Biomedical subjects

K Avlund

Publications and source records attributed to K Avlund.

At least 19 recordsLinked to original sources

PubMed2006

Functional ability at age 75: is there an impact of physical inactivity from middle age to early old age?

The aim of this study is to analyze the impact of physical inactivity from middle age to early old age on functional ability at age 75. Physical activity is measured both as cumulated activity from age 50 to 60 to 70 and at three separate points in time. Three hundred eighty-seven men and women born in 1914 and living in seven municipalities in the western part of the County of Copenhagen were followed for 25 years with examinations in 1964, 1974, 1984 and 1989. Analyses were conducted with physical inactivity as an independent variable (accumulated and separately for each point in time) and smoking, sex, school education, household composition, chronic disease at baseline and functional ability at age 70 as possible confounders. There was a strong association between physical inactivity at age 70 and disability at age 75. However, the analyses showed no effect of cumulated physical inactivity from age 50 to 60 to 70 on disability at age 75 when adjusting for functional ability at age 70. Physical inactivity is a risk factor for disability among old people. Thus, old people should be encouraged to take up and maintain physical training throughout the aging process.

Aged↗

PubMed2002

Body composition of 80-years old men and women and its relation to muscle strength, physical activity and functional ability.

OBJECTIVE: To measure body composition and analyse the relation to muscle strength, physical activity and functional ability in healthy, old subjects, and to relate the results to an optimal BMI level for the elderly. SETTING: Subjects aged 80 years living at home from the 1914-population in Glostrup, Denmark. SUBJECTS AND METHOD: 121 men and 113 women had their height and weight measured. Body fat mass and fat-free mass were assessed by bioelectrical impedance. Muscle strength was measured as handgrip, elbow flexion, knee extension, body flexion and body extension. Physical activity was self reported and functional ability was assessed by the Physical Performance Test (PPT) and self reported mobility including information about tiredness and help. RESULTS: After dividing BMI into three groups: BMI < 24, BMI 24-29 and BMI > 29 no relationship was seen between a BMI interval of 24-29 kg/m2, and physical activity and functional ability. BMI was related to body fat mass, and FFM was related to muscle strength. Muscle strength was related to mobility and PPT. Mobility and PPT were mutually related and were related to physical activity. CONCLUSION: Our cross sectional study did not support newly proposed guidelines for the elderly of an optimal BMI interval of 24-29 kg/m2. We found relations between body composition, muscle strength, physical activity and functional ability.

Adipose Tissue↗

PubMed2001

A longitudinal study of gender differences in depressive symptoms from age 50 to 80.

The Obvious Depression Scale was administered to 739 community residents at ages 50, 60, and 80 years, with 151 present at all waves. Although selective attrition influenced the level of depressive symptoms in cross-sectional vs. longitudinal samples, both sets of analyses revealed higher scores in women than in men at ages 50 and 60, but not at age 80. Men showed increases in depressive symptoms from age 60 to 80, but women did not (interaction p < .002). This interaction was not present in somatic symptoms, which increased across time in both genders. Potential explanations include differential changes in social roles with aging.

Age Distribution↗

PubMed2001

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. DESIGN: The study included a random sample of 75-year-olds at baseline and a follow-up study 5 years later. The data are treated as two cross-sectional studies at age 75 and 80, respectively, and as a longitudinal study from age 75 to 80. SETTING: The western part of Copenhagen County. PARTICIPANTS: The two cross-sectional studies of 75- and 80-year-old people included 411 and 321 persons, respectively. The longitudinal study from age 75 to 80 included the 326 persons who participated in both surveys. MEASUREMENTS: Oral health status was measured roughly by number of teeth and chewing ability. Use of dental services was measured by frequency of visits to a dentist or denturist. Functional ability was measured by two scales on mobility in relation to tiredness and need of help. Changes in mobility from age 75 to 80 is described as (1) improved or sustained good, (2) decreased, and (3) sustained poor. Gender, chronic diseases, self-rated health, socio-demographic factors, living alone, and social relations were included as possible confounders. RESULTS: The odds ratio of having no or few teeth was 1.7 (1.1-2.6) in 75-year-old individuals who felt tired in mobility, 1.7 (1.0-2.9) in 80-year-old persons who needed help with mobility, and 2.7 (0.94-7.5) in persons with sustained need of help with mobility from age 75 to 80. The odds ratio of chewing difficulties was 1.7 (1.1-2.8) in 80-year-old people in need of help, and 1.8 (1.1-3.0) in persons age 75 to 80 needing sustained help. Dentate 80-year-old persons who felt tired in mobility had an odds ratio of 2.0 (0.94-4.2) of not using dental services. CONCLUSIONS: The results indicate that oral impairment (e.g., having no or few teeth), oral functional limitations (e.g., chewing problems), and general functional limitations (e.g., mobility problems) are interrelated and that prevention of disabilities should be aimed at both functional limitations and oral health problems if the intention is to promote a good life in old age. In addition, the results point to the importance of taking problems in mobility seriously in delivering preventive services to old people because people who are tired or dependent on help seem to be at a higher risk of not using dental services regularly.

