| 61. |
- Ekman, Inger, 1952, et al.
(författare)
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The clinical implications of cognitive impairment in elderly patients
- 2001
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Ingår i: Journal of Cardiovascular Nursing. - 0889-4655. ; 16:1, s. 47-55
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine whether cognitive dysfunction was associated with poor participation in an outpatient treatment program for patients with chronic heart failure and if it was related to specific patient characteristics. Cognitive function was measured with the Mini Mental State Examination (MMSE). Twenty-three of 78 (29%) patients randomized to structured care did not participate in this program and nonparticipation during 6-month follow-up was associated with an MMSE score below the median and a low calculated creatinine clearance (CrCl) (R2=0.15, p=0.0025) at entry. In the entire group long duration of heart failure and low blood hemoglobin concentration were independently associated with an MMSE score below the median at entry (R2=0.14, p < 0.0001). Among elderly patients hospitalized with moderate-severe chronic heart failure, judged to be eligible for a nurse-directed outpatient program after discharge, a low MMSE score predicted nonparticipation in such a program. Cognitive dysfunction, which was related to the duration of heart failure, should be evaluated in the treatment of patients with chronic heart failure.
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| 62. |
- Falk Erhag, Hanna, et al.
(författare)
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Activities of daily living (ADL) and instrumental activities of daily living (IADL) disability in Swedish 85-year-olds born three decades apart-findings from the H70 study
- 2021
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 50:6, s. 2031-2037
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Older adults make up the fastest growing segment of the population, and disability rates increase with age. There is much debate whether later born cohorts of 85-year-olds will face the same disability rates as earlier born cohorts. This study aimed to examine ADL and IADL disability in three birth cohorts of Swedish 85-year-olds born three decades apart, examined in 1986-87, 2008-10 and 2015-16, as well as potential factors associated with ADL and IADL disability in these birth-cohorts. Methods: Systematically selected population-based birth cohorts of 85-year-olds (n= 1,551) from theGothenburg H70 Birth Cohort studies, Sweden, born in 1901-02 (n= 494), 1923-24 (n= 571) and 1930 (n= 486) and examined with identical methods. Disability was defined as a need for assistance in any ADL/IADL activities. Results: ADL/IADL disability decreased between cohorts in both men and women (from 76.7% in 1986-87, to 58.4% in 2008-10, and 48.4% in 2015-16, P-value trend <.001). Factors associated with ADL/IADL disability varied between cohorts, although dementia and depression increased the odds of disability in all three birth cohorts. Conclusion: Later born cohorts of 85-year-olds face less ADL/IADL disability compared to earlier born cohorts. As disability poses a significant financial burden on healthcare services, our findings might contribute to a more positive view on global ageing and the demographic challenges ahead. However, it might also be that in later born cohorts, ADL/IADL disability affects people at later ages, but due to increased longevity, the total number of years in late-life with a functional disability will remain the same.
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| 63. |
- Falk Erhag, Hanna, et al.
(författare)
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Alcohol use and drinking patterns in Swedish 85 year olds born three decades apart - findings from the Gothenburg H70 study
- 2023
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 52:3
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about alcohol consumption among the oldest old. Objective To compare alcohol use and drinking patterns among 85 year olds born three decades apart. Design Cross-sectional. Setting The Gothenburg H70 Birth Cohort Studies. Subjects About 1,160 85 year olds born in 1901-02, 1923-24, and 1930. Methods Self-reported questions about alcohol included how often study participants drank beer, wine, and spirits and how many centilitres in total/week. Risk consumption was defined as >= 100 g alcohol/week. Descriptive statistics and logistic regression were used to explore cohort characteristics, differences in proportions, factors associated with risk consumption and 3-year mortality. Results The proportion of at-risk drinkers increased from 4.3 to 14.9% (9.6-24.7% in men and 2.1-9.0% in women). The proportion of abstainers decreased from 27.7 to 12.9%, with the largest decrease observed among women (29.3-14.1%). Controlling for sex, education and marital status, 85 year olds in the later-born cohorts were more likely to be risk consumers than those in the earlier-born cohort [odds ratio (OR) 3.1, 95% confidence nterval (CI) 1.8-5.6]. The only factor associated with an increased likelihood was male sex (OR 3.7, 95% CI 1.0-12.7 and OR 3.2, 95% CI 2.0-5.1). There were no associations between risk consumption of alcohol and 3-year mortality in any of the cohorts. Conclusion Alcohol consumption and the number of risk consumers among 85 year olds have increased considerably. This could have large public health consequences since older adults are more sensitive to alcohol's adverse health effects. Our findings show the importance of detecting risk drinkers also in the oldest old.
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| 64. |
- Falk, Hanna, 1977, et al.
