| 1. |
- Almevall, Albin Dahlin, et al.
(författare)
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Accepting the inevitable : A mixed method approach with assessment and perceptions of well-being in very old persons within the northern Sweden Silver-MONICA study
- 2021
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 92
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAs the group of very old persons will form an increasing part of society, the study of how well-being is described and affected by specific factors will be of importance to meet the future needs of these persons. The aim of the study was to increase knowledge of well-being in very old persons by combining assessments and perceptions using the Philadelphia Geriatric Morale Scale (PGCMS).MethodIn a mixed method, convergent parallel design, 52 persons 80 years or older were assessed and interviewed using the PGCMS to combine assessment of morale and descriptions of perceptions of well-being using a mixed method approach.ResultsQuantitative and qualitative results converged in four areas: not feeling lonely and being included, rating and perceiving health as good, high physical function/ability and being physically active, living in own house and feeling at home. Areas perceived as important to well-being captured only in qualitative analysis were having freedom and engagement. An example of insights not achievable from the quantitative or qualitative analysis alone was that individuals with high morale expressed anxiety about losing their health due to potential ageing-related threats and that individuals with low morale struggled with acceptance. Acceptance was the key strategy for handling adverse consequences of ageing in all described areas.ConclusionWhen using standardized assessment scales in clinical practice, it could be useful to combine quantitative and qualitative data. Acceptance was key for well-being; however, acceptance could be resigned or reorienting in nature.
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| 2. |
- Almevall, Ariel, et al.
(författare)
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Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort
- 2024
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 122
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.
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| 3. |
- Andersson, Ingalena, et al.
(författare)
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Meal pattern and risk factor evaluation in one-year completers of a weight reduction program for obese men : The 'Gustaf' study
- 2000
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 247, s. 30-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate changes in meal patterns and in obesity related risk factors after 1 year of treatment in obese men. Design: Data from two 24-h dietary recalls, performed at base-line and after 1 year of treatment, were related to changes in medical risk factors. Setting: Academic obesity unit. Subjects: Sixty-three men, aged 44 (eight) years (mean [SD]) and Base- line Body Mass Index (BMI) 37.4 (4.6) kg m-2, who had completed 1 year of treatment. The men were subdivided by tertiles according to weight change: tertile I (n = 21), mean +0.3 kg, tertile II (n = 21), mean -5.8 kg and tertile III (n = 21), mean -14.2 kg. Main outcome measures: Weight loss, changes in meal patterns and in obesity related medical risk factors. Results: The reported mean energy intake decreased after treatment in tertiles II and III by 700 (1300) kcal (P < 0.05) and 700 (900) kcal (P = 0.001), respectively. In tertile III the energy-% from fat decreased (P < 0.05) with a reciprocal increase in energy-% from protein (P < 0.05). The frequency of snacks of a low nutritional quality decreased (P < 0.01) in tertile III together with an increase in energy-% from 'hot meals of good quality' (P < 0.05). Obesity related risk factors (anthropometry, blood pressure, serum lipid concentrations, blood glucose and plasma insulin) improved in a beneficial way only in tertile III. Conclusions: The weight loss in the successful tertile III men was to a great extent explained by fewer low quality snacks but more energy from high quality meals. These changes reflected the behaviour modification strategy recommended.
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| 4. |
- 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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| 5. |
- Brogårdh, Christina, et al.
(författare)
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Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio : A qualitative study
- 2017
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 49:8, s. 652-658
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls. Design: A qualitative study with face-To-face interviews. Data were analysed by systematic text condensation. Participants: Fourteen ambulatory persons (7 women; mean age 70 years) with late effects of polio. Results: Analysis resulted in one main theme, "Everyday life is a challenge to avoid the consequences of falls", and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions. Conclusion: Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problemfocused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.
