Adults In Finland Research Articles

Trends of fatal unintentional injuries among working-age adults in Finland between 1998 and 2022

Trends of fatal unintentional injuries among working-age adults in Finland between 1998 and 2022

All-cause and cause-specific mortality among older migrant and non-migrant adults in Finland: a register study on all deaths, 2002-2020.

Migrant mortality advantage is established in various studies, but there is a lack of evidence on migrant mortality trends in old age. Previous studies have primarily concentrated on all-cause mortality, and few include older age groups. Discussions about the migrant mortality advantage continue due to concerns about data availability and accuracy. Additionally, the mechanisms explaining the migrant mortality advantage remain unclear. This study examines all-cause and cause-specific mortality among older migrant and nonmigrant adults aged 70 and above using Finnish Cause of Death register data (2002-20) and the corresponding risk population. We investigate differences in overall and cause-specific mortality between migrant and Finnish-born population and by geographical region of origin. We calculated direct age-standardized mortality rates and age group-specific death rates followed by Poisson regression to study relative mortality differences. Age at death, sex, income, region of residence, and year of death were controlled for in the regression analysis. We found evidence of migrant mortality advantage across various causes of death, but there was variation by regions of origin groups and sex. Notably, women exhibit the strongest advantage in respiratory and digestive system diseases, while men demonstrated pronounced advantages in external causes and respiratory diseases. Our study challenges the notion of a general diminishing healthy migrant effect in old age. Our findings emphasize the need for nuanced investigations into socioeconomic factors and tailored interventions for older migrants.

Sleep During the COVID-19 Pandemic: Longitudinal Observational Study Combining Multisensor Data With Questionnaires.

The COVID-19 pandemic prompted various containment strategies, such as work-from-home policies and reduced social contact, which significantly altered people's sleep routines. While previous studies have highlighted the negative impacts of these restrictions on sleep, they often lack a comprehensive perspective that considers other factors, such as seasonal variations and physical activity (PA), which can also influence sleep. This study aims to longitudinally examine the detailed changes in sleep patterns among working adults during the COVID-19 pandemic using a combination of repeated questionnaires and high-resolution passive measurements from wearable sensors. We investigate the association between sleep and 5 sets of variables: (1) demographics; (2) sleep-related habits; (3) PA behaviors; and external factors, including (4) pandemic-specific constraints and (5) seasonal variations during the study period. We recruited working adults in Finland for a 1-year study (June 2021-June 2022) conducted during the late stage of the COVID-19 pandemic. We collected multisensor data from fitness trackers worn by participants, as well as work and sleep-related measures through monthly questionnaires. Additionally, we used the Stringency Index for Finland at various points in time to estimate the degree of pandemic-related lockdown restrictions during the study period. We applied linear mixed models to examine changes in sleep patterns during this late stage of the pandemic and their association with the 5 sets of variables. The sleep patterns of 27,350 nights from 112 working adults were analyzed. Stricter pandemic measures were associated with an increase in total sleep time (TST) (β=.003, 95% CI 0.001-0.005; P<.001) and a delay in midsleep (MS) (β=.02, 95% CI 0.02-0.03; P<.001). Individuals who tend to snooze exhibited greater variability in both TST (β=.15, 95% CI 0.05-0.27; P=.006) and MS (β=.17, 95% CI 0.03-0.31; P=.01). Occupational differences in sleep pattern were observed, with service staff experiencing longer TST (β=.37, 95% CI 0.14-0.61; P=.004) and lower variability in TST (β=-.15, 95% CI -0.27 to -0.05; P<.001). Engaging in PA later in the day was associated with longer TST (β=.03, 95% CI 0.02-0.04; P<.001) and less variability in TST (β=-.01, 95% CI -0.02 to 0.00; P=.02). Higher intradaily variability in rest activity rhythm was associated with shorter TST (β=-.26, 95% CI -0.29 to -0.23; P<.001), earlier MS (β=-.29, 95% CI -0.33 to -0.26; P<.001), and reduced variability in TST (β=-.16, 95% CI -0.23 to -0.09; P<.001). Our study provided a comprehensive view of the factors affecting sleep patterns during the late stage of the pandemic. As we navigate the future of work after the pandemic, understanding how work arrangements, lifestyle choices, and sleep quality interact will be crucial for optimizing well-being and performance in the workforce.

Experiences of Decision Making and Attitudes Toward Digital Health Services Among Older Adults in Finland.

Shared decision making (SDM) is based on the clinical expertise of healthcare professionals and patients' preferences and values. Digital health services may offer new possibilities for patient-generated data e.g. in SDM. This study aimed to assess older adults' experiences of decision making in healthcare and attitudes toward digital health and social services. Data were collected via an online survey of 629 respondents. Results showed that digital services are considered beneficial, yet half of respondents needed guidance in their use. Many factors affect SDM and the perceived benefits of digital services. Based on our findings digital services are expected to provide guidance and individualised user experience. More research is needed to provide services with equitable access for people with special needs.

