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"The gut matters": an interdisciplinary approach to health and gut function in older adults
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-7678-5954
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Improved life expectancy is a triumph of modern medicine. However, today’s senior citizens are predicted to soon consume 75% of the available health-care resources. Identifying new strategies to promote a healthy ageing process has thus become a priority. In contribution to the research field of healthy ageing this thesis is focused on the health and gut function of older adults. Paper I explored ‘optimal functionality’; a new approach to put the older adult’s own perspectives on health in focus. According to the results a plethora of factors related to the body, the self and the external environment needs to be considered in order to create a comprehensive understanding of the health experience in old age. Paper II characterised senior orienteering athletes as a new model of healthy ageing, due to their significantly better percived health as compared to other free-living older adults; in particular they report better gut health. As the gut is important to health maintenance and immune function paper III explored inflammation and oxidative stress in senior orienteering athletes, and older adults with gut problems, generally finding low levels in both groups. Subsequently, Paper IV investigated the health status of free-living older adults in Örebro County and also reports the results from a randomised controlled trial evaluating the effect of a probiotic supplement on self-reported health and gut symptoms. Two-thirds of the included older adults reported gut problems, however, the probiotic intervention failed to show any effects.

This thesis provides additional perspectives on older adults health and gut function, by concluding that 1) optimal functionality may be a useful concept to map areas of importance to the older adult’s health experience, 2) senior orienteers may be regarded as a suitable model to study healthy ageing, 3) the prevalence of gut problems among the general population of Swedish older adults is high, but was not improved by probiotic supplementation with Lactobacillus reuteri.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2016. , 81 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 140
Keyword [en]
healthy ageing, gut health, old age, senior orienteering athletes
National Category
Family Medicine Geriatrics
Research subject
Geriatrics
Identifiers
URN: urn:nbn:se:oru:diva-49072ISBN: 978-91-7529-130-7 (print)OAI: oai:DiVA.org:oru-49072DiVA: diva2:910781
Public defence
2016-04-22, Prismahuset, Hörsal 1, Örebro universitet, Fakultetsgatan 1, Örebro, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2016-03-10 Created: 2016-03-10 Last updated: 2016-04-11Bibliographically approved
List of papers
1. Exploring the concept of optimal functionality in old age
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2014 (English)In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 7, 69-79 p.Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Aging is characterized by loss of function and represents a perspective that puts the focus on the negative aspects of aging. Thus, it is fundamental to shift the focus from loss of function to maintaining good health and personal satisfaction through life; in other words, to promote optimal functionality at a level appropriate for older adults. However, it is not yet known what constitutes optimal functionality from the older adult's own perspective.

OBJECTIVE: To explore the concept of optimal functionality in old age from the older adult's perspective (ie, people over 65 years of age) in industrialized Western countries.

METHODS: We undertook a scoping review and searched two electronic databases (PubMed and the Cumulative Index to Nursing and Allied Health Literature [CINAHL]) from January 2002 to July 2013 for scientific studies, using the key search term personal satisfaction. In total, 25 scientific studies were analyzed.

RESULTS: Only six of the included articles applied a qualitative methodology. By analyzing the results of these articles, three major themes were identified as cornerstones in the concept of optimal functionality at old age: 1) self-related factors (eg, mental well-being); 2) body-related factors (eg, physical well-being); and 3) external factors equal to demographic and environmental factors.

CONCLUSION: There is a lack of qualitative studies in the current literature, and hence of what constitutes optimal functionality from the older adult's perspective. The results outlined in this review identify three cornerstones (self-related factors, body-related factors, and external factors) of what constitutes optimal functionality at old age. However, it is vital that these findings are taken further and are evaluated through qualitative studies to reflect older adults' opinions.

Place, publisher, year, edition, pages
Dove Medical Press, 2014
Keyword
optimal functionality, aging, personal satisfaction
National Category
Nursing
Research subject
Medicine; Nursing Science
Identifiers
urn:nbn:se:oru:diva-33866 (URN)10.2147/JMDH.S55178 (DOI)24516333 (PubMedID)2-s2.0-84893293812 (Scopus ID)
Available from: 2014-02-20 Created: 2014-02-20 Last updated: 2017-03-13Bibliographically approved
2. Senior orienteering athletes as a model of healthy aging: a mixed-method approach
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2015 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, 76Article in journal (Refereed) Published
Abstract [en]

Background: The proportion of individuals reaching an old age is increasing and will, in the near future consume a majority of health care resources. It is therefore essential to facilitate the maintenance of optimal functionality among older adults. By characterizing older individuals experiencing wellbeing, factors important to promote and maintain health through life can be identified. Orienteering is an endurance-running sport involving cross-country navigation, demanding both cognitive and physical skills of its practitioners. In this study we aim to explore a Swedish population of senior orienteering athletes as a potential model of healthy aging.

Methods: We undertook a mixed-method approach using quantitative (i.e. questionnaires) and qualitative (i.e. focus group discussions) methodologies to explore a population of senior orienteering athletes (n = 136, median age = 69 (67-71) years). Quantitative data was collected to evaluate health status, assessing physical activity (Frandin-Grimby activity scale (FGAS)), functional wellbeing (EQ-5D-5 L), gut health (Gastrointestinal symptoms rating scale (GSRS)), anxiety and depression (Hospital Anxiety and Depression scale (HADS)) and overall health (Health index (HI)). The data was further compared to reference values obtained from a free-living Swedish population of older adults. Focus group discussions (FGD) were performed as a complement to the quantitative data to facilitate the individuals' own views on health and physical activity.

Results: The orienteering athletes enrolled in the study reported a significantly better health compared to the free-living older adults (p < 0.0015) on all questionnaires except HADS. The high health status displayed in this population was further confirmed by the FGD findings, in which all participants declared their engagement in orienteering as a prerequisite for health.

Conclusions: In conclusion our results show that senior orienteering may represent an ideal model in studies of healthy aging. Furthermore, our results show that even though the senior orienteering athletes are well aware of the long-term benefits of physical activity and have practiced the sport from a young age, they particularly point out that their engagement in orienteering is driven by short-term values such as enjoyment and passion. This may be important to consider when introducing public health interventions among the general older population.

Keyword
Healthy aging, Successful aging, Orienteering, Mixed-method, Older adults
National Category
Geriatrics
Research subject
Geriatrics
Identifiers
urn:nbn:se:oru:diva-45536 (URN)10.1186/s12877-015-0072-6 (DOI)000357558900001 ()26152308 (PubMedID)2-s2.0-84936746895 (Scopus ID)
Funder
Knowledge Foundation, 20110225
Note

Funding Agencies:

Olle Engkvist Byggmästare Foundation

Faculty of Medicine at Örebro University

Available from: 2015-08-13 Created: 2015-08-12 Last updated: 2016-12-13Bibliographically approved
3. Low levels of inflammation and oxidative stress in senior orienteering athletes
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(English)Manuscript (preprint) (Other academic)
National Category
Family Medicine
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-49596 (URN)
Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2016-11-21Bibliographically approved
4. Probiotic administration among free-living older adults: a double blinded, randomised, placebo-controlled clinical trial
Open this publication in new window or tab >>Probiotic administration among free-living older adults: a double blinded, randomised, placebo-controlled clinical trial
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(English)Manuscript (preprint) (Other academic)
National Category
Family Medicine
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-49597 (URN)
Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2016-11-30Bibliographically approved

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