The aim of this study was to evaluate the long-term reproducibility and validity of 24-h ambulato... more The aim of this study was to evaluate the long-term reproducibility and validity of 24-h ambulatory blood pressure measurements (ABPM) in an unselected elderly population. In a rural Finnish community 503 randomly chosen invited persons over 65 years of age participated and went through 24-h ABPM. As part of the validation of the methodology, the reproducibility study was conducted in 26 persons (age 65-76 years). Two identical sets of measurement were performed at 4-12 (median 8) month intervals. The agreement between measurements was assessed by correlation coefficients and standard deviation (SD) of the differences. There were no significant differences in 24-h, daytime and night-time average diastolic blood pressure (DBP) and daytime average systolic blood pressure (SBP) between the two measurements. During the second measurement, 24-h SBP and night-time average SBP were slightly higher than those obtained by the first monitoring. Average 24-h SBP and DBP were 18 and 7 mmHg lower, respectively, than office blood pressure averages. The correlation coefficients were significantly higher for 24-h ambulatory blood pressure than for office blood pressure. The SD of the mean difference between visits was significantly lower for 24-h ambulatory blood pressure than for office blood pressure measurements. These findings show that the long-term reproducibility of ambulatory blood pressure is good in an elderly unselected population and better than the office blood pressure reproducibility.
ABSTRACT A prospective follow-up of depressed elderly patients is described. The subjects, 91 men... more ABSTRACT A prospective follow-up of depressed elderly patients is described. The subjects, 91 men and 173 women aged 60 years or over, were diagnosed as depressed in an epidemiological study using the DSM-III criteria. One hundred ninety-nine patients suffered from dysthymic disorder. The mean duration of the follow-up was 14.9 +/- 4.3 months. Outcome was not associated with sex and was good in 41% of the cases. In men, poor outcome was associated with low social participation, low frequency of visiting contacts, and poor insight into the depressive disorder. In women, poor outcome was associated with multiple depressive symptoms, depression diagnosed previous to this study, not living alone, low social participation, low self-perceived health, diurnal variation of symptoms, and the occurrence of initial insomnia, loss of libido, and hypochondriacal and compulsive symptoms. Many similarities were found in factors associated with outcome between all depressed patients and the patients whose depression was diagnosed during our epidemiological study.
The study describes the prevalence of urinary incontinence and factors associated with incontinen... more The study describes the prevalence of urinary incontinence and factors associated with incontinence among the population of Tampere aged 84/85 years (n = 320). 18% of the males were occasionally incontinent and 21% were daily incontinent. The corresponding figures for females were 20 and 21% respectively. Incontinence was not associated with sex, living alone, parity, or outdoor toilet facilities. On the other hand, incontinence was found to be related to use of home nursing, home help or day hospital services, living in institutions, limitations in mobility, and the use of diuretics.
The relationships between physical and Social functioning and depression in old age are described... more The relationships between physical and Social functioning and depression in old age are described. Findings from a longitudinal study carried out in 1984 on a population aged 60 years or over in the town of Ähtäri in Finland give evidence that disturbed physical and Social functioning can predispose individuals to depression. Having poor emotional relations with one's wife predicted depression within five years among the initially non‐depressed men, and not living alone among the women. From a preventive viewpoint, the independence of the elderly and Social roles that support self‐esteem in old age should be stressed. Marital counselling should be developed for the elderly.
To describe functional ability of elderly persons with diabetes (DM) or impaired glucose toleranc... more To describe functional ability of elderly persons with diabetes (DM) or impaired glucose tolerance (IGT) and to describe associations between functional ability and glucose tolerance. A survey among an unselected non-institutionalized elderly population. Diabetes was assessed on the basis of self-reports and 2-h oral glucose tolerance tests. Functional ability was assessed in interviews by four items on mobility, five items on activities of daily living, and four items on instrumental activities of daily living. Three municipalities in northern Finland. All non-institutionalized persons aged 70 years or over (n = 483; 180 men). The participation rate was 79%. Mobility, activities of daily living, and instrumental activities of daily living. The functional ability of the diabetic persons was poorer than that of the non-diabetic persons. The subjects with IGT also graded their functional ability as somewhat poorer than the non-diabetic subjects. When adjusted for age, gender, history of cardiovascular disease or stroke, these associations became weaker. Impaired functional ability is associated not only with diabetes but also with IGT in the elderly, but, in addition to age, cardio- and/or cerebrovascular disease is the best predictor of decreased functional ability in the elderly.
This paper discusses the findings in the 1012 55-year-old inhabitants of Oulu (a medium-sized Fin... more This paper discusses the findings in the 1012 55-year-old inhabitants of Oulu (a medium-sized Finnish town), 780 of whom (77%) were examined. The purpose was to determine the possible associations between depressive symptoms and subjective and clinical symptoms of the temporomandibular joint pain and dysfunction syndrome (PDS). The PDS symptoms were determined using Helkimo's Clinical Dysfunction Index. Depressive symptoms in 768 subjects were determined using Zung's self-rating depression scale. The prevalences of high rates of depressive symptoms, subjective symptoms of PDS, and clinical symptoms of PDS in the population were 12.2%, 12.0%, and 4.9%, respectively. Subjective symptoms of PDS were more common in depressed dentate men and women than in nondepressed dentate men and women. There was a significantly higher prevalence of subjective symptoms of PDS in depressed edentulous women than in nondepressed edentulous women. There were significantly more moderate or severe clinical symptoms of PDS in depressed dentate women than in nondepressed dentate women. A similar trend was seen in dentate men. An integrated approach is of crucial importance in the diagnosis and treatment of depression and the temporomandibular joint pain and dysfunction syndrome.
