Frailty and mortality : an 18-year follow-up study among Finnish community-dwelling older people

Background There is a lack of agreement about applicable instrument to screen frailty in clinical settings. Aims To analyze the association between frailty and mortality in Finnish community-dwelling older people. Methods 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. Results 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]). Discussion 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. Conclusions FS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.Peer reviewe

Frailty and mortality: an 18-year follow-up study among Finnish community-dwelling older people

BackgroundThere is a lack of agreement about applicable instrument to screen frailty in clinical settings.AimsTo analyze the association between frailty and mortality in Finnish community-dwelling older people.MethodsThis 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.ResultsPrevalence 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]).DiscussionFrailty 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.ConclusionsFS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.</div

Circular Economy Transition in the Context of Multi-Level European Governance: The Cases of Finland and Scotland

The aim of this study is to outline how a circular economy (CE) is emerging as public policy programs in the context of European multi-level governance. Our findings highlight strong and relatively functional vertical governance relationships visible in the Finnish effort to promote a CE transition. We also found that Scotland faces difficulties with its ambitious CE policy, because it tries to follow the framework of the European mainstream multi-level governance as a non-EU-member country which contrasts with more conservative policies of the United Kingdom. Furthermore, the study identified clear horizontal governance relationships at national levels of both countries, because the central governments have to acquire know-how and support services from many arm’s length bodies which have the necessary expertise and capability to work flexibly with local governments and other stakeholders

FOKUS työhyvinvoinnin johtamiseen : arviointi, kehittämisehdotukset, keinot ja menetelmät kehittämiseen

FOKUS työhyvinvoinnin johtamiseen! Työhyvinvoinnin johtaminen on tavoitteellista ja systemaattista johtamistyötä, jolla edistetään henkilöstön työhyvinvointia ja sen kautta yrityksen suorituskykyä. Siinä asetetaan työhyvinvoinnille ja sen edistämiselle selkeitä tavoitteita, valitaan tarkoituksenmukaisia keinoja, määritellään selkeät vastuut, varataan riittävät resurssit sekä arvioidaan ja kehitetään toimintaa jatkuvasti. Päämääränä on hyvinvoiva henkilöstö, työhyvinvointia edistävä yrityskulttuuri ja päivittäisjohtaminen sekä näitä vahvistava toimiva työhyvinvoinnin johtamisjärjestelmä. Tämän kirjan avulla yritys voi arvioida omaa työhyvinvoinnin johtamisen tilaansa ja kehittää työhyvinvoinnin johtamisjärjestelmäänsä kirjassa esitettyjen kehittämisehdotusten, keinojen ja menetelmien avulla itsenäisesti ja oman aikataulun mukaan

FOKUS kriisien hallintaan:Tartuntavaarat, onnettomuudet, kyberturvaongelmat, henkilökriisit, liiketoimintamuutokset

© FOKUS-hanke. Ohjeita ei saa kopioida eikä levittää eteenpäin maksullisena. Ohjeita käytettäessä tulee mainita alkuperäinen tekijä © FOKUS-hanke.fi=vertaisarvioimaton|en=nonPeerReviewed