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Title [sv]
Betydelsen av levnadsförhållanden och hälsa i medelåldern för ett gott och aktivt åldrande: Silver MONICA studien
Title [en]
Impact of living conditions and health in middle age on active and healthy aging: The Silver MONICA study
Abstract [sv]
Detta projekt kommer att undersöka hur socioekonomiska och kardiovaskulära faktorer i medelåldern (50-64 år) och senare kardiovaskulära händelser har betydelse för ett aktivt liv i mycket hög ålder (? 80 år). Deltagare från norra Sveriges MONICA studie (MONItoring of Trends and Determinants of CArdiovascular Disease) kommer att följas upp med det protokoll som tillämpas av GERDA studien (GErontologisk Regionala DAtabasen).Det finns begränsad kunskap om effekterna av och trender för socioekonomiska och kardiovaskulära faktorer och incidens av hjärt- och kärlsjukdomar i medelåldern för utveckling av fysiska och psykiska sjukdomar bland mycket gamla människor. Individer från MONICA studien som har screenats minst två gånger kommer att erbjudas deltagande i Silver MONICA studien. I april 2016 fanns 602 MONICA deltagare som var 80 år eller äldre och var fortfarande vid liv och bodde i Norr- och Västerbotten. Detta innebär att uppföljningstiden varierar mellan 17 och 30 år när hembesöken kommer att påbörjas under 2016. Specifikt kommer vi att studera: (i) livskvalitet och social integration/deltagande, (ii) fysisk kapacitet och aktivitet, rädsla för att falla, fall och höftfrakturer, (iii) demens, depression, (iv) beroende i dagliga aktiviteter (ADL), levnadsförhållanden, konsumtion av vård och omsorg och dödlighet. Med bättre förståelse för hur riskfaktorer i medelåldern påverkar de äldre kan dessa resultat användas för att utforma förebyggande åtgärder.
Abstract [en]
Several large population-based surveys are ongoing in Northern Sweden. In the mid-eighties, the MONICA study (Monitoring of Trends and Determinants of CArdiovascular Disease) was initiated by WHO to monitor trends in mortality and morbidity in cardiovascular disease and related risk factors, and eight surveys with more than 12 000 participants have been performed since 1986.  The GERDA study (GErontological and Regional DAtabase) started in year 2000 with the focus healthy ageing and its threats in the very old population. By using appropriate methods tailored for very old people including home visits and careful selection of assessment scales, the GERDA study has reached a high participation rate in this age group. Quality of data in both surveys have been ascertained by cross-validation with medical records and central registers.In the Silver-MONICA study, we will follow up participants with at least two previous assessments in the MONICA study (n=602) that have now reached very old age, using the methodology from the GERDA study that has proved to be effective in this age group. This study will enable analysis of the long-term effect of socioeconomic and cardiovascular factors in middle-age for healthy aging. This design provides the opportunity to evaluate various selection mechanisms (e.g. survival and colloidal bias) hampering cross-sectional studies of the very old. Identification and prevention of modifiable risk factors in middle age that determine disease in the very old may have a major impact on healthy aging in the future.
Publications (1 of 1) Show all publications
Awad, A., Sundström, A., Gramner, F., Werneke, U., Toots, A., Olofsson, B., . . . Niklasson, J. (2025). Association between executive functions and fear of falling among people aged 80 years or older: a cross-sectional study. BMC Geriatrics, 25(1), Article ID 400.
Open this publication in new window or tab >>Association between executive functions and fear of falling among people aged 80 years or older: a cross-sectional study
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2025 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 25, no 1, article id 400Article in journal (Refereed) Published
Abstract [en]

Objectives: Fear of falling (FoF) is a common problem among older adults. It can lead to reduced quality of life and less physical activity, which increases fall risk. Earlier work has shown that FoF can be a manifestation of executive dysfunction in adults over 50 years, but studies on people over age 75 years are lacking. Executive functions (EFs) are cognitive functions associated with the frontal lobes and the prefrontal cortex. The aim of this study was to assess associations of EFs and FoF among people aged 80 years or older.

Methods: This cross-sectional study was based on data from the Northern Sweden Silver-MONICA study and included 434 participants aged 80 years or older. EFs were assessed with the Frontal Assessment Battery (FAB) and FoF with the Falls Self-Efficacy Scale–International (FES-I). Multivariable linear regression analysis was used to examine associations among EF, FoF, and a comprehensive set of adjustment factors. Pearson correlation analysis was used to evaluate associations of FES-I and the subitems of the FAB.

Results: EFs as measured by FAB were inversely associated with FoF (β = -0.23; 95% confidence interval, -0.42 to -0.03; p = 0.021), even after comprehensive adjustments. The FAB subitems measuring lexical fluency, inhibitory control, sustained attention, self-organization, motor programming, and planning also were inversely associated with FoF.

Conclusions: Lower EF is associated with higher FoF among people aged 80 years or older. This information is important for treating and preventing FoF in this population.
Place, publisher, year, edition, pages
BioMed Central (BMC), 2025
Keywords
Aged, 80 and over, Executive function, Fear of falling, FAB, FES-I
National Category
Geriatrics
Research subject
Geriatrics
Identifiers
urn:nbn:se:umu:diva-240134 (URN)10.1186/s12877-025-06067-5 (DOI)001501237500001 ()40457245 (PubMedID)2-s2.0-105007075679 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016–01074Visare NorrThe Dementia Association - The National Association for the Rights of the DementedFoundation for the Memory of Ragnhild and Einar LundströmSwedish Society of MedicineKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2025-06-12 Created: 2025-06-12 Last updated: 2025-06-12Bibliographically approved
Principal InvestigatorSöderberg, Stefan
Coordinating organisation
Umeå University
Funder
Period
2017-01-01 － 2019-12-31
National Category
Geriatrics
Identifiers
DiVA, id: project:616Project, id: 2016-01074_Forte

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