Family Members’ Perspectives on the Unmet Care Needs of People Living With Dementia in Nursing Homes

While the number of older people living with dementia grows, savings in public resources leads to situations where services and supports for older people are cut, even in the traditionally generous Nordic welfare states, such as Finland. This development is expected to lead to care poverty, meaning older people are not receiving the services they need. Our aim was to uncover whether care poverty already exists within institutional care for older adults in Finland. Thematic analysis was utilized to study 19 interviews with family members of people with dementia living in a nursing home. Signs of care poverty were found in relation to timeliness and safety of access to long-term care and quality of professional care. In addition, the threshold of questioning the care system was high, and managing disagreements about care with professionals was challenging for the family members. The results raise concerns that reducing long-term care risks the whole concept of welfare states. Family members should be more systematically involved in needs assessment and decision-making concerning the care of older people with dementia.

Social exclusion in service settings amongst Swedish-speaking older adults in Finland: Language incongruency or identity discrimination, or both?

Social exclusion in service settings amongst Swedish-speaking older adults in Finland: Language incongruency or identity discrimination, or both?

Age-inclusive Arctic outdoor spaces: a policy review in four Nordic countries

ABSTRACT In the last decade, policy strategies were adopted in response to population ageing in the Nordic countries. Governmental actions have to be evaluated in terms of their efficacy. The objective of this article is to identify and review the policies related to age-inclusive outdoor spaces in the Arctic regions of Nordic countries. Our analysis focuses on central government white papers that address the older adults in Finland, Norway, Sweden, and Iceland. A review of such policy documents provides insights into the predominant understandings of older adults and healthy ageing. Moreover, such analysis may identify “blind spots” in the national policies, especially regarding the sparsely researched northernmost and rural Arctic territories. Our results demonstrate how the older populations in the Nordic Arctic and their access to outdoor spaces are addressed in the policy documents. We found that with few exceptions, the older people of the rural Arctic is strikingly absent in the Nordic national governmental papers. Moreover, access to outdoor spaces is mentioned in general terms, and specific challenges of the rural Arctic context, such as the harsh climate, long winters and geographical distances are not addressed. The noticed omissions might be the result of “urban-rural”, “south-north”, “indoor-outdoor”, and “generalisation” biases.

Physical Activity Changes From Before to During the First Wave of the COVID-19 Pandemic Among Community-Dwelling Older Adults in Finland.

This study aimed to compare community-dwelling older adults' physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants' (n = 809, initial age 75-85years) self-reported PA was assessed at baseline in 2017-2018 and May/June 2020 as total weekly minutes of walking and vigorous PA. Physical performance was assessed at baseline using the maximal handgrip strength and Short Physical Performance Battery tests. During the first wave of the COVID-19 pandemic, a median change in total weekly minutes of walking and vigorous PA among all participants was + 20.0 (interquartile range: -60.0 to 120.0, p < .001)min per week compared with 2years earlier. Higher baseline Short Physical Performance Battery total scores were associated with higher total weekly minutes of walking and vigorous PA over the follow-up in men and women, and better handgrip strength in women.

Representation of Vulnerable Adults in Finland in the Light of the CRPD

Representation of Vulnerable Adults in Finland in the Light of the CRPD

Trends in clinical characteristics, medication use, and glycemic control in insulin-treated patients with type 1 and type 2 diabetes in Finland in 2012-2019: Nationwide real-world evidence study.

To describe the clinical characteristics and medication purchases of insulin-treated adults in Finland at index (January 1, 2012 or first insulin purchase) and December 31, 2019. Additionally, to describe basal insulin (BI) treatment patterns and associated changes in hemoglobin A1c (HbA1c) values. In this descriptive study using nationwide registries, we included adults with at least two reimbursed insulin purchases within 12 months of the first purchase between January 1, 2012 and December 31, 2019. We formed four study groups: type 1 diabetes (T1D) and type 2 diabetes (T2D)-diagnosed people who were further divided into prevalent or naïve users (start of insulin use before or after January 1, 2012). Insulin treatment patterns were estimated from medication purchase data and glycemic control from HbA1c results. Out of 145 020 people included, 34 359 had T1D and 110 661 T2D. By 2019, in parallel with the adaptation of new noninsulin medications, second-generation basal insulin (BI) analogues were adopted by 45.9% and 21.1% of prevalent T1D and T2D users. At index, HbA1c target (≤53 mmol/mol) was reached by 17% and 35% of T2D naïve and prevalent users, respectively, and by 17% of T1D prevalent users. At study end, the target was reached respectively by 41%, 34%, and 22% of insulin users. Insulin initiation improved and discontinuation worsened glycemic control in T2D, with lesser effects seen after treatment gaps or switches between BIs. Our study showed that glycemic control in insulin users has remained stable or improved between 2012 and 2019 despite aging population and in parallel with introduction of new treatment options, providing valuable insight into Finnish national diabetes care.

