| 1. |
- Sidenvall, Birgitta, et al.
(författare)
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Elderly patients' meal patterns : A retrospective study
- 1996
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Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 9:4, s. 263-272
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty-five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficiency.
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| 2. |
- Thunborg, Charlotta, 1965-, et al.
(författare)
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Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial
- 2024
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Ingår i: Alzheimer's Research & Therapy. - : Springer Nature. - 1758-9193. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer’s disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear.Methods: MIND-ADmini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60–85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale.Results: During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (βLifestyle×Time = 1.11, P = 0.038; βLifestyle+medical food×Time = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P < 0.05, exploratory analysis). There were 5 serious adverse events (control group: 1; lifestyle intervention: 3; lifestyle + medical food: 1) unrelated to interventions.Conclusions: The multidomain lifestyle intervention, alone or combined with medical food, had good feasibility and adherence in prodromal AD. Longer-term cognitive and other health benefits should be further investigated in a larger-scale trial.
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| 3. |
- Edlund, Agneta, et al.
(författare)
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Delirium before and after operation for femoral neck fracture
- 2001
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Ingår i: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 49:10, s. 1335-1340
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to investigate the differences between preoperative and postoperative delirium regarding predisposing, precipitating factors and outcome in older patients admitted to hospital with femoral neck fractures.DESIGN: A prospective clinical assessment of patients treated for femoral neck fractures.SETTING: Department of orthopedic surgery at Umeå University Hospital, Sweden.PARTICIPANTS: One hundred one patients, age 65 and older admitted to the hospital for treatment of femoral neck fractures.MEASUREMENTS: The Organic Brain Syndrome (OBS) Scale.RESULTS: Thirty patients (29.7%) were delirious before surgery and another 19 (18.8%) developed delirium postoperatively. Of those who were delirious preoperatively, all but one remained delirious postoperatively. The majority of those delirious before surgery were demented, had been treated with drugs with anticholinergic properties (mainly neuroleptics), had had previous episodes of delirium, and had fallen indoors. Patients who developed postoperative delirium had perioperative falls in blood pressure and had more postoperative complications such as infections. Male patients were more often delirious both preoperatively and postoperatively. Patients with preoperative delirium were more often discharged to institutional care and had poorer walking ability both on discharge and after 6 months than did patients with postoperative delirium only.CONCLUSIONS: Because preoperative and postoperative delirium are associated with different risk factors it is necessary to devise different strategies for their prevention.
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| 4. |
- Lundström, Maria, et al.
(författare)
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Postoperative delirium in old patients with femoral neck fracture : a randomized intervention study.
- 2007
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 178-186
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Delirium is a common postoperative complication in elderly patients which has a serious impact on outcome in terms of morbidity and costs. We examined whether a postoperative multi-factorial intervention program can reduce delirium and improve outcome in patients with femoral neck fractures.METHODS: One hundred and ninety-nine patients, aged 70 years and over (mean age+/-SD, 82+/-6, 74% women), were randomly assigned to postoperative care in a specialized geriatric ward or a conventional orthopedic ward. The intervention consisted of staff education focusing on the assessment, prevention and treatment of delirium and associated complications. The staff worked as a team, applying comprehensive geriatric assessment, management and rehabilitation. Patients were assessed using the Mini Mental State Examination and the Organic Brain Syndrome Scale, and delirium was diagnosed according to DSM-IV criteria.RESULTS: The number of days of postoperative delirium among intervention patients was fewer (5.0+/-7.1 days vs 10.2+/-13.3 days, p=0.009) compared with controls. A lower proportion of intervention patients were delirious postoperatively than controls (56/102, 54.9% vs 73/97, 75.3%, p=0.003). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (p<0.001). Intervention patients suffered from fewer complications, such as decubitus ulcers, urinary tract infections, nutritional complications, sleeping problems and falls, than controls. Total postoperative hospitalization was shorter in the intervention ward (28.0+/-17.9 days vs 38.0+/-40.6 days, p=0.028).CONCLUSIONS: Patients with postoperative delirium can be successfully treated, resulting in fewer days of delirium, fewer other complications, and shorter length of hospitalization.
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| 5. |
- Wimo, Anders, et al.
