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Biomedical subjects

H Luukinen

Publications and source records attributed to H Luukinen.

32 records · Page 2Linked to original sources
PubMed1997

Factors predicting fractures during falling impacts among home-dwelling older adults.

OBJECTIVE: To investigate the predictors of fractures during falling impacts among home-dwelling older adults. DESIGN: A case-control study within a prospective, population-based survey. SETTING: Five rural municipalities in northern Finland. PARTICIPANTS: The study population consisted of all home-dwelling persons aged 70 or older living in these five municipalities (n = 790 (85%)). The cases for this study were those with fracture, using the first fracture (n = 82) in the analyses, during a follow-up period of 4 years. Controls (n = 82) were selected from among the persons who suffered soft tissue injuries; matching was by age, sex, and location of the first injury during the period. MEASUREMENTS: During a 4-year follow-up period, all falls in the population were recorded using fall diaries, telephone interviews, and information from medical records. Risk factors for fractures during the 4-year follow-up were determined according to the number and severity of previous falls, circumstances and place of falls, disease history, use of medicines, symptoms, clinical examinations and tests, nutritional status, functional abilities and social and health behavior. Cross-tabulations for categorial variables, paired t tests for the means of continuous variables, and conditional logistic regression analysis were performed. RESULTS: According to the bivariate analyses, the risk factors for falls resulting in a fracture were frequent fear of falling, abnormal heel-shin test, reduced knee extension strength, reduced grip strength, poor distance visual acuity, low supine pulse rate, inability to carry a 5-kg load 100 meters, not doing heavy outdoor work, and no habitual exercise. A limited amount of social participation was associated negatively with fracturing. Conditional logistic regression analysis showed that the risk factors for fracture-causing falls were frequent fear of falling (OR 2.50; CI 1.11-5.65), reduced knee extension strength (OR 3.38; CI 1.00-11.4), and poor distance visual acuity (OR 3.45; CI 1.13-10.6), whereas limited social participation (OR 0.29; CI 0.11-0.79) protected against the occurrence of fractures. CONCLUSION: Impaired perception, muscle strength, and psychological and social functioning may influence fracture risk during injurious fall impacts. Studies with larger sample sizes are needed to confirm this and to examine the circumstances and mechanisms contributing to the fracture risk during falls via these risk factors.

Accidental Falls↗
PubMed1996

Social status, life changes, housing conditions, health, functional abilities and life-style as risk factors for recurrent falls among the home-dwelling elderly.

OBJECTIVE: To define the risk factors for recurrent falls in the home-dwelling elderly. DESIGN: A prospective population-based study covering two years. SETTING: Five rural municipalities around the city Oulu, northern Finland. PARTICIPANTS: All home-dwelling elderly persons (N = 1,016) aged 70 years or older living in the municipalities. OUTCOME MEASURES: The risk factors of recurrent falling by variables related to social status, life changes, housing conditions, health, functional abilities and life style, using cross-tabulations and multivariate analyses. RESULTS: The recurrent fallers (at least two falls within 365 days after the examination day) consisted of 17 men (6% of the men) and 71 women (14%). Logistic regression analyses showed female sex, urinary urgency, frequent fear of falling, dizziness, a poor pulse rate rise 30 seconds after standing up and falling during the previous year to be risk factors for recurrent falls. After the variable representing previous falls had been removed from the analysis, urinary incontinence and a change in housing conditions during the past two years emerged and urinary urgency dropped out of the model. CONCLUSIONS: Women particularly are a target group for the prevention of falls among the elderly. Urinary urgency and urinary incontinence, fear of falling, dizziness and changes in the housing conditions should be inquired about to identify the elderly at risk for falling and to take preventive interventions. In addition to testing blood pressure changes after standing up, the changes in pulse rate should be determined to identify and treat elderly people who have orthostatic conditions.

Accidental Falls↗
PubMed1996

Risk factors of age-related maculopathy in a population 70 years of age or older.

PURPOSE: To evaluate possible risk factors for age-related maculopathy (ARM) in an epidemiologic cross-sectional population study of inhabitants 70 years of age or older in a rural area in Oulu County, Northern Finland. METHODS: Five hundred of the 560 (89 percent) eligible subjects were examined. The diagnosis of ARM was based on fundus photographs in 83 percent of the population or on ophthalmoscopic findings in 13 percent; in 4 percent, the fundi could not be seen. Both early and late forms of ARM were included. RESULTS: The prevalence of ARM increased steadily with age without overall significant difference between men and women. The condition was, however, related to high body mass index in men. The ARM appeared to be also associated with the presence of cataract, broad peripapillary atrophy, and severe sclerosis of the retinal arteries, but after controlling for age, these associations were nonsignificant. No association was found between ARM and systemic hypertension, diabetes, smoking, working outside, myopia, glaucoma, or the presence of exfoliation. In logistic regression analysis, age was the only statistically significant risk factor for ARM in both sexes. In men, a high body mass index also was found to be a predictor for ARM. CONCLUSIONS: The presence of ARM was associated with cataract and signs of age-related vascular changes in the eyes. Of the general factors, age in both sexes and high body mass index in men were found to be the only predictors of ARM.

