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| 2. |
- Bergh, Ingrid, et al.
(författare)
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An application of pain rating scales in geriatric patients
- 2000
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Ingår i: Aging Clinical and Experimental Research. - : Elsevier. - 1594-0667 .- 1720-8319. ; 12:5, s. 380-7
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the applicability of three different pain rating scales, the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numeric Rating Scale (NRS), in geriatric patients. Data collection was performed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age = 80.5 years). Patients rated their current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hurt (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r = 0.78-0.92; p < 0.001) (alternative-forms reliability), and between the test and retesting (r = 0.75-r = 0.83; p < 0.001) (test-retest reliability). A logistic regression analysis showed that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the VAS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was especially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p < 0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or distress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated experience of pain tended to decrease with advancing age. This indicates that the pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress.
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| 3. |
- Bergh, Ingrid, 1956, et al.
(författare)
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Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.
- 2001
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Ingår i: Aging (Milan, Italy). - : Kurtis. - 0394-9532. ; 13:5, s. 355-361
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Tidskriftsartikel (refereegranskat)abstract
- Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.
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| 4. |
- Carlsson-Agren, M, et al.
(författare)
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The oldest old and their children : how strong are the relationships?
- 1992
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 4:4, s. 293-300
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Tidskriftsartikel (refereegranskat)abstract
- Eighty-five-year-old parents (N = 99) and their middle-aged children (N = 58) participated in a study on solidarity in intergenerational relationships in Sweden. The research model utilized evaluated six dimensions of family solidarity: family structures and associational, affectional, consensual, functional and normative solidarity. The finding of close family bonds in most of these areas may be attributed to the fact that the extensive Swedish public home-help system facilitated relationships on more equal terms. While the children were relieved from much responsibility for their parents' needs, most parents did not experience feelings of dependency on their children. It was in fact evident that even very old parents can be a source for help to their children. Children were, however, the main providers for emotional support and this role could not be substituted by formal caregivers.
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| 5. |
- Edberg, Anna-Karin, et al.
(författare)
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Mood and general behavior of patients with severe dementia during one year of supervised, individualized planned care and systematic clinical supervision. : Comparison with a similar control group
- 2024
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Ingår i: Aging clinical and experimental research. - : Springer Verlag. - 0394-9532 .- 1720-8319 .- 1594-0667. ; 11:6, s. 395-403
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effects of one year of systematic clinical supervision, and supervised individually planned care on the mood and general behavior of patients with dementia in relation to their cognitive function and level of confusion. The intervention was carried out in a ward devoted to the care of patients with severe dementia (EW), with a similar ward (CW) where no changes were made serving as a control. Each ward housed 11 patients, of whom 7 patients in each ward survived throughout the study time. Assessment of the patients' mood, general behavior, cognitive functions (MMSE), orientation and confusion (OBS) was made at baseline, and after 6 and 12 months of intervention. Significant deteriorations for the patients in CW were seen during the study period as regards the factor strength, functional performance and orientation in the ward, and speech performance and psychomotor slowing. For the patients in the EW, deterioration was seen only in the factor accessibility, and improvement was seen in the factor sensitivity and euphoria. The differences indicated that the development in the two wards went in opposite directions to the benefit of the patients in the EW. Because of the small sample size, the findings are more the result of a pilot trial, rather than generalizable. The intervention, however, seemed to have a positive effect on the secondary symptoms of the disease. (C) 1999, Editrice Kurtis.
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| 7. |
- Elmståhl, Sölve, et al.
(författare)
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Body composition and dietary habits in 80-year-old smoking men without cardiovascular disease
- 1991
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 3:3, s. 77-269
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Tidskriftsartikel (refereegranskat)abstract
- Eighty-year-old male residents in the community of Malmö were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). Of 1,280 subjects, 122 were selected for further studies and allocated into 4 groups: 1) no CVD, non-smokers; 2) no CVD, smokers; 3) CVD, smokers; and 4) CVD, non-smokers. The smokers had consumed on the average 13 g of tobacco daily for 59 years. Lean body mass (LBM), body fat (BF), % body fat (%BF), and total body water (TBW) were estimated by means of bioelectrical impedance analysis. The mean body weight (BW), LBM, and %BF for all subjects were 74.1 +/- 10.2 kg, 58.0 +/- 6.8 kg, and 21.3 +/- 5.9 kg, respectively. There were no significant differences between all subjects with and without CVD. A lower BW among smokers than in non-smokers was explained by lower BF and %BF in the former. Smokers who had lived predominantly in rural areas had lower BW (6.9 kg) and LBM (5.2 kg) than those from an urban area. A positive correlation was noted between the degree of physical activity and LBM and TBW. Seventeen percent of the smokers exercised regularly. The CVD group had higher plasma cholesterol concentrations than the non-CVD group. Plasma triglycerides showed a positive correlation with BF, %BF and BW, whereas HDL cholesterol was negatively correlated with BF, %BF and BW. It is concluded that smoking is one of several important factors related to body composition, and the penetrance of this factor is still apparent in elderly men.
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| 8. |
- Elmståhl, S., et al.
