Papers by Milla Saajanaho
Developmental Perspectives on Transitions at Age 60: Individuals Navigating Across the Lifespan (TRAILS) – latest data collection in a longitudinal JYLS study
Longitudinal and life course studies, Apr 1, 2024
Older Adults' Physical Activity and the Relevance of Distances to Neighborhood Destinations and Barriers to Outdoor Mobility
Frontiers in Public Health
The role of personality traits in leisure time physical activity during COVID-19 pandemic
Personality and Individual Differences
Journal of Aging and Health
Objectives: The aim of this study was to report preplanned secondary analyses of the effects of a... more Objectives: The aim of this study was to report preplanned secondary analyses of the effects of a 12-month individualized active aging counseling intervention on six mobility and physical activity outcomes. Methods: A two-arm, single-blinded randomized controlled trial was conducted among 75- and 80-year-old community-dwelling people. The intervention group (IG, n = 101) received counseling aimed at increasing self-selected, primarily out-of-home activity. The control group (CG, n = 103) received general health information. Data were analyzed with generalized estimating equations. Results: Physical performance improved in the IG more than that in the CG (group by time p = .022), self-reported physical activity increased in both groups (time p = .012), and autonomy in outdoor mobility declined in the IG and was enhanced in the CG (group by time p = .011). No change was observed for life-space mobility, proportion of persons perceiving difficulty walking 2 km, or monitored physical ac...
The Associations of Activity Fragmentation With Physical and Mental Fatigability Among Community-Dwelling 75-, 80-, and 85-Year-Old People
The Journals of Gerontology: Series A
Background Fatigue related to task standardized by duration and intensity, termed fatigability, c... more Background Fatigue related to task standardized by duration and intensity, termed fatigability, could manifest as shortening of activity bouts throughout the day causing daily activity to accumulate in a more fragmented pattern. Our purpose was to study the association of activity fragmentation with physical and mental dimensions of fatigability. Methods A cross-sectional study of 485 community-dwelling 75-, 80-, and 85-year-old people using a thigh-worn accelerometer for 3–7 days. Activity fragmentation was studied as Active-to-Sedentary Transition Probability for 2 operational definitions of physical activity: accelerations equivalent to at least light physical activity and for upright posture. Physical fatigability was assessed as perceived exertion fatigability, performance fatigability severity, and with the Physical Fatigue Subscale of the Situational Fatigue Scale. Mental fatigability was assessed with the Mental Fatigue Subscale of the Situational Fatigue Scale and as a decr...
European Journal of Ageing
Social distancing during the COVID-19 pandemic decreased older people’s opportunities to lead an ... more 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 dif...
European Journal of Ageing
Active aging refers to striving for well-being through preferred activity and may be restricted w... more Active aging refers to striving for well-being through preferred activity and may be restricted with declining mobility. We investigated whether psychological resilience, i.e., the ability to tolerate hardship, can aid older people in being active despite mobility limitations. Participants were 961 community-dwelling persons aged 75, 80, or 85 years living in Jyväskylä, Central Finland. Mobility limitations were indicated as self-reported difficulty in walking 2 km. Categories were no difficulty (reference), difficulty, and unable to walk. Resilience was assessed with the 10-item Connor–Davidson Resilience Scale and active aging with the University of Jyvaskyla Active Aging scale. Data were analyzed with OLS regression analyses, which were stratified by age. In all age-groups, having difficulties walking or being unable to walk 2 km was associated with lower active aging scores. Resilience moderated this association especially among the 75-year-olds, but not among the 85-year-olds: ...
Informaatiotutkimus
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Aging Clinical and Experimental Research
Background Although depressive symptoms are more common among older than younger age groups, life... more 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 lonelines...
Aging Clinical and Experimental Research
Background We define active aging as a striving for activities as per one’s goals, capacities and... more Background We define active aging as a striving for activities as per one’s goals, capacities and opportunities. Aim To test the 1-year counselling intervention effects on active aging. Methods In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active aging total score measured with the University of Jyväskylä Active Aging Scale (UJACAS, range 0–272, higher values indicate more activity) and secondary outcomes were its subscores for goals, ability, opportunity and activity (range 0–68) and a quality of life (QoL) score. Measures took place at pre-trial, mi...
