| 1. |
- Kajonius, Petri, 1974-
(författare)
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An Inquiry into Satisfaction and Variations in User-Oriented Elderly Care
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The foundation for this thesis is an ongoing discussion about quality in Swedish elderly care: Which are the most important factors that contribute to elderly care in terms of satisfaction among older persons, and what are the primary reasons for their differences? Aims. The principal aim was to examine what determines satisfaction with elderly care in home care and nursing homes, using the perspective of older persons (Studies I and II). The secondary aim was to analyze why these determinants differ, using the perspective of care workers, managers, and observers (Studies III and IV). Methods. Study I analyzed aggregated statistical data from the level of municipalities and districts (N = 324) based on the Swedish elderly care quality reports “Open Comparisons”, while Study II analyzed individual data based on the original ratings in the annual, nationwide elderly surveys (N = 95,000). Study III describes field observations and interviews with care workers and managers in two municipalities, one with a high rating for user satisfaction and one with an average rating. Study IV describes investigations in these two municipalities concerning their organizing principles and departmental level management climate. Results. The results relating to the principal aim showed that process factors (such as respect, information, and influence) are related considerably more closely than structural factors (such as budget, staffing levels, and training levels) to satisfaction with care. Other process factors (such as treatment, safeness, staff and time availability) were also able to alleviate person factors (such as health, anxiety, and loneliness). Moreover, the results relating to the secondary aim showed that differences in user-oriented elderly care are mainly due to interpersonal factors between the caregiver and the older person. Care workers, however, reported that other factors (such as organizing principles and leadership support) influence the quality of the care process. Overall, older persons who receive home care generally report higher satisfaction with care than those in nursing homes, and feeling less safe. It is possible that differences in the process of aging explain this. Value. This thesis shows that satisfaction with elderly care can be largely explained by psychological quality at the individual level. The sizes of structural resources and organizing principles at the municipal level have minimal effect (< 5%). The thesis also presents a theoretical multiple-level Quality Agents Model to explain the sources of differences in satisfaction with care, and it presents recommendations for elderly care practices. A renewed focus on the psychology of satisfaction may contribute to the development of quality in elderly care.
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| 2. |
- Aronsson, Gunnar, et al.
(författare)
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Healthy workplaces for women and men of all ages
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this knowledge compilation is to contribute with knowledge about the work environment in relation to the ever-older workforce. How do employee needs and possibilities change from a course of life perspective? What should the employer and other work environment actors think about in order for the workforce to be able to and want to work to a high age?The Swedish Work Environment Authority wishes to give an overarching knowledge profile of different aspects of the work environment and the ageing workforce, and we therefore asked seven researchers to summarise the research-based knowledge within each of their areas, from a course of life and gender perspective. An eighth researcher acted as an editor for the anthology, and has also written the preface.In summary, the report shows that we are becoming even healthier, living ever longer and working to an ever higher age. Older people in the workforce are positive for the economy because productivity increases, and the business sector can make use of competent and experienced staff for a longer time. But for the older labour force to be healthy and want to work at higher ages, one needs to take into consideration how ageing influences health and the capacity to work. With age, all people are affected to different degrees by reduced vision, hearing and physical capacity, as well as longer reaction times. Even their cognitive capacity changes. Certain cognitive abilities are strengthened with rising age, while others deteriorate. With an ageing workforce, more employees have chronic illnesses, which, however, seldom affect the actual working ability. Changes in working life also affect health and wellbeing, for example deregulated work and the technical development. Age and previous experiences impact upon our ability to adapt to these changes. One factor that promotes adaptation is partly resilience (that is to say, resistance and the ability to adapt to the new), partly compensation strategies when the mental and physical resources change. There are no great differences between gender when it comes to the consequences of ageing on health and wellbeing in the work. On the other hand, the public health trend shows increasing differences in health between the lower educated and the higher educated - a difference increasing more quickly among women than among men. The gender-segregated labour market also means that more women than men work in physical and mentally burdensome work. Attitudes at the workplace also affect wellbeing and the will to continue working at higher ages. Men tend to be more sensitive to age discrimination while women run the risk of double discrimination, that is to say based upon both gender and age. Work environment and the attitude to an older workforce are central to the considerations that an employee makes in the choice between continuing to work and retiring. Other prerequisites that influence the decision are one’s own health, private finances and self-fulfilling activities.The employer can do a great deal to lengthen and improve their employees’ working life. Systematic work environment management benefits everyone, and it can contribute to everyone keeping their working ability and to older people wanting to and being able to work for longer. Occupational health services of good quality also play an important role. Technical aids and adaptation of the working pace and working tasks are other measures that improve the work environment for the older workforce. The employer can also contribute to stimulating work arrangements and organisational support for the employees in order to strengthen their resilience and promote the development of compensation strategies.