Activities of Daily Living↗

PubMed2001

Tiredness as determinant of subsequent use of health and social services among nondisabled elderly people.

OBJECTIVE: To examine whether self-reported tiredness in daily activities at age 75 is an independent determinant of incident hospitalization and use of home services 5 years later. METHODS: In all, 275 people participated in a prospective study in Glostrup, Denmark, when they were 75 and 80 years old. Four subgroups were created according to whether participants had been hospitalized or used home care in the year before the baseline study and whether or not they were disabled at the time. The key predictor variables were measured by two scales about tiredness in daily activities. RESULTS: Nondisabled individuals who felt tired in their daily activities had about twice the risk of being hospitalized and of being users of home help 5 years later. CONCLUSIONS: Because tiredness in daily activities is related to subsequent hospitalization and use of home help, it should be taken seriously in preventive services among elderly people.

Activities of Daily Living↗

PubMed2001

Socioeconomic position and smoking behaviour in Danish adults.

AIMS: The associations between smoking and various socioeconomic indicators may have different implications and causes, which may also vary according to sex and birth cohort. This study analyses how two dimensions of socioeconomic position, an individual (education) and a structural (occupation) indicator, are associated with ever, current and ex-smoking. METHODS: Data on smoking behaviour were collected in five cross-sectional surveys of random samples of the general Danish population aged 20 years or more at intervals between 1982 and 1994. In total, 8,054 men and 8,281 women participated. Logistic regression was used to analyse the influence of education and occupation on smoking behaviour controlling for sex and birth cohort. RESULTS: In cohorts born after 1930 ever and current smoking were related to years of school education and current occupation. The prevalences of ever and current smoking were highest among the least educated, unskilled workers, unemployed persons and persons who received welfare benefits. A significant interaction between birth cohort and education indicated that the educational difference in ever and current smoking increased significantly with increasing year of birth. In multivariate analysis controlling for sex and birth cohort, ex-smoking seemed to be more strongly associated with education than occupation. Those with 12 or more years of school education had twice as high a chance of being ex-smokers as those with 7 years of school or less. CONCLUSION: Smoking behaviour is strongly associated with both individual and structural indicators of socioeconomic position in Danish adults in all cohorts except for those born before 1930.

Adult↗

PubMed1999

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.

Adult↗

PubMed1999

Active life in old age. Combining measures of functional ability and social participation.

UNLABELLED: This paper describes a new measure of Active Life Expectancy, called Active Life Classification (ALC) in which the criterion for successful aging is a combination of good functional ability and high social participation. OBJECTIVES: 1) to describe the distribution of ALC among 75-year-old men and women, 2) to investigate the association between ALC and life satisfaction and 3) to describe how ALC is determined by socio-demographic, psycho-social, and health factors. DESIGN: A cross-sectional population survey. SETTING: Eleven municipalities in the Western part of Copenhagen County in 1989. SUBJECTS: A random sample of 75-year-old people who were invited to participate in the study (participation rate: 89, n = 477). MAIN OUTCOME MEASURE: ALC is a combination of two dichotomized variables: functional ability (dependent vs not dependent of help) and social participation (low vs. high). RESULTS: For both men and women an active life (measured by ALC) was significantly associated with life satisfaction. For men only good self-rated health was related to ALC in the multivariate analysis. Among women high income, many social contacts, good self-rated health, good memory and lack of chronic diseases were associated with ALC. CONCLUSIONS: It is an advantage to combine functional ability and social participation in the description of quality of life in old age, as 1) a high social participation may compensate for a poor functional ability, and vice versa, 2) the combined measure is meaningful for both sexes, and 3) it gives more information than the two concepts used as separate outcome measures.

