Erja Portegijs

• PhD
• Associate Professor Rosalind Franklin Fellow at University of Groningen

Physical activity-an important determinant of health and function in old age-may vary according to the life-space area reached. Our aim was to study how moving through greater life-space areas is associated with greater physical activity of community-dwelling older people. The association between objectively measured physical activity and life-spac...

The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75–90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-...

The aim was to study the correspondence between the objective and perceived environment and to assess their associations with physical activity (PA) in older people. 848 community-dwelling older people aged 75-90 were interviewed on their difficulties in walking 500m, perceiving nature as a facilitator for outdoor mobility, and PA. The presence of...

Aim: To determine the relevance of features located close to home and further away, our aim was to study associations between older adults' physical activity and self-reported neighborhood destinations and barriers to outdoor mobility categorized by presence and maximal distance from home. Methods: Cross-sectional analyses comprising men and women...

Objectives: To study associations between perceived neighborhood resources and time spent by older adults in active travel. Methods: Respondents in six European countries, aged 65-85 years, reported on the perceived presence of neighborhood resources (parks, places to sit, public transportation, and facilities) with response options "a lot," "so...

Background The rapidly emerging integration of both technological applications and environmental factors in physical activity (PA) interventions among older adults highlights the need for an overarching investigation. Objective This scoping review compiled the current literature and aimed to provide an overview of the role of physical, social, soc...

Introduction The ability to perform bodily movement varies in ageing men and women. We investigated whether physical fitness may explain sex differences in daily physical activity energy expenditure (PAEE) among older people. Methods In this cross-sectional study, a population-based cohort of 75, 80, and 85-year-old men and women (n = 409, 62% wom...

PURPOSE: Physical activity (PA) is distinct from physical capacity (PC), even though they are correlated in old age. PC defines the limits for PA, while activities in daily life typically remain submaximal. Individuals whose intensity of daily activities is close to physical capacity may be better protected from future decline in physical function...

Purpose Physical activity (PA) is distinct from physical capacity (PC), even though they correlate strongly in old age. Physical capacity defines the boundaries for PA, while activities in daily life typically remain submaximal. Older people who approach their capacity in terms of intensity and duration of daily activities might be better protected...

Objectives: This study investigated the longitudinal association between coping ability and depressive symptoms from before to during and after the COVID-19 pandemic and whether engagement in meaningful activities plays a mediating role in this association. Method: Individuals aged 75, 80, and 85 years (n = 1021) were interviewed in 2017-2018 (T...

Objectives: To examine the reciprocal associations between walking performance, physical activity (PA), and perceived autonomy in outdoor mobility in 322 older adults. Methods: At baseline and four years later, a 6-min walk test assessed walking performance. A thigh-mounted accelerometer monitored relative PA (acceleration exceeding the individual'...

Background The University of Jyvaskyla Active Aging Scale (UJACAS) assesses active aging through willingness, ability, opportunity, and frequency of involvement in activities. Recognizing the lack of a German version, the Finnish original was translated (UJACAS-G). This study aimed: (1) to evaluate the test-retest reliability of UJACAS-G; and (2) t...

Purpose Survival rates of lower extremity musculoskeletal tumours (LEMTs) have been increasing. However, patients continue to experience functional limitations after LEMT followed by limb-salvage surgery (LSS). This study aimed to identify factors influencing functional recovery after LSS for LEMT. Methods A qualitative study was conducted using s...

Objectives: To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure activities among older people. Methods: Self-reported 2 km walking difficulty (intact, modifications, difficulties) at baseline and participating in organized group, outdoor rec...

In old age, walking difficulty may reduce opportunities to reach valued activity destinations. Walking modifications, e.g., slower pace or using a walking aid, may enable individuals to continue going where they wish, and hence postpone the consequences of the onset of walking difficulties. We studied visited activity destinations (type, distance)...

Purpose Habitual strength and power-demanding activities of daily life may support the maintenance of adequate lower-extremity functioning with ageing, but this has been sparingly explored. Hence, we examined whether the characteristics of free-living sit-to-stand (STS) transitions predict a decline in lower-extremity functioning over a 4-year foll...

