ACTIVE AGEING – RESILIENCE AND EXTERNAL SUPPORT AS MODIFIERS OF THE DISABLEMENT OUTCOME

Project Information

AGNES

Grant agreement ID: 693045

DOI

10.3030/693045

Project closed

EC signature date 27 July 2016

Start date 1 September 2016

End date 31 August 2021

Funded under

• EXCELLENT SCIENCE - European Research Council (ERC)

Total cost

€ 2 044 364,00

EU contribution

€ 2 044 364,00

Coordinated by

JYVASKYLAN YLIOPISTO
Finland

Periodic Reporting for period 4 - AGNES (ACTIVE AGEING – RESILIENCE AND EXTERNAL SUPPORT AS MODIFIERS OF THE DISABLEMENT OUTCOME)

Reporting period: 2021-03-01 to 2021-08-31

Summary of the context and overall objectives of the project

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 ... based on the rights, needs, preferences and capacities of older people”. We realized that in research we need to distinct active aging policies and active aging of individuals, and that the empirical research of active aging has progressed only little, because a definition concerning individuals was not available. To this end, we developed a definition and an assessment methods of active ageing centered on the individual: “The striving for elements of wellbeing through activities relating to a person’s goals, functional capacities and opportunities”. The 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 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 with wearable sensors expands knowledge on the person-environment interactions. We developed and studied novel indicators of physical activity using signal from accelerometers and found promising results that lay grounds for new research. My group also studied indicators of physical resilience suitable for research on older people. The results showed that positive adaptation to functional decline together with environmental support are vital for maintaining active ageing. We studied birth cohort differences of functional phenotypes that underlie active aging and disability, and found that people aged 75 and 80 years show 'younger' results than people of the same age 30 ears ago.

The second set of goals concerned promoting active aging through individual behavior changes. We promoted activities in line with a person’s goals and values. We chose individualized counselling as a method for promoting active aging at the micro level and conducted a randomized controlled trial. The effects of the intervention on active aging was statistically significant but rather modest, so we are not yet sure whether the effect was meaningful. The survey conducted during COVID-19 social distancing suggested that changes in opportunities for social participation may have much larger effects on active ageing than interventions targeting individuals.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

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.
The cohort study consists of a phone interview, a self-report questionnaire, face-to-dace interview at participants' homes, monitoring of free living physical activity and heart rate for one week, and laboratory assessments 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. We have a dataset on predictors and consequences of active ageing that is profoundly interdisciplinary. Following this, efforts were directed to analyzing and reporting of data. We also prepared for a follow-up study of the AGNES cohort that will be supported by new grants from Academy of Finland and Finnish Ministry of Education and Culture.

The COVID-19 pandemic made it paramount to study active ageing among our cohort during the social distancing and the emergency powers act. Even though the COVID-19 pandemic was a tragedy, scientifically it was an interesting natural experiment on reducing the opportunities of older people for social participation. It enabled us to plan experiments related to resilience of older people in terms of their activity. This opportunity presented itself, and we chose to expand our study to cover it. In spring 2020 we sent out questionnaires to all baseline participants to enquire about their activity during the social distancing recommendation. More than 80% of the baseline participants responded.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

The AGNES project propelled forward the conceptual and empirical basis of active ageing studies. We created a novel assessment method of active ageing that is quantifiable and may be used when studying older individuals. will lead emergence of novel findings. We found that active ageing underlies good quality of life. Active ageing is compromised when physical functioning declines, but the detrimental consequences may be at least to some extent compensated by higher psychological and physiological resilience. 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.
Resilience refers to the ability to recover from adverse effects. We found that physical capacity, i.e. muscle strength and walking speed are especially important for recovery from physical trauma (bone fracture). We also found that people with higher physical capacity were better able to maintain high quality of life amid the COVID-19 social distancing recommendations.We found that supporting individual autonomous motivation for self-selected activities promoted active ageing, but the effect modest. This was especially true when compared to how much the reduced opportunities for social participation during COVID-19 pandemic reduced active ageing. The finding that physical capacity of older people has meaningfully increased over the last 30 years was important and widely reported in media. The novel indicators of physical activity that we developed can be considered breakthroughs and will offer interesting research opportunities also for future studies.

The process and factors underlying active ageing.