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Copenhagen, Denmark

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

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. Source

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

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. Source

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

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. Source

Adegboye A.R.A.,Institute of Preventive Medicine | Christensen L.B.,Copenhagen University | Holm-Pedersen P.,Copenhagen University | Avlund K.,Copenhagen University | And 3 more authors.

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. Source

Hansen N.L.,Functional Imaging Unit | Hansen N.L.,Copenhagen University | Lauritzen M.,Copenhagen University | Mortensen E.L.,Copenhagen University | And 7 more authors.
Human Brain Mapping

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. Source

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