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| 3. |
- Henning, Georg, 1989, et al.
(författare)
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Towards an active and happy retirement? Changes in leisure activity and depressive symptoms during the retirement transition.
- 2021
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Ingår i: Aging & Mental Health. - : Routledge. - 1360-7863 .- 1364-6915. ; 25:4, s. 621-631
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Retirement is a major life transition in the second half of life, and it can be associated with changes in leisure activity engagement. Although theories of retirement adjustment have emphasized the need to find meaningful activities in retirement, little is known about the nature of changes in leisure activity during the retirement transition and their association with mental health.Methods: Based on four annual waves of the 'Health, Aging and Retirement Transitions in Sweden' study, we investigated the longitudinal association of leisure activity engagement and depressive symptoms using bivariate dual change score models. We distinguished intellectual, social, and physical activity engagement.Results: We found increases in all three domains of activity engagement after retirement. Although level and change of activity and depressive symptoms were negatively associated, the coupling parameters were not significant, thus the direction of effects remains unclear.Conclusion: The results highlight the need to consider the role of lifestyle changes for retirement adjustment and mental health.
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| 4. |
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| 5. |
- Thorvaldsson, Valgeir, 1976, et al.
(författare)
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Impact of Stroke on Cognition in Old Age: Comparison of Two Population-Based Cohorts, Born up to 30 Years Apart and Followed From Age 70 to 85
- 2024
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Ingår i: Psychology and Aging. - 0882-7974 .- 1939-1498. ; 39, s. 484-494
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about birth cohort differences in the impact of stroke on cognitive aging. Given improved poststroke rehabilitation and better treatments for vascular health risk, we may expect a reduction in the stroke impact in later-born cohorts. We tested this prediction using data from two cohorts, born in 1901– 1907 (n = 1,155) and 1930 (n = 919), identified from the same city population at the same age of 70 and subsequently measured on the same cognitive outcomes (i.e., spatial ability, perceptual–motor speed, and reasoning) at ages 70, 75, 79, and 85. We fitted multiple-group second-order latent growth curve models to the data, regressing the first-order cognitive factor on the time-varying stroke variable and controlling for relevant covariates. Findings revealed moderate to large average cognitive decline (d = −.45) following stroke, and the impact was relatively similar across cohorts (1901–1907: d = −.52; 1930: d = −.39). However, there was a stroke by age by cohort interaction, implying that the stroke impact increased with age in the 1901–1907 cohort (dage≤75 = −.42; dage≥79 = −.70) but decreased in the 1930 cohort (dage≤75 = −.53; dage≥79 = −.17). We found no evidence for lagged effect of stroke beyond the impact on measures following the incidence. Our hypothesis was only partially supported, as the impact of stroke was reduced in the laterborn cohort but solely at higher ages.
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| 6. |
- Thorvaldsson, Valgeir, 1976, et al.
(författare)
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Nonlinear blood pressure effects on cognition in old age: separating between-person and within-person associations.