BACKGROUND The rapidly emerging integration of both technological applications and environmental factors in physical activity (PA) interventions among older adults highlights the need for an overarching investigation. OBJECTIVE This scoping review compiled the current literature and aimed to provide an overview of the role of physical, social, soc...

Introduction The ability to perform bodily movement varies in ageing men and women. We investigated whether physical fitness may explain sex differences in daily physical activity energy expenditure (PAEE) among older people. Methods A population-based cohort of 75, 80, and 85-year-old men and women (n=409, 62 % women) underwent laboratory-based a...

Background Among older people, community mobility was reduced at the beginning of the COVID-19 pandemic, but the longer-term changes are unclear. Aims To study lower extremity performance and car driving as predictors of changes in older adults’ life-space mobility, autonomy in participation outdoors, and the risk of developing restricted life-spa...

Aim Older adults show considerable diversity in their use of digital devices, e.g., computers, tablets, and smart phones: some are non-users, some are learning to use them, and some use them fluently. The factors contributing to older adults’ digital device use are likely to differ between learners and fluent users. This paper examines whether diff...

We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 ( n = 441) wore triaxial accelerometers for 3–7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait b...

Objectives: To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods: Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989–1990 (n = 617) and 2017–2018 (n = 794). They reported their depressive sym...

This study aimed to compare community-dwelling older adults’ physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2 years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants’ ( n = 809, initial age 75–85 years) self-reported PA was assessed at baseline...

Purpose Active aging refers to the process where older people strive for activity in line with their goals, abilities and opportunities. However, the will does not always lead to action, creating a conflict between goals and actions. The aim of this study was to determine in which activities older people have conflicting goals and actions, and whet...

Introduction Five times sit-to-stand (STS) test is commonly used as a clinical assessment of lower-extremity functional ability, but its association with free-living performance has not been studied. Therefore, we investigated the association between laboratory-based STS capacity and free-living STS performance using accelerometry. The results were...

Purpose Motorized transport to and from places of physical exercise (PE) causes considerable amounts of carbon emissions. We study how locations of home and PE place on urban zones (UZs), reflecting options for transport modes, relate to use of active transport (AT) among older adults. No previous knowledge on the topic exists. Methods Data of AGN...

Purpose Physical activity is often quantified as physical activity energy expenditure (PAEE), which may be affected by individual ability to sustain physical activity intensity. We examined if there is a true difference in physical activity between older women and men when their physical capacity is considered. Methods Out of the population-based...

Reduced age-specific mortality and increased muscle strength and walking speed of current older adults may have altered the relationships between these factors as more people may be above the reserve capacity threshold. We compared the cross-sectional associations between muscle strength and walking speed, and the associations of muscle strength an...

Background Low muscle strength predisposes older people to health decline in terms of walking limitations and increased mortality rates. Some studies have reported greater functional reserve capacity in more recently born cohorts, but it is unclear what impact these birth cohort differences have on the associations of muscle strength with walking a...

Background Life-space mobility is defined as the size of the area in which a person moves about within a specified period of time. Our study aimed to characterize life-space mobility, identify factors associated with its course, and detect typical trajectories in the first year after ischemic stroke. Methods MOBITEC-Stroke (ISRCTN85999967; 13/08/2...

Purpose: Five times sit-to-stand (STS) test is commonly used as a clinical assessment of lower-extremity functional ability, but its association with free-living performance has not been studied. Therefore, we investigated the association between laboratory-based STS capacity and free-living STS performance using accelerometry. The results were st...

Little is known about older adults' physical exercise destinations. We studied associations between physical activity (PA) level and physical exercise destinations (total number and surrounding environment) in community-dwelling 75- to 85-year-old adults living in Central Finland. Participants (N = 901) reported the amount of at least moderate-inte...

