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Lieto, Finland

Salminen M.,University of Turku | Salminen M.,Harkatie Health Center | Kuoppamaki M.,University of Turku | Kuoppamaki M.,Naantali Health Center | And 4 more authors.
Acta Diabetologica | Year: 2011

The aim was to analyze the relationship between metabolic syndrome (MetS) and vascular risk among the aged. A prospective population-based study, with a 9-year follow-up. All subjects of the municipality of Lieto in Finland aged ≥64 in 1998-99 participated (n = 1183). Hazard ratios (HRs) for fatal or non-fatal coronary (CHD), cerebrovascular (CV), or all vascular events predicted by MetS (defined by International Diabetes Federation) were estimated. During the 9-year follow-up, a total of 348 vascular events occurred, including 208 CHD and 150 CV events. After multivariable adjustment, CHD events (1.70, 1.07-2.71, P = .026) and vascular events (1.57, 1.07-2.30, P = .021) were more common in men with MetS compared to men without it. Evaluating MetS components individually, low HDL-cholesterol among women predicted a higher occurrence of CV (2.44, 1.46-4.09, P < .001) and all vascular (1.78, 1.26-2.53, P = .001) events. Elevated blood pressure among men was related to fewer CHD events (0.46, 0.25-0.83, P = .010). Our findings suggest that MetS does predict vascular events in late life among men. In older women, only low HDL-cholesterol was associated with vascular risk. Slightly or moderately elevated blood pressure values do not predict vascular events in this age group. © 2011 Springer-Verlag. Source


Nurminen J.,University of Turku | Nurminen J.,Harkatie Health Center | Nurminen J.,Turku Health Center | Puustinen J.,University of Turku | And 3 more authors.
BMC Public Health | Year: 2010

Background. There is evidence that the use of any psychotropic and the concomitant use of two or more benzodiazepines are related to an increased risk of fractures in old age. However, also controversial results exist. The aim was to describe associations between the use of a psychotropic drug, or the concomitant use of two or more of these drugs and the risk of fractures in a population aged 65 years or over. Methods. This study was a part of a prospective longitudinal population-based study carried out in the municipality of Lieto, South-Western Finland. The objective was to describe gender-specific associations between the use of one psychotropic drug [benzodiazepine (BZD), antipsychotic (AP) or antidepressant (AD)] or the concomitant use of two or more psychotropic drugs and the risk of fractures in a population 65 years or over. Subjects were participants in the first wave of the Lieto study in 1990-1991, and they were followed up until the end of 1996. Information about fractures confirmed with radiology reports in 1,177 subjects (482 men and 695 women) during the follow-up was collected from medical records. Two follow-up periods (three and six years) were used, and previously found risk factors of fractures were adjusted as confounding factors separately for men and women. The Poisson regression model was used in the analyses. Results. The concomitant use of two or more BZDs and the concomitant use of two or more APs were related to an increased risk of fractures during both follow-up periods after adjusting for confounding factors in men. No similar associations were found in women. Conclusions. The concomitant use of several BZDs and that of several APs are associated with an increase in the risk of fractures in older men. Our findings show only risk relations. We cannot draw the conclusion that these drug combinations are causes of fractures. © 2010 Nurminen et al; licensee BioMed Central Ltd. Source


Salminen M.,University of Turku | Salminen M.,Harkatie Health Center | Kuoppamaki M.,University of Turku | Kuoppamaki M.,Naantali Health Center | And 4 more authors.
Diabetes and Metabolism | Year: 2010

