Ideally, treatment of hypercholesterolemia for patients at risk of ASCVD should start before they turn 80 years old. No RCT evidence exists to guide statin initiation after age 80 years. Decisions to use statins in older individuals are made individually and are not supported by high-quality evidence.

Background frailty syndrome is common amongst older people. Low physical activity is part of frailty, but long-term prospective studies investigating leisure-time physical activity (LTPA) during the life course as a predictor of frailty are still warranted. The aim of this study is to investigate whether earlier life LTPA predicts frailty in older age. Methods the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) included older adults (aged 60–77 years) from the general population who were at increased risk of cognitive decline. Frailty was assessed for 1,137 participants at a baseline visit using a modified version of Fried’s phenotype, including five criteria: weight loss, exhaustion, weakness, slowness and low physical activity. Self-reported data on earlier life LTPA were available from previous population-based studies (average follow-up time 13.6 years). A binomial logistic regression analysis was used to investigate the association between earlier life LTPA and pre-frailty/frailty in older age. Results the prevalence of frailty and pre-frailty was 0.8% and 27.3%, respectively. In the analyses, pre-frail and frail groups were combined. People who had been physically very active (OR 0.37, 95% CI 0.23–0.60) or moderately active (OR 0.45, 95% CI 0.32–0.65) earlier in life had lower odds of becoming pre-frail/frail than individuals who had been sedentary. Conclusions frailty was rare in this relatively healthy study population, but almost a third of the participants were pre-frail. Earlier life LTPA was associated with lower levels of pre-frailty/frailty. The results highlight the importance of physical activity when aiming to promote healthy old age.

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BackgroundNational action plan for injury prevention among children and youth in Finland was launched in 2009. National Institute for Health and Welfare (THL), national research and expert agency under the Ministry of Social Affairs and Health (MSAH), has coordinated the program. National action plan includes 216 objectives and proposed measures to promote and prevent accidental injuries and suicides.Description of the problemAround 122 Finnish children and young people under the age of 25 die annually in accidental injuries and 13,500 are hospitalised (2011–2013). Accidental injuries remain the leading cause of death under the age of 25. Majority of the deaths (83%) occur to 15–24 year olds. Around 25 percent of all 15–24 year-olds who die from accidental injury are intoxicated. Traffic accidents are the most common accidental cause of death in this age group. Accidental falls are causing most of the treatment inpatients periods in hospital, respectively.ResultsDespite the continuous decrease of deaths from accidental injuries since the 1970’s, accidental injuries causes major health losses among children and youth. The objectives, measures and their implementation and responsibilities of the National action plan are divided into a number of different experts and government departments. Legislation and national policy guidelines, as well as statistics and databases are generally at a good level in Finland. The monitoring of the management and implementation should be paid more attention.ConclusionsIn order to be successful a National action plan requires high level recognition and adequate resources together with systematic coordination. National action plan is essential to be approved by the appropriate ministries and politicians. That made possible and empowered the national level activities and promoted a network of cooperation between the different actors. There is need for targeted accidental injury prevention especially for youth from 15 to 25 years.

BackgroundIn Finland, more than 900 older people 65+ died due the fall in 2012. In addition, a fall was contributing factor of death of 770 persons 70 years and older. In 2012, costs of hospital inpatient care due to falls were close to EUR 400 million (THL injury database 2014).Description of the problemFalls prevention has become extremely timely along with Finnish ageing policy prioritising older people living at their own home as long as possible. Despite vast quantity of evidence about falls prevention, the actions to put them in practice have not been as systematic and widespread as possible. Falls prevention needs to be an integral part of care and services for older people at all levels of care and among all service providers.ResultsNational program, called IKINÄ, was launched in 2006 to enhance dissemination and implementation of sustainable falls prevention in Finland. Aim of the program is to provide knowledge and stress the importance of falls prevention to policy-makers and other executive authorities in national level as well as municipalities. To enhance implementation of falls prevention IKINÄ-program produces evidence-based tools and materials for professionals and organisations working with older people.During past ten years awareness of falls, their consequences and need for falls prevention have increased among professionals, both at executive level and those working in clinical practice, in the field of older people care and services in Finland. For example, several social and health care organisations have set the reduction of falls and fall injuries as their strategic goals. Thus, implementation of evidence-based falls prevention has become more systematic.ConclusionsFalls prevention requires to be continuous work and a joint effort of professionals working at all levels of care system of older people services. Sufficient resources should be allocated for falls prevention to ensure safe living at home for older people.

BackgroundAll pupils participating in education are entitled to a safe learning environment. The Health Care Act (1326/2010) obliges comprehensive schools to monitor health and safety of school environments and well-being in learning communities every three years.MethodsHealth and welfare promotion in schools and educational institutions has been monitored by the National Institute for Health and Welfare and the Board of Education since 2006. In 2013 data were collected nationally using a form addressed to headmasters of Finnish comprehensive schools (N = 2734). The response rate was 74% (N = 2022). The topics covered also accidental injuries at school, accidental injury prevention, and safety promotion.ResultsInspection of health and safety of school environments and well-being in learning communities provides valuable information about the safety situation in the schools and their surroundings. One in four schools (24%) reported either that they did not know whether an accidental injury risk assessment indoors had been part of the inspection or that these issues had not been considered in the inspection. About three in four schools (76%) had taken into account indoors risk locations for accidental injuries.One in three schools (33%) did not know whether an accidental injury risk assessment outdoors had been included in the most recent inspection or not. Accidental injury risks had been assessed in 68 per cent of the schools, and outdoors safety was found deficient in 28 per cent of the schools.ConclusionsMultiprofessional inspection provides valuable information about school indoors and outdoors conditions, school surroundings, and safety at school trips. Most schools had paid attention to accidental injury prevention and safety both indoors and outdoors. However, a significant part of the schools did not monitor the risk of accidental injuries indoors or in the school yard.