Background Stroke is a common cause of mobility limitation, including a reduction in life space. Life space is defined as the spatial extent in which a person moves within a specified period of time. We aimed to analyze patients’ objective and self-reported life space and clinical stroke characteristics. Methods MOBITEC-Stroke is a prospective obs...

Aim of this study was to test the reliability and validity of the life-space measures and walking speed delivered by the MOBITEC-GP app. Participants underwent several supervised walking speed assessments as well as a 1-week life-space assessment during two assessment sessions 9 days apart. Fifty-seven older adults (47.4% male, mean age= 75.3 (±5.9...

Background The neighborhood environment may enhance or restrict older people's opportunities to participate in leisure activities, and thus impact quality of life. Walkability depicts the environment's suitability for walking to different destinations. Little is known concerning about the relation between environment walkability and participation i...

Background Conducting everyday activities out-of-home may accumulate a large share of older adults' daily physical, especially if active transportation is used. Environmental features in home neighborhood may motivate for higher physical activity, but the role of features around destinations is less known. Our goal was to study 1) clustering of old...

Background and aim Arterial stiffening – a process that is largely due to intimal thickening, collagen disposition or elastin fragmentation – significantly contributes to cardiovascular events and mortality. There is also some evidence that it may negatively affect physical function. This study aimed to evaluate whether arterial stiffness was assoc...

Background: Good sit-to-stand (STS) performance is an important factor in maintaining functional independence. This study investigated whether free-living STS transition volume and intensity, assessed by a thigh-worn accelerometer, is associated with characteristics related to functional independence. Methods: Free-living thigh-worn accelerometr...

Purpose Social distancing during the COVID-19 pandemic reduced possibilities for activities of choice potentially threatening quality of life (QoL). We defined QoL resilience as maintaining high quality of life and studied whether walking speed, absence of loneliness, living arrangement, and stress-coping ability predict QoL resilience among older...

Purpose: Information about mobility, and physical function may be encoded in the complexity of daily activity pattern. Therefore, daily activity pattern complexity metrics could provide novel insight regarding the relationship between daily activity behaviour and health. The purpose of the present study was to examine the association between the c...

Background Outdoor mobility enables participation in essential out-of-home activities in old age. Aim To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported walking. Methods Community-dwelling participants of AGNES study (2017–2018, initial age 75–85) responded t...

Background The usual accelerometry-based measures of physical activity (PA) are dependent on physical performance. We investigated the associations between PA relative to walking performance and the prevalence and incidence of early and advanced walking difficulties compared to generally used measures of PA. Methods Perceived walking difficulty wa...

(1) Background: The purpose of this study was to evaluate the day-to-day variability and year-to-year reproducibility of an accelerometer-based algorithm for sit-to-stand (STS) transitions in a free-living environment among community-dwelling older adults. (2) Methods: Free-living thigh-worn accelerometry was recorded for three to seven days in 86...

Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive s...

Objective To examine whether pre-admission community mobility explains the effects of a rehabilitation program on physical performance and activity in older adults recently discharged from hospital. Design A secondary analysis of a randomized controlled trial. Setting Home and community. Participants Community-dwelling adults aged ⩾60 years reco...

Background: Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we st...

Social distancing during the COVID-19 pandemic decreased older people’s opportunities to lead an active life. The purpose of this study was to investigate whether walking difficulties predict changes in leading an active life during the COVID-19 social distancing recommendation compared to 2 years before, and whether self-rated resilience moderates...

Background Older people with limited health literacy may encounter difficulties in finding relevant information on COVID-19, understanding its relevance, and complying with recommended protective measures. Complying with such recommendations has required older as well as younger persons to change their daily lives in ways that have reduced their op...

This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, m...

The authors examined whether accelerometer-based free-living walking differs between those reporting walking modifications or perceiving walking difficulty versus those with no difficulty. Community-dwelling 75-, 80-, or 85-year-old people ( N = 479) wore accelerometers continuously for 3–7 days, and reported whether they perceived no difficulties,...