Aged↗

PubMed1998

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.

Activities of Daily Living↗

PubMed1998

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.

Activities of Daily Living↗

PubMed1998

Functional ability among elderly people in three service settings: the discriminatory power of a new functional ability scale.

The purpose is to assess the discriminatory power of the Avlund scales: (1) by assessing the ability of the scales to discriminate between three different populations of elderly people, and (2) by studying groups with a poor fit between use of formal home care and functional ability. The study included (A) all residents in new sheltered housing facilities (response rate 68%, n = 102), (B) a random sample of users of home care (response rate 67%, n = 435), and (C) a random sample of individuals not using home care (response rate 74%, n = 501). All participants were 60+ years old. Data were collected by personal interviews (group A) and by postal questionnaires (group B and C). Functional ability was measured by The Avlund Mob-T scale about tiredness related to mobility and the Mob-H scale about need of help to mobility. Both scales were able to distinguish the three sub-populations. The whole range of the Mob-T scale was used in all three subpopulations, and the whole range of the Mob-H scale was used among the oldest residents and the oldest users of home care. A small group of well-functioning users of home care (n = 52) was characterized by good self-rated health, good hearing, vision and memory abilities; they gave more help to others, had higher social participation, and lived alone (only the women). A somewhat lager group of poor functioning non-users of home care (n = 266) had the opposite characteristics. In addition, they were older, had a poor social network and poor social support.

Activities of Daily Living↗

PubMed1997

Methodological challenges in measurements of functional ability in gerontological research. A review.

This article addresses two important challenges in the measurement of functional ability in gerontological research: the first challenge is to connect measurements to a theoretical frame of reference which enhances our understanding and interpretation of the collected data; the second relates to validity in all stages of the research from operationalization to meaningful follow-up measurements in longitudinal studies. Advantages and disadvantages in different methods to do the measurements of functional ability are described with main focus on frame of reference, operationalization, practical procedure, validity, discriminatory power, and responsiveness. In measures of functional ability it is recommended: 1) always to consider the theoretical frame of reference as part of the validation process (e.g., the theory of "The Disablement Process"; 2) always to assess whether the included activities and categories are meaningful to all people in the study population before they are combined into an index and before tests for construct validity; 3) not to combine mobility, PADL and IADL in the same index/scale; 4) not to use IADL as a health-related functional ability measure or, if used, to ask whether problems with IADL or non-performance of IADL are caused by health-related factors; 5) always to make analyses of functional ability for men and women separately as patterns of functional ability and patterns of associations between other variables and functional ability often vary for men and women; and 6) to exclude the dead in analyses of change in functional ability if the focus is on predictors of deterioration in functional ability.

Activities of Daily Living↗

PubMed1997

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 self-reported functional ability (mobility and ADL) and general physical activity in elderly men and women living in three different Nordic environments. PARTICIPANTS: A random sample of 448 men and 556 women from among the 75-year-old residents in Glostrup, Denmark, and Göteborg, Sweden, and all the residents of relevant age (127 men and 261 women) in Jyväskylä, Finland. MEASUREMENTS: Assessment of postural balance with eyes open and closed using a piezoelectric force platform. A structured interview on self-reported functional ability and physical activity. An in-laboratory medical examination. RESULTS: In spite of some differences in balance between the groups studied (better results in women compared with men and, to some extent, better results in the participants from Denmark and Finland than in those from Sweden), the performance in the balance tests was similarly associated with functional ability within all groups. The subjects reporting no need of help in performing the ADL and mobility functions performed significantly better in the balance tests. These differences were seen more clearly in the control of anteroposterior movement of center of forces than in the mediolateral direction. The performance in the balance tests was also significantly better among the subjects reporting a higher level of general physical activity than in their less active counterparts. Physical activity and than in their less active counterparts. Physical activity and certain long standing illnesses modified significantly the relationship between postural balance and ADL-performance. When these factors were analyzed simultaneously, the role of balance as a predictor of ADL-performance largely disappeared. CONCLUSIONS: The results suggest that good balance is one of the prerequisites of performance without difficulty in mobility and ADL functions. Physical exercise may help to maintain balancing abilities in old age; good balance, in turn, may also enable a physically active way of life. The associations of balance with functional ability and physical activity were independent of sex and locality. The results also support the validity of static stabilometry as a tool for evaluating threats to functional limitations in older subjects.

