Sosiaalisen toimintakyvyn arviointi ja mittaaminen väestötutkimuksessa

TOIMIA-suositu

Social engagement, mood, and mortality in old age

Social relationships, social activity, and experiencing fulfilment of interpersonal needs are essential aspects of well-being in older people. The purpose of this research was twofold: first, to investigate the associations of various dimensions of social activity and perceived togetherness with indicators of health decline; and second, to identify potential mediators in these associations. This dissertation is based on data from two research projects. The first, the Evergreen project, is a multidisciplinary, longitudinal follow-up study on the health and functional capacity of people aged 65–84 in 1988 (n=1 181) resident in Jyväskylä, Finland. Data on institutionalization and mortality were obtained from local and nationwide registers. The second, Promotion of mental well- being in older people (GoodMood), was a randomized controlled trial lasting for 1.5 years targeting persons aged 75–79 years (n=222–223) who reported symptoms of loneliness or melancholy at study entry. In both studies, data on social factors and health were gathered in face-to-face interviews. The results showed that those who were more active in collective social activity had reduced risk for mortality and institutionalization over the 17-year follow-up. Better mobility partially explained the association between collective and productive social activities and mortality risk. Better cognitive functioning and fewer depressive symptoms were prerequisites for participating in social activities. Of the dimensions of perceived togetherness, higher sense of attachment and opportunity for giving nurturance at baseline predicted a lower number of depressive symptoms at follow-up. In addition, the presence of depressive symptoms and loneliness at baseline predicted lower scores in the dimensions of perceived togetherness at follow-up. A social intervention of choice increased experiences of social integration, but did not affect depressive symptoms. Loneliness and melancholy were attenuated over time, also equally among controls, suggesting no additional benefit from the social intervention. Collective and productive social activity may contribute to preventing health decline in older people. A higher level of social activities and contentment in perceived togetherness, less frequent feelings of loneliness and fewer depressive symptoms often co-exist, but increased social activity may not lead to improvements in these variables

Associations between the dimensions of perceived togetherness, loneliness, and depressive symptoms among older Finnish people

Objectives: We studied the associations between perceived togetherness, depressive symptoms, and loneliness over a six-month period among 222 people aged 75-79 who reported loneliness or depressive mood at baseline. Method: The present cross-lagged models utilized baseline and six-month follow-up data of a randomized controlled trial that examined the effects of a social intervention on loneliness and depression (ISRCTN78426775). Dimensions of perceived togetherness, i.e., attachment, social integration, guidance, alliance, nurturance, and reassurance of worth, were measured with the Social Provisions Scale, depressive symptoms with a short form of the Geriatric Depression Scale, and loneliness with a single item. Results: After controlling for baseline loneliness and depressive symptoms, baseline higher attachment in all participants and baseline higher opportunity for nurturance in the social intervention group predicted lower depressive mood at follow-up. No cross-lagged associations between the dimensions of perceived togetherness at baseline and loneliness at follow-up were observed. In addition, depressive symptoms and loneliness at baseline tended to negatively predict the dimensions of perceived togetherness at follow-up. Discussion: Depressive symptoms and loneliness appear to be precursor for perceived togetherness, rather than dimensions of perceived togetherness to be antecedents of loneliness and depressiveness among older people

Self-rated resilience and mobility limitations as predictors of change in active aging during COVID-19 restrictions in Finland : a longitudinal study

Social distancing during the COVID-19 pandemic decreased older people’s opportunities to lead an active life. The purpose of this study was to investigate whether walking difficulties predict changes in leading an active life during the COVID-19 social distancing recommendation compared to 2 years before, and whether self-rated resilience moderates this association among older people. Data were collected during social distancing recommendation in May and June 2020 and 2 years before (2017–18) among community-living AGNES study participants initially aged 75, 80, or 85 years (n = 809). Leading an active life was assessed with the University of Jyväskylä Active Aging Scale (UJACAS; total score range 0–272) and resilience with the 10-item Connor-Davidson Resilience Scale (0–40). Self-reported walking difficulties over a 2 km distance were categorized into no difficulty, difficulty, and unable to walk. The total UJACAS score declined 24.9 points (SD 23.5) among those without walking difficulty, 27.0 (SD 25.0) among those reporting walking difficulty and 19.5 (SD 31.2) among those unable to walk 2 km. When adjusted for baseline UJACAS score, those unable to walk 2 km demonstrated the greatest decline. Baseline resilience moderated this association: Higher resilience was associated with less declines in UJACAS scores among persons with or without walking difficulty, and with more declines among persons unable to walk 2 km. When opportunities for leading an active life are compromised, those with less physical and psychological resources become particularly vulnerable to further declines in activity.peerReviewe

Do opposite ends of same factors underlie life satisfaction vs. depressive symptoms among older people?

Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. Methods The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one’s life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling. Results Better physical performance, not perceiving loneliness, having special interests in one’s life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes. Discussion The opposite ends of the same factors underlie positive and negative dimensions of mental well-being. Conclusion Further studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.peerReviewe