Active aging refers to striving for well-being through preferred activity and may be restricted with declining mobility. We investigated whether psychological resilience, i.e., the ability to tolerate hardship, can aid older people in being active despite mobility limitations. Participants were 961 community-dwelling persons aged 75, 80, or 85 year...

Older adults with lower limb osteoarthritis (LLOA) are highly dependent on their physical and social environment for being physically active. Longitudinal data from 2286 older adults (Mage = 73.8 years; 50.3% female) in six European countries were analyzed using cross-lagged Structural Equation Modeling (SEM) and multi-group SEM. In cross-sectional...

The aim was to study various types of older adult's activity destinations (counts, frequency of visitation, and distance from home) in the pre-COVID-19 era, and to study prospectively how COVID-19-related regulations limiting mobility affected these. Using a map-based questionnaire, 75-85-year-old participants reported activity destinations, that i...

From the individual viewpoint, active aging refers to the ability of older persons, depending on their goals, functional capacity and opportunities, to engage in desired activities. This study investigated the role of health literacy in active aging among persons differing in their number of chronic conditions. Data were collected from 948 individu...

Objective: To evaluate cohort differences in cognitive performance in older men and women born and assessed 28 years apart. Methods: Data in this study were drawn from two age-homogeneous cohorts measured in the same laboratory using the same standardized cognitive performance tests. Participants in the first cohort were born in 1910 and 1914 an...

Objectives: The aim of this study was to report preplanned secondary analyses of the effects of a 12-month individualized active aging counseling intervention on six mobility and physical activity outcomes. Methods: A two-arm, single-blinded randomized controlled trial was conducted among 75- and 80-year-old community-dwelling people. The intervent...

Objectives: To examine associations of perceived outdoor environment with the prevalence and development of adaptive (e.g., slower pace) and maladaptive (e.g., avoiding walking) modifications in walking 2 km among older people. Methods: Community-dwelling 75–90 -year-old persons (N = 848) reported environmental outdoor mobility facilitators and bar...

Background Map-based tools have recently found their way into health-related research. They can potentially be used to quantify older adults’ life-space. This study aimed to evaluate the validity (vs. GPS) and the test-retest reliability of a map-based life-space assessment (MBA). Methods Life-space of one full week was assessed by GPS and by MBA....

Background Social distancing, i.e. avoiding places with other people and staying at home, was recommended to prevent viral transmission during the COVID-19 pandemic. Potentially, reduced out-of-home mobility and lower activity levels among older people may lower their quality of life (QOL). We studied cross-sectional and longitudinal associations o...

Background: Physical activity (PA) of higher intensity and longer duration mainly accumulates from older adults' out-of-home activities. Outdoor PA is influenced by environmental features; however, the day-to-day variability of PA and its associations with environmental features have not been widely studied. This study focused on the associations o...

Background We define active aging as a striving for activities as per one’s goals, capacities and opportunities.AimTo test the 1-year counselling intervention effects on active aging.Methods In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation...

Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an unmet PA need, which is defined as the desire...

Background: Stroke is a major cause of disability and stroke incidence increases with age. Stroke frequently results in permanent limitations of mobility, and, consequently, the need for the help of others in activities of daily living. In order to optimize rehabilitative efforts and their functional outcomes, detailed knowledge of the functional...

Background: Whether increased life expectancy is accompanied by increased functional capacity in older people at specific ages is unclear. We compared similar validated measures of maximal physical performance in two population-based older cohorts born and assessed 28 years apart. Methods: Participants in the first cohort were born in 1910 and 1...

Background Fatigue related to task standardized by duration and intensity, termed fatigability, could manifest as shortening of activity bouts throughout the day causing daily activity to accumulate in a more fragmented pattern. Our purpose was to study the association of activity fragmentation with physical and mental dimensions of fatigability....

Background Walking forms a large portion of physical activity (PA) of older adults. We assessed free-living PA using acceleration corresponding to preferred walking speed as a relative cut-point, and studied how it relates to age. We compared the relative cut-point to a common absolute cut-point of moderate-to-vigorous PA (MVPA). Methods 444 commu...

