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- Aléx, Lena, et al.
(author)
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Constructions of various femininities among the oldest old women.
- 2006
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In: Health Care for Women International. - Washington, D.C. : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 27:10, s. 853-72
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Journal article (peer-reviewed)abstract
- This study forms part of the Umeå 85+ Study, and the aim was to explore various gendered constructions of femininities among the oldest old women. Femininities are seen as various ways of shaping oneself as a woman in relation to the impact of historical, social, and cultural circumstances. Thematic narratives were analyzed using qualitative content analysis. Through interpreting these narratives in the light of gender theories, we were able to discern four femininities: "being connected," "being an actor," "living in the shadow of others," and "being alienated." The oldest old women displayed complex outlooks on femininities, and no femininity was interpreted as being in the center related to the other femininities. Further research is needed in order to disclose the complexity of femininities related to factors such as social class, ethnicity, and financial situation among the oldest old, and to acquire a greater knowledge of various femininities.
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| 3. |
- Bergdahl, Ellinor, 1981-
(author)
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Depression among the very old
- 2007
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Doctoral thesis (other academic/artistic)abstract
- Emotional suffering in old age is largely caused by various psychiatric conditions, of which depression is the most common. Depression is associated with a decline in both well-being and daily functioning and reduces both morale and social capacity among the very old, which may produce high health and social costs for society. The overall aim of the thesis was to study the prevalence of depression among the very old, to identify factors associated with depression and to evaluate the prognosis of depression among the very old. In total, 363 people were evaluated for depression, 242 from an urban municipality in the year 2000 and 121 from five rural municipalities in 2002. In 2005, those still alive in the urban municipality were asked to participate again, and were therefore re-evaluated. The prevalence of depression was 27% in the urban municipality, 34% in the rural municipalities and 29% in the total sample. Of those depressed, about 67% were receiving antidepressive treatment, and of those, approximately 50% had responded to treatment. In the rural municipality, the depressed were less often treated with Selective Serotonin Re-uptake Inhibitor medications, receiving instead Tri-Cyclic Antidepressants. In the rural municipalities, only 38% of the depressed had responded to treatment. A higher proportion of women were diagnosed as depressed, 33% vs. 19%, p=0.006, although the response rate was the same for men and women. Depression was twice as common among those with dementia, 44% vs. 23%. There were discrepancies concerning associated factors between the depressed participants with dementia and those without. Experiencing the death of a child during the preceding ten years was associated with depression and independently associated with depression among men and participants with dementia. In all the studies, the depressed were less often able to go outside independently and to visit others. They also received fewer visits from others and often experienced loneliness. The great majority of those who were depressed in 2000 died during the subsequent five years, only 13 out of 65, 22%, were still alive in 2005, compared to 41% of those who were not depressed, p=0.003. Of 13 who survived, only two had recovered. Twenty-four out of 70 non-depressed people, 34%, had developed depression during the five years (2000-2005), and the total prevalence in year 2005 was 42% (35 out of 83 participants). Ten out of the 24 who had developed depression were prescribed antidepressants. Of those ten, four were regarded as responders. In the group with persistent depression, nine out of eleven were receiving antidepressants and 67% were responders. In conclusion, a large proportion of the very old suffer from under-diagnosed and undertreated depression. The response rate to treatment seems to be low, and the quality of treatment and follow-up also seems to be poor. The mortality rate among the depressed was high. The spectrum of factors associated with depression in people with dementia is different from that associated with depression among non-demented. Depression among the very old clearly emerges as a common and serious public health problem, with probably the most serious impact on quality of life. More efforts have to be made to improve the quality of assessments, treatment and research regarding depression among the very old.
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| 6. |
- Berggren, Monica, et al.
