-institutionalized residents of the city of Jyväskylä, central Finland, born in 1904-1923. At baseline, 80% (N = 1224) and after the 8-year follow-up period (1996) 88% (N = 663) of eligible persons were interviewed. All non-institutionalized men and women (N = 384) who participated in both baseline and follow-up interviews, who supplied data on the main questions of interest and who had no depressive symptoms at baseline, were selected for analysis. Depressive symptoms were assessed using the Finnish modified version of Beck's 13-item depression scale (RBDI). Physical activity was assessed on a seven-point scale. Mobility status was defined as the ability to walk two kilometers and climb one flight of stairs. RESULTS: Subjects who were mobility-disabled and had a sedentary life-style had a higher risk (OR = 2.44) for depressive symptoms at follow-up than those who had good mobility and were physically active. The risk was also higher (OR = 1.99) in those who were mobility-disabled and had a physically active life-style, compared with physically active individuals with intact mobility. Those with good mobility had fewer depressive symptoms than those who had mobility problems, irrespective of the level of physical activity. No significant interaction was observed between physical activity and mobility in predicting the development of depressive symptoms. Older age significantly increased, and the number of chronic illnesses tended to increase the risk of developing depressive symptoms during the follow-up period. Gender and length of education were not significant predictors of depressive symptoms. CONCLUSIONS: Mobility problems and older age seem to increase the risk for developing depressive symptoms in elderly people. The risk is not associated with the level of physical activity.

Aged↗