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Background Few studies have examined longitudinal changes in lifestyle-related factors and frailty. Methods We examined the association between individual lifestyle factors (exercise, diet, sleep, alcohol, smoking and body composition), their sum at baseline, their change over the 17-year follow-up and the rate of change in frailty index values using linear mixed models in a cohort of 2,000 participants aged 57–69 years at baseline. Results A higher number of healthy lifestyle-related factors at baseline was associated with lower levels of frailty but not with its rate of change from late midlife into old age. Participants who stopped exercising regularly (adjusted β × Time = 0.19, 95%CI = 0.10, 0.27) and who began experiencing sleeping difficulties (adjusted β × Time = 0.20, 95%CI = 0.10, 0.31) experienced more rapid increases in frailty from late midlife into old age. Conversely, those whose sleep improved (adjusted β × Time = −0.10, 95%CI = −0.23, −0.01) showed a slower increase in frailty from late midlife onwards. Participants letting go of lifestyle-related factors (decline by 3+ factors vs. no change) became more frail faster from late midlife into old age (adjusted β × Time = 0.16, 95% CI = 0.01, 0.30). Conclusions Lifestyle-related differences in frailty were already evident in late midlife and persisted into old age. Adopting one new healthy lifestyle-related factor had a small impact on a slightly less steeply increasing level of frailty. Maintaining regular exercise and sleeping habits may help prevent more rapid increases in frailty. [ABSTRACT FROM AUTHOR]

Background objective indicators of sleep and mental health problems in family caregivers have rarely been reported. Objective to study the use of prescription benzodiazepines and related drugs (BZDRD) in Finnish family caregivers and matched controls. Design prospective follow-up in 2012–17. Setting nationwide register-linkage study. Subjects all individuals who received family caregiver's allowance in Finland in 2012 (N  = 42,256; mean age 67 years; 71% women) and controls matched for age, sex and municipality of residence (N  = 83,618). Methods information on purchases of prescription BZDRD, including the number of defined daily doses (DDDs), between 2012 and 2017 was obtained from the Dispensations Reimbursable under the National Health Insurance Scheme register. Background information was obtained from national registers. Results more caregivers than controls used BZDRD, both among women (users per 100 person-years: 17.2 versus 15.2, P  < 0.001) and men (14.6 versus 11.8, P  < 0.001). These differences were largely explained by hypnotic BZDRD use. There were also more long-term BZDRD users per 100 person-years among caregivers than controls, both among women (5.0 versus 4.3, P  = 0.001) and men (5.3 versus 3.8, P  < 0.001). Use of hypnotic BZDRD in number of DDDs was higher in caregivers than in controls, particularly among men above 50 years. Caregivers used more anxiolytic BZDRD than controls from middle age to 75 years but less in the oldest age groups. Conclusions higher level of BZDRD use among caregivers indicates that caregivers have more sleep and mental health problems than non-caregivers. Adequate treatment of these problems and support for caregiving should be ensured for caregivers. [ABSTRACT FROM AUTHOR]

Background: Early-life exposures have been associated with the risk of frailty in old age. We investigated whether early-life exposures predict the level and rate of change in a frailty index (FI) from midlife into old age.Methods: A linear mixed model analysis was performed using data from 3 measurement occasions over 17 years in participants from the Helsinki Birth Cohort Study (n = 2 000) aged 57-84 years. A 41-item FI was calculated on each occasion. Information on birth size, maternal body mass index (BMI), growth in infancy and childhood, childhood socioeconomic status (SES), and early-life stress (wartime separation from both parents) was obtained from registers and health care records.Results: At age 57 years the mean FI level was 0.186 and the FI levels increased by 0.34%/year from midlife into old age. Larger body size at birth associated with a slower increase in FI levels from midlife into old age. Per 1 kg greater birth weight the increase in FI levels per year was -0.087 percentage points slower (95% confidence interval = -0.163, -0.011; p = 0.026). Higher maternal BMI was associated with a higher offspring FI level in midlife and a slower increase in FI levels into old age. Larger size, faster growth from infancy to childhood, and low SES in childhood were all associated with a lower FI level in midlife but not with its rate of change.Conclusions: Early-life factors seem to contribute to disparities in frailty from midlife into old age. Early-life factors may identify groups that could benefit from frailty prevention, optimally initiated early in life. [ABSTRACT FROM AUTHOR]

