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Biomedical subjects

K Pahkala

Publications and source records attributed to K Pahkala.

At least 19 recordsLinked to original sources
PubMed2006

Leisure-time physical activity of 13-year-old adolescents.

The leisure-time physical activity of 13-year-old Finnish adolescents was assessed in the prospective STRIP study. A self-administered questionnaire (N=565) was used. The leisure-time physical activity index (PAI; MET h/week) was calculated on the basis of reported exercise intensity, duration and frequency (N=558; 53% boys). The participants were divided into Sedentary, Moderately Active and Active groups by PAI tertiles. A subpopulation (N=197) also used a heart rate monitor (3 days, >/=8 h/day) to assess the time spent on different activity intensities. The median male PAI was 31.3 (inter-quartile range (IQR) 44.2) MET h/week and female 19.5 (IQR 26.3) MET h/week (P=0.0002). The cutoff points of the PAI tertiles were similar for the Active girls (31.3 MET h/week) and boys (32.6 MET h/week), but for the Sedentary boys it was 19.5 MET h/week and only 5.0 MET h/week for the Sedentary girls. High self-reported leisure-time physical activity associated poorly with time spent on moderate or vigorous exercise measured by heart rate monitoring. Active mothers had more often Active daughters or sons. In conclusion, the amount of leisure-time physical activity of one-third of 13-year-old girls is extremely low. Sedentary adolescents, especially girls, should therefore be put into focus for active efforts to increase their leisure-time physical activity. Parental models may be important.

Adolescent↗
PubMed2006

Longitudinal trends in consumption of vegetables and fruit in Finnish children in an atherosclerosis prevention study (STRIP).

OBJECTIVE: To assess prospectively the consumption of fruit and vegetables and its' correlation to the parental consumption in boys and girls taking part in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study). HYPOTHESIS: Nutrition counselling focused on cardiovascular health effects vegetable and fruit consumption. DESIGN: A prospective, randomised, clinical trial. SUBJECTS: Children were recruited to the STRIP study between 1989 and 1992. At the age of 7 months, children were randomised to the intervention (n = 540) or the control group (n = 522) and were followed up until the age of 11 years. INTERVENTION: Families in the intervention group have, since randomisation, received biannual individualised dietary counselling aimed at reduction of cardiovascular risk factors, especially saturated fat intake. Food records were used to assess fruit and vegetable consumption of children and parents. RESULTS: The percentage of total energy intake provided by fruit and vegetables decreased when the children grew older (P for age <0.001). The 1- to 10-year-old intervention boys consumed more vegetables (mean difference 3.18 g/day; CI 1.48-4.86; P < 0.001) and fruit (mean difference 10.1 g/day; CI 5.28-14.94; P < 0.001) than did the control. Mother's consumption correlated with the consumption of their daughters and sons, whereas father's consumption correlated only with the consumption of their sons. CONCLUSIONS: Finnish children taking part in the atherosclerosis prevention study had a remarkably low fruit and vegetable consumption, which furthermore decreased with age. The children's consumption correlated with the parental consumption, except between boys and mothers. A slight intervention effect was present only among boys.

Atherosclerosis↗
PubMed2001

Depressive disorder as a predictor of physical disability in old age.

