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Biomarkers of kidney function and prediction of death from cardiovascular and other causes in the elderly: A 9-year follow-up study
Background: Cystatin C is claimed to be superior to creatinine-based estimates of glomerular filtration rate (eGFRcr). The purpose of the study is to analyze whether cystatin C, creatinine, and/or estimated glomerular ...
Psychosocial resources related to survival among non-robust community-dwelling older people: an 18-year follow-up study
Psychosocial resources have been considered to be associated with survival among frail older adults but the evidence is scarce. The aim was to investigate whether psychosocial resources are related to survival among ...
Chronic conditions and multimorbidity associated with institutionalization among Finnish community-dwelling older people: an 18-year population-based follow-up study
<p>Key summary points</p><p>Aim The aim of the study is to assess the association of chronic conditions and multimorbidity with institutionalization in older people.</p><p>Findings Having dementia, mood or neurological ...
Frailty and mortality: an 18-year follow-up study among Finnish community-dwelling older people
<div><h3>Background</h3><p>There is a lack of agreement about applicable instrument to screen frailty in clinical settings.</p></div><div><h3>Aims</h3><p>To analyze the association between frailty and mortality in Finnish community-dwelling older people.</p></div><div><h3>Methods</h3><p>This was a prospective study with 10- and 18-year follow-ups. Frailty was assessed using FRAIL scale (FS) (n = 1152), Rockwood’s frailty index (FI) (n = 1126), and PRISMA-7 (n = 1124). To analyze the association between frailty and mortality, Cox regression model was used.</p></div><div><h3>Results</h3><p>Prevalence of frailty varied from 2 to 24% based on the index used. In unadjusted models, frailty was associated with higher mortality according to FS (hazard ratio 7.96 [95% confidence interval 5.10–12.41] in 10-year follow-up, and 6.32 [4.17–9.57] in 18-year follow-up) and FI (5.97 [4.13–8.64], and 3.95 [3.16–4.94], respectively) in both follow-ups. Also being pre-frail was associated with higher mortality according to both indexes in both follow-ups (FS 2.19 [1.78–2.69], and 1.69 [1.46–1.96]; FI 1.81[1.25–2.62], and 1.31 [1.07–1.61], respectively). Associations persisted even after adjustments. Also according to PRISMA-7, a binary index (robust or frail), frailty was associated with higher mortality in 10- (4.41 [3.55–5.34]) and 18-year follow-ups (3.78 [3.19–4.49]).</p></div><div><h3>Discussion</h3><p>Frailty was associated with higher mortality risk according to all three frailty screening instrument used. Simple and fast frailty indexes, FS and PRISMA-7, seemed to be comparable with a multidimensional time-consuming FI in predicting mortality among community-dwelling Finnish older people.</p></div><div><h3>Conclusions</h3><p>FS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.</p></div>...
Frailty, walking ability and self-rated health in predicting institutionalization: an 18-year follow-up study among Finnish community-dwelling older people
<p>Background <br></p><p>In clinical practice, there is a need for an instrument to screen older people at risk of institutionalization. Aims To analyze the association of frailty, walking-ability and self-rated health (SRH) with institutionalization in Finnish community-dwelling older people. <br></p><p>Methods <br></p><p>In this prospective study with 10- and 18-year follow-ups, frailty was assessed using FRAIL Scale (FS) (n = 1087), Frailty Index (FI) (n = 1061) and PRISMA-7 (n = 1055). Walking ability was assessed as self-reported ability to walk 400 m (n = 1101). SRH was assessed by a question of general SRH (n = 1105). Cox regression model was used to analyze the association of the explanatory variables with institutionalization. <br></p><p>Results <br></p><p>The mean age of the participants was 73.0 (range 64.0-97.0) years. Prevalence of institutionalization was 40.8%. In unadjusted models, frailty was associated with a higher risk of institutionalization by FS in 10-year follow-up, and FI in both follow-ups. Associations by FI persisted after age- and gender-adjustments in both follow-ups. By PRISMA-7, frailty predicted a higher risk of institutionalization in both follow-ups. In unadjusted models, inability to walk 400 m predicted a higher risk of institutionalization in both follow-ups and after adjustments in 10-year follow-up. Poor SRH predicted a higher risk of institutionalization in unadjusted models in both follow-ups and after adjustments in 10-year follow-up. <br></p><p>Discussion <br></p><p>Simple self-reported items of walking ability and SRH seemed to be comparable with frailty indexes in predicting institutionalization among community-dwelling older people in 10-year follow-up. Conclusions In clinical practice, self-reported walking ability and SRH could be used to screen those at risk.</p>...
Komplisoituneen verenpainetaudin hoito terveyskeskuksessa: Hoitosuositukset hallinnassa - käytännön haasteena diabetespotilaat
<p><b>Lähtökohdat </b>: Kohonneen verenpaineen lääkehoito on kehittynyt sepelvaltimotautia sairastavilla potilailla Käypä hoito -suositusten mukaisesti, mutta lääkevalinnat diabetesta sairastaville eivät ole olleet ...
Midlife insulin resistance, APOE genotype, and late-life brain amyloid accumulation
ObjectiveTo examine whether midlife insulin resistance is an independent risk factor for brain amyloid accumulation in vivo after 15 years, and whether this risk is modulated by APOE epsilon 4 genotype.MethodsThis observational ...
Long-term persistence of withdrawal of temazepam, zopiclone, and zolpidem in older adults: a 3-year follow-up study
Background: Studies on persistence of benzodiazepine agonist (BZDA) withdrawal in older outpatients are few, and few studies on long-term persistence over years have yet been published. To describe the persistence of ...