Århus, Denmark
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Idland G.,Oslo University College | Pettersen R.,University of Oslo | Avlund K.,Copenhagen University | Avlund K.,Universities of Aarhus | Bergland A.,Oslo University College
Archives of Gerontology and Geriatrics | Year: 2013

Disability in ADL of aging women is an important public health concern. It is thus of interest to identify modifiable factors underlying onset of ADL disability. We assessed whether three physical performance-based measurements could predict ADL disability 9 years later. The participants were 113 non-disabled community-dwelling women with a mean age of 79.5 years at baseline. The baseline examinations of physical performance were: functional reach, climbing steps and comfortable walking speed. ADL disability was defined as need of personal assistance in at least one of five basic ADL items. The participants were followed for 9 years. Logistic regression models were fitted for each of the physical performance measurements together with the covariates in relation to ADL disability. At follow-up 25.7% were disabled in ADL. All three performance measurements were significantly associated with the onset of ADL disability at 9 years of follow-up, however, only walking speed remained significantly related to onset of ADL disability, when all three performance measurements were included in the same model. In conclusion all the three performance measurements were related to onset of ADL disability, with walking speed having the strongest predictive value. Systematic screening based on walking speed measurements of non-disabled older women might help health professionals to identify those at risk of ADL disability and introduce preventive measures in time. © 2012 Elsevier Ireland Ltd.

Avlund K.,Copenhagen University | Avlund K.,Glostrup University Hospital | Avlund K.,Universities of Aarhus | Schultz-Larsen K.,Copenhagen University | And 3 more authors.
Journal of the American Geriatrics Society | Year: 2011

Objectives: To examine whether tooth loss at age 70 is associated with fatigue in a nondisabled community-dwelling population cross-sectionally at age 70 and with onset of fatigue longitudinally at 5-, 10-, and 15-year follow-ups. Setting: Community-based population in Copenhagen. Participants: Five hundred seventy-three nondisabled 70-year-old individuals in 1984. Measurements: Data from interviews and a medical and oral examination. Oral health was measured according to number of teeth (0, 1-9, 10-19, ≥20). Fatigue was measured using the Avlund Mobility-Tiredness Scale on six mobility activities. Covariates, all measured at baseline, were sex, education, income, comorbidity, and smoking. Results: Bivariate logistic regression analyses showed significant cross-sectional and longitudinal associations between number of teeth at age 70 and onset of fatigue at 5- and 10- but not 15-year follow-up. The associations between having no teeth and fatigue were attenuated when adjusted for socioeconomic position and smoking. Conclusion: Tooth loss is associated with onset of fatigue in old age, but the estimates are attenuated when adjusting for socioeconomic position and smoking. Tooth loss may be an early indicator of frailty. © 2011, The American Geriatrics Society.

Maynard S.,Copenhagen University | Keijzers G.,Copenhagen University | Keijzers G.,Universities of Aarhus | Gram M.,Copenhagen University | And 15 more authors.
Aging | Year: 2013

Low vitality (a component of fatigue) in middle-aged and older adults is an important complaint often identified as a symptom of a disease state or side effect of a treatment. No studies to date have investigated the potential link between dysfunctional mitochondrial ATP production and low vitality. Therefore, we measured a number of cellular parameters related to mitochondrial activity in peripheral blood mononuclear cells (PBMCs) isolated from middle-aged men, and tested for association with vitality. These parameters estimate mitochondrial respiration, reactive oxygen species (ROS) production, and deoxyribonucleotide (dNTP) balance in PBMCs. The population was drawn from the Metropolit cohort of men born in 1953. Vitality level was estimated from the Medical Outcomes Study Short Form 36 (SF- 36) vitality scale. We found that vitality score had no association with any of the mitochondrial respiration parameters. However, vitality score was inversely associated with cellular ROS production and cellular deoxythymidine triphosphate (dTTP) levels and positively associated with deoxycytidine triphosphate (dCTP) levels. We conclude that self-reported persistent low vitality is not associated with specific aspects of mitochondrial oxidative phosphorylation capacity in PBMCs, but may have other underlying cellular dysfunctions that contribute to dNTP imbalance and altered ROS production. © Maynard et al.