OBJECTIVES: To determine whether the occurrence of depression predicts physical disability in older people. DESIGN: A longitudinal epidemiological study with a follow-up of 5 years. SETTING: A comparison between depressed and nondepressed participants. PARTICIPANTS: The series consisted of the persons who participated in the longitudinal epidemiological study on depression in old age performed in Ahtari, Finland. The first round of interviews and examinations was performed in 1984/1985 and the second round in 1989/1990. The study series (N = 786) was composed of persons functionally independent in activities of daily living (ADLs) during the first round and alive and participating in both rounds. MEASUREMENTS: Depression was determined according to DSM-III criteria. Physical functional abilities were measured with self-assessments of ability to manage ADLs. RESULTS: In bivariate analyses, depression at the baseline did not predict lowering of functional abilities during follow-up, but the occurrence of depression with a long-term or relapsing course during follow-up and the onset of depression during follow-up in persons not depressed at the baseline predicted lowering of functional abilities during follow-up. The logistic regression analyses showed the presence of the following variables measured during the first round--older age, low basic education, poor self-perceived health, and occurrence of a physical disease--and the onset of the following diseases during follow-up--any physical disease, neurological disease, cerebrovascular disease, or depressive symptoms (in persons nondepressed at the baseline)--predicted lowered functional abilities after a follow-up of 5 years. CONCLUSION: Depression that developed during the follow-up in previously nondepressed persons was associated with an increased risk for lowering of functional abilities, even when controlling for age, sociodemographic factors, physical diseases, and baseline disabilities. Depressed older people are at high risk for physical disability, and an individually planned program to maintain their functional abilities by training in ADLs and instrumental activities of daily living (IADLs) and physical exercise should be included in their treatment.

Activities of Daily Living↗
PubMed2000

Factors predicting the relapse of depression in old age.

BACKGROUND: Studies in mixed-aged populations show differences between the predictors of a relapse and those of a long-term course of depression, supporting the hypothesis about similar differences among the aged. AIM: The aim was to identify the factors predicting or related to a relapse of depression among the Finnish elderly having recovered from depression during treatment. MATERIAL AND METHODS: The population consisted of 70 depressed (DSM-III criteria) elderly (60 yr-) Finns having recovered from depression during treatment as determined 15 months after baseline. By the 4-year follow-up after the recovery, 20 patients had relapsed and 50 persons were non-depressed. RESULTS: The logistic regression model showed major depression and psychomotor retardation to be independent predictors. Relapses were not related to stressors in life or physical illnesses occurring during the follow-up. CONCLUSIONS: Major depressive elderly patients have a high risk for relapses without the occurrence of the stressors or physical illnesses. In clinical practice, major depressive elderly patients should be followed up in order to detect and treat potential relapses as early as possible. Cooperation between psychiatrists and general practitioners is needed in the follow-up. Theoretically, the results suggest the assumption of a biochemical aetiology of major depression.

Aged↗
PubMed2000

Depressive symptoms predicting six-year mortality in depressed elderly finns.

The specific symptoms of depression associated with increased mortality in the depressed elderly are poorly known. The aim of this paper is to analyse the individual depressive symptoms measured by the Zung Self Rated Depression Scale (ZSDS) and the Hamilton Rating Scale for Depression (HRSD) in association with mortality among depressed elderly subjects. The population consisted of 169 depressed (DSM-III criteria) aged (65+ years) persons from a Finnish epidemiological research project. The follow-up for deaths continued for about 6 years. When age, sex, smoking, physical health and functional abilities were taken into account, dissatisfaction, weight loss and gastrointestinal symptoms (anorexia and constipation) predicted mortality together with high age and poor physical health. Weight loss was related to an increased risk of death, specifically in the depressed. Dissatisfaction and gastrointestinal symptoms were more general markers of increased mortality.

Activities of Daily Living↗
PubMed2000

Factors predicting chronicity of depression in elderly primary care patients.

AIM: The aim was to identify the factors predicting and related to chronicity of depression among depressed Finnish elderly subjects. MATERIAL AND METHODS: The study consisted of 97 depressed (DSM-III criteria) elderly (60 years or older) Finns treated in primary health care. The occurrence of depression was assessed after treatment and follow-up periods of about 15 months and 5 years, and the persons were classified according to their recovery: (a) persons depressed in all the three examinations (the chronically depressed) (n = 47), and (b) persons depressed in the first examination, but nondepressed in both follow-up examinations (the recovered) (n = 50). RESULTS: Diurnal variation of symptoms and poor self-appreciation at the baseline and the onset of a severe disease, the deterioration of one's health status, and the death of a family member during the follow-up emerged as independent predictors or associates of the chronic course of depression in the logistic regression model. CONCLUSIONS: Depressed elderly subjects who develop a physical disease or whose family member dies during the treatment of depression have a high risk for a chronic course. Intensive antidepressant and psychotherapeutic treatment and adequate physical treatment of these patients are proposed, in order to increase the probability of recovery from depression.

