Introduction: There are few longitudinal studies of relationships between vacation and later health outcomes. We studied these during a 26-year follow-up of the Helsinki Businessmen Study. Methods: In 1974, at mean age of 47 years, 2741 members of a cohort of executives and businessmen born 1919-1934 were clinically examined and reported their annual vacation time (dichotomized >21 [n = 2001]vs. Results: At baseline, shorter vacation was associated with longer work time, higher BMI, more coffee consumption and worse SRH. During the 26-year follow-up, 778 men out of 2741 (28.4%) had died. Shorter annual vacation was associated with higher mortality with curves starting to diverge after 18 years of follow-up, (fully adjusted hazard ratio 1.29, 95% confidence interval 1.08-1.55, P = 0.005). In old age, shorter vacation in midlife was tentatively associated with worse general health. Conclusions: Shorter vacation time in midlife was associated with characteristics related to lifestyle and with worse perceived health status, and predicted mortality up to old age in men. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Peer reviewed
The International Network for Social Workers in Acquired Brain Injury (INSWABI) commissioned a systematic scoping review to ascertain the social work generated evidence base on people with traumatic brain injury (TBI) of working age. The review aimed to identify the output, impact and quality of publications authored by social workers on this topic. Study quality was evaluated through assessment frameworks drawn from the United Kingdom National Service Framework for Long-Term Conditions. In the 40-year period from 1975 to 2014, 115 items were published that met the search criteria (intervention studies, n = 10; observational studies, n = 52; literature reviews, n = 6; expert opinion or policy analysis, n = 39; and others, n = 6). The publications could be grouped into five major fields of practice: families, social inclusion, military, inequalities and psychological adjustment. There was a significant increase in the number of publications over each decade. Impact was demonstrated in that the great majority of publications had been cited at least once (80.6%, 103/115). Articles published in rehabilitation journals were cited significantly more often than articles published in social work journals. A significant improvement in publication quality was observed across the four decades, with the majority of studies in the last decade rated as high quality.
Introduction: Comprehensive geriatric assessment (CGA) is one of the most important evaluation tools in geriatrics, but there is variability in its use in different clinical settings. In this study we aimed to clarify how Finnish geriatricians apply CGA in their clinical practice. Methods: We organized a web-based survey among the members of Finnish Geriatricians (n = 248). The questionnaire included items about use and content of CGA. The evaluated domains were assessment of cognition, nutrition and functional ability, evaluation of depression, and measurement of orthostatic blood pressure. Results: Altogether 121 physicians (49%) responded, and the present analysis included 95 geriatricians performing clinical work. Majority of the respondents (94%) used CGA. Of them, 38% performed CGA to all new patients and 62% to selected patients only. Ten respondents (11%) incorporated all five domains into CGA whereas others selected domains according to their clinical judgment. Greater proportion of female than male physicians included evaluation of depression (39% vs. 16%, P = 0.045) and assessment of functional ability (48% vs. 24%, P = 0.01) always in CGA. Respondents, who applied CGA to all new patients, incorporated nutritional assessment (68% vs. 34%, P = 0.002) and measurement of orthostatic blood pressure (76% vs. 54%, P = 0.04) always into CGA more often than those who performed CGA to selected patients only. Respondents' working conditions were not associated with the application of CGA. Conclusions: Majority of the respondents performed CGA to their patients. The content of CGA varied between geriatricians. Incomplete evaluation may lead to inadequate detection of geriatric syndromes and other problems. (C) 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Peer reviewed
Background: Neuropsychiatric symptoms (NPS) are common in Alzheimer's disease (AD) and are associated with admission to institutional care. Current guidelines recommend non-pharmacological interventions as the first-line treatment for NPS. However, high-quality randomized studies focused on NPS are scarce. The objective here was to examine whether a regular and long-term exercise programme either at home or as a group-based exercise at an adult day care centre has beneficial effects on AD patients' NPS or permanent institutionalizations. Design, setting, and participants: A randomized, controlled trial with 210 community-dwelling AD patients. Intervention: Two types of intervention comprising (1) group-based exercise in day care centres (GE) and (2) tailored home-based exercise (HE), both twice a week for 12 months, were compared with (3) a control group (CG) receiving usual community care. Measurements: NPS were measured with the Neuropsychiatric Inventory (NPI) at baseline and 6 months, and depression with the Cornell Scale for Depression in Dementia (CSDD) at baseline and 12 months. Data on institutionalizations were retrieved from central registers. Results: No significant differences between the groups were detected in NPI at 6 months or in CSDD at 12 months when analyses were adjusted for age, sex, baseline Clinical Dementia Rating, and Functional Independence Measure. There was no difference in admissions to permanent institutional care between the groups. Conclusions: Regular, long-term exercise intervention did not decrease NPS in patients with AD. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Peer reviewed