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| 6. |
- Dahlin Almevall, Albin, 1984-
(författare)
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Healthy Ageing and Well-Being in Old Age
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the decades to come, Sweden will be facing an unprecedented increase in the proportion of inhabitants aged 80 years or older. This age group is characterised by large heterogeneity; however ageing also poses challenges for health and well-being. These challenges apply not only to the individual, but also to the health care systems. Care of this older age group employs much of the nursing resources, affecting society as a whole. Healthy ageing can and should, therefore, be promoted in the decades prior to reaching old age, and once having reached old age, well-being should be a continued focus of health care and society. In this way older adults can continue perceiving good health and well-being. The overall aim of this thesis was to explore and describe areas of importance to healthy ageing and well-being in old age. Predictors of healthy ageing were prospectively studied as part of the northern Sweden Silver-MONICA project, from baseline in 1999 (n=1595) to follow-up 20 years later (n=541). For the healthy ageing outcome, a composite outcome comprised of measures of cognition (MMSE), 2.4 metre walking speed, personal independence in everyday life (Katz P-ADL) and depression (GDS15) was constructed. To study perceptions of general well-being in old age, a subsample (n=52) age > 80 was analysed as a cross-section using mixed method with open-ended interviews and the PGCMS well-being measure. A similar approach was used (n=50) to investigate specific aspects of well-being in relation to home. To study the relationship between well-being and objectively measure everyday physical activity, an accelerometer was worn 24 hours per day for at least 5 consecutive days (n=77) and analysed for associations with the PGCMS and its subscales. The five top ranking predictors determined by the healthy ageing index, comprising the total baseline cohort including those who passed away before possible follow-up were smoking status, NT-proBNP, waist circumference, leisure time physical activity level and HbA1c. For those who participated in the Silver-MONICA follow-up, the top five ranking predictors as determined by the healthy ageing index were leisure time physical activity, HbA1c, BMI, waist circumference and high sensitivity Troponin I. In interviews of general well-being, six areas were described that related to social context, health, physical activity, home, engagement and freedom. In regression analysis independence in activities of everyday living along with age were significantly associated with well-being. Acceptance was key for handling consequences of ageing that impacted well-being. Home was perceived as a central aspect of well-being; however, participants described being in the margins of home. Morale was higher among persons living in single-dwelling housing compared to those living in apartments. In activity measures, well-being was associated with the number of steps, time spent stepping and time spent stepping at >75 steps/minute.In conclusion, the combination of qualitative, quantitative and mixed methodology utilised in this thesis to study healthy ageing allowed for the possibility to nuance conclusions and to describe the subject from different points of view. Based on the findings, this thesis suggests that physical ability in old age is the basis for being able to engage in and experience the important factors of well-being described above. However, support from others, often family, can compensate for the lack of physical ability. The support is positive to well-being as long as it does not create feelings of being a burden. As consequences of ageing affect the areas most crucial to well-being, it seems that the extent and way these changed conditions are accepted has an important role in the maintaining of well-being in old age.
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| 7. |
- Eriksson Sörman, Daniel, et al.
(författare)
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Social relationships and risk of dementia : a population-based study
- 2015
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Ingår i: International psychogeriatrics. - : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 27:8, s. 1391-1399
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective was to examine whether aspects of social relationships in old age are associated with all-cause dementia and Alzheimer's disease (AD).Methods: We studied 1,715 older adults (>= 65 years) who were dementia-free at baseline over a period of up to 16 years. Data on living status, contact/visit frequency, satisfaction with contact frequency, and having/not having a close friend were analyzed using Cox proportional hazards regressions with all-cause dementia or AD as the dependent variable. To control for reverse causality and to identify potential long-term effects, we additionally performed analyses with delayed entry.Results: We identified 373 incident cases of dementia (207 with AD) during follow-up. The variable visiting/visits from friends was associated with reduced risk of all-cause dementia. Further, a higher value on the relationships index (sum of all variables) was associated with reduced risk of all-cause dementia and AD. However, in analyses with delayed entry, restricted to participants with a survival time of three years or more, none of the social relationship variables was associated with all-cause dementia or AD.Conclusions: The results indicate that certain aspects of social relationships are associated with incident dementia or AD, but also that these associations may reflect reverse causality. Future studies aimed at identifying other factors of a person's social life that may have the potential to postpone dementia should consider the effects of reverse causality.
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| 8. |
- Gard, Anna, et al.
(författare)
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Quality of life of ice hockey players after retirement due to concussions
- 2020
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Ingår i: Concussion. - : Future Medicine. - 2056-3299. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sports-related concussion (SRC) is increasingly recognized as a potential health problem in ice hockey. Quality of life (QoL) in players retiring due to SRC has not been thoroughly addressed. Materials & methods: QoL using the Sports Concussion Assessment Tool 5th Edition, Impact of Event Scale-Revised and Short Form Health Survey was measured in Swedish ice hockey players who retired due to persistence of postconcussion symptoms or fear of attaining additional SRC. Results: A total of 76 players were assessed, on average of 5 years after their most recent SRC. Overall, retired players had a high burden of postconcussion symptoms and reduced QoL. Conclusion: Retired concussed ice hockey players have a reduced QoL, particularly those retiring due to postconcussion symptoms. Symptom burden should be continuously evaluated and guide the decision to retire.
