| 1. |
- von Heideken Wågert, Petra, 1977-, et al.
(författare)
-
Large variations in walking, standing up from a chair, and balance in women and men over 85 years : An observational study
- 2009
-
Ingår i: Australian Journal of Physiotherapy. - 0004-9514. ; 55:1, s. 39-45
-
Tidskriftsartikel (refereegranskat)abstract
- Question: How do three different age groups of women and men >85 years perform in tests of gait speed, chair stands, and balance?Design: A population-based cross-sectional observational study.Participants: Half the 85-year-old population, and the total population aged 90 and ³95 (-103) in Umeå, Sweden were assessed in the Umeå 85+ Study (n=238).Outcome measures: Usual and fastest gait speed (m/s) over 2.4 meters (8 feet), three consecutive chair stands (s), the Berg Balance Scale and ability to perform the tests (yes/no).Results: The median (10th-90th percentile) usual gait speed was 0.49 m/s (0.23-0.75), time to perform the chair stands test 12.6 seconds (8.5-20.2), and median Berg Balance Scale scores 45 (0-54). An age-related decline in physical ability was seen in women, but not in men. Men had greater physical ability than women. The Berg Balance Scale showed no floor or ceiling effects, but the gait speed and chair stands tests resulted in a floor effect especially for women.Conclusion: There were large variations in physical ability in these very old people. These data provide valuable reference values for physical ability in the oldest age groups for commonly used clinical measurements.
|
|
| 2. |
- Åberg, Anna Cristina, et al.
(författare)
-
Implementation of evidence-based prevention of falls in rehabilitation units : a staff's interactive approach
- 2009
-
Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 41:13, s. 1034-1040
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. DESIGN: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? RESULTS: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described. CONCLUSION: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas.
|
|
| 3. |
- Rosendahl, Erik, et al.
(författare)
-
A randomised controlled trial of fall prevention by a high-intensity functional exercise program for older people in residential care facilities
- 2008
-
Ingår i: Aging Clinical and Experimental Research. - Milan : Editrice Kurtis SRL. - 1594-0667 .- 1720-8319. ; 20:1, s. 67-75
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Falls are particularly common among older people living in residential care facilities. The aim of this randomized controlled trial was to evaluate the effectiveness of a high-intensity functional exercise program in reducing falls in residential care facilities.METHODS: Participants comprised 191 older people, 139 women and 52 men, who were dependent in activities of daily living. Their mean+/-SD score on the Mini-Mental State Examination was 17.8+/-5.1 (range 10-30). Participants were randomized to a high-intensity functional exercise program or a control activity, consisting of 29 sessions over 3 months. The fall rate and proportion of participants sustaining a fall were the outcome measures, subsequently analysed using negative binominal analysis and logistic regression analysis, respectively.RESULTS: During the 6-month follow-up period, when all participants were compared, no statistically significant differences between groups were found for fall rate (exercise group 3.6 falls per person years [PY], control group 4.6 falls per PY), incidence rate ratio (95% CI) 0.82 (0.49-1.39), p=0.46, or the proportion of participants sustaining a fall (exercise 53%, control 51%), odds ratio (95% CI) 0.95 (0.52-1.74), p=0.86. A subgroup interaction analysis revealed that, among participants who improved their balance during the intervention period, the exercise group had a lower fall rate than the control group (exercise 2.7 falls per PY, control 5.9 falls per PY), incidence rate ratio (95% CI) 0.44 (0.21-0.91), p=0.03.CONCLUSIONS: In older people living in residential care facilities, a high-intensity functional exercise program may prevent falls among those who improve their balance.
|
|
| 4. |
- von Heideken Wågert, Petra, et al.
(författare)
-
Health status in the oldest old : Age and sex differences in the Umeå 85+ Study.