Aim: The aim of this study was to investigate the relationship between the metabolic syndrome (MetS) and mortality in the aged population. Methods: In this prospective population-based study with a 9-year follow-up, the participants were all residents of the municipality of Lieto, Finland, aged 64 and over in 1998-99 (n= 1529). Altogether, 1260 (82%) were included in the study. Cox proportional-hazard models were used to estimate hazard ratios (HRs) for all-cause, cardiovascular (CVD), coronary heart disease (CHD) and cerebrovascular (CV) mortality as predicted by MetS (defined by modified International Diabetes Federation criteria). Results: At baseline, 17% of the men and 21% of the women had MetS. During the 9-year follow-up, 422 deaths occurred. After multivariable adjustment, no significant differences were found between subjects with and without MetS for all-cause, CVD, CHD or CV mortality in all study participants or by gender. On evaluating MetS components separately, elevated blood pressure was found to predict lower all-cause mortality in all participants [HR: 0.65; 95% confidence interval (CI): 0.47-0.89], and lower CHD mortality in men (HR: 0.42; 95% CI: 0.18-0.97). In women, high triglyceride levels predicted lower all-cause mortality (HR: 0.67; 95% CI: 0.47-0.95), whereas low HDL cholesterol predicted higher all-cause (HR: 1.61; 95% CI: 1.15-2.24) and CV (HR: 2.44; 95% CI: 1.05-5.67) mortality. Conclusion: These findings suggest that MetS does not predict mortality later in life and, of the separate components of MetS, only low HDL cholesterol is predictive of mortality in women. Also, even markedly higher blood pressure values than those included in the criteria for MetS fail to predict mortality in this age group. Objectif: L'objectif de cette étude était d'examiner les relations éventuelles entre syndrome métabolique (SMET) et mortalité chez les sujets âgés. Méthodes: Étude prospective en population avec suivi de neuf ans. Tous les sujets étaient résidents de la commune de Lieto en Finlande et âgés de 64 ans ou plus en 1998-1999 (n= 1529). Au total, 1260 sujets (82 %) ont participé à l'étude. Le risque relatif (RR) de mortalité toutes causes confondues et de mortalité cardiovasculaire, coronaire et vasculaire cérébrale a été calculé grâce au modèle proportionnel de Cox en fonction de l'existence ou non d'un SMET (défini selon les critères révisés de la Fédération internationale du diabète). Résultats: À l'inclusion, 17 % des hommes et 21 % des femmes étaient atteints de SMET. Pendant le suivi de neuf ans, 422 sujets sont décédés. L'ajustement multivarié n'a révélé aucune différence importante liée au SMET entre les sujets des deux sexes quant à la mortalité cardiovasculaire, coronaire et vasculaire cérébrale et la mortalité toutes causes confondues. L'évaluation de chacun des composants du SMET a montré que l'hypertension artérielle était associée à une mortalité toutes causes confondues plus basse pour l'ensemble de la population étudiée (RR 0,65; intervalle de confiance à 95 % 0,47-0,89) et à une mortalité coronaire plus basse chez les hommes (RR 0,42; IC 95 % 0,18-0,97). Chez les femmes, l'hyperglycémie était associée à une mortalité toutes causes confondues plus basse (RR 0,67; IC à 95 % 0,47-0,95), tandis que des concentrations basses de HDLc étaient associées à une mortalité toutes causes confondues et à une mortalité vasculaire cérébrale plus élevées (respectivement RR 1,61; IC à 95 % 1,15-2,24) et (RR 2,44; IC à 95 % 1,05-5,67). Conclusion: Ces résultats suggèrent que le SMET est dépourvu de valeur pronostique de mortalité dans les phases ultérieures de la vie. Parmi les composants individuels du SMET, seules des concentrations basses de HDLc sont associées à la mortalité chez les femmes. Même des valeurs de pression artérielle plus élevées que les critères du SMET sont dépourvues de valeur pronostique de la mortalité dans cette tranche d'âge. © 2010 Elsevier Masson SAS. Source


Salminen M.,University of Turku | Salminen M.,Harkatie Health Center | Kuoppamaki M.,University of Turku | Kuoppamaki M.,Naantali Health Center | And 5 more authors.
Diabetes and Vascular Disease Research | Year: 2013

The aim was to analyse the relationship between metabolic syndrome and type 2 diabetes mellitus risk among the aged. This was a prospective population-based study, with a 9-year follow-up. All subjects of the municipality of Lieto in Finland aged ≥64 in 1998-1999 with no type 2 diabetes mellitus at baseline (n=1117) were included. Hazard ratios for incident type 2 diabetes mellitus predicted by metabolic syndrome (defined by modified International Diabetes Federation criteria) were estimated. During the 9-year follow-up, a total of 69 participants (6.2%) developed type 2 diabetes mellitus. After multivariable adjustment (age, gender, smoking, frequency of exercise, cardiovascular disease and low-density lipoprotein-cholesterol), type 2 diabetes mellitus (hazard ratio, 95% confidence interval) (3.15, 1.89-5.25, p < 0.001) was more common in subjects with metabolic syndrome compared to subjects without it. Evaluating metabolic syndrome components individually, impaired fasting glucose (5.09, 2.64-9.82, p < 0.001) and obesity (1.71, 1.05-2.97, p = 0.034) predicted a higher incidence of type 2 diabetes mellitus. Our findings suggest that metabolic syndrome predicts onset of type 2 diabetes mellitus even in late life. Impaired fasting glucose and obesity should be targets for primary prevention of diabetes among the aged with metabolic syndrome. © 2012 The Author(s). Source


Salminen M.,University of Turku | Salminen M.,Harkatie Health Center | Raiha I.,University of Turku | Heinonen J.,University of Turku | And 2 more authors.
Archives of Gerontology and Geriatrics | Year: 2012

Aim: The aim was to carry out a systematic review of original studies about morbidity in the aged in Finland. Methods: Publications with data on morbidity in the aged (≥65 years) in peer-reviewed scientific journals in Finnish and English were systematically searched for in literature databases, websites of National Institute of Health and Welfare (NIHW), National Public Health Institute (NPHI), and Stakes and reference lists of retrieved articles. Publications from 1990 onwards were included. Results: The search produced 39 publications about morbidity in the aged in Finland fulfilling the inclusion criteria. The most common disease categories in the aged were cardiovascular diseases (CVDs), musculoskeletal disorders (MSDs), hypertension, orthostatic hypotension (OH), insomnia, diabetes, articular diseases, diseases causing cognitive decline, and depression. The prevalence of many of these diseases increased with age. Conclusions: The morbidity increases with aging, and even the oldest-old are not exceptionally healthy. Because of the increasing number of aged people, the absolute use of health and social services by this population sector will most probably increase in Finland and other developed countries. © 2011 Elsevier Ireland Ltd. Source

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