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  • Resultat 1-10 av 198380
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1.
  • Bai, Ge, et al. (författare)
  • Frailty trajectories in three longitudinal studies of aging : Is the level or the rate of change more predictive of mortality?
  • 2021
  • Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
  • 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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2.
  • Eckerblad, Jeanette, et al. (författare)
  • To adjust and endure : a qualitative study of symptom burden in older people with multimorbidity
  • 2015
  • Ingår i: Applied Nursing Research. - : Elsevier. - 0897-1897 .- 1532-8201. ; 28:4, s. 322-327
  • Tidskriftsartikel (refereegranskat)abstract
    • Context Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life. Objectives The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.Method A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden. The participants were 79-€“89 years old with a mean of 12 symptoms per person. Data were analyzed using content analyses.Results The experience of living with a high symptom burden revealed the overall theme, “To adjust and endure” and three sub-themes. The first sub-theme was "To feel inadequate and limited". Participants reported that they no longer had the capacity or the ability to manage, and they felt limited and isolated from friends or family. The second sub-theme was "To feel dependent". This was a new and inconvenient experience; the burden they put on others caused a feeling of guilt. The final sub-theme was "To feel dejected". The strength to manage and control their conditions was gone; the only thing left to do was to sit or lie down and wait for it all to pass.Conclusion This study highlights the importance of a holistic approach when taking care of older people with multi-morbidity. This approach should employ a broad symptom assessment to reveal diseases and conditions that are possible to treat or improve.
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3.
  • Elden, Helen, 1959, et al. (författare)
  • Effects of craniosacral therapy as adjunct to standard treatment for pelvic girdle pain in pregnant women: A multicentre, single blind, randomised controlled trial
  • 2013
  • Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 92:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. Pelvic girdle pain (PGP) is a disabling condition affecting 30% of pregnant women. The aim of this study was to investigate the efficacy of craniosacral therapy as an adjunct to standard treatment compared to standard treatment alone for PGP during pregnancy. Design. Randomised, multicentre, single blind, controlled trial. Setting. University hospital, a private clinic and 26 maternity care centres in Gothenburg, Sweden. Population. 123 pregnant women with PGP. Methods. Participants were randomly assigned to standard treatment (control group, n=60) or standard treatment plus craniosacral therapy (intervention group, n=63). Main Outcome Measures. Primary outcome measures: Pain intensity (Visual Analogue Scale 0-100mm) and sick leave. Secondary outcomes: function (Oswestery Disability Index), health-related quality of life (Euro-Qol), unpleasantness of pain (VAS), and assessment of the severity of PGP by an independent examiner. Results. Between-group differences for morning pain, symptom-free women and function in the last treatment week were in favor of the intervention group. VAS median was 27 mm (95%CI 24.6-35.9) vs. 35 mm (95%CI 33.5-45.7)(p=0.017) and the function disability index was 40 (range 34-46) vs. 48 (range 40-56)(p=0.016). Conclusions. Lower morning pain intensity and lesser deteriorated function was seen after craniosacral therapy in conjunction with standard treatment compared to standard treatment alone, but no effects regarding evening pain and sick-leave. Treatment effects were small and clinically questionable and conclusions should be drawn carefully. Further studies are warranted before reccomending craniosacral therapy for pelvic girdle pain.
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4.
  • Pettersson, Cecilia, 1963, et al. (författare)
  • Enablers and Barriers in the Physical Environment of Care for Older People in Ordinary Housing: A Scoping Review
  • 2020
  • Ingår i: Journal of Housing for the Elderly. - : Informa UK Limited. - 0276-3893 .- 1540-353X. ; 34:3, s. 332-350
  • Forskningsöversikt (refereegranskat)abstract
    • Our aim was to explore enablers and barriers in ordinary housing for older people in care. We systematically searched Scopus, Web of Science, and Google Scholar for relevant published research and gray material. The search resulted in a final sample of eight publications, four of which focused on accessibility for older people with dementia. Thematic analysis resulted in two themes: safety and accessibility. Future studies should focus on modifications to ordinary housing to achieve safe and comfortable environments for people who want to age in place and those who provide them with care.
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6.
  • Sixsmith, Judith, et al. (författare)
  • Healthy Ageing and Home: the Perspectives of Very Old People in Five European Countries
  • 2014
  • Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 106
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated.
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7.