Aged↗
PubMed1999

Can brief intervention through community dental care have an effect on adolescent smoking?

BACKGROUND: Community dental clinics are good settings for smoking intervention. The aim here was to put forward a strategy for preventing adolescent smoking by means of a brief intervention. METHODS: A total of 2,586 12-year-olds participated in this follow-up study. They were asked upon arrival for their annual routine dental examination to complete a smoking questionnaire and were randomly assigned to either the intervention group or the usual care control group according to the last digit of their date of birth (odd or even). The intervention comprised annually inquiring about smoking, showing photographs of the harmful effects of smoking on the teeth, allowing participants to examine their own mouth with a mirror, and finally counselling them in accordance with their answer to the question on smoking habits. The smoking status reported was not verified by other means. RESULTS: The prevalence of smoking at the end of the 2-year follow-up was 18.1%, in the intervention group and 20.8% among the controls. However, no statistically significant differences between groups were found. CONCLUSIONS: These results reflect the difficulties of achieving successful results with long-term smoking cessation programs with adolescents in unstable conditions.

Adolescent↗
PubMed1998

Early loss of mother or father predicts depression in old age.

The independent predictive roles of early losses, personality traits, acute losses and long-term stress situations for the occurrence of depression in elderly Finns were described using a longitudinal design. The persons non-depressed in an epidemiological study in 1984-85 were interviewed in 1989-90 (N = 679) and the occurrence of depression was determined according to DSM III-criteria. Logistic regression models were used to assess the independent roles of the hypothesized factors as predictors. An early loss of the mother among men and an early loss of the father among women independently predicted the occurrence of depression in logistic regression models. Older age in men, and a higher number of symptoms, the occurrence of previous depression and not living alone in women were also independent predictors. In men, impaired functional abilities and poor self-perceived health tended to predict depression. In conclusion, the psychological trauma which develops upon the experience of an early parental loss contributes to the development of depression even in old age. The role of stressors in life as independent predictors of depression in old age was also ascertained.

Age Factors↗
PubMed1998

Survival of elderly Finns suffering from dysthymic disorder: a community study.

The survival of aged Finns suffering from dysthymic disorder (DSM-III criteria) was assessed in two cohorts (60+ yrs and 65+ yrs) in a longitudinal epidemiological study conducted in Ahtäri in western Central Finland from 1984 onwards. The mortality of dysthymic persons (N = 214 and N = 115) was compared to that of the non-depressed population living in the same municipality (N = 982 and N = 853). Two follow-up periods (6 yrs and 11.5 yrs) were used for the first cohort, and one (6 yrs) for the second cohort. The Kaplan-Meier procedure and Mantel-Cox statistics followed by Cox proportional hazards models were used in the analyses. The occurrence of dysthymic disorder in men was related to higher mortality in both cohorts during all follow-up periods. In women, the occurrence of dysthymic disorder was related to higher mortality in the first cohort during the follow-up of 11.5 years, and in the second during the follow-up of 6 years. When age, sex, marital status, education, smoking, physical health and functional abilities were taken into account in the Cox proportional hazards models, high age, male sex, smoking, low educational level, the use of more than two medicines and lowered functional abilities emerged as predictors of mortality in the first cohort during both follow-up periods. In the second cohort, high age male sex, smoking, poor physical health and lowered functional abilities emerged as predictors. The results suggest that the higher mortality of the aged suffering from dysthymic disorder is explained by the high occurrence of somatic diseases and disabilities in dysthymic persons. They do not suggest that there might exist biochemical factors in the aetiology of dysthymic disorders that would increase mortality. Nor do they give any evidence to suggest that dysthymic disorders might be precursors of somatic diseases increasing mortality.

Aged↗
PubMed1998

Major depression as a predictor of premature deaths in elderly people in Finland: a community study.