Aged↗
PubMed1996

Physiological factors and medications as predictors of injurious falls by elderly people: a prospective population-based study.

To determine the physiological factors and medications predicting injurious falls among the elderly population, the authors conducted a prospective study in a rural home-dwelling population aged 70 years or over, initially 979 persons (377 men and 602 women), from 1 January 1991 to 31 December 1992, in Northern Finland. The independent risk factors for all falling injuries, falls leading to minor injuries and ones leading to major injuries were determined. In men, the independent risk factors for all injuries were gait disturbances [odds ratio (OR) = 3.5] and the use of digitalis (OR = 2.2), those for minor injuries were gait disturbances (OR = 2.7) and the use of calcium blockers (OR = 3.0), and those for major injuries were the absence of a quadriceps reflex (OR = 4.8), gait disturbances (OR = 2.8) and the use of digitalis (OR = 2.9). In women, the corresponding independent risk factors were short step length (OR = 32.1), the use of calcium blockers (OR = 2.5) and the use of medications for improving peripheral circulation (OR = 3.7) for all injurious falls, path deviation (OR = 2.3) the use of calcium blockers (OR = 2.8) and the use of anti-inflammatory drugs (OR = 2.1) for minor injuries, and foot deformity (OR = 2.0), short step length (OR = 15.8), the use of long-acting benzodiazepines (OR = 4.0) and the use of calcium blockers (OR = 2.4) for major injuries. In order to prevent injurious falls, attention should be given to the prescription of tranquillizers, cardiovascular medications and anti-inflammatory drugs. The walking abilities of elderly people should be maintained and chronic diseases leading to peripheral neuropathy should be treated adequately.

Accidental Falls↗
PubMed1995

Risk factors for recurrent falls in the elderly in long-term institutional care.

All the persons aged 70 years or older and living in long-term institutional care in five rural northern Finnish municipalities (N = 145) were followed up for two years, and all their fall incidents were recorded through diary reporting by the nursing staff and by examining the medical records in hospitals, health centres and nursing homes. The study population was examined halfway through the follow-up period by two nurses, a physiotherapist and a physician. Of the 93 ambulatory subjects, 57% of the men and 56% of the women experienced at least two falls in six months (recurrent falls): 10% of the recurrent falls resulted in a major soft tissue injury and 5% in a fracture. Logistic regression analyses showed the independent risk factors for recurrent falls to be slow walking speed, a change in living conditions during the previous two years, reduced quadriceps strength and existence of an ophthalmic disease. Many of the risk factors are potentially remediable, and they should be minimized by optimizing the care and by improving or maintaining the functional abilities of the elderly.

Accidental Falls↗
PubMed1995

Prevalence and risk factors of lens opacities in the elderly in Finland. A population-based study.

PURPOSE: The distribution and prevalence of lens opacities and visual impairment caused by cataract were studied in an epidemiologic cross-sectional population study of inhabitants 70 years of age or older in three communities in Oulu County, Finland. METHODS: Of the 560 eligible subjects, 500 (89.3%) were examined. The best-corrected visual acuity for distance in both eyes was determined. The diagnosis of lens opacities was based on clinical biomicroscopy. The findings were compared with standardized photographs of the Lens Opacities Classification System II. RESULTS: One hundred sixty-five (33.0%) persons in the study population had a clear lens in both eyes. Cataract, aphakia, or pseudophakia was recorded in one or both of the eyes in 64.4% (322 persons) of the participants. The prevalence increased with age from 44.6% of persons (n = 88) in the 70- to 74-year-old age group to 97.6% of persons (n = 41) in the 85- to 89-year-old age group. A total of 56.4% of persons had cataract, aphakia, or pseudophakia in both eyes. Nuclear, cortical, and posterior subcapsular opacities were detected in 38.5%, 37.6%, and 27.7% of the participants, respectively. Exfoliation was present in one or both eyes in 22.1% of the participants. There was no difference in the prevalence of cataract between the sexes when age was considered. Visual impairment to 20/50 or worse was at least partly due to cataract in 23.8% of the right eyes and 22.4% of the left eyes. Significant risk factors for cataract were age and the presence of exfoliation in men and age, occupational exposure to sunlight, and current cigarette smoking in women. CONCLUSIONS: Almost two thirds of the population 70 years of age or older had lens opacities, and in 23.1% of the eyes visual impairment to 20/50 or worse was at least partly due to cataract. Including the patients who had undergone surgery, 30.3% of all the eyes of persons 70 years of age or older can be considered for cataract surgery.

Aged↗
PubMed1995

Incidence of injury-causing falls among older adults by place of residence: a population-based study.