Background We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs). Methods Subjects who responded MLs questionnaires (1985–2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectories of MLs. Odds ratio (OR) and their 95% Confidence interval (CI) were assessed by using multinomial logistic regression. Results We identified four trajectories of MLs, namely low persistent, low increasing, high decreasing and high persistent. Among the SP recipients, shift work with night shifts was associated with an increased risk (adjusted OR 1.49; 95% CI 1.03–2.14) of belonging to the high persistent MLs trajectory. The inactive LTPA (SP: OR 5.99, 95% CI 3.39–10.58, DP: OR 6.81, 95% CI 2.52–18.43) was similarly associated with high persistent MLs trajectory. Conclusion Nearly two-thirds of the people retired due to disability belonged to high MLs trajectory. High persistent MLs trajectory was associated with physical inactivity in midlife among those retired on SP and on DP. Shift work with night shift predicted high persistent MLs in SP strata. Active involvement in LTPA during midlife could be beneficial to spend MLs free later life. [ABSTRACT FROM AUTHOR]

Objective childhood adversities have been linked with adverse health outcomes, but less is known about the long-term consequences of childhood home atmosphere. We investigated whether childhood adversities and home atmosphere were associated with physical and mental functioning in older age. Methods in the Helsinki Birth Cohort Study 2003, participants born in the year 1934–44 had data available on nine childhood home atmosphere items, e.g. whether it was supportive and warm (sum score ranged between 0 and 36, higher score indicating better atmosphere), and nine childhood adversities, e.g. unemployment and divorce (sum score 0–9, coded into no; one; and two or more adversities) assessed in 2001–04. Of those, 835 had data on physical and mental functioning assessed using the Short Form 36 questionnaire in 2011–13. Results those who had experienced two or more childhood adversities were more likely to have poorer physical and mental functioning in older age compared to those with no adversities. A better home atmosphere score was associated with better mental functioning (per one unit higher score β 0.24, 95% CI 0.16–0.32, P < 0.001). In models including both childhood adversities and home atmosphere, a more favourable home atmosphere was associated with better mental functioning while the association for childhood adversities attenuated. There were no associations between childhood adversities or home atmosphere and physical functioning in the models that included both childhood exposures. Conclusions childhood adversities and home atmosphere have long-term associations with physical and mental functioning in older age. [ABSTRACT FROM AUTHOR]

Objectives We investigated the 28-year development trajectories of work ability among initially middle-aged male and female municipal employees and the association of perceived mental and physical work strain in midlife by work ability trajectory groups. Methods The baseline data of the Finnish longitudinal study of municipal employees (FLAME) were collected in 1981 (N=6257) with follow-ups in 1985, 1992, 1997, and 2009. Work ability was assessed in all the waves as present perceived work ability relative to lifetime best. Altogether, N=2690 had work ability data in 1981 and 2009, and at least for one wave in between these years, and were included in group-based semi-parametric mixture modeling trajectory analyses. Baseline differences in mental and physical work strain according to the work ability trajectories were assessed with MANCOVA (multivariate analysis of covariance). Results A five-group work ability trajectory model was identified for men and a four-group model for women. For the majority, a linear decline from excellent to moderate or moderate to poor work ability was observed while non-linear trajectories with sudden collapse and, in some cases, modest subsequent recovery of work ability were also observed. Individuals who maintained their work ability on an excellent-to-moderate level throughout the follow-up more often reported low mental and physical work strain in midlife. Conclusions A substantial proportion of individuals seem to maintain their work ability on a moderate level from midlife to old age. Work strain may have far-reaching negative effects on individuals' work ability from midlife to old age, warranting vigilance in maintaining and promoting work ability throughout the lifespan. [ABSTRACT FROM AUTHOR]