Activities of Daily Living↗

PubMed1996

Item bias in self-reported functional ability among 75-year-old men and women in three Nordic localities.

The purpose of this article is to analyse item bias in a measure of self-reported functional ability among 75-year-old people in three Nordic localities. The present item bias analysis examines whether the construction of a functional ability index from several variables results in bias in relation to geographical locality and gender. Information about self-reported functional ability was gathered from surveys on 75-year-old men and women in Glostrup (Denmark), Göteborg (Sweden) and Jyväskylä (Finland). The data were collected by structured home interviews about mobility and Physical activities of daily living (PADL) in relation to tiredness, reduced speed and dependency and combined into three tiredness-scales, three reduced speed-scales and two dependency-scales. The analysis revealed item bias regarding geographical locality in seven out of eight of the functional ability scales, but nearly no bias in relation to gender in the combined data. The conclusion is that only one tiredness-scale (Lower Limb-T), one reduced speed-scale (Lower Limb-S) and the two dependency-scales (PADL-H and Mob-H) can be proposed for use in comparisons between the three localities (with removal of one or more items).

Activities of Daily Living↗

PubMed1995

Changes in functional ability from ages 70 to 75. A Danish longitudinal study.

The purpose of this article is (a) to describe changes in functional ability from the age of 70 to 75 years, (b) to examine whether a new functional ability measure is a good predictor of dependency, and (c) to examine whether sociodemographic factors are associated with transitions. The investigation is part of the longitudinal study of the 1914 population in Glostrup, Denmark, and comprised 576 men and women who were interviewed in their homes about functional ability, social situation, and so forth when they were 70 and 75 years old. Tiredness in mobility and daily activities measured by two functional ability scales at age 70 were independent predictors of need for help in mobility and daily activities at age 75. Among the sociodemographic variables, education among women and income among men were found to be independent predictors of dependency at age 75.

Activities of Daily Living↗

PubMed1994

Abdominal syndromes and functional ability in the elderly.

Data concerning a random cohort of 1,119 70-year-old subjects were analyzed to evaluate the association between Upper Dyspepsia and Irritable Bowel Syndrome and functional ability. Seven hundred and thirty-four subjects were interviewed about abdominal symptoms and were visited at home by an occupational therapist who evaluated their functional ability. Among the survivors, 94% participated in a follow-up study five years later. Functional ability was registered on validated scales constructed for its measurement in a normal elderly population. It was found that both syndromes occurred more often among subjects with reduced functional ability. A significant association was found between the occurrence of Upper Dyspepsia and a reduction of mobility and lower limb function, and between reduced functional ability and Irritable Bowel Syndrome at the five-year follow-up. It is concluded that abdominal syndromes are associated to functional ability, suggesting that there is a diffuse disorder affecting both smooth and striated muscles.

Activities of Daily Living↗

PubMed1993

The measurement of instrumental ADL: content validity and construct validity.

A new measure of Instrumental Activities of Daily Living (IADL), which is able to discriminate among the large group of elderly who do not depend on help, was tested for content validity and construct validity. Most assessments of functional ability include Physical ADL (PADL) and Instrumental ADL (IADL). PADL-scales assess the basic capacity of persons to care for themselves. IADL-scales are used to assess somewhat higher levels of performance, such as the ability to perform household chores or go shopping. Data were collected from 734 70-year-old people in Denmark in the county of Copenhagen. The measure of Instrumental ADL included 30 activities in relation to tiredness and reduced speed. Construct validity was tested by the Rasch model for item analysis; internal validity was specifically addressed by assessing the homogeneity of items under different conditions. The Rasch item analysis of IADL showed that 14 items could be combined into two qualitatively different additive scales. The IADL-measure complies with demands for content validity, distinguishes between what the elderly actually do, and what they are capable of doing, and is a good discriminator among the group of elderly persons who do not depend on help. It is also possible to add the items in a valid way. However, to obtain valid IADL-scales, we omitted items that were highly relevant to especially elderly women, such as house-work items. We conclude that the criteria employed for this IADL-measure are somewhat contradictory.

Activities of Daily Living↗

PubMed1993

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.

Activities of Daily Living↗