- 2006
-
Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 18:2, s. 116-126
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: With an increasing population aged 85 years and over, the aim of this study was to describe health status and living conditions in the oldest old and to estimate age and sex differences in a Northern European population. METHODS: A population-based cross-sectional study, The Umeå 85+ Study, was carried out in the municipality of Umeå in northern Sweden. Out of 319 eligible participants aged 85, 90 and 95 years and over, 253 participated. Structured interviews and assessments were conducted with the participants in their homes, and data were also collected from relatives, caregivers and medical charts. Cognition was screened with the Mini-Mental State Examination (MMSE), depressive symptoms with the Geriatric Depression Scale-15 (GDS-15) and nutritional status with the Mini Nutritional Assessment (MNA). Activities of daily living (ADL) were assessed applying the Staircase of ADL (including Katz' Index of ADL) and morale with the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants also rated their own health. RESULTS: Over half of the participants had hypertension, one out of four was depressed, and the same proportion had had a hip fracture; the mean number of drugs taken was 6.4+/-4.0. Younger participants had lower rates of diagnoses and prescribed drugs, and were less dependent in ADL and other functional variables; men had lower rates of diagnoses and reported symptoms. The majority of participants rated their general health and morale as good. CONCLUSIONS: There were large variations in social, medical and functional variables within and between age and sex groups. This northern population of the oldest old seems to have a very high prevalence of hypertension, depression, hip fractures, and many prescribed drugs.
|
|
| 5. |
- von Heideken Wågert, Petra, et al.
(författare)
-
Morale in the oldest old : the Umeå 85+ study
- 2005
-
Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 34:3, s. 249-255
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to describe morale among the oldest old, and to investigate which social, functional and medical factors are associated with morale in this population. DESIGN: a cross-sectional study. SETTING: a population-based study in the municipality of Umeå, a city in Northern Sweden. SUBJECTS: half of the 85-year-old population, and the total population of 90-year-olds and > or = 95-year-olds (95-103) were asked to participate (n = 319) and 238 were interviewed. METHODS: structured interviews and assessments during home visits, interviews with relatives and caregivers and review of medical charts. The 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) was used to measure morale. Participants were assessed with the Barthel Activities of Daily Living (ADL) Index, Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), and a symptom questionnaire. Multiple regression analyses were conducted to find independent factors to explain the variation in the PGCMS score. RESULTS: eighty-four per cent (n = 199) of those interviewed answered the PGCMS. Three-quarters had middle range or high morale. GDS score, type of housing, previous stroke, loneliness and number of symptoms, adjusted for age group and sex, explained 49.3% of the variance of total PGCMS score. CONCLUSIONS: a large proportion of the oldest old had high morale. The most important factors for high morale were the absence of depressive symptoms, living in ordinary housing, having previously had a stroke and yet still living in ordinary housing, not feeling lonely and low number of symptoms. The PGCMS seems applicable in the evaluation of morale among the oldest old.
|
|
| 6. |
- Arnadottir, Solveig A, 1968-, et al.
(författare)
-
Are rural older Icelanders less physically active than those living in urban areas? : a population-based study
- 2009
-
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:4, s. 409-417
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Older people in rural areas have been labelled as physically inactive on the basis of leisure-time physical activity research. However, more research is needed to understand the total physical activity pattern in older adults, considering all domains of physical activity, including leisure, work, and domestic life. AIMS: We hypothesised that: (a) total physical activity would be the same for older people in urban and rural areas; and (b) urban and rural residency, along with gender and age, would be associated with differences in domain-specific physical activities. METHODS: Cross-sectional data were collected in Icelandic rural and urban communities from June through to September 2004. Participants were randomly selected, community-dwelling, 65-88 years old, and comprised 68 rural (40% females) and 118 urban (53% females) adults. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total physical activity score and subscores in leisure, during domestic life, and at work. RESULTS: The total PASE score was not associated with rural vs. urban residency, but males were, in total, more physically active than females, and the 65-74-year-olds were more active than the 75-88-year-olds. In the leisure domain, rural people had lower physical activity scores than urban people. Rural males were, however, most likely of all to be physically active in the work domain. In both urban and rural areas, the majority of the physical activity behaviour occurred in relation to housework, with the rural females receiving the highest scores. CONCLUSIONS: Older Icelanders in rural areas should not be labelled as less physically active than those who live in urban areas. Urban vs. rural living may, however, influence the physical activity patterns among older people, even within a fairly socioeconomically and culturally homogeneous country such as Iceland. This reinforces the need to pay closer attention to the living environment when studying and developing strategies to promote physical activity.
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Conradsson, Mia, et al.