The Scales of Psychological Well-Being – a validation, usability and test–retest study among community-dwelling older people in Finland
Aging & Mental Health
BMC Public Health
Background The current study aims to compare correlations between a range of measures of physical... more Background The current study aims to compare correlations between a range of measures of physical performance and physical activity assessing the same underlying construct in different settings, that is, in a home versus a highly standardized setting of the research center or accelerometer recording. We also evaluated the selective attrition of participants related to these different settings and how selective attrition affects the associations between variables and indicators of health, functioning and overall activity. Methods Cross-sectional analyses comprising population-based samples of people aged 75, 80, and 85 years living independently in Jyväskylä, Finland. The AGNES study protocol involved the following phases: 1) phone interview (n = 1886), 2) face-to-face at-home interview (n = 1018), 3) assessments in the research center (n = 910), and 4) accelerometry (n = 496). Phase 2 and 3 included walking and handgrip strength tests, and phase 4 a chest-worn and thigh-worn acceler...
Assimilative and Accommodative Coping and Older People’s Leisure Activities
Journal of Aging and Health
Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation... more Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation to leisure activities in old age. We investigated whether tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) influence the association between physical performance and participation in leisure activities. Methods: A cross-sectional analysis was conducted among 187 community-dwelling people aged 79 to 93 years. TGP, FGA, and leisure activity participation were asked with questionnaires. Physical performance was assessed with the Short Physical Performance Battery (SPPB). Results: TGP moderated the relationship between physical performance and leisure activity participation. Despite low physical performance, people with high TGP had close to mean level of leisure activity participation, whereas low TGP was associated with very little activity. Most notably, people without high TGP had fewer outdoor activities and group activities outside home. Similar effects were not found f...
Aging Clinical and Experimental Research
Aims This study examined the feasibility of the HLS-EU-Q16 (in Finnish) for use among older Finns... more Aims This study examined the feasibility of the HLS-EU-Q16 (in Finnish) for use among older Finns and whether the health literacy score correlates with indicators of health and functioning. Methods To determine the feasibility of the instrument, we first conducted a focus group discussion with nine participants. For the quantitative analyses, we used data from the AGNES cohort study, collected between October 2017 and April 2018 at the University of Jyväskylä in Finland. 292 75-year-old Finnish men and women were interviewed face-to-face in their homes. Health literacy was measured with the HLS-EU-Q16 and health literacy score, ranging from 0 to 50, computed. The reproducibility of the instrument was test-retested. Chi-square tests were used to compare health literacy scores between participants by different socioeconomic variables, and Spearman correlation coefficients were calculated to study the associations of health literacy with cognition, depressive symptoms, chronic conditions, life-space mobility and physical performance. Results The mean health literacy score for all participants was 35.05 (SD 6.32). Participants who rated their financial situation and self-rated health as very good had the highest health literacy scores (38.85, SD 5.09 and 39.22, SD 6.77, respectively). Better health literacy was associated with better cognitive status, fewer depressive symptoms and chronic conditions, higher life-space mobility and better physical performance. Conclusions The HLS-EU-Q16 is a feasible measure for research purposes among older Finns. The associations between health literacy and indicators of health and functioning need to be more closely investigated in larger samples with a wider age-range.
BMC Geriatrics
Background: Active aging has been established as a policy goal for aging societies. We define act... more Background: Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person's goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different aspects of well-being in older people. The aim of the present randomized controlled trial is to test the feasibility and effectiveness of a one-year community-based intervention on active aging. The AGNES intervention aims at increasing older peoples' participation in self-selected valued activities. Methods: The proposed study is a two-arm single-blinded randomized controlled trial. The intervention group receives individually tailored counselling for an active life (one face-to-face session, four phone calls and supportive written material) and the control group written general health information only. Two hundred older adults aged 75and 80-year old, with intermediate mobility function and without cognitive impairment, living independently in the municipality of Jyväskylä, Finland, are recruited and randomized with a 1:1 allocation to the intervention and control group. Randomization is computer-generated stratified by sex and age. The primary outcome is active aging and secondary outcomes are well-being, depressive symptoms, quality of life, personal goals, mobility and physical activity. Measures are administered at pre-trial, mid-trial (at 6 months) and post-trial (12 months after baseline). Discussion: The AGNES intervention study will provide new knowledge on the effects of individualized counselling on active aging and the potential of older people to promote their own well-being. Trial registration: The trial is registered at ISRCTN-ISRCTN16172390: Promoting well-being through active aging.