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| 9. |
- Jörgensen, Sophie, et al.
(författare)
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Secondary health conditions, activity limitations, and life satisfaction in older adults with long-term spinal cord injury
- 2017
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Ingår i: PM&R. - : Elsevier. - 1934-1482 .- 1934-1563. ; 9:4, s. 356-366
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMany individuals with a spinal cord injury (SCI) have lived several decades with their injury, leading to a need for a deeper understanding of factors associated with healthy aging in people with long-term SCI.ObjectivesTo (1) describe secondary health conditions, activity limitations, and life satisfaction in older adults with long-term SCI, and to (2) investigate how sociodemographics, injury characteristics, and secondary health conditions are associated with their activity limitations and life satisfaction.DesignCross-sectional descriptive cohort study.SettingHome and community settings.ParticipantsA total of 123 individuals (71% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time since injury 24 years.MethodsBaseline data as part of the Swedish Aging with Spinal Cord Injury Study. Associations between variables were investigated with multivariable linear regression analyses.Main Outcome MeasurementsBowel and bladder function, nociceptive and neuropathic pain, spasticity, the Spinal Cord Independence Measure, third version, and the Satisfaction With Life Scale.ResultsBowel-related and bladder-related problems were reported by 32% and 44%, respectively, 66% reported moderate or severe nociceptive and/or neuropathic pain, and 44% reported spasticity. Activity limitations were moderate (mean Spinal Cord Independence Measure, third version, total score 65.2, range 8-100) where injury characteristics and spasticity explained 68% of the variance. Higher level and more severe SCI (based on the American Spinal Injury Association Impairment Scale) exhibited the strongest association with more activity limitations. Life satisfaction was rated just above the midpoint between satisfied and dissatisfied with life (mean Satisfaction With Life Scale total score 20.7, range 6-34). Marital status, vocational situation, bladder function and injury characteristics explained 38% of the variance, where having a partner showed the strongest association with greater life satisfaction. Activity limitations and life satisfaction were not associated with gender, age and time since injury.ConclusionOlder adults with long-term SCI can maintain a relatively high level of physical independence and generally are satisfied with their lives, regardless of gender, age or time since injury. The associations demonstrate the importance of injury characteristics for the performance of daily activities and the social context for life satisfaction in older adults with long-term SCI.Level of EvidenceIII
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| 10. |
- Körlof, Linnéa, et al.
(författare)
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Older Adults’ Experiences of Using Strategies to Maintain and Foster Social Participation: A Systematic Review with Metasynthesis of Qualitative Studies
- 2024
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Ingår i: Health & Social Care in the Community. - : Hindawi Publishing Corporation. - 0966-0410 .- 1365-2524.
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Forskningsöversikt (refereegranskat)abstract
- Social participation is positively associated with older adults’ health. Health-care services, therefore, need to empower older adults to adapt to the social changes that accompany aging. This systematic review, with a metasynthesis of qualitative studies, aimed to describe and develop an understanding of home-dwelling older adults’ (65 yrs+) experiences of using strategies to maintain and foster their social participation. The main search was performed in March 2022 using the PubMed, CINAHL, PsycINFO, and AMED databases and included peer-reviewed articles published between 2012 and 2022. A total of 35 full-text articles from 15 different countries were included and assessed for quality by the assessment tool for qualitative studies provided by the Critical Appraisal Skills Programme (CASP). The metasynthesis resulted in the main theme: strategically creating routines that foster social participation and two main categories: inward-looking strategies for social participation and outward-looking strategies for social participation. Each main category contained three subcategories. The findings suggest that for perceiving social participation, it is important for older adults to create routines with patterns of activities and to be able to engage in these activities. The findings further reflect that older adults use earlier experiences of social participation to facilitate the making of routines. This indicates that health-care interventions supporting older adults’ social participation must be applied early and with a health-promotive focus. Conclusively, researchers need to develop interventions that support older adults in healthy activity patterns by raising awareness of how to use inward-looking and outward-looking strategies to create routines for social participation. The findings further suggest that older adults’ possibilities for social participation could be supported by designing accessible venues that facilitate spontaneous meetings and encourage older adults’ own choices and initiatives for social participation.
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