| 21. |
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| 22. |
- Haak, Maria, et al.
(författare)
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The influence of participation on mortality in very old age among community-living people in Sweden
- 2019
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 31:2, s. 265-271
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Tidskriftsartikel (refereegranskat)abstract
- Background: Participation in everyday life and society is generally seen as essential for health-related outcomes and acknowledged to affect older people’s well-being. Aims: To investigate if aspects of performance- and togetherness-related participation influence on mortality among very old single living people in Sweden. Methods: ENABLE-AGE Survey Study data involving single-living participants in Sweden (N = 314, aged 81–91 years), followed over 10 years were used. Multivariate Cox regression models adjusted for demographic and health-related variables were used to analyse specific items influencing mortality. Results: Participation in performance- or togetherness-oriented activities was found to significantly influence mortality [HR 0.62 (0.44–0.88), P value 0.006, and HR 0.72 (0.53–0.97), P value 0.031, respectively]. Talking to neighbours and following local politics had a protective effect on mortality, speaking to relatives on the phone (CI 1.10–2.02) and performing leisure activities together with others (CI 1.10–2.00) had the opposite influence. That is, those performing the latter activities were significantly more likely to die earlier. Discussion: The main contribution of this study is the facet of the results showing that aspects of performance- and togetherness-related participation have a protective effect on mortality in very old age. This is important knowledge for designing health promotion and preventive efforts for the ageing population. Moreover, it constitutes a contribution to the development of instruments capturing aspects of participation influencing on mortality. Conclusion: In the development of health promotion and preventive efforts the inclusion of participation facets could be considered in favour of potential positive influences on longevity.
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| 23. |
- Heimburg, Katarina, et al.
(författare)
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Agreement between self-reported and objectively assessed physical activity among out-of-hospital cardiac arrest survivors.
- 2023
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961 .- 1475-097X.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Low level of physical activity is a risk factor for new cardiac events in out-of-hospital cardiac arrest (OHCA) survivors. Physical activity can be assessed by self-reporting or objectively by accelerometery.AIM: To investigate the agreement between self-reported and objectively assessed physical activity among OHCA survivors HYPOTHESIS: Self-reported levels of physical activity will show moderate agreement with objectively assessed levels of physical activity.METHOD: Cross-sectional study including OHCA survivors in Sweden, Denmark, and the United Kingdom. Two questions about moderate and vigorous intensity physical activity during the last week were used as self-reports. Moderate and vigorous intensity physical activity were objectively assessed with accelerometers (ActiGraph GT3X-BT) worn upon the right hip for 7 consecutive days.RESULTS: Forty-nine of 106 OHCA survivors answered the two questions for self-reporting and had 7 valid days of accelerometer assessment. More physically active days were registered by self-report compared with accelerometery for both moderate intensity (median 5 [3:7] vs. 3 [0:5] days; p < 0.001) and vigorous intensity (1 [0:3] vs. 0 [0:0] days; p < 0.001). Correlations between self-reported and accelerometer assessed physical activity were sufficient (moderate intensity: rs = 0.336, p = 0.018; vigorous intensity: rs = 0.375, p = 0.008), and agreements were fair and none to slight (moderate intensity: k = 0.269, p = 0.001; vigorous intensity: k = 0.148, p = 0.015). The categorization of self-reported versus objectively assessed physical activity showed that 26% versus 65% had a low level of physical activity.CONCLUSION: OHCA survivors reported more physically active days compared with the results of the accelerometer assessment and correlated sufficiently and agreed fairly and none to slightly.
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| 24. |
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| 25. |
- Holgersson, Johan, et al.
(författare)
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Hypothermic versus Normothermic Temperature Control after Cardiac Arrest
- 2022
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Ingår i: NEJM Evidence. - 2766-5526. ; 1:11, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThe evidence for temperature control for comatose survivors of cardiac arrest is inconclusive. Controversy exists as to whether the effects of hypothermia differ per the circumstances of the cardiac arrest or patient characteristics.METHODSAn individual patient data meta-analysis of the Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest (TTM) and Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trials was conducted. The intervention was hypothermia at 33°C and the comparator was normothermia. The primary outcome was all-cause mortality at 6 months. Secondary outcomes included poor functional outcome (modified Rankin scale score of 4 to 6) at 6 months. Predefined subgroups based on the design variables in the original trials were tested for interaction with the intervention as follows: age (older or younger than the median), sex (female or male), initial cardiac rhythm (shockable or nonshockable), time to return of spontaneous circulation (above or below the median), and circulatory shock on admission (presence or absence).RESULTSThe primary analyses included 2800 patients, with 1403 assigned to hypothermia and 1397 to normothermia. Death occurred for 691 of 1398 participants (49.4%) in the hypothermia group and 666 of 1391 participants (47.9%) in the normothermia group (relative risk with hypothermia, 1.03; 95% confidence interval [CI], 0.96 to 1.11; P=0.41). A poor functional outcome occurred for 733 of 1350 participants (54.3%) in the hypothermia group and 718 of 1330 participants (54.0%) in the normothermia group (relative risk with hypothermia, 1.01; 95% CI, 0.94 to 1.08; P=0.88). Outcomes were consistent in the predefined subgroups.CONCLUSIONSHypothermia at 33°C did not decrease 6-month mortality compared with normothermia after out-of-hospital cardiac arrest. (Funded by Vetenskapsrådet; ClinicalTrials.gov numbers NCT02908308 and NCT01020916.)