(författare)
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Functional disability and ability 75-year-olds: a comparison of two Swedish cohorts born 30 years apart
- 2014
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 43:5, s. 636-641
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the level of functional disability and involvement in leisure activities between two birth cohorts of Swedish 75-year-olds examined in 1976-77 and 2005-06. Design :Cohort comparison. Setting and Participants: Representative data from the general population in Gothenburg, Sweden, examined at age 75 in 1976–77 (N= 744), and in 2005–06 (N= 731) with comprehensive somatic and psychiatric examinations. Measurements: Activities of daily living (ADL); Instrumental activities of daily living (IADL); a battery of self-report measures, including involvement in leisure activities, satisfaction with home environment, social networks, and self-rated health. Results: Functional disability in ADL decreased between the cohorts (13.9% vs. 5.6%, p<.001). Functional disability in IADL also decreased between the cohorts (33.4% vs. 13.0%, p<.001). Combining ADL and IADL resulted in an overall decreased dependency, with the largest decrease seen in women (42.3% vs. 15.1%, p<.001). Involvement in leisure activities increased between the cohorts. For example, the proportion going on international and domestic holiday travels increased (44.6% vs. 72.8%, p<.001), and the proportion who independently drove their own car also increased (10.0% vs. 53.0%, p<.001). Conclusion: Later born cohorts of 75-year-olds are less dependent in activities of daily living and more engaged in leisure activities compared to earlier cohorts. Later born cohorts of 75-year-olds are thus better equipped to maintain a non-age related identity compared to earlier cohorts. Our findings might serve as a reason to adopt a more positive view to aging in a world with an increasing number of older people.
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| 65. |
- Falk, Hanna, 1977, et al.
(författare)
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Internet use and self-rated health among Swedish 70-year-olds: a cross-sectional study
- 2019
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: The Internet is increasingly becoming an infrastructure for a number of services, both commercial, public (including health related) and personal. Using the internet have the potential to promote social interaction and social connectedness by upholding social networks and social contacts. However, Internet use is lower in older adults compared to other age groups. This digital divide is considered a risk to the health of older adults since it limits their participation in society, access and use of relevant health related information and services. This study focuses on whether there is an association between Internet use and self-rated health. Method: A cross-sectional population-based sample of 70-year-olds from The Gothenburg H70 Birth Cohort Study (n=1136) was examined in 2014–16. All data was collected using structured interviews and questionnaires. Differences in proportions were tested with chi-square test and ordinary least square regression analysis was used to estimate the relationship between Internet use and self-rated health controlling for health factors, hearing and visual impairment, and social contacts. Results: There is a relationship between more frequent Internet use and good self-rated health (unstandardized β 0.101 p<0.001), and the effect remained after adjusting for all covariates (unstandardized β 0.082 p<0.001). Our results also show that, in comparison to health factors, Internet use is of minor importance to the SRH of older adults, since adding these improved the explanatory power of the model by approximately 400% (from 0.04 to 0.18). Conclusion: Although the direction of the relationship between more frequent interne use and better self-rated health is undetermined in the present study, it can be suggested that using the Internet informs and educates older adults, strengthening their position as active and engaged participants of society. It can also be suggested that those using the Internet report less loneliness and a possibility to establish new computer-mediated relationships within online communities. Further research needs to examine what aspects of Internet use, and in what contexts such positive perceptions arise.
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| 66. |
- Falk, Hanna, 1977, et al.
(författare)
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Self-rated health and its association with mortality in older adults in China, India and Latin America - a 10/66 Dementia Research Group study
- 2017
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 46:6
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Tidskriftsartikel (refereegranskat)abstract
- Background empirical evidence from high-income countries suggests that self-rated health (SRH) is useful as a brief and simple outcome measure in public health research. However, in many low- and middle-income countries (LMIC) there is a lack of evaluation and the cross-cultural validity of SRH remains largely untested. This study aims to explore the prevalence of SRH and its association with mortality in older adults in LMIC in order to cross-culturally validate the construct of SRH. Methods population-based cohort studies including 16,940 persons aged ≥65 years in China, India, Cuba, Dominican Republic, Peru, Venezuela, Mexico and Puerto Rico in 2003. SRH was assessed by asking ‘how do you rate your overall health in the past 30 days’ with responses ranging from excellent to poor. Covariates included socio-demographic characteristics, use of health services and health factors. Mortality was ascertained through a screening of all respondents until 2007. Results the prevalence of good SRH was higher in urban compared to rural sites, except in China. Men reported higher SRH than women, and depression had the largest negative impact on SRH in all sites. Without adjustment, those with poor SRH showed a 142% increase risk of dying within 4 years compared to those with moderate SRH. After adjusting for all covariates, those with poor SRH still showed a 43% increased risk. Conclusion our findings support the use of SRH as a simple measure in survey settings to identify vulnerable groups and evaluate health interventions in resource-scares settings.
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| 67. |
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| 68. |
- Fatima, Tahzeeb, et al.