Associations of allostatic load with sociodemographic factors, depressive symptoms, lifestyle, and health characteristics in a large general population-based sample

ObjectiveWe examined the associations between allostatic load (AL) and sociodemographic factors, depressive symptoms, lifestyle and health characteristics in a population-based sample of 4993 adults in Finland. MethodsThirteen biomarkers were used to construct AL. High AL was defined as scoring highly in ≥4 items. ResultsAL scores of 4 and above were exceeded in the age group of 45–54 years in men and 65–74 years in women. Age was the strongest predictor for belonging to the high AL score group. In addition, elevated depressive symptoms (BDI-6 ≥ 4), male sex, not engaging in physical exercise, high alcohol use and a low level of education were associated with an increased likelihood of belonging to the high AL group. ConclusionThe older the participants were, the greater their AL burden was. However, AL burden increased more steeply as a function of age in men. In addition to lifestyle interventions, effective prevention strategies for depression at the population level could have a major public health impact in reducing the accumulation of AL burden.

Perceptions of health changes and support for self-limiting social media use among young adults in Finland—A qualitative study.

Perceptions of health changes and support for self-limiting social media use among young adults in Finland—A qualitative study.

Trends in severe allergic reactions of adults in Finland between 1999 and 2020: A national population study.

Trends in severe allergic reactions of adults in Finland between 1999 and 2020: A national population study.

Trends of fall-related and other fatal injuries in older adults in Finland between 1998 and 2020.

The number of falls and fall-related injuries will likely increase as the number of older adults expands. Increases in total deaths due to falls have been observed over Europe. Less is known about other injuries leading to death. We analyzed open data from Statistics Finland's register on the causes of death of those aged ≥65 collected between 1998 and 2020 yielding a total of 32150 deaths due to injury using Poisson regression and distributional comparisons chi-squared tests. The most common injuries leading to death among people aged ≥65 in Finland were fall related. There has been an increase in the absolute number of fall-related and other injuries, but when adjusting for person-years in population, a significant decrease can be observed. The crude rates of deaths from fall-related injuries among males annually increased 1.1-4.4% from 1998 to 2020, while the changes in rates among females ranged between -2% and 1.6%. The crude rates of other injuries ranged between -0.5% to +3.8%. Recently (2018-20), nearly 40% of the cases in males and 25% of cases in females were not fall related but comprised other types of injury mechanisms such as traffic, poisoning and drowning. Strengthening the implementation of preventive strategies is essential to prevent injuries. To reduce injury-related mortality and disability, improvement of acute and post-acute care for injured older patients is warranted.

Socioeconomic resources and family formation among young Finnish adults

How do individuals’ employment or financial resources affect childbearing in Finland? Are these resources equally important to men and women, or in couples?&#x0D; This study examines the relationship between individuals’ socioeconomic resources – employment, education, and income– and entry into parenthood. The results show that employment stability is a key prerequisite for family formation among young adults in Finland. Being unemployed or having fewer financialresources is related to postponement of parenthood in most population groups, notably among those who are approaching age 30, or above it. A lack of economic resources appears to be an obstacle to family formation at several stages: first through union formation, and next, within unions. The associations are very similar among men and women, indicating that policies that support gender equality in employment are advantageous to childbearing.

Association between psychosocial well-being and problematic social media use among Finnish young adults: A cross-sectional study

The aim of the study was to identify associations between problematic social media use (PSMU), type of internet activity, various background factors, psychosocial factors (mood, fear of missing out, need to belong, social relationships) and the COVID-19-pandemic’s impacts on social media use among young adults in Finland. Data were collected from 381 young adults aged 18–35 (M = 26.01; SD = 4.55) in Finland through a web-based survey conducted during the autumn of 2020. PSMU was identified using the Bergen Social Media Addiction Scale. Nine types of social media platform used were considered. Information about health-related factors was assessed using Beck Depression Inventory scale and a further single question. Social factors were measured using the Fear of Missing Out scale, the Single Item Need to Belong scale, and social engagement scale. 9.8 % of participants were found to exhibit PSMU. Younger people and women were more prone to PSMU. Social networking sites were the most used platform and were more strongly related to PSMU. Social media engagement, depression, fear of missing out and the effects of the pandemic on social media use were all positively and significantly associated with PSMU. These results may facilitate the development of guidelines for healthy social media use, and early detection of PSMU.

Polarization of body mass index among adults in Finland

Polarization of body mass index among adults in Finland

Estimated Number of Symptomatic Lyme Borreliosis Cases in Adults in Finland in 2021 Using Seroprevalence Data to Adjust the Number of Surveillance-Reported Cases: A General Framework for Accounting for Underascertainment by Public Health Surveillance.