(author)
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Evaluation of a fall-prevention program in older people after femoral neck fracture : a one-year follow-up
- 2008
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In: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 19:6, s. 801-809
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Journal article (peer-reviewed)abstract
- A randomized, controlled fall-prevention study including 199 patients operated on for femoral neck fracture reduced inpatient falls and injuries. No statistically significant effects of the intervention program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone old people. Introduction This study evaluates whether a postoperative multidisciplinary, multifactorial fall-prevention program performed by a geriatric team that reduced inpatient falls and injuries had any continuing effect after discharge. The intervention consisted of staff education, systematic assessment and treatment of fall risk factors and vitamin D and calcium supplementation. Methods The randomized, controlled trial with a one-year follow-up at Umea University Hospital, Sweden, included 199 patients operated on for femoral neck fracture, aged >= 70 years. Results After one year 44 participants had fallen 138 times in the intervention group compared with 55 participants and 191 falls in the control group. The crude postoperative fall incidence was 4.16/1,000 days in the intervention group vs. 6.43/1,000 days in the control group. The incidence rate ratio was 0.64 (95% CI: 0.40-1.02, p = 0.063). Seven new fractures occurred in the intervention group and 11 in the control group. Conclusion A team applying comprehensive geriatric assessment and rehabilitation, including prevention and treatment of fall-risk factors, reduced inpatient falls and injuries, but no statistically significant effects of the program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone elderly.
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| 7. |
- Bergström, Ulrica, 1970-, et al.
(author)
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The hip fracture incidence curve is shifting to the right : a forecast of the age-quake
- 2009
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In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 80:5, s. 520-524
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Journal article (peer-reviewed)abstract
- Background The number of hip fractures has doubled in the last 30–40 years in many countries. Age-adjusted incidence has been reported to be decreasing in Europe and North America, but is there a decreasing trend in all age groups? Patients and methods This population-based study included all hip-fracture patients over 50 years of age (a total of 2,919 individuals, 31% of whom were men) admitted to Umeå University Hospital, Sweden, from 1993 through 2005. Results The incidence of hip fracture declined between the periods 1993–1996 and 2001–2005: from 706 to 625 hip fractures per 105 women and from 390 to 317 hip fractures per 105 men. However, there was a 114% increase in the number of fractures in women aged 90 or older (12 and 25 hip fractures/year, respectively, in the two time periods). For the period 2001–05, women ≥ 90 years of age accounted for almost the same numbers of hip fractures as women aged 75–79 (27 fractures/year). The rate increased during this period, from 2,700 per 105 women to 3,900 per 105 women > 90 years. In men there were declining trends for both relative and absolute numbers. Interpretation Although age-adjusted incidence declined in the population > 50 years of age, absolute fracture rate and incidence increased in the very old. Women over 90 now have the same absolute number of hip fractures every year as women aged 75–79 years. There was a right-shift in hip fracture distribution towards the oldest old, probably due to an increased number of octo/nonagenarians, a new population of particularly frail old people that hardly existed earlier. Better health among septuagenarians may also have delayed the age at which fractures occurred. This changing pattern will strain orthopedic and geriatric resources even more.
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| 8. |
- Carlsson, Maine, 1955-, et al.
(author)
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Body composition in Swedish old people aged 65-99 years, living in residential care facilities
- 2009
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In: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 49:1, s. 98-107
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Journal article (peer-reviewed)abstract
- It is important to evaluate body composition changes in subjects with an existing multi-system reduction in capacity, as a small decrease in fat-free mass (FFM) can cause serious impairments. The aim of the study was to describe body composition in old people living in institutions. Body composition data were collected within a study of 173 subjects with functional and cognitive impairment, aged 65-99 years, and living in residential care facilities. A bioelectrical impedance spectrometer (BIS) (Xitron Hydra 4200; 5-1000 kHz) was used to assess the amount of both FFM and fat mass (FM) which where adjusted for height. The Harpenden caliper and a tape measure were used to assess body fat, arm-muscle and arm-fat area (mm(2)). A large proportion of the old and functionally impaired population was at risk of malnutrition or already malnourished (63.4% vs. 17.4%) according to Mini-Nutritional Assessment (MNA). Women had significantly lower fat-free mass index (FFMI) and higher FMI, inversely related to age, than men. Bioelectrical impedance spectroscopy and anthropometrical measurements correlated but on different levels. In addition the FM% differed between the two methods (46.3% vs. 33.4%).