In order to analyse the survival of elderly Finnish people with major depression, a total of 29 elderly (> or =65 years) subjects suffering from major depression (DSM-III criteria) and 853 non-depressed elderly subjects were followed up for 6 years. The Kaplan-Meier survival curves showed the survival of patients suffering from major depression to be poorer than that of non-depressed subjects. When age, sex, marital status, level of education, smoking habits, physical health, functional abilities and major depression were introduced into the Cox model, advanced age, male sex, smoking, poor physical health, reduced functional abilities and the occurrence of major depression were found to be related to higher levels of mortality. The results suggest that major depression in the elderly predicts higher mortality which is not explained by their poor baseline level of physical health alone.

Aged↗
PubMed1998

Changes in the oral health of adolescents treated by the Finnish public dental services between the ages of 13 and 15 years.

Oral cavity health was monitored in 2422 young people aged 13-15 years attending four health centres in Finland between 1992 and 1995. Assessments were made in terms of DMF, D and CPITN indices at clinical examinations. Of those who had no carious teeth at the initial examination, 60% did not develop cavities during the whole period, whereas half of those who had at least two carious teeth at the initial examination developed at least three new carious teeth. The treatment time needed by the latter accounted for half of the total time expended by the researchers until the end of the period. Costs can be saved or new patients brought into the dental care system by reorganizing the treatment of the patients who suffer from abundant caries and by reducing the resources devoted to the treatment of healthy patients.

Adolescent↗
PubMed1997

Six-year survival of depressed elderly Finns: a community study.

BACKGROUND: The 6-year survival of depressed elderly (N = 290) Finns was assessed and compared to that of a non-depressed population (N = 982), and the factors related to high mortality were analysed. METHOD: Depression was determined according to the DSM-III criteria, and a majority of the depressed population suffered from dysthymic disorder. Survival distributions were represented as Kaplan-Meier survival curves. The Cox proportional hazards model was used to analyse the simultaneous relationships between mortality and certain variables. RESULTS: The survival curves showed an increased mortality of the depressed elderly in both men and women. However, when the simultaneous relationships of age, marital status, education, smoking, functional abilities, somatic illnesses and depression were taken into account, depression did not predict mortality. The predictors of mortality were high age, a high number of medicines, smoking, disability, male sex and occurrence of somatic illnesses. CONCLUSIONS: Evidence of once measured depression is not predictive of increased mortality in an unselected elderly population (60+) when the other factors known to influence survival probability are taken into account.

Age Factors↗
PubMed1996

Social and psychosocial factors predicting depression in old age: a longitudinal study.

The predictive value of social and psychosocial factors for the occurrence of depression in elderly Finns is described using a longitudinal design. A population determined as not being depressed in an epidemiological study in 1984-1985 was clinically interviewed and examined in a follow-up study in 1989-1990 (N = 679). The potential predictive factors for depression were analyzed by contrasting the persons depressed in 1989-1990 with the ones not depressed. In men, depression was predicted by a poor relationship with one's wife and feelings about low appreciation of old persons or of the participant himself during the initial study and the loss of a mother while under 20 years of age. Certain changes and life events during the follow-up were related to the occurrence of depression in men, such as a change in the relationship with one's wife into a poorer direction, a decrease in the amount of hobbies, getting married, a grandchild's divorce, separation from someone important, moving into long-term institutional care, giving up hobbies or a position in a voluntary organization, and alcohol problems of a close person. In women, depression was predicted by living together with one's husband, living with other people, and a low activity in participating in religious events during the initial study and a loss of father while under 20 years of age. The risk of women living alone was lower compared to women not living alone. Also, certain changes and life events during the follow-up were associated with a high risk of depression in women, including a change in the relationship with one's neighbors into a poorer direction, an increase in the amount of time spent alone, a decline of the social activity level, getting married, occurrence of serious marital problems, separation from someone important, giving up hobbies or a position in a voluntary organization, alcohol problems of a close person, and a small number of social growth events. The results support the hypothesis about psychosocial factors playing a role in the etiology of depression in old age.