Objective: The objective of this study is to study the associations of objectively defined hilliness with the prevalence and incidence of walking difficulties among community-dwelling older adults, and to explore whether behavioral, health, or socioeconomic factors would fully or partially explain these associations. Method: Baseline interviews (n...

Objectives: To validate the Finnish version of the 42-item Scales of Psychological Well-Being among community-dwelling older people. The study also examined the test–retest reliability and usability, i.e. user experience, of the scales in this age group. Method: The 42-item version of the SPWB was administered as part of a face-to-face interview am...

Introduction: If survived, stroke is the most common cause of disability in adults. Stroke frequently results in permanent limitations of mobility, and consequently limitation of independence in daily life. Survivors report a restriction in mobility being their number one concern. In order to optimize rehabilitative efforts and their functional out...

Objectives The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital. Design Randomized controlled trial. Setting Home and community. Participants Community-dwelling people aged ⩾60 years recovering from a lower limb o...

Background: Mobility limitations in older adults are associated with poor clinical outcomes including higher mortality and disability rates. A decline in mobility (including physical function and life-space) is detectable and should be discovered as early as possible, as it can still be stabilized or even reversed in early stages by targeted inter...

The authors studied associations of nature- and infrastructure-based features with physical activity (PA) in different urban neighborhood types; 848 community-dwelling people aged 75–90 years reported PA and three perceived nature-based destinations and seven infrastructure-based features as outdoor mobility facilitators. Neighborhood type was defi...

Background: The current study aims to compare correlations between a range of measures of physical performance and physical activity assessing the same underlying construct in different settings, that is, in a home versus a highly standardized setting of the research center or accelerometer recording. We also evaluated the selective attrition of p...

Background: Many older people report a willingness to increase outdoor physical activity (PA), but no opportunities for it, a situation termed as unmet PA need. The authors studied whether lower neighborhood mobility and PA precede the development of unmet PA need. Methods: Community-dwelling 75- to 90-year-old people (n = 700) were interviewed...

Background As people age, functional losses may limit the potential to get outside the home and participate in desired activities and community life. Coping with age-related losses has been reported to be important for psychological well-being. Hitherto is not known whether active use of coping strategies also helps maintain out-of-home mobility....

Background In old age, decline in functioning may cause changes in walking ability. Our aim was to study whether older people who report adaptive, maladaptive or no walking modifications differ in outdoor mobility. Methods Community-dwelling people aged 75–90 years (N=848) were interviewed at baseline, of whom 761 participated in the 2-year follow...

Objective: To develop an assessment method of active aging for research on older people. Method: A multiphase process that included drafting by an expert panel, a pilot study for item analysis and scale validity, a feedback study with focus groups and questionnaire respondents, and a test–retest study. Altogether 235 people aged 60 to 94 years prov...

Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation to leisure activities in old age. We investigated whether tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) influence the association between physical performance and participation in leisure activities. Methods: A cross-sectional analysi...

Background Transportation walking represents a promising target for physical activity promotion in older adults. Perceived characteristics of the neighbourhood physical environment may affect older adults’ choice of transportation mode for a routine activity such as walking to the grocery store. Aims To (1) evaluate associations between older adul...

Aims This study examined the feasibility of the HLS-EU-Q16 (in Finnish) for use among older Finns and whether the health literacy score correlates with indicators of health and functioning. Methods To determine the feasibility of the instrument, we first conducted a focus group discussion with nine participants. For the quantitative analyses, we u...

Background: Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person's goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different a...

Background The purpose of the study was to explore the single and combined contributions of body mass index (BMI) and lower extremity performance as modifiable physical factors, and the influence of use of a private car as an environmental factor on prevalent and incident life-space restriction in community-dwelling older people. Methods Community...

Background We studied the combined effects of cognitive performance and lower extremity function on self-reported walking modifications and walking difficulty, and on self-reported walking difficulty incidence over a two-year follow-up. Methods A total of 848 community-dwelling older people aged 75–90 years participated at baseline, 816 at the one...

Background Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual’s striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of hea...