(författare)
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Association between serum urate and CSF markers of Alzheimer's disease pathology in a population-based sample of 70-year-olds
- 2021
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Ingår i: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. - : Wiley. - 2352-8729. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The relationship between urate and biomarkers for Alzheimer's disease (AD) pathophysiology has not been investigated. Methods: We examined whether serum concentration of urate was associated with cerebrospinal fluid biomarkers, amyloid beta (A beta)(42), A beta(40), phosphorylated tau (p-tau), total tau (t-tau), neurofilament light (NfL), and A beta(42)/A beta(40) ratio, in cognitively unimpaired 70-year-old individuals from Gothenburg, Sweden. We also evaluated whether possible associations were modulated by the apolipoprotein E (APOE) epsilon 4 allele. Results: Serum urate was positively associated with A beta(42) in males (beta = 0.55 pg/mL, P = .04). There was a positive urate-APOE epsilon 4 interaction (1.24 pg/mL, P-interaction = .02) in relation to A beta(42) association. The positive urate and A beta(42) association strengthened in male APOE epsilon 4 carriers (beta = 1.28 pg/mL, P = .01). Discussion: The positive association between urate and A beta(42) in cognitively healthy men may suggest a protective effect of urate against deposition of amyloid protein in the brain parenchyma, and in the longer term, maybe against AD dementia.
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| 69. |
- Fredén Klenfeldt, Isak, 1980, et al.
(författare)
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Prevalence of Obsessive-compulsive Disorder in Relation to Depression and Cognition in an Elderly Population
- 2014
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481. ; 22:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives We examined the 1-month prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) not fulfilling OCD criteria in relation to sex, age, social and mental function, comorbid depression, and cognitive functioning in an elderly nondemented population. Settings and Participants Population-based sample (N = 900), stratified into two age groups: 70-year-olds (335 women and 224 men) and those aged 78 and above (341 women). Measurements Semi-structured interviews. Psychiatric symptoms were assessed with the Comprehensive Psychopathological Rating Scale and Mini-International Neuropsychiatric Interview, mental and social function with the GAF-scale, memory function with the Word Recall Task and general cognition with MMSE. OCD and Depression were diagnosed according to DSM-IV. Results The one-month prevalence of OCD was 2.9%; a further 21% had OCS. Among 70-year-olds, the prevalence of OCD was 1.3% in men and 4.5% in women. Depression was more common among those with OCD (34.6%) than among those with (12.7%) and without (8.0%) OCS. GAF-score was lower among those with OCD (74.8) and OCS (82.9) compared with individuals without obsessions and compulsions (88.2). The association between OCD and GAF-score remained after adjustment for age, sex, and depression. The OCD subgroup with checking behavior had more memory and concentration problems and did worse on Word Recall Task than other groups in our sample. Conclusions We found that OCD and OCS are common among the elderly. Both conditions are related to depression and poorer mental and social functioning. Physicians who meet elderly patients need to be aware of OCD as it is potentially treatable.
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| 70. |
- Fredén Klenfeldt, Isak, 1980, et al.
(författare)
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The natural history of lifetime psychiatric disorders in patients with obsessive-compulsive disorder followed over half a century
- 2024
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Ingår i: ACTA PSYCHIATRICA SCANDINAVICA. - 0001-690X .- 1600-0447.
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveFew long-term studies have examined the life-time prevalence of comorbid psychiatric conditions in patients with obsessive-compulsive disorder (OCD). We therefore studied the frequency of comorbid psychiatric disorders, and their relation to onset and prognosis, in patients with OCD who were followed for almost half a century.MethodsDuring 1947-1953, 285 OCD patients were admitted as inpatients to a university hospital in Gothenburg, Sweden. Among those, 251 (88%) accepted a structured comprehensive psychiatric examination in 1954-1956. In 1989-1993, 176 survivors were eligible and 144 (response rate 82%) were re-examined. The same psychiatrist performed both examinations. OCD was diagnosed according to the Schneider criteria, and other mental disorders according to DSM-IV. Mean follow-up since onset was 47 years.ResultsThe lifetime frequency of depressive disorders was 84.7% (major depression 43.8%), generalized anxiety disorder (GAD) 71.5%, panic anxiety disorder 47.9%, agoraphobia 52.1%, specific phobias 64.6%, social phobia 47.9%, paranoid conditions 40.3% (29.1% paranoid ideation), psychotic disorders 15.3%, alcohol abuse 13.2% (men 39%, women 3%) and substance abuse 17.4%. Specific phobia most often started before OCD, while depression had a varied onset in relation to OCD. Social phobia, agoraphobia, GAD, alcohol and substance abuse, psychotic disorders and paranoid conditions most often started after OCD. Presence of GAD, psychotic disorder and substance abuse worsened prognosis of OCD.ConclusionComorbid psychiatric conditions are common in OCD patients, and have onset throughout the course. OCD signals vulnerability for other psychiatric conditions, which are important to detect in clinical practice as they negatively affect the outcome.
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