(författare)
-
The Berg Balance Scale : Intra-rater reliability in older people dependent in ADL and living in residential care facilities
- 2006
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this study was to investigate the absolute and the relative intra-rater reliability of the Berg Balance Scale (BBS) among older people who are dependent in activities of daily living (ADL) and living in residential care facilities.Methods: The participants were 45 older people, 36 females and 9 men, who were dependent in ADL and living in three residential care facilities. Their mean age ± SD was 82.3 ± 6.6 (range 68-96) and mean ± SD of Mini Mental State Examination score was 17.5 ± 6.3 (range 4-30). The BBS was assessed twice by the same assessor, at approximately the same time of day, and with 1-3 days in between. The absolute reliability for the difference in score between the two test occasions was calculated with the Bland and Altman analysis of variance with 95 % confidence level. The relative reliability was calculated with Intraclass Correlation Coefficient (ICC).Results: For the first test of the BBS, mean ± SD was 30.1 ± 15.9 (range 3-53) points and for the retest 30.6 ± 15.6 (range 4-54). The absolute difference between the two test occasions was in mean ± SD 2.8 ± 2.7 (range 0-11) points. The absolute intra-rater reliability was calculated to 7.7 points and the ICC value was 0.97. Conclusions: Despite a high ICC value, the result of the absolute reliability show that a change of 8 BBS points is required to reveal a genuine change of function among older people who are dependent in ADL 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.
|
|
| 10. |
- Eriksson, Staffan, 1969-
(författare)
-
Falls in people with dementia
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Falls and concomitant injuries are common problems among large groups of the elderly population, leading to immobility and mortality. These problems are even more pronounced among people suffering from dementia. This thesis targets fall risk factors for people with dementia in institutions. The overall aim of this thesis was to investigate risk factors for falls, predisposing as well as related to circumstances surrounding falls, and to do this as efficiently as possible. In a prospective cohort study including residents of residential care facilities with and without dementia, the fall rate was higher for those with dementia, the crude incidence rate ratio (IRR) was 2.55 (95% CI 1.60–4.08) and the adjusted IRR was 3.79 (95% CI 1.95–7.36). In the group of people suffering from dementia, including 103 residents, a total of 197 falls resulted in 11 fractures during the 6-months follow-up period. From the same baseline measurements 26% and 55%, respectively, of the variation in falls could be explained in the group of residents with and without dementia. Fall predictors significantly and independently associated with an increased risk of falls in the group of people suffering from dementia were the category “man walking with an aid” and the use of more than four drugs. In a prospective cohort study, including 204 patients in a psychogeriatric ward, a total of 244 falls resulted in 14 fractures. Fall predictors significantly and independently associated with an increased risk of falls were male sex, failure to copy a design, use of clomethiazole, and walking difficulties. Treatment with statins was associated with a reduced risk of falls. With these fall predictors in the negative binomial regression (Nbreg) model, 48% of the variation in falls was explained. The data from the psychogeriatric ward were also analysed with the use of partial least squares regression (PLS) and regression tree to be compared with the results of the Nbreg analysis. PLS and regression tree are techniques based on combinations of variables. They both showed similar patterns, that a combination of a more severe level of dementia, behavioral complications and medication related to these complications is associated with an increased fall rate. Thirty-two percent and 38%, respectively, of the variation in fall rate were explained in the PLS and regression tree analysis. The circumstances surrounding the falls in the psychogeriatric ward were analysed. It was found that the fall rate was equally high during the night and the day. A large proportion of the falls was sustained in the patients’ own room and a small proportion of the falls was witnessed by the staff. This pattern was even more pronounced during the night. The proportion of diurnal rhythm disturbances and activity disturbances was higher for falls at night than for falls during the day. Circumstances associated with an increased risk of falls, as shown by a short time to first fall, were anxiety, darkness, not wearing any shoes and, for women, urinary tract infection. The proportion of urinary tract infection was also higher in connection to falls sustained by women than to falls sustained by men. This thesis confirms that people suffering from dementia are prone to fall. Walking difficulties, male sex and impaired visual perception are factors that should be considered in the work of reducing falls among people suffering from dementia. Furthermore, falls at night, behavioral complications and medication related to these complications should also be considered in this work, especially as the dementia disease progresses. A larger portion of the variation of the outcome variable was explained by the Nbreg model than the regression tree and PLS. However, these statistical methods, based on combinations of variables, gave a complementary perspective on how the fall predictors were related to falls.
|
|