Heegaard K.M.,Copenhagen University | Holm-Pedersen P.,Copenhagen University | Bardow A.,Copenhagen University | Hvidtfeldt U.A.,National Health Research Institute | And 3 more authors.
Gerodontology | Year: 2011

Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe the design, measurement procedures, and baseline values for COHS including spatial distribution of restorations and dental caries as well as reasons for non-participation. Materials and methods: Seven hundred and eighty-three individuals aged 65 years or older, from a total of 1918 invited elderly people, underwent an interview regarding oral health-related behaviour and a clinical oral examination including measurement of unstimulated whole saliva flow rate. Results: Twelve percent of the COHS was edentulous. The number of dental restorations was higher for women compared to men; however, men had more caries than women. Coronal caries was most frequent on mesial and distal surfaces and on the maxillary incisors and canines; root caries was most frequent on labial surfaces and evenly distributed within the dentition. Only 41% of all invited elderly people accepted the invitation, with old age and poor health being the primary reasons for non-participation. Conclusion: The baseline values for COHS show that a substantial proportion of the participants had retained a natural dentition and that dental caries was prevalent with the anterior maxillary teeth being most affected. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

Hansen N.L.,Glostrup Hospital | Hansen N.L.,Copenhagen University | Lauritzen M.,Copenhagen University | Lauritzen M.,Glostrup Hospital | And 8 more authors.
Human Brain Mapping | Year: 2014

Cognitive abilities decline with age, but with considerable individual variation. The neurobiological correlate of this variation is not well described. Functional brain imaging studies have demonstrated reduced task-induced deactivation (TID) of the brain's default mode network (DMN) in a wide range of neurodegenerative diseases involving cognitive symptoms, in conditions with increased risk of Alzheimer's disease, and even in advanced but healthy aging. Here, we investigated brain activation and deactivation during a visual-motor task in 185 clinically healthy males from a Danish birth cohort, whose cognitive function was assessed in youth and midlife. Using each individual as his own control, we defined a group with a large degree of cognitive decline, and a control group. When correcting for effects of total cerebral blood flow and hemoglobin level, we found reduced TID in the posterior region of the DMN in the cognitive decline group compared to the control group. Furthermore, increased visual activation response was found in the cognitive decline group, indicating that the TID reduction was not exclusively due to overall impaired vascular reactivity. These results suggest a neurobiological basis for subclinical cognitive decline in late midlife, which includes TID alterations similar to the pattern seen in patients with AD and mild cognitive impairment. Hence, TID reduction might be suggested as an early marker for subtle cognitive decline in aging. © 2014 Wiley Periodicals, Inc.

Mortensen E.L.,Copenhagen University | Barefoot J.C.,Copenhagen University | Barefoot J.C.,Duke University | Avlund K.,Copenhagen University | Avlund K.,Universities of Aarhus
Journal of Aging Research | Year: 2012

Certain personality traits are likely to be associated with stress and distress through the lifespan, and as a consequence these traits may influence the rate of age-related cognitive decline. The present study uses data from the Glostrup 1914 cohort to analyze potential effects of personality on decline in general intelligence over a 30-year period. The Minnesota Multiphasic Personality Inventory was administered at a 50-year baseline exam, and from this inventory the Obvious Depression Scale and an abbreviated version of the Cook-Medley Hostility Scale were derived. At the 50-year baseline and at the 60-, 70-, and 80-year followups the full version of Wechsler's Adult Intelligence Scale (WAIS) was administered to 673, 513, 136, and 184 participants. Mixed effects statistical models were used to evaluate both the effect of the personality scores on level of intelligence and the interaction between the personality scores and the time since followup. Analyses were adjusted for demographic background and a wide range of lifestyle factors. Both obvious depression and hostility were negatively associated with level of intelligence, but personality scores did not influence rate of decline in general intelligence. © 2012 Erik Lykke Mortensen et al.

Adegboye A.R.A.,Frederiksberg Hospital | Christensen L.B.,Copenhagen University | Holm-Pedersen P.,Copenhagen University | Avlund K.,Copenhagen University | And 3 more authors.
Nutrients | Year: 2012

This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment loss ≥3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings. © 2012 by the authors; licensee MDPI, Basel, Switzerland.