Aging Clinical and Experimental Research
Background As people age, functional losses may limit the potential to get outside the home and p... more Background As people age, functional losses may limit the potential to get outside the home and participate in desired activities and community life. Coping with age-related losses has been reported to be important for psychological well-being. Hitherto is not known whether active use of coping strategies also helps maintain out-of-home mobility. Aims We investigated how two coping strategies, tenacious goal pursuit (TGP; persistency in reaching one's goals) and flexible goal adjustment (FGA; adjusting one's goals to changed circumstances), are associated with life-space mobility and perceived autonomy in participation outdoors among community-dwelling older people. Methods Participants (n = 186) were aged 79-93 years. TGP and FGA were self-reported using separate scales. Perceived autonomy in participation was assessed with the Impact on Participation and Autonomy Outdoors-subscale, and life-space mobility with the Life-Space Assessment. Two-step cluster analysis was used to create data-driven coping profiles of TGP and FGA. Results General linear model analyses showed that the profile including highly tenacious and flexible older people had the highest life-space mobility and perceived autonomy outdoors, whereas the profile including people with low TGP and low FGA showed the lowest scores. Depressive symptoms attenuated the associations. Conclusions Active use of both TGP and FGA is favorable for out-of-home mobility and enables more active participation in society in later life.
Journal of aging and health, 2018
To develop an assessment method of active aging for research on older people. A multiphase proces... more To develop an assessment method of active aging for research on older people. A multiphase process that included drafting by an expert panel, a pilot study for item analysis and scale validity, a feedback study with focus groups and questionnaire respondents, and a test-retest study. Altogether 235 people aged 60 to 94 years provided responses and/or feedback. We developed a 17-item University of Jyvaskyla Active Aging Scale with four aspects in each item (goals, ability, opportunity, and activity; range 0-272). The psychometric and item properties are good and the scale assesses a unidimensional latent construct of active aging. Our scale assesses older people's striving for well-being through activities pertaining to their goals, abilities, and opportunities. The University of Jyvaskyla Active Aging Scale provides a quantifiable measure of active aging that may be used in postal questionnaires or interviews in research and practice.
BMC public health, Jan 2, 2018
Population aging increases the need for knowledge on positive aspects of aging, and contributions... more Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual's striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of health, health behaviors, health literacy and functional abilities, environmental and social support with active aging and wellbeing. We will develop and validate assessment methods for physical activity and physical resilience suitable for research on older people, and examine their associations with active aging and wellbeing. We will examine cohort effects on functional phenotypes underlying active aging and disability. For this population-based study, we plan to recruit 1000 participants aged 75, 80 or 85 years living in central Finland, by drawing personal details from the population register. Participants are interviewed on active aging, wellb...
The journals of gerontology. Series A, Biological sciences and medical sciences, Jan 8, 2018
We studied the combined effects of cognitive performance and lower extremity function on self-rep... more We studied the combined effects of cognitive performance and lower extremity function on self-reported walking modifications and walking difficulty, and on self-reported walking difficulty incidence over a two-year follow-up. A total of 848 community-dwelling older people aged 75-90 years participated at baseline, 816 at the one-year follow-up, and 761 at the two-year follow-up. Baseline lower extremity function was measured with the Short Physical Performance Battery (<10 vs. ≥10) and cognitive performance with the Mini Mental State Examination (<24 vs. ≥24). Difficulty in walking 2km was self-reported and categorized into no difficulties, no difficulties but walking modifications, and prevalent difficulties. Data were analyzed with multinomial and Cox regressions and a mediation analysis. At baseline, 33% reported no walking difficulties, 25% walking modifications and 42% walking difficulty. Poorer lower extremity function and lower cognition increased the odds for walking d...
Psychiatry and Clinical Neurosciences, 2010
Connor-Davidson Resilience Scale (CD-RISC) has been demonstrated to be a valid and reliable tool ... more Connor-Davidson Resilience Scale (CD-RISC) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 10-item CD-RISC in a sample of Chinese earthquake victims. Methods: A total of 341 participants (185 women, 156 men) aged 20-63 years were recruited from a psychological relief program supported by the Institute of Psychology, Chinese Academy of Sciences following the 'Wenchuan' earthquake. The participants were given the 10-item CD-RISC and the 17-item post-traumatic stress disorder (PTSD) subscale of the Los Angeles Symptom Checklist (LASC) 4 months after the earthquake. Results: The results of exploratory factor analysis indicated that a single-factor model consistent with the original design of the 10-item CD-RISC was support. The scale was also demonstrated to have good internal consistency (Cronbach's alpha = 0.91) and test-retest reliability (r = 0.90 for a two-week interval). Scores on the scale could reflect different levels of resilience in populations that are thought to be differentiated (probable PTSD vs healthy controls, t(339) =-7.60, P < 0.01, Cohen's d = 0.84). Moreover, the total resilience scores were significantly negatively correlated with scores on total PTSD scale and its three subscales for all participants. Conclusion: The Chinese version of the 10-item CD-RISC has excellent psychometric properties, and is applicable for Chinese people.
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Papers by Milla Saajanaho