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| 9. |
- Carlsson, Maine, 1955-, et al.
(author)
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The feasibility of serving liquid yoghurt supplemented with probiotic bacteria, Lactobacillus rhamnosus LB 21, and Lactococcus lactis L1A : a pilot study among old people with dementia in a residential care facility
- 2009
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In: The Journal of Nutrition, Health & Aging. - Paris : Serdi. - 1279-7707 .- 1760-4788. ; 13:9, s. 813-819
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Journal article (peer-reviewed)abstract
- Background: Constipation and body weight loss are prevalent among old people. Treatment with different species of lactic acid bacteria has been suggested for various forms of gastrointestinal disorders. Objective, participants and intervention: This pilot study was performed to assess the feasibility of administering and consuming a drinkable yoghurt containing Lactobacillus rhamnosus LB 21 and Lactococcus L1A, and to evaluate the influence on bowel movements and body weight in 15 people with dementia, aged 65–95 years in residential care facility. Design: A drinkable yoghurt (Verum Drickyoghurt©) with added bacteria was served daily for 6 months in conjunction with ordinary food intake. Body weight, bowel movement frequency and consistency, food and fluid intake and time spent in various activities were recorded for two weeks preintervention, and 3 times during the follow-up period. Result: This study showed that the yoghurt was easy to serve, with few side effects for the participants and that the various recording forms and diaries were easy for the staff to complete. The extra intake of yoghurt did not have any detectable beneficial effect on bowel movements. The overnight fast was almost 15 hours per day. Body weight decreased by 0.65 kg/month (95% confidence interval. 0.27–0.97). Conclusions: The present study design was feasible in this group of old people with dementia. The absence of any detectable effect of the supplement on constipation, but rather a considerable loss in body weight, indicate that further research is needed in a large randomised controlled trial, if associations between dementia, constipation and energy balance are to be understood.
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| 10. |
- Conradsson, Mia, et al.
(author)
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Berg Balance Scale : intrarater test-retest reliability among older people dependent in activities of daily living and living in residential care facilities
- 2007
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 87:9, s. 1155-1163
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Journal article (peer-reviewed)abstract
- The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about the absolute reliability of BBS scores. The aim of this study was to investigate the absolute and relative intrarater test-retest reliability of data obtained with the BBS when it is used among older people who are dependent in activities of daily living and living in residential care facilities. The participants were 45 older people (36 women and 9 men) who were living in 3 residential care facilities. Their mean age was 82.3 years (SD=6.6, range=68-96), and their mean score on the Mini Mental State Examination was 17.5 (SD=6.3, range=4-30). The BBS was assessed twice by the same assessor. The intrarater test-retest reliability assessments were made at approximately the same time of day and with 1 to 3 days in between assessments. Absolute reliability was calculated using an analysis of variance with a 95% confidence level, as suggested by Bland and Altman. Relative reliability was calculated using the intraclass correlation coefficient (ICC). The mean score was 30.1 points (SD=15.9, range=3-53) for the first BBS test and 30.6 points (SD=15.6, range=4-54) for the retest. The mean absolute difference between the 2 tests was 2.8 points (SD=2.7, range=0-11). The absolute reliability was calculated as being 7.7 points, and the ICC was calculated to .97. Despite a high ICC value, the absolute reliability showed that a change of 8 BBS points is required to reveal a genuine change in function among older people who are dependent in activities of daily living and living in residential care facilities. This knowledge is important in the clinical setting when evaluating an individual's change in balance function over time in this group of older people.
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