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Gepubliceerd in: Geron 1/2015

01-12-2015 | Finland

Hot topics in ageing research

Auteur: PhD Jenni Kulmala

Gepubliceerd in: Geron | bijlage 1/2015

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Abstract

Finland is one of the leading countries in thorough scientific ageing research. Several universities and research institutes in Finland have been conducting large population-based longitudinal studies for decades, investigating especially the lifestyle risk factors for old age physical and cognitive functioning. This brief overview describes some of the recent and ongoing projects that have gained interest in Finnish ageing-related research
Opmerkingen
About the author
Jenni Kulmala is PhD teacher and Adjunct Professor at the Gerontology School of Health Care and Social Work of the Seinäjoki University of Applied Sciences, Seinäjoki, Finland.
Email: jenni.kulmala@seamk.fi
Large prospective cohort studies with follow-up periods extending up to over forty years, as well as recent qualitative randomized controlled trials (RCTs) have provided groundbreaking new knowledge on lifestyle factors that contribute to old age health and functioning. These studies highlight the importance of a life-course perspective when aiming to promote a healthy and active old age. One of the recent interests in Finnish ageing research has been occupational gerontology. It refers to research that investigates the relationship between working life and old age (Goedhard 2011). It provides knowledge on how to promote the work ability of older workers and it also investigates, whether working life and working conditions have longitudinal effects on later life health outcomes. The research area provides further understanding how working life affects life after retirement.
The Finnish Longitudinal study on Municipal Employees (FLAME) is an ongoing prospective longitudinal study. The study was initiated by the Finnish Institute of Occupational Health in 1981 and is currently a collaboration study in which several research institutes in Finland participate. The baseline cohort in the beginning of 1980s consisted of 6257 occupationally active middle-aged persons, whose work ability, working conditions and health-related factors were assessed with postal questionnaires (Tuomi et al. 1997). This cohort has been followed for almost thirty years, which has provided a unique opportunity to assess the long-term effects of working life. The FLAME study has resulted in several interesting findings. For example, studies published in 2013-2014 showed that perceived work-related stress significantly increases the risk of old age functional and mobility decline (Kulmala et al. 2013). Compared to persons who did not report work-related stress in midlife, those who suffered from stress symptoms during their working life, such as negative reactions to work and depressiveness, perceived decrease in cognition, sleep disturbances or somatic stress symptoms, had a significantly higher risk of developing difficulties in walking and mobility as well as difficulties in basic and instrumental activities of daily life in old age.
In addition to mental stress, physically straining work was associated with poorer physical functioning in old age (Hinrichs et al. 2014). The FLAME study has also provided evidence that mental and physical strain during work may modify the future mortality risk. The results published in 2012 showed that low job control in men increased, whereas high job demand in women decreased the mortality risk during the following decades (von Bonsdorff et al. 2012). These findings clearly demonstrated that unfavorable working conditions may have detrimental effects on health in later life and also increase the vulnerability of the elderly for physical disabilities or even premature death.

Dementia prevention

Finland has also been one of the leading countries in dementia prevention studies. Large prospective studies with follow-up periods extending up to thirty years have provided knowledge on several lifestyle factors that either increase or decrease the dementia risk (physical activity and fitness, dietary factors and cardiovascular risk factors). Recently, Finland has gained wide national and international attention after publishing the results from the large randomized controlled trial FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) in the highly respected medical journal the Lancet. The FINGER study is the first large randomized controlled trial in the world that showed that multidomain lifestyle- based intervention (changes in diet, increasing physical activity, cognitive training and vascular risk monitoring), significantly decreases the risk of old age cognitive decline (Ngandu et al. 2015). These results gave the first scientific evidence that by modifying the lifestyle habits of the elderly, it may be possible to maintain cognitive capacity in later life. Since dementia is one of the main public health concerns in Finland and also across the world, these findings give hope that cognitive decline and dementia may be partly prevented, or at least that the onset of the disease may possibly be postponed.

Unique research possibilities

As briefly described above, several earlier - work-related - life events and lifestyle factors are key determinants of a healthy and active old age. In order to investigate these lifestyle effects in relation to old age health and functioning, there is a need for large population- based datasets, where the same persons have been followed for several decades. It also requires well-conducted randomized controlled trials in order to really test the effects of interventions. This kind of research provides opportunities to identify the risk and protective factors and causal pathways that influence old age health and wellbeing. Finland has a long tradition in conducting such studies, and prospective large population- based datasets used in the Finnish aging studies are rare worldwide. Finnish well-organized register-based data also give unique research possibilities. Several studies related to ageing and life-course epidemiology are currently in progress in Finland. Therefore, remarkable research news is also expected in the future.
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Literatuur
go back to reference Bonsdorff M.B. von. et al. (2012). Job strain among blue-collar and white-collar employees as a determinant of total mortality: a 28-year population-based follow-up. BMJ Open 15;2:e000860. Bonsdorff M.B. von. et al. (2012). Job strain among blue-collar and white-collar employees as a determinant of total mortality: a 28-year population-based follow-up. BMJ Open 15;2:e000860.
go back to reference Goedhard W.J.A. (2011). Occupational gerontology. In Nygård CH, Savinainen M, Kirsi T, Lumme-Sandt K. (Eds). Age management during the life course. Goedhard W.J.A. (2011). Occupational gerontology. In Nygård CH, Savinainen M, Kirsi T, Lumme-Sandt K. (Eds). Age management during the life course.
go back to reference Hinrichs T. et al. (2014). Inverse effects of midlife occupational and leisure time physical activity on mobility limitation in old age – a 28-year prospective follow-up study. J Am Geriatr Soc. 62:812-20. CrossRef Hinrichs T. et al. (2014). Inverse effects of midlife occupational and leisure time physical activity on mobility limitation in old age – a 28-year prospective follow-up study. J Am Geriatr Soc. 62:812-20. CrossRef
go back to reference Kulmala J. et al. (2013). Perceived stress symptoms in midlife predict disability in old age. A 28-year prospective cohort study. J Gerontol A Biol Sci Med Sci. 68:984-91. CrossRef Kulmala J. et al. (2013). Perceived stress symptoms in midlife predict disability in old age. A 28-year prospective cohort study. J Gerontol A Biol Sci Med Sci. 68:984-91. CrossRef
go back to reference Ngandu T. et al. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 385(9984):2255-63. CrossRef Ngandu T. et al. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 385(9984):2255-63. CrossRef
go back to reference Tuomi K. et al. (1997). Finnish research project on aging workers in 1981-1992. Scand J Work Environ Health 23 Suppl 1:7-11. Tuomi K. et al. (1997). Finnish research project on aging workers in 1981-1992. Scand J Work Environ Health 23 Suppl 1:7-11.
Metagegevens
Titel
Hot topics in ageing research
Auteur
PhD Jenni Kulmala
Publicatiedatum
01-12-2015
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Geron / Uitgave bijlage 1/2015
Print ISSN: 1389-143X
Elektronisch ISSN: 2352-1880
DOI
https://doi.org/10.1007/s40718-015-0113-4