Activities of Daily Living↗
PubMed1995

Prevalence of depression in an aged population in Finland.

The prevalence of depression by sex, age and certain sociodemographic variables was investigated among elderly Finns (65 years or over) living in the semi-industrialized town of Ahtäri (n = 1225). The prevalence of depression, determined using the DSM-III criteria, was 16.5% for the total population, 14.4% for the men and 17.9% for the women. Dysthymic disorder was the commonest category of depression in both sexes, with atypical depression the second most common category among the men and major depression among the women. A few cases of cyclothymic disorder were diagnosed in each sex, but no cases of bipolar depression. The occurrence of depression was not associated with sex, but it was related to older age, widowhood and lower educational level in the men, although not in the women. In both sexes, a high risk of depression was associated with being in long-term institutional care and receiving home nursing and/or a home help. The occurrence of depression was not related to earlier occupation.

Aged↗
PubMed1994

Five-year prognosis for depression in old age.

The 5-year prognosis for 264 depressed elderly Finns (60 years or older) living in the community and treated through the primary health care service is described. The majority of the patients were suffering from dysthymic disorder. It was found that 25% of the men and 35% of the women had recovered, 29% of the men and 24% of the women were still suffering from depression after the five-year period, 9% of the men and 11% of the women had become demented, 33% of the men and 26% of the women had died, and 4% of the cases were not contacted. The prognosis did not differ between the sexes, neither was it associated with age. Poor psychic health and pronounced depressive symptoms at the beginning of the treatment, and the occurrence of a serious disease or a decline in functional capacities during the follow-up were related to a poor prognosis in both sexes. The specific disease group related to a poor prognosis in women was that of cardiovascular diseases. A close connection between a poor prognosis and a low socioeconomic status was found in the depressed men, while a favorable prognosis was shown for relatively healthy, even widowed, depressed women who moved to live alone during the follow-up period, women who increased their amount of physical exercise, and men and women whose hobby activities increased.

Activities of Daily Living↗
PubMed1993

Relationships between social and health factors and depression in old age in a multivariate analysis.

This community-based epidemiological survey concerns relationships between social and health factors and depression in a Finnish population aged 60 years or over. A multivariate analysis based on log-linear models is used in this study. The log-linear model showed five interactions for the depressed men and eight for the depressed women surveyed. These indicated that the depressive persons had experienced detrimental events either of an interpersonal nature or concerning health status more often than those who were not depressed. A positive connection between life stress and depression was found even though no cause-and-effect relationship could be defined. Social stress factors seemed somewhat important prior to the onset of depression in the women studied, whereas stressful health factors played a significant role for the men. Despite this, the log-linear models for the selected variables used here did not point to a combination of interactions between a high incidence of current social stress factors and a high incidence of stressful health factors during the six-month period prior to the onset of depression.

Activities of Daily Living↗
PubMed1992

Social and environmental factors and dysthymic disorder in old age.

This community-based epidemiological survey is concerned with relationships between social and environmental factors and dysthymic disorder (long-lasting depression according to the DSM-III classification) in a Finnish population aged 60 years or over. A greater proportion of dysthymic than non-depressed men had retired and did not work at all. The occurrence of dysthymic disorders in both men and women was related to retirement because of sickness rather than age, a small number of rooms in their homes, lack of intimate friendships and the occurrence of many long-standing and current social stress factors. The dysthymic women had lived at their present place of residence for a shorter period than had the non-depressed women. A positive association of dysthymic disorders with moving house due to poor health and living in institutions was also found in the men, and with a low number of hobbies and poor social participation in the women. In addition, the dysthymic women felt their relationships with their spouse, children, daughters-in-law and friends to be more distant than did their non-depressed counterparts. The dysthymic women also felt that elderly people were not appreciated. The log-linear models showed three interactions for the dysthymic men and six for the dysthymic women. The dysthymic persons reported a significantly larger number of detrimental events of an interpersonal nature than did the non-depressed persons.

Aged↗