(författare)
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Increased medical attention needed for frail elderly initially admitted to the emergency department for lack of community support
- 1999
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Ingår i: Aging. - 0394-9532. ; 11:1, s. 56-60
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Tidskriftsartikel (refereegranskat)abstract
- The demographic changes in society with growing numbers of elderly subjects will inevitably increase admission rates to acute emergency departments (AMU). Early discharge might augment emergency readmissions due to a relapse in medical conditions. Our aim was to study precipitating factors in frail elderly patients who got the diagnosis 'lack of community support' after initial medical examination at an AMU, as well as discharge rates and one-year mortality. The study population was 380 cases of 18 015 patients attending the AMU at a city hospital during one year. Inclusion criteria were age above 65 years, and given the diagnosis 'lack of community support' by a physician, defined as no other etiological or symptom diagnosis after an initial medical examination, and in some cases 24 to 48-hours observation. All but three medical records were checked. Reduced ability to eat, drink and walk prior to admission were noted among 22 to 58% of cases. Two thirds of the patients needed further medical care as inpatients, and physical medical causes were identified in 85% of the cases (mean number 3 causes); infectious diseases, cardiovascular diseases, dementia and trauma were the most prevalent factors. The median hospital stay was 14 days, and 10% had been discharged from the hospital the week prior to admission. The one-year mortality was 34%. The deceased had more precipitating physical causes, and were more often admitted to medical wards, but fewer had been referred to a senior consultant at the time of admission than survivors, adjusted for age (14% vs 42%, p<0.05). Multiple medical conditions were noted in the majority of patients admitted to an emergency department with reduced abilities to cope with basic activities of daily life, even though a preliminary examination stated lack of social support as the underlying cause. The need for better medical attention seems important, especially for patients discharged directly home from an emergency department.
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| 9. |
- Fäldt, Roger, et al.
(författare)
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Prevalence of thyroid hormone abnormalities in elderly patients with symptoms of organic brain disease.
- 1996
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 8:5, s. 347-357
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Tidskriftsartikel (refereegranskat)abstract
- Analysis of the serum concentrations of free thyroid hormones (fT3, fT4) and thyrotropin (TSH) in 173 psychogeriatric patients (94 females and 79 males, mean age 79 +/- 8 years) disclosed that the hormone levels were related to sex, psychiatric diagnosis, medication and the presence of nonthyroid illness (NTI). Subnormal concentrations of thyroid hormones and/or TSH were found in 25% of the patients. In addition, fT3 and fT4 concentrations were significantly lower (p < 0.05 and p < 0.001, respectively) in demented males compared with demented females although the levels were within the reference limits. Strongly negative correlations between fT3 and age (p < 0.001), and between fT3 and the sedimentation rate (SR) (p < 0.01) were found in demented but not in non-demented patients. These correlations were most pronounced in (age) or restricted to (SR) demented males. In addition, the correlation between fT3 and Hb was strongly positive (p < 0.001) in demented as well as in nondemented patients, particularly in males. The concentration of fT4 was positively correlated to Hb in demented males (p < 0.001), whereas TSH concentration was positively correlated to Hb in demented females (p < 0.05). The results show that TSH is not sufficient as the sole screening assay for evaluation of possible thyroid dysfunction in psychogeriatric patients. In addition, central (hypothalamic?) hypothyroidism may be present in a substantial amount of psychogeriatric patients, as we found an adequate TSH response to exogenous thyrotropin-releasing hormone (TRH) also in patients with decreased fT3/fT4 and no signs of non thyroid diseases. Furthermore, there was an apparent lack of correlation between thyroid hormone levels and dementia (or subgroups of dementia), even though thyroid hormone abnormalities seemed to be rather common in frontotemporal dementia (38%) and non specified dementia (36%).
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| 10. |
- Hallengren, B, et al.
(författare)
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80-year-old men have elevated plasma concentrations of catecholamines but decreased plasma renin activity and aldosterone as compared to young men
- 1992
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 4:4, s. 5-341
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Tidskriftsartikel (refereegranskat)abstract
- Plasma concentrations of adrenaline, noradrenaline, aldosterone and plasma renin activity were determined in a selected group of 80-year-old men (N = 41) in good health without clinical signs of cardiovascular disease, and were compared to levels in young healthy males (N = 20, 24-28 years). Plasma adrenaline and noradrenaline concentrations were higher (0.24 median; 25th-75th percentiles 0.16-0.34 nmol/L vs 0.15; 0.11-0.18 nmol/L, p < 0.01 and 2.22; 1.58-3.27 nmol/L vs 1.15; 1.00-1.74 nmol/L, p < 0.001), and plasma renin activity and plasma aldosterone concentration were lower in the old than in the young men (0.65; 0.35-1.04 micrograms/L/1h vs 2.09; 1.23-2.41 micrograms/L/1h, p < 0.001 and 0.12; 0.09-0.19 nmol/L vs 0.38; 0.28-0.54 nmol/L, p < 0.001). In conclusion, increased plasma concentrations of catecholamines and decreased plasma concentration of aldosterone and plasma renin activity in old men, as compared to young men, must be considered when interpreting data of these hormones in elderly men.
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