OBJECTIVE: To describe the incidence and associated factors of injury-causing falls by place of residence. DESIGN: A prospective population-based study. SETTING: Five municipalities in northern Finland. PARTICIPANTS: All persons in the five communities aged 70 years or older living at home (n = 1016) and in long-term institutionalized care (n = 143). MEASUREMENTS: We recorded all fall incidents during a 2-year period by occurrence and severity of injury, using diary reporting and regular calls and by examining the medical and nursing records of all participants. The times, places, circumstances, and medical treatment needed were recorded as well. RESULTS: Men living at home experienced 71 minor injuries/1000 person years (PY), 42 major soft tissue injuries/1000PY, and 12 fractures/1000PY; women at home experienced 175 minor injuries/1000PY, 65 major soft tissue injuries/1000PY, and 33 fractures/1000PY. Institutionalized older men had 272 minor injuries/1000PY, 122 major soft tissue injuries/1000PY, and 41 fractures/1000PY; institutionalized women had 292 minor injuries/1000PY, 131 major soft tissue injuries/1000PY, and 58 fractures/1000PY. Falls causing injury to older adults in long-term institutionalized care were more evenly distributed by time of day than those that occurred at home. The majority of the injuries sustained in long-term institutionalized care were injuries to the head. The incidence rate of fall injuries requiring medical attention in women, 113/1000PY, was twice that in men, 57/1000PY. CONCLUSIONS: Injury-causing falls are more frequent in older people living in long-term institutionalized care, and the time-distribution and some circumstances differ from those of injury-causing falls in home-dwelling older people.

Accidental Falls↗
PubMed1995

Predictors for recurrent falls among the home-dwelling elderly.

OBJECTIVE: Scant attention has been paid to the risk factors for recurrent falls among the home-dwelling elderly, although there are remarkable age and sex differences according to whether or not the falls recur. In this report we describe and analyse the risk factors for recurrent falls by selected clinical variables and the history of falling during the previous year. DESIGN: A community-based prospective study covering two years. SETTING: All home-dwelling persons (N = 1016) aged 70 years or older living in five municipalities in northern Finland. OUTCOME MEASURES: The risk factors of recurrent falling by selected clinical variables using cross-tabulations and multivariate analyses. RESULTS: Previous falls, peripheral neuropathy, use of psychotropic medication and slow walking speed were independent risk factors for recurrent falling. The risk of recurrent falling increased with an increasing number of previous falls. CONCLUSIONS: Early preventive measures should be taken among the elderly persons who are prone to falling. In order to reduce the risk of recurrent falls among the elderly, the attending physician should take a critical view of the use of psychotropic medications, and attempts should be made to treat conditions underlying peripheral neuropathies and abnormal gait.

Accidental Falls↗
PubMed1994

Incidence rate of falls in an aged population in northern Finland.

The total elderly population aged 70 years or over living in five rural districts in northern Finland, 1159 persons in all, were monitored by 'phone prospectively for 1 year, all falls being recorded separately for those living at home and in institutions. Of those living at home, 30% fell at least once during the year, 19% just once, this proportion not depending on age or sex. The home-dwelling men and women experienced 368/1000 PY and 611/1000 PY falls, respectively, the incidences tending to increase with advancing age. The men in institutions experienced 2021 falls/1000 PY and the women 1423/1000 PY, without clear age dependence. The home-dwelling women had a greater risk of falling repeatedly than the men, but the sex differences disappeared with advancing age. The falls among home-dwellers were concentrated in the day-time, whereas no variation with time of day was found in the institutions. Falls are common in the elderly, but their incidence and certain characteristics differ considerably between the home-dwellers and those living in institutions.

Accidental Falls↗
PubMed1994

Prevalence of diabetes mellitus in an elderly Finnish population.

The prevalence of diabetes mellitus was investigated in a northern Finnish community population aged 70 years or over. Of the eligible 483 persons, 78.5% (n = 379) took part in the study. The presence of diabetes mellitus was assessed by questions about the participants' previously diagnosed diabetes and 2 h oral glucose tolerance tests, which were performed according to the current WHO criteria. Only the participants who were on oral hypoglycaemic drugs or insulin treatment were excluded from the 2 h oral glucose tolerance tests. In the total population the prevalence of Type 2 diabetes was 22.0% among men and 28.2% among women; the difference between sexes was not significant (women's risk ratio (RR) 1.3, 95% confidence interval (CI) 0.9-1.9). Among those aged 80 years or over the risk ratio for women was 11.3 compared with men (95% CI 1.6-79.5). Among men the prevalence was higher in the age group 70-79 years compared with those aged 80 years or over (RR 8.1, 95% CI 1.2-57.1). By contrast, among women, diabetes was less common among those aged 70-79 years compared with those aged 80 years or over (RR 0.6, 95% CI 0.4-1.0). The proportion of undiagnosed diabetes was clearly over one-third among men and just over one-third among women. Of men, 31.9% suffered from impaired glucose tolerance; the corresponding figure for women was 35.3%. The comparatively high proportion of undiagnosed diabetes and impaired glucose tolerance among elderly people lends support to the more frequent use of the 2 h glucose tolerance test in clinical practice.

Age Factors↗