  • Thorvaldsson, Valgeir, 1976, et al. (författare)
  • Better Cognition in New Birth Cohorts of 70 Year Olds, But Greater Decline Thereafter
  • 2017
  • Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - Cary, NC : Oxford University Press. - 1079-5014 .- 1758-5368. ; 72:1, s. 16-24
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesTo evaluate birth cohort differences in level of cognition and rate of change in old age.MethodsData were drawn from three population-based Swedish samples including age-homogenous cohorts born 1901/02, 1906/07, and 1930, and measured on the same cognitive tests at ages 70, 75, and 79 as part of the Gerontological and Geriatric Populations Studies in Gothenburg (H70). We fitted growth curve models to the data using a Bayesian framework and derived estimates and inferences from the marginal posterior distributions.ResultsWe found moderate to large birth cohort effects in level of performance on all cognitive outcomes. Later born cohorts, however, showed steeper linear rate of decline on reasoning, spatial ability, and perceptual- and motor-speed, but not on picture recognition memory and verbal ability.DiscussionThese findings provide strong evidence for substantial birth cohort effects in cognition in older ages and emphasize the importance of life long environmental factors in shaping cognitive aging trajectories. Inferences from cognitive testing, and standardization of test scores, in elderly populations must take into account the substantial birth cohort differences. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
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8.
  • Westgård, Theresa, et al. (författare)
  • Feeling respected as a person: a qualitative analysis of frail older people's experiences on an acute geriatric ward practicing a Comprehensive Geriatric Assessment
  • 2019
  • Ingår i: Geriatrics. - : MDPI AG. - 0016-867X .- 2308-3417. ; 4:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary analysis, interviews and transcripts were revisited in an attempt to discover the meaning behind the participants’ implied, ambiguous, and verbalized thoughts that were not illuminated in the primary study. Feeling “respected as a person” is the phenomenon participants described on a CGA acute geriatric ward, achieved by having a reciprocal relationship with the ward staff, enabling their participation in decisions when engaged in communication and understanding. However, when a person was too ill to participate, then care was person-supportive care. CGA, when delivered by staff practicing person-centered care, can keep the frail older person in focus despite them being a patient. If a person-centered care approach does not work because the person is too ill, then person-supportive care is delivered. However, when staff and/or organizational practices do not implement a person-centered care approach, this can hinder patients feeling “respected as a person”.
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9.
  • Wongsala, Manothai, et al. (författare)
  • Applying the PDSA cycle to a group activity promoting lifestyle change for the active ageing of older Thai adults - a focused ethnography
  • 2022
  • Ingår i: BMC Geriatrics. - : NLM (Medline). - 1471-2318 .- 1471-2318. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The proportion of the older Thai population is increasing rapidly. Lifestyle may impact active ageing in later life. Interventions that empower older Thai adults to initiate and carry out lifestyle changes are needed. This study applied the Plan-Do-Study-Act (PDSA) cycle, a tool for improving lifestyle changes, with the aim of exploring interactions among older Thai adults when participating in group activities. METHOD: Focused ethnography was used based on participant observations, field notes and video recordings of 15 older Thai adults aged 62-78 years. RESULTS: Older Thai adults faced difficulties at the beginning since they were unfamiliar with initiating and carrying out lifestyle changes according to the PDSA concept. This provided a learning opportunity enabling older Thai adults to reach their individual goals of lifestyle change. CONCLUSIONS: The PDSA cycle has the potential to empower older adults in group contexts to promote lifestyle changes related to active ageing. 
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10.
  • Alt Murphy, Margit, 1970, et al. (författare)
  • An upper body garment with integrated sensors for people with neurological disorders – early development and evaluation
  • 2019
  • Ingår i: BMC Biomedical Engineering. - : Springer Science and Business Media LLC. - 2524-4426. ; 1:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To develop a novel wearable garment with integrated sensors for continuous monitoring of physiological and movement related variables to evaluate progression, tailor treatments and improve diagnosis in epilepsy, Parkinson’s disease and stroke. Methods: An iterative development process and evaluation of an upper body garment with integrated sensors included: identification of user needs, specification of technical and garment requirements, garment development and production as well as evaluation of garment design, functionality and usability. The project is a multidisciplinary collaboration with experts from medical, engineering, textile, and material science within the wearITmed consortium. The work was organized in regular meetings, task groups and hands-on workshops. User needs were identified using results from a mixed-methods systematic review, a focus group study and expert groups. Usability was evaluated in 19 individuals (13 controls, 6 patients with Parkinson’s disease) using semi-structured interviews and qualitative content analysis. Results: A prototype designed to monitor movements and heart rate was developed. The garment was well accepted by the users regarding design and comfort, although the users were cautious about the technology and suggested improvements. All electronic components passed a washability test. The most robust data was obtained from accelerometer and gyroscope sensors while the electrodes for heart rate registration were sensitive to motion. artefacts. The algorithm development within the wearITmed consortium has shown promising results. Conclusions: The prototype was accepted by the users. Technical improvements are needed, but preliminary data indicate that the garment has potential to be used as a tool for diagnosis and treatment selection and could provide added value for monitoring seizures in epilepsy, fluctuations in PD and activity levels in stroke. Future work aims to improve the prototype further, develop algorithms, and evaluate the functionality and usability in targeted patient groups. The potential of incorporating blood pressure and heart-rate variability monitoring will also be explored.
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