Background: Finland conducts public health surveillance for Lyme borreliosis (LB) based on clinically diagnosed and laboratory-confirmed cases. We used data from seroprevalence studies to determine the extent to which LB cases were underascertained by public health surveillance. Methods: The numbers of incident symptomatic LB cases in 2011 in six regions in Finland were estimated using (1) data from Borrelia burgdorferi sensu lato seroprevalence studies, (2) estimates of the proportion of LB infections that are asymptomatic, and (3) estimates of the duration of LB antibody detection. The numbers of estimated incident symptomatic LB cases were compared with the numbers of surveillance-reported LB cases to estimate regional underascertainment multipliers. Underascertainment multipliers were applied to the numbers of surveillance-reported LB cases in each region in 2021 and summed to estimate the number of symptomatic LB cases in Finland among adults in 2021. A sensitivity analysis evaluated the impact of different durations of antibody detection. Results: Using an asymptomatic proportion of 50% and a 10-year duration of antibody detection, the estimated regional underascertainment multipliers in Finland ranged from 1.0 to 12.2. Applying the regional underascertainment multipliers to surveillance-reported LB cases in each region and summing nationally, there were 19,653 symptomatic LB cases in Finland among adults in 2021 (526/100,000 per year). With 7,346 surveillance-reported LB cases in Finland among adults in 2021, the estimated number of symptomatic LB cases indicate that there were 2.7 symptomatic LB cases for every surveillance-reported LB case among adults. With a 5- or 20-year duration of antibody detection, there were an estimated 36,824 or 11,609 symptomatic LB cases among adults in 2021, respectively. Discussion: Finland has robust public health surveillance for LB, but cases are underascertained. This framework for estimating LB underascertainment can be used in other countries that conduct LB surveillance and have conducted representative LB seroprevalence studies.

Changes in symptom burden from 2019 to 2021 amongst community-dwelling older adults in Finland.

Symptom burden causes suffering amongst older adults and is associated with healthcare visits and prognosis. We evaluated the prevalence of 10 symptoms and changes in symptom burden amongst home-dwelling older adults in 2019 and 2021 using Finnish cohort data. We analysed factors associated with symptom burden increase during follow-up. Altogether 1,637 people aged 75+ participated in the Helsinki Ageing Study postal survey in 2019, where they reported the presence of 10 common symptoms over the past 2 weeks. Of them, 785 participated in a follow-up in 2021, where the same symptoms were queried. We compared the prevalence of various symptoms and symptom burden scores in the 2-year interval and evaluated factors associated with increased symptom burden during this time. Of participants, 33% reported at least one daily symptom in 2019 versus 44% in 2021. Symptom burden increased by a mean ratio of 1.29 between 2019 and 2021. The most common symptoms were joint pain, back pain, urinary incontinence and fatigue. The prevalence of four symptoms increased between 2019 and 2021: joint pain, urinary incontinence, dizziness and shortness of breath. Higher age, reduced functional capacity and comorbidities were associated with higher odds of symptom burden increase during follow-up. Psychological well-being (PWB) was strongly associated with lower odds of symptom burden increase in the logistic regression model. Symptom burden increased in our cohort aged 75+ between 2019 and 2021 before and during the COVID-19 pandemic. PWB was associated with lower odds of acquiring additional symptoms over time.

Outpatient Antibiotic Use and Costs in Adults: A Nationwide Register-Based Study in Finland 2008-2019.

The objective of this study was to describe the prevalence of outpatient use and costs for systemic antibacterials by age and sex among adults in Finland from 2008-2019. Data from the Finnish statistical database Kelasto, containing information concerning all reimbursed medicines for 18+-year-olds during 2008-2019, were analyzed. In addition to the decreased (26%) use of systemic antibiotics, decreased use was observed in all antibiotic categories, notably including several wide-spectrum antibiotics. The use of quinolones decreased by 49% and of tetracyclines by 39%. The 10 most frequently used antibiotics covered 89% of all adult antibiotic prescriptions. Antibiotic use also decreased in every age group during the study period. Although the overall yearly costs of outpatient antibiotics during the 10-year study period decreased from EUR 36.4 million to EUR 30.7 million, the cost per prescription increased slightly. In conclusion, according to the findings of this study, concerning adults and the results of our previous study concerning children and adolescents (2008-2016), there has been a decreasing trend of outpatient antibacterial use among the whole Finnish outpatient population over the duration of nearly one decade. However, during the same time period, there has been a specific increasing trend for the Gram-negative AMR threat regarding E. coli resistance. Therefore, based on our important findings in Finland, methods other than the restriction of antibiotic use, such as new anti-infective innovations, including antibacterials, are needed as soon as possible to tackle this major global health threat-a silent pandemic.