Mortensen E.L.,Copenhagen University | Mortensen E.L.,Bispebjerg Hospital | Flensborg-Madsen T.,Copenhagen University | Flensborg-Madsen T.,University of Southern Denmark | And 8 more authors.
Journal of Aging and Health | Year: 2014

Objectives: To analyze associations in late midlife between sex, age, education and social class, and the Big Five personality traits; to analyze associations between personality traits and cognitive ability in late midlife; and to evaluate how these associations are influenced by demographic factors. Methods: The study sample comprised 5,397 late midlife participants from three cohorts who had completed the NEO Five-Factor Inventory (NEO-FFI) and a measure of cognitive ability. Results: Associations were demonstrated between the five NEO-FFI personality traits, and all included demographic factors. Cognitive ability and years of education correlated with several NEO-FFI personality traits in analyses adjusting for demographic variables. Cohort differences were observed for Extraversion and Openness. Discussion: Robust sex, educational, and social class differences in personality may contribute to late midlife social gradients in health and early aging. Demographic factors did not fully explain correlations between personality and cognitive ability or cohort differences in personality. © The Author(s) 2014.

Brown P.J.,Columbia University | Roose S.P.,Columbia University | Fieo R.,Columbia University | Liu X.,Columbia University | And 7 more authors.
American Journal of Geriatric Psychiatry | Year: 2014

Objective To identify salient characteristics of frailty that increase risk of death in depressed elders. Methods Data were from the Nordic Research on Ageing Study from research sites in Denmark, Sweden, and Finland. Participants were 1,027 adults aged 75 years (436 men and 591 women). Time of death was obtained, providing a maximum survival time of 11.08 years (initial evaluation took place between 1988 and 1991). Results Depressed elders showed greater baseline impairments in each frailty characteristic (gait speed, grip strength, physical activity levels, and fatigue). Simultaneous models including all four frailty characteristics showed slow gait speed (hazard ratio: 1.84; 95% confidence interval: 1.05-3.21) and fatigue (hazard ratio: 1.94; 95% confidence interval: 1.11-3.40) associated with faster progression to death in depressed women; none of the frailty characteristics in the simultaneous model was associated with death in depressed men. In women, the effect of impaired gait speed on mortality rates nearly doubled when depression was present (nondepressed women: no gait impairment = 26%; slow gait = 40%; depressed women: no gait impairment = 32%; slow gait = 58%). A similar pattern was observed for fatigue. Conclusion The confluence of specific characteristics of frailty (fatigue and slow gait speed) and depressive illness is associated with an increased risk of death in older adults; this association is particularly strong in older depressed women. Future research should investigate whether multimodal interventions targeting depressive illness, mobility deficits, and fatigue can decrease mortality and improve quality of life in older depressed individuals with characteristics of the syndrome of frailty. © 2014 American Association for Geriatric Psychiatry.

Manty M.,Copenhagen University | Ekmann A.,Copenhagen University | Ekmann A.,Universities of Aarhus | Thinggaard M.,Universities of Aarhus | And 5 more authors.
Aging Clinical and Experimental Research | Year: 2014

Background and aims: Mobility-related fatigue is an important indicator of functional decline in old age, however, very little is known about fatigue in the oldest old population segment. The aim of this study was to examine the association between indoor mobility-related fatigue and muscle strength decline in nonagenarians. Methods: The study is based on a prospective longitudinal study of all Danes born in 1905 and assessed in 1998, 2000 and 2003, and includes 92- to 93-year-old persons who were independent of help in basic indoor mobility at baseline (n = 1,353). Fatigue was assessed at baseline and defined as a subjective feeling of fatigue when transferring or walking indoors. The outcome measure, maximum grip strength, was measured at each measurement point. Results: Grip strength declined throughout the study in participants with and without fatigue, but those reporting fatigue had significantly (P < .001) lower muscle strength during the entire study period. Longitudinal analyses indicated slightly slower decline in muscle strength among participants with fatigue compared to those without; however, observed selective dropout of participants with fatigue and poor performance at baseline needs to be considered when interpreting the results. Accordingly, participants without fatigue had significantly higher chances of being alive and having muscle strength above gender-specific median at first (RR 1.32, 95% CI 1.07-1.58), second (RR 1.51, 1.06-1.96) and third (RR 1.39, 1.01-1.97) measurement points. Conclusions: Indoor mobility-related fatigue in advanced later life should not merely be considered as an unpleasant symptom, but rather an indicator of physical impairment, and consequently declined physiological reserve. © Springer International Publishing 2013.

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