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K Pitkälä

Publications and source records attributed to K Pitkälä.

14 recordsLinked to original sources
PubMed2003

Impact of midlife weight change on mortality and quality of life in old age. Prospective cohort study.

OBJECTIVE: To examine the effects of weight change during midlife on long-term mortality risk and quality of life in old age. DESIGN: Prospective cohort study with a 26-y follow-up. SUBJECTS: Socioeconomically homogeneous sample of 1657 men (born 1919-1934) who had attended health checks during the 1960s, were healthy and professionally active in 1974, and could recall their weight at the age of 25 y. MAIN OUTCOME MEASURES: Total mortality 1974-2000, scales of the RAND-36 (SF-36) health survey in 91% (n=1147) of the survivors in 2000. RESULTS: Body weight increased from 25 y of age until midlife, but not thereafter. During the 26-y follow-up, 392 men (23.7% of the initial 1974 cohort) died. Weight at 25 y of age did not predict death, but the adjusted mortality risk was significantly increased in the highest quartile of midlife weight gain (>/=15.0 kg) compared with lower quartiles (RR 1.39, 95% CI 1.12-1.73). In 2000, multivariate analyses (adjusted for body weight at the age of 25 y and in 2000, age, smoking, alcohol and subjective health and physical fitness in 1974) showed impairment in all eight RAND-36 scales (statistically significantly in seven) with increasing weight gain in midlife. CONCLUSION: In this homogeneous male cohort, only the largest weight gain from 25 y of age to midlife predicted long-term mortality. Weight gain sensitively affected later health-related quality of life, and zero weight gain up to midlife was associated with the best quality of life in old age.

Adult↗
PubMed2001

Blood pressure and mortality during an up to 32-year follow-up.

BACKGROUND: Elevated blood pressure is an established risk factor of cardiovascular diseases, but there is a constant debate whether the association is continuous or with a threshold. METHODS: During the 1960s (1964 onwards), 3,267 initially healthy male business executives (born 1919-1934) participated in voluntary health check-ups with measurements of cardiovascular disease risk factors. At baseline none of the men were on antihypertensive medication. Mortality follow-up was performed using national registers up to 31 December, 1995. Follow-up total and cardiovascular mortality was related to systolic (by 10 mmHg) and diastolic (by 5 mmHg, Korotkoff's 4th phase) blood pressure at baseline. Analyses were adjusted for age, body mass index, smoking and serum cholesterol. RESULTS: During an up to 32-year follow-up, there were 701 deaths, 234 (33.4%) of them due to coronary heart disease, 49 (7.0%) to stroke, 42 (6.0%) to other cardiovascular diseases and 204 (29.1%) to cancer. Total mortality curves of the whole cohort (all age groups) were flat until 131-140 mmHg (systolic) and 81-85 (diastolic) and increased thereafter. Among men who smoked and had baseline serum cholesterol > 6.5 mmol/l (n = 986), the risk of death increased progressively with systolic blood pressure, whereas among non-smoking normocholesterolaemic men (n = 504) the association was J-shaped, i.e. higher mortality at < or = 110 mmHg than between 111-150 mmHg and a more consistent rise from 151-160 mmHg. The curves were essentially similar for cardiovascular mortality. The results were supported by analyses where major cardiovascular risk factors were controlled. CONCLUSION: During a truly long-term follow-up, the relationship between systolic blood pressure and mortality was initially flat up to 131-140 mmHg although a linear relationship is suggested in men with other cardiovascular risk factors.

Adult↗
PubMed2001

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Adaptation, Psychological↗
PubMed2000

Predictors and clinical significance of declining plasma dehydroepiandrosterone sulfate in old age.

Dehydroepiandrosterone sulfate (DHEAS) was measured in random persons of three age cohorts (75, 80 and 85 years, N=271) at five-year intervals in order to find out predictors and significance of declining DHEAS in old age. The mean values decreased from 2.88 micromol/L to 2.39 micromol/L in men (p<0.001), and from 1.93 micromol/L to 1.73 micromol/L in women (p<0.05) at entry. Strong correlations were found between the baseline levels of DHEAS and those measured after five years both in men (r=0.727, p<0.001) and women (r=0.605, p<0.001), and the changes in DHEAS were associated with DHEAS levels at entry (r=-0.418, p<0.05). Baseline DHEAS was higher (2.47 micromol/L vs 2.05 micromol/L, p<0.05) and the decline more pronounced (-0.50 micromol/L vs 0.20 micromol/L, p<0.05) in the healthy subjects than in those suffering from diseases at entry, but the percentage five-year decline was similar (-6.5% and -5.2%) in both groups. The five-year decline in DHEAS was predicted neither by the baseline levels of risk indicators, e.g., serum lipids, body mass index, electrocardiographic, nor echocardiographic findings at entry. The age-and gender-adjusted baseline levels of DHEAS predicted neither mortality nor cognitive decline with 5- and 10-year follow-up periods. The 5-year decline in DHEAS was significant (p<0.05) in the subjects who died or developed cognitive decline during the subsequent 5-year follow-up. However, the changes did not differ significantly from those with favorable prognosis. The data indicate that the decline in DHEAS is primarily a gender-specific aging phenomenon, and only partly a consequence of actual diseases and frailty.