- 2012
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Ingår i: Psychology and Aging. - : American Psychological Association (APA). - 0882-7974 .- 1939-1498. ; 27:2, s. 375-383
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Tidskriftsartikel (refereegranskat)abstract
- Midlife hypertension is associated with increased risk of cognitive impairment in later life. The association between blood pressure (BP) in older ages and cognition is less clear. In this study we provide estimates of between-person and within-person associations of BP and cognition in a population-based sample (N = 382) followed from age 70 across 12 occasions over 30 years. Between-person associations refer to how individual differences in BP relates to individual differences in cognition. Within-person associations refer to how individual and time specific changes in BP relate to variation in cognition. Hierarchical linear models were fitted to data from three cognitive measurements (verbal ability, spatial ability, and perceptual speed) while accounting for demographic and health-related covariates. We found consistent nonlinear between-person associations between diastolic BP (DBP) and cognition, such that both low (<75 mmHg) and high (>95 mmHg) pressure were associated with poorer cognition. Within-person decreases in systolic BP (SBP) and DBP were associated with decreases in perceptual speed. Notably, between-person and within-person estimates did not reveal similar associations, suggesting the need to separate the two effects in the analysis of associations between BP and cognition in old age. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
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| 7. |
- Yoneda, Tomiko, et al.
(författare)
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Trajectories of Personality Traits Preceding Dementia Diagnosis.
- 2017
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 72:6, s. 922-931
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several retrospective studies using informant report have shown that individuals with dementia demonstrate considerable personality change. Two prospective studies, also using informant report, have shown that individuals who develop dementia show some personality changes prior to diagnosis. The current study is the first to assess personality trait change prior to dementia diagnosis using self-report measures from longitudinal data. Method: This study used data from the Swedish OCTO-Twin Study, a longitudinal panel of 702 twins aged 80 and older. Analysis was restricted to 86 individuals who completed the Eysenck Personality Inventory and received a dementia diagnosis during follow-up occasions. Latent growth curve analyses were used to examine trajectories of extraversion and neuroticism preceding dementia diagnosis. Results: Controlling for sex, age, education, depressive symptoms, and the interaction between age and education, growth curve analyses revealed a linear increase in neuroticism and stability in extraversion. Individuals who were eventually diagnosed with dementia showed a significant increase in neuroticism preceding diagnosis of dementia. Discussion: Personality change, specifically an increase in neuroticism, may be an early indicator of dementia. Identification of early indicators of dementia may facilitate development of screening assessments and aid in early care strategies and planning.
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| 8. |
- Bai, Ge, et al.
(författare)
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Frailty trajectories in three longitudinal studies of aging : Is the level or the rate of change more predictive of mortality?
- 2021
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Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.OBJECTIVES: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.METHODS: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis.RESULTS: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.CONCLUSIONS: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.
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| 9. |
- Hassing, Linda, 1967, et al.
(författare)
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Åldrande och kognition
- 2005
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Ingår i: Nordisk Psykologi. ; 57, s. 4-20
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Forskningsöversikt (refereegranskat)abstract
- This article provides an overview of cognitive aging research with focus on normal aging. Results from longitudinal studies have revealed that cognitive abilities are more stable than early findings from cross-sectional studies indicated. It is also clear that crystallized abilities, such as knowledge, vocabulary, and verbal abilities are mostly stable or even may show an improvement across the adult life-span, whereas fluid abilities such as speed, executive function, working memory, and episodic memory are negatively affected in aging. Although fluid cognitive abilities tend to decline with age crystallized abilities can provide cognitive support and in this respect compensate deficits in everyday problem solving. Much research has been conducted in the last decades to identify factors that contribute to cognitive aging. It is well established that genetic, health-related (e.g., hypertension, diabetes, homocysteine, and vitamin status), as well as lifestyle factors (e.g., education, substance use, physical- and social activities) are of importance for cognitive functioning. Some of the age-related variation in cognitive performance is also mediated by changes in other cognitive processes such as speed. There is, however, still age-related variation that has not been accounted for which emphasize the need for further research and suggest that multiple aging processes affect our central nervous system and thereby various mechanisms involved in cognitive functioning.
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| 10. |
- Piccinin, A. M., et al.
(författare)
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Coordinated analysis of age, sex, and education effects on change in MMSE scores
- 2013
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 68:3, s. 374-390
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Tidskriftsartikel (refereegranskat)abstract
- We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.
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