Report

Teaser, summary, work performed and final results

Periodic Reporting for period 2 - AGNES (ACTIVE AGEING – RESILIENCE AND EXTERNAL SUPPORT AS MODIFIERS OF THE DISABLEMENT OUTCOME)

Teaser

A key question in aging societies concerns whether old age is lived with disability and limited opportunities to contribute to the society, or whether it is spent with opportunities for participation and involvement in meaningful life situations. Participation in valued...

Summary

A key question in aging societies concerns whether old age is lived with disability and limited opportunities to contribute to the society, or whether it is spent with opportunities for participation and involvement in meaningful life situations. Participation in valued activities in old age will promote wellbeing. Signaling this, World Health Organization defined the policy goal of active aging in 2002 as follows: “Active aging is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age”. The same document also states, “these policies and programs should be based on the rights, needs, preferences and capacities of older people”.

We realized that we need to distinct active aging policies and active aging of individuals. Policies are goal-oriented actions of authorities while active aging in individual lives is diverse and not necessarily in line with policy goals. Even though there has been a lot of attention on active aging, the empirical research and knowledge of active aging has progressed only little, because the term has been used to refer to many even contradicting policies. To this end, we developed the following definition of active aging that is centered on the individual: “The striving for elements of wellbeing through activities relating to a person’s goals, functional capacities and opportunities” [4]. We developed a scale to assess active aging of individuals that is entitled the University of Jyvaskyla Active Aging Scale (UJACAS). This scale includes the four central sides in the active aging of individuals: their goals (what they want to do), their functional capacity (what they are able to do), their autonomy (perceived opportunities to do the valued activities) and their activities (what they actually do). Active aging is not a static position with clear-cut boundaries but a striving for elements of wellbeing through activities relating to a person’s goals, functional capacities and opportunities.

Muscle strength, reaction speed or sensory functions are the building blocks of functioning and active aging in terms that they underlie mobility, activities of daily living and opportunities to take part in social life.
Aging increases the risk decline in the bodily and mental functions, which may decrease the ability for active aging. Resilience refers to the ability to recover from adverse effects. Earlier research has predominantly concentrated on social and psychological resilience and physiological indicators of resilience have been less studied even though with aging the risk of stressors increases and the capacity to recover from them diminishes. Potential biomarkers of resilience are heart rate and heart rate variability reflecting the function of the autonomic nervous system.

Active aging may be reached by compensating for the reduced abilities by environmental or social support. Addressing the person-environment interplay with objective technologies based on geographical maps and by recording physical activity and associated individual physiological responses such as heart rate under everyday living conditions and in standardized laboratory conditions with wearable sensors will provide expand knowledge on the person-environment interactions. Social engagement is a resource for active aging.

The goal was to develop a quantifiable assessment method centered on individuals that may be used to study predictors and consequences of active ageing. When that was accomplished we started to study health, health behaviors, health literacy and functional abilities as predictors of active aging and analyse whether active aging supports wellbeing in old age (even) when facing functional decline. The goal is also to examine how environmental support and social engagement influence active aging and wellbeing by researching person-environment interaction. My group will also validate validate biomarkers of physical resilience s

Work performed

The first work package concerned developing the active ageing scale in a multiphase process including literature review, expert panel work, pilot data collecting, feedback study and psychometric testing. The University of Jyväskylä active ageing scale was completed at month 12 and published a bit later. Parallel to scale development we initiated the process on planning the individualized counselling intervention. The intervention planning was completed in schedule after 12 months. The next phase was planning and setting up the cohort and intervention study protocol and recruitment of participants. We then recruited research assistants and trained them to conduct the assessment. We also trained the interventionist.
The cohort study consists of a phone interview, a self-report questionaire, face-to-dace interview at participants\' homes, monitoring of free living physical activity and heart rate for one week, and laboratory assesments of health, physical functioning and cognition. Collecting cohort data took 1.5 years (excluding summer months). The participants were recruited from the population register data by contacting everybody in the sample personally and enquiring about their interest to take part and by assessing their suitability for the study (living in the target area, consent, able to communicate in a meaningful way). Participants were visited at their home by a trained interviewer and one week later arrived to the research laboratory for assessments. The assessments were completed in month 28. We are currently preparing data for complete analytical files. During the data collection pahse we have published protocol reports of the active ageing cohort study and the randomized controlled study designed to test the effectiveness of the active ageing counselling intervention. The randomized controlled trial will be completed in month 37. While data collection has been uderway we have published further 12 scientific articles presenting pilot analyses.

During months 31-60 more efforts will be directed the analyses and reporting of data. We produce new knowledge on predictors and consequences of active ageing and report on the effectivenes of the active ageing counselling intervention.

Final results

The AGNES project propelled forward the conceptual basis of active ageing studies. We have created a novel assessment method of active ageing that is quatifiable and may be used when studying older individuals. We have created a database on predictors and consequences of active ageing that is profoundly interdisciplinary will lead emergence of novel findings. New groundbreaking results will be produced on the effectiveness of active ageing promotion.

Website & more info

More info: https://www.gerec.fi/en/research/activeageing/active-ageing-agnes-study/.