The aim of this study was to evaluate the long-term reproducibility and validity of 24-h ambulato... more The aim of this study was to evaluate the long-term reproducibility and validity of 24-h ambulatory blood pressure measurements (ABPM) in an unselected elderly population. In a rural Finnish community 503 randomly chosen invited persons over 65 years of age participated and went through 24-h ABPM. As part of the validation of the methodology, the reproducibility study was conducted in 26 persons (age 65-76 years). Two identical sets of measurement were performed at 4-12 (median 8) month intervals. The agreement between measurements was assessed by correlation coefficients and standard deviation (SD) of the differences. There were no significant differences in 24-h, daytime and night-time average diastolic blood pressure (DBP) and daytime average systolic blood pressure (SBP) between the two measurements. During the second measurement, 24-h SBP and night-time average SBP were slightly higher than those obtained by the first monitoring. Average 24-h SBP and DBP were 18 and 7 mmHg lower, respectively, than office blood pressure averages. The correlation coefficients were significantly higher for 24-h ambulatory blood pressure than for office blood pressure. The SD of the mean difference between visits was significantly lower for 24-h ambulatory blood pressure than for office blood pressure measurements. These findings show that the long-term reproducibility of ambulatory blood pressure is good in an elderly unselected population and better than the office blood pressure reproducibility.
ABSTRACT A prospective follow-up of depressed elderly patients is described. The subjects, 91 men... more ABSTRACT A prospective follow-up of depressed elderly patients is described. The subjects, 91 men and 173 women aged 60 years or over, were diagnosed as depressed in an epidemiological study using the DSM-III criteria. One hundred ninety-nine patients suffered from dysthymic disorder. The mean duration of the follow-up was 14.9 +/- 4.3 months. Outcome was not associated with sex and was good in 41% of the cases. In men, poor outcome was associated with low social participation, low frequency of visiting contacts, and poor insight into the depressive disorder. In women, poor outcome was associated with multiple depressive symptoms, depression diagnosed previous to this study, not living alone, low social participation, low self-perceived health, diurnal variation of symptoms, and the occurrence of initial insomnia, loss of libido, and hypochondriacal and compulsive symptoms. Many similarities were found in factors associated with outcome between all depressed patients and the patients whose depression was diagnosed during our epidemiological study.
The study describes the prevalence of urinary incontinence and factors associated with incontinen... more The study describes the prevalence of urinary incontinence and factors associated with incontinence among the population of Tampere aged 84/85 years (n = 320). 18% of the males were occasionally incontinent and 21% were daily incontinent. The corresponding figures for females were 20 and 21% respectively. Incontinence was not associated with sex, living alone, parity, or outdoor toilet facilities. On the other hand, incontinence was found to be related to use of home nursing, home help or day hospital services, living in institutions, limitations in mobility, and the use of diuretics.
The relationships between physical and Social functioning and depression in old age are described... more The relationships between physical and Social functioning and depression in old age are described. Findings from a longitudinal study carried out in 1984 on a population aged 60 years or over in the town of Ähtäri in Finland give evidence that disturbed physical and Social functioning can predispose individuals to depression. Having poor emotional relations with one's wife predicted depression within five years among the initially non‐depressed men, and not living alone among the women. From a preventive viewpoint, the independence of the elderly and Social roles that support self‐esteem in old age should be stressed. Marital counselling should be developed for the elderly.
To describe functional ability of elderly persons with diabetes (DM) or impaired glucose toleranc... more To describe functional ability of elderly persons with diabetes (DM) or impaired glucose tolerance (IGT) and to describe associations between functional ability and glucose tolerance. A survey among an unselected non-institutionalized elderly population. Diabetes was assessed on the basis of self-reports and 2-h oral glucose tolerance tests. Functional ability was assessed in interviews by four items on mobility, five items on activities of daily living, and four items on instrumental activities of daily living. Three municipalities in northern Finland. All non-institutionalized persons aged 70 years or over (n = 483; 180 men). The participation rate was 79%. Mobility, activities of daily living, and instrumental activities of daily living. The functional ability of the diabetic persons was poorer than that of the non-diabetic persons. The subjects with IGT also graded their functional ability as somewhat poorer than the non-diabetic subjects. When adjusted for age, gender, history of cardiovascular disease or stroke, these associations became weaker. Impaired functional ability is associated not only with diabetes but also with IGT in the elderly, but, in addition to age, cardio- and/or cerebrovascular disease is the best predictor of decreased functional ability in the elderly.
This paper discusses the findings in the 1012 55-year-old inhabitants of Oulu (a medium-sized Fin... more This paper discusses the findings in the 1012 55-year-old inhabitants of Oulu (a medium-sized Finnish town), 780 of whom (77%) were examined. The purpose was to determine the possible associations between depressive symptoms and subjective and clinical symptoms of the temporomandibular joint pain and dysfunction syndrome (PDS). The PDS symptoms were determined using Helkimo's Clinical Dysfunction Index. Depressive symptoms in 768 subjects were determined using Zung's self-rating depression scale. The prevalences of high rates of depressive symptoms, subjective symptoms of PDS, and clinical symptoms of PDS in the population were 12.2%, 12.0%, and 4.9%, respectively. Subjective symptoms of PDS were more common in depressed dentate men and women than in nondepressed dentate men and women. There was a significantly higher prevalence of subjective symptoms of PDS in depressed edentulous women than in nondepressed edentulous women. There were significantly more moderate or severe clinical symptoms of PDS in depressed dentate women than in nondepressed dentate women. A similar trend was seen in dentate men. An integrated approach is of crucial importance in the diagnosis and treatment of depression and the temporomandibular joint pain and dysfunction syndrome.
Uploads
Papers by Sirkka-liisa Kivelä