Introduction: To investigate how frailty status affects the outcome of exercise intervention among home-dwelling participants with Alzheimer disease (AD). Methods: This is a sub-group analysis of a randomized controlled trial. In this trial, home-dwelling participants with AD received either home-based or group-based exercise twice a week for one year (n = 129); the control group received normal care (n = 65). Both the intervention and control group were subdivided into two groups according to modified Fried criteria: prefrail (0-1 criteria) and advanced frailty (2-5 criteria). The Functional Independence Measure (FIM) and number of falls per person-years served as outcome measures. Results: Whereas there was no significant difference in FIM between the prefrail intervention (PRI) and control (PRC) groups at 3 or 6 months, the PRI group deteriorated significantly slower at 12 months (-6.6 [95% CI -8.6 to -4.5] for PRI and -11.1 [95% CI -13.9 to -8.3] for PRC; P = 0.010). Similarly, there was no significant difference between the advanced frailty intervention (AFI) and control (AFC) groups at 3 months, but the difference became significant at 6 months (-8.1 [95% CI -11.1 to -5.2] for AFI and -15.5 [95% CI -20.0 to -11.1] for AFC; P = 0.007) and at 12 months (-8.9 [95% CI -11.9 to -5.9] for AFI and -15.3 [95% CI -20.2 to -10.3] for AFC; P = 0.031). There was also a significant difference in the number of falls in favor of PRI and AFI groups compared to their respective control groups. Conclusion: A long-term exercise intervention benefited people with AD regardless of their stage of frailty. Trial registration: : ACTRN12608000037303. (C) 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Peer reviewed
Background/aim: Deficiency of acetyl-L-carnitine (ALC) and L-carnitine (LC) appears to play a role in peripheral diabetic neuropathy, although the evidence in humans is still limited. We conducted a systematic review and meta-analysis investigating the effect of ALC on pain and electromyographic parameters in people with diabetic neuropathy. Methods: A literature search in major databases, without language restriction, was undertaken. Eligible studies were randomized controlled trials (RCTs) or pre-and post-test studies. The effect of ALC supplementation on pain perception and electromyographic parameters in patients with diabetic neuropathy was compared vs. a control group (RCTs). The effect of ALC/LC on electromyographic parameters were also calculated vs. baseline values. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were used for summarizing outcomes. Results: Six articles, with a total of 711 diabetic participants, were included. Three RCTs (340 treated with ALC vs. 203 placebo and 115 with methylcobalamine) showed that ALC reduces pain perception (SMD = -0.45; 95% CI: -0.86 to -0.04; P = 0.03; I-2 = 85%). Compared to controls, ALC supplementation improved nerve conduction velocity and amplitude response for ulnar nerve (both sensory and motor component). Compared to baseline values, ALC/LC supplementation improved nerve conduction velocity for all the sensory and motor nerves (except ulnar and peroneal) investigated and the amplitude of all nerves. The onset of adverse events was generally limited to minor side effects. Conclusion: ALC appears to be effective in reducing pain due to diabetic neuropathy compared to active or placebo controls and improving electromyographic parameters in these patients. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Peer reviewed
Introduction: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) successfully demonstrated that multidomain lifestyle intervention can improve or maintain cognitive functioning in at-risk individuals. Health-related quality of life (HRQoL) was a secondary endpoint. Methods: The intervention (n = 631) aimed at healthy diet, increased physical activity, cognitive training, and vascular risk management. The control group (n = 629) was given general health advice. HRQoL was assessed at baseline, 12, and 24 months using validated RAND-36 (SF-36) instrument with 8 scales. Results: During the 2-year intervention period, mean scores in all scales decreased in the control group, but increased in the intervention group for vitality (12 months), social function (12 months), and especially general health at both 12 and 24 months. There was a statistically significant beneficial effect of intervention on the change in general health and physical function at 12 and 24 months. Conclusion: Multidomain lifestyle intervention improved also important dimensions of HRQoL. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Peer reviewed
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people. ; Non peer reviewed
Published also in Aging Clinical and Experimental Research, Vol.28, No.4, WOS: 000379034800030 ; Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people. ; Peer reviewed
Published also in Aging Clinical and Experimental Research, Vol.28, No.4, WOS: 000379034800030 ; Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) - European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people. (C) 2016 Published by Elsevier Masson SAS. ; Peer reviewed