(författare)
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The societal costs of dementia in Sweden 2012 : relevance and methodological challenges in valuing informal care
- 2016
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Ingår i: Alzheimer's Research & Therapy. - : Springer Science and Business Media LLC. - 1758-9193. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: In this study, we sought to estimate the societal cost of illness in dementia in Sweden in 2012 using different costing approaches to highlight methodological issues.Methods: We conducted a prevalence-based cost-of-illness study with a societal perspective.Results: The societal costs of dementia in Sweden in 2012 were SEK 62.9 billion (approximately €7.2 billion, approximately US$ 9.0 billion) or SEK 398,000 per person with dementia (approximately €45,000, approximately US$ 57,000). By far the most important cost item is the cost of institutional care: about 60% of the costs. In the sensitivity analysis, different quantification and costing approaches for informal care resulted in a great variation in the total societal cost, ranging from SEK 60 billion (€6.8 billion, US$ 8.6 billion) to SEK 124 billion (€14.1 billion, US$ 17.8 billion).Conclusions: The societal costs of dementia are very high. The cost per person with dementia has decreased somewhat, mainly because of de-institutionalisation. The majority of the costs occur in the social care sector, but the costing of informal care is crucial for the cost estimates.
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| 6. |
- Öhlin, Jerry, et al.
(författare)
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Concurrent validity of the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) - tested with accelerometer data from the SilverMONICA study
- 2022
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Ingår i: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 92, s. 135-143
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical activity and sedentary behavior vary across the life span, and in very old people activity behavior can vary considerably over 24 h. A physical activity questionnaire adapted for this age group is lacking. This study was conducted to validate such a newly developed questionnaire suitable for use in very old people.Research question: Is the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) a valid measure of physical activity in very old people?Methods: Seventy-six participants (55.3% women) with a mean age of 84.4 ± 3.8 years wore accelerometers for ≥ 5 consecutive days, and completed the IPAQ-E 80 +. Spearman's rho and Bland-Altman plots were used to analyze the validity of IPAQ-E 80 + against accelerometer measures. Analyses were conducted for the separate items sitting, laying down at daytime and nighttime, walking, moderate to vigorous (MV) walking, and moderate to vigorous physical activity (MVPA), and the summary measures: total inactive time, sedentary time (i.e. lying down at daytime + sitting), total active time, and total MVPA + MV walking.Results: The IPAQ-E 80 + correlated with the accelerometer measures of total inactive- (r = 0.55, p < 0.001), sedentary- (r = 0.28, p = 0.015), walking- (r = 0.54 p < 0.001) and total active- (r = 0.60, p < 0.001) times, but not with measures of intensity of walking or physical activity; MV walking (r = 0.06, p = 0.58), MVPA (r = 0.17, p = 0.13).Significance: In this study the IPAQ-E 80 + showed fair to substantial correlations with accelerometers, and it therefore seems able to rank very old people according to levels of PA (total inactive-, sedentary-, and total active time, and walking time). The IPAQ-E 80 + seems promising for use in studies investigating associations between activity behavior and health in this population. Further investigation is needed to determine whether the IPAQ-E 80 + can accurately measure PA intensity.
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| 7. |
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| 8. |
- Björk, Sabine, et al.
(författare)
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Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes : a cross-sectional study
- 2016
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay. Methods: Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test. Results: The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units. Conclusions: The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and initiating future nursing assessments.
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| 9. |
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| 10. |
- Kekäläinen, Tiia, et al.
(författare)
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Does personality moderate the efficacy of physical and cognitive training interventions? A 12-month randomized controlled trial in older adults
- 2023
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Ingår i: Personality and Individual Differences. - : Elsevier. - 0191-8869 .- 1873-3549. ; 202
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated whether personality traits moderate the effects of a 12-month physical or combined physical and cognitive training interventions on physical and cognitive functioning. Participants were community-dwelling 70–85-year-old adults (n = 314). They were randomly assigned to physical training (weekly supervised walking/balance and strength/balance training, home exercises 2–3×/wk and moderate aerobic activity) or to a physical and cognitive training group (the same physical training and computer training on executive functions 3–4×/wk). The outcomes assessed at baseline and post-intervention were physical (maximum gait speed, six-minute walking distance, dual-task cost on gait speed) and cognitive functioning (Stroop, Trail-Making Test-B, verbal fluency, CERAD total score). Personality traits (NEO-PI-3, n = 239) were assessed post-intervention. Personality traits did not moderate intervention effects on physical functioning. Higher openness was associated with greater improvement in CERAD scores, especially in the physical and cognitive training group (group×time×trait B = -0.08, p = .038). Lower neuroticism (time×trait B = -0.04, p = .021) and higher conscientiousness (time×trait B = 0.04, p = .027) were associated with greater improvement in CERAD scores in both groups. Personality traits had mostly null moderating effects across physical and cognitive outcomes, with the possible exception of CERAD score. Individuals with more adaptive personality traits gained more on global cognitive scores during a 12-month training intervention.
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