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| 26. |
- Jakobsen, Janus Christian, et al.
(författare)
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Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest: a statistical analysis plan.
- 2020
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- To date, targeted temperature management (TTM) is the only neuroprotective intervention after resuscitation from cardiac arrest that is recommended by guidelines. The evidence on the effects of TTM is unclear.The Targeted Hypothermia Versus Targeted Normothermia After Out-of-hospital Cardiac Arrest (TTM2) trial is an international, multicentre, parallel group, investigator-initiated, randomised, superiority trial in which TTM with a target temperature of 33 °C after cardiac arrest will be compared with a strategy to maintain normothermia and active treatment of fever (≥ 37.8 °C). Prognosticators, outcome assessors, the steering group, the trial coordinating team, and trial statisticians will be blinded to treatment allocation. The primary outcome will be all-cause mortality at 180 days after randomisation. We estimate a 55% mortality in the targeted normothermia group. To detect an absolute risk reduction of 7.5% with an alpha of 0.05 and 90% power, 1900 participants will be enrolled. The secondary neurological outcome will be poor functional outcome (modified Rankin scale 4-6) at 180 days after cardiac arrest. In this paper, a detailed statistical analysis plan is presented, including a comprehensive description of the statistical analyses, handling of missing data, and assessments of underlying statistical assumptions. Final analyses will be conducted independently by two qualified statisticians following the present plan.This SAP, which was prepared before completion of enrolment, should increase the validity of the TTM trial by mitigation of analysis-bias.
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| 27. |
- Jonasson, Stina, et al.
(författare)
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Concerns About Falling in Parkinson's Disease: Associations with Disabilities and Personal and Environmental Factors.
- 2015
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Ingår i: Journal of Parkinson's Disease. - 1877-718X. ; 5:2, s. 341-349
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Tidskriftsartikel (refereegranskat)abstract
- Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related self-efficacy. It is common in people with Parkinson's disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors.
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| 28. |
- Kader, Manzur, et al.
(författare)
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Factors associated with perceived walking difficulties in people with Parkinson’s disease
- 2017
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Ingår i: Movement Disorders. - 0885-3185. ; 32:Suppl. 2
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Konferensbidrag (refereegranskat)abstract
- Objective: To investigate factors that independently contribute to perceived walking difficulties in people with Parkinson’s disease (PD). Background: Despite that walking difficulties are common in people with PD, there is limited knowledge regarding factors that independently contribute to their perceived walking difficulties in daily life. Methods: The study included 243 persons (62% men) with PD; mean (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey with self-administered questionnaires preceded a home visit which included observations, clinical tests and interviews. The dependent variable was perceived walking difficulties assessed with the self-administered generic Walk-12 (Walk-12G, scored 0-42; higher=worse). The independent variables included personal (e.g., age, general self-efficacy) and socio-environmental factors (e.g., social support, living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG), lower extremity functions) and non-motor symptoms (e.g., orthostatic hypotension, cognitive function). Each independent variable was examined with simple linear regression analyses, and variables with p-values <0.3 were then entered into a multivariable linear regression analysis model. Results: The multivariable model identified eight (out of 15) significant independent variables, explaining 56.3% of the variance in perceived walking difficulties. The strongest contributing factor was FOG (25% of the variance), followed by general self-efficacy, fatigue, PD duration, lower extremity function, orthostatic hypotension, bradykinesia and postural instability. Conclusions: Personal factors (i.e., general self-efficacy) as well as motor and non-motor symptoms (e.g. FOG, PD duration and fatigue) seem to be of importance when addressing perceived walking difficulties in people with PD. With such knowledge at hand, interventions addressing modifiable factors could be developed, ultimately enhancing walking ability in people with PD.
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| 29. |
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| 30. |
- Kader, Manzur, et al.
(författare)
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Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease
- 2017
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Ingår i: Journal of Parkinson's Disease. - 1877-718X. ; 7:2, s. 397-407
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Tidskriftsartikel (refereegranskat)abstract
- Background: While walking difficulties are common in people with Parkinson's disease (PD), little is known about factors that independently contribute to their perceived walking difficulties. Objective: To identify factors that independently contribute to perceived walking difficulties in people with PD.Methods: This study involved 243 (62% men) participants; their mean (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey preceded a home visit that included observations, clinical tests, questions and questionnaires that were administered as a structured interview. Perceived walking difficulties (dependent variable) were assessed with the self-administered generic Walk-12 (Walk-12G, scored 0-42, higher=worse). Independent variables included personal (e.g., age and general self-efficacy) and social environmental factors (e.g., social support and living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG) and postural instability) and non-motor symptoms (e.g., fatigue and orthostatic hypotension). Linear multiple regression analysis was used to identify factors that independently contributed to perceived walking difficulties.Results: Eight significant independent variables explained 56.3% of the variance in perceived walking difficulties. FOG was the strongest significant contributing factor to perceived walking difficulties, followed by general self-efficacy, fatigue, PD duration, lower extremity function, orthostatic hypotension, bradykinesia and postural instability.Conclusion: Motor and non-motor symptoms as well as personal factors (i.e., general self-efficacy) seem to be of importance for perceived walking difficulties in PD. These findings might nurture future interventions that address modifiable factors in order to enhance walking ability in people with PD.
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