Aged↗
PubMed2000

Elderly suicide in Finland.

Suicide mortality among the elderly is high in most Western countries. We investigated the characteristics of suicide victims 65 years or older in a nationwide psychological autopsy study, the research phase of the National Suicide Prevention Project in Finland. This study population included all completed suicides (N = 1,397, of whom 211 were 65 years or older) that occurred in Finland during a 12-month research period in 1987-1988. The elderly suicide victims were found to have used violent suicide methods more often than the young. Although almost 70% of the elderly persons who had committed suicide had been in contact with health care services during the month before their death, their suicidal intentions were rarely communicated in these contacts. They had been referred to psychiatric services less often than the young, and only 8% had received adequate antidepressive medication. The fact that most elderly suicides have contact with health care services during their final month suggests a potential for suicide prevention. However, the major obstacle to this is the poor recognition of mental disorders and suicidal ideation among the elderly.

Aged↗
PubMed1998

The effectiveness of day hospital care on home care patients.

OBJECTIVE: To study the effectiveness of rehabilitative and medically oriented day hospital care on community-based long-term care patients. DESIGN: A randomized, controlled trial. SETTING AND PARTICIPANTS: 177 patients on home-care in a rural area were randomized into two groups. Patients in one group were offered a 2-month period of rehabilitation and medical care in a recently opened day hospital, and in the other group patients were offered treatment, as before, in home care. Both groups were examined at the beginning and at 2, 5 and 12 months. INTERVENTION: Rehabilitative and medically oriented day hospital care. OUTCOME MEASURES: Use of health services, physical functioning measured by the Katz ADL Index, subjective health, symptoms, and satisfaction with care. RESULTS: The groups used hospitals (excluding the day hospital treatment) equally during the follow-up year. The treatment group had significantly more specialist consultations than did the control group. There were no clinically significant differences in the changes in the Katz ADL Index although more changes were found in the treatment group. The number of symptoms was reduced significantly in the treatment group, whereas the number of symptoms remained unchanged in the control group. The patients' views of their own health improved in the treatment group. CONCLUSION: Day hospital care affects the quality of life of older people, but it does not reduce the use of other health services, nor does it clinically significantly improve the physical functioning of older people.

Adult↗
PubMed1996

[Confusional states in the elderly--an underdiagnosed syndrome with a poor prognosis].

Confusion in the elderly, ie, delirium, is an organic mental disorder often associated with severe somatic disease. Approximately 20-60 per cent of elderly in-patients are afflicted with transient confusion states during hospitalisation, and in more than 50 per cent of cases this escapes the notice of the attending physician. The disorder is characterised by a remarkably poor prognosis; even among those whose confusion state is transient, 20-30 per cent die before discharge, and approximately one third remain hospitalised. The occurrence of confusion in the elderly patient should alert the physician to the need of investigation to detect underlying severe disease without delay. Despite the otherwise poor prognosis, improved diagnosis and treatment should not only yield better results but also economic gain to the community.

Aged↗
PubMedDate not supplied

Long-term changes in mood of an aged population: repeated Zung-tests during a 10-year follow-up.

Associates and predictors of lowered mood were investigated in a 10-year prospective study of 411 random persons of three birth cohorts (aged 75, 80 and 85 years) in Helsinki, Finland. High Zung-score ( > 45 points = lowered mood) was found in 24% of subjects and clearly associated with age. Lowered mood was also associated with pessimistic attitudes towards life and impaired survival prognosis. The mean Zung-score fell drastically during the first follow-up (from 39.1 to 34.6 points, P < 0.001) and remained unchanged thereafter at 10-year examination of the survivors (33.9 points). Lowering mood (increase in Zung-score) was best predicted by low baseline Zung-score (r = -0.673, P < 0.001), high baseline MMSE-score (r = -159. P < 0.05) and simultaneous changes in MMSE-scores (r = 0.269, P < 0.01). The data show that lowered mood is associated with pessimistic attitudes towards life, cognitive impairment and impaired survival and that cognitive impairment exposes a patient to lowering mood. It is possible that a screening program improves the mood of aged population.

Age Distribution↗