| 1. |
- Agüero-Torres, Hedda, et al.
(författare)
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Disability in activities of daily living among the elderly
- 2001
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Ingår i: Current Opinion in Psychiatry. - 0951-7367 .- 1473-6578. ; 14:4, s. 355-359
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Tidskriftsartikel (refereegranskat)abstract
- The rise in number and proportion of older people, and the functional disability that is associated with increasing age, generate concern regarding the societal consequences of a large number of disabled elderly persons. Therefore, measuring disability in terms of activities of daily living has become routine in surveys of older people in most studies on ageing. Despite methodological obstacles, research into functional ability in the elderly has progressed during the past few decades. A high prevalence of functional disability in the elderly is consistently reported, although considerable variation has been found among studies. In contrast to functionally independent elderly, disabled elderly have been found to make increased use of home help services, and have higher institutionalization rates and premature mortality. Factors that are consistently reported as being associated with increased functional disability are older age, female sex, lower educational level, lack of exercise, chronic disease and impaired cognition. Among the chronic diseases, dementia is a progressive and disabling condition that accounts for a large proportion of the disability in elderly populations. A combination of various strategies must be employed in the approach to reduction of disability in the elderly population. More research is needed to gain a better understanding of risk and protective factors, so that we will be able to detect persons at early stages of disability, and to plan for services or rehabilitation for severely disabled persons.
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| 2. |
- Agüero-Torres, Hedda, et al.
(författare)
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Institutionalization in the elderly : The role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study
- 2001
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Ingår i: Journal of Clinical Epidemiology. - : Elsevier. - 0895-4356 .- 1878-5921. ; 54:8, s. 795-801
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Tidskriftsartikel (refereegranskat)abstract
- A population-based study of 1810 persons, aged 75+, was investigated to evaluate the role of dementia and other chronic diseases as determinants of institutionalization in the elderly. The study population was examined at baseline and after a 3-year interval. After adjustment for sociodemographic characteristics, functional dependence, dementia, cerebrovascular disease and hip fracture were associated with living in an institution at baseline. Additionally, functional dependence, hip fracture and dementia were also associated with moving to an institution during the 3-year follow-up. In a similar analysis, including only nondemented subjects, the Mini-Mental State Examination emerged as one of the strongest determinants. The population attributable risk percentage of institutionalization during the 3-year follow-up due to dementia was 61%. This study confirms that dementia and cognitive impairment are the main contributors to institutionalization in the elderly, independently of their sociodemographic status, social network, or functional status.
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| 3. |
- Hillerås, Pernilla, et al.
(författare)
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Factors influencing well-being in the elderly
- 2001
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Ingår i: Current Opinion in Psychiatry. - 0951-7367 .- 1473-6578. ; 14:4, s. 361-365
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Tidskriftsartikel (refereegranskat)abstract
- One of the aims of research on well-being is to discover the factors that either increase or decrease well-being, in both young and old people. Many factors have been studied in relation to well-being, but only some have been found to be associated with it. These factors are demographic (age, sex, culture, marital status), social (socioeconomic status, having children, religion, social contacts) or are related to personality, life events, health, and activities. However, some of these factors have a stronger association than others. This article gives a brief review of this research with special focus on the elderly.
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| 4. |
- Hillerås, Pernilla K, et al.
(författare)
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Factors influencing well-being in the elderly
- 2001
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Ingår i: Current Opinion in Psychiatry. - : Ovid Technologies (Wolters Kluwer Health). - 0951-7367 .- 1473-6578. ; 14:4, s. 361-365
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Forskningsöversikt (refereegranskat)
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| 5. |
- von Strauss, Eva, et al.
(författare)
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Women are more disabled in basic activities of daily living than men only in very advanced ages : A study on disability, morbidity, and mortality from the Kungsholmen Project
- 2003
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Ingår i: Journal of Clinical Epidemiology. - : Elsevier. - 0895-4356 .- 1878-5921. ; 56:7, s. 669-677
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We explored the effect of morbidity, mortality, and occurrence of new disability on gender differences in activities of daily living (ADL) functioning in different age groups in the elderly population.Methods: All 77+-year-old members of a community-based cohort were clinically examined by physicians, assessed by psychologists, and interviewed by nurses at baseline and after a 3-year interval. Diseases were diagnosed according to ICD-9 and the DSM-III-R criteria for dementia. The Katz index of ADL was used to measure basic functional status.Results: After adjustment for socio-demographic characteristics, the oldest women (90+ years) had higher disability prevalence and a tendency for higher long-term disability incidence. Women aged 85+ years also had higher morbidity prevalence. Mortality among disabled subjects was similar for both genders, whereas higher mortality was found in younger nondisabled men (77–84 years).Conclusion: We conclude that gender differences in disability, morbidity, and mortality vary with age in the elderly population. Gender differences in morbidity and basic functional dependence were evident only in the oldest old. Based on current and previous findings, we speculate that more women may be at higher risk of developing severe disability than men in the advanced ages due to longer survival with slight disability earlier in adult life.
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| 6. |
- Westerbotn, Margareta, et al.
(författare)
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A population-based study on well-being in the very old : the role of cardiovascular diseases and drugs
- 2005
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 40:3, s. 287-297
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Tidskriftsartikel (refereegranskat)abstract
- Cardiovascular diseases constitute the most common health problems in very old people. Consequently, cardiovascular drugs are the medicines that are most frequently used by elderly subjects. Although many studies have examined the physiological effect and adverse reactions of these drugs, knowledge on their effect on emotional well-being is missing. The present study aims to examine the association between cardiovascular diseases and their medical treatment on the emotional well-being of very old people. We investigated a representative group of elderly subjects gathered from a population-based study (n=235). Participants were 84 years or older and cognitively intact (mini-mental state examination (MMSE) > or =24 points). Well-being was assessed with the positive and negative affect schedule (PANAS), measuring different mood categories. Cardiovascular diseases were diagnosed following the International Classification of Diseases. In this population the prevalence of cardiovascular diseases was high (62%). Multivariate regression analysis showed that while being affected by a cardiovascular disease did not affect the emotional well-being of the subjects (PANAS-PA, p=0.171; PANAS-NA, p=0.209), the use of some cardiovascular drugs showed an association. Cardiac glycosides (p=0.006) and nitrates (p=0.008) were associated with increased negative feelings. Due to high prevalence of cardiovascular diseases and use of cardiovascular medicines, this finding has relevance on the quality of life of elderly people. However, due to the nature of this study we cannot assess cause-effect relationship of this positive association. Therefore, the present findings suggest that there is a need for clinical studies in this increasing and limited studied age group.
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| 7. |
- Westerbotn, Margareta, et al.
(författare)
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Factors influencing the handling of medicines among very old people living at home in an urban area
- 2006
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 18:6, s. 497-502
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Elderly people in Sweden live longer in their own homes, some of them with good health, and others with chronic conditions that require medical treatment. Thus, the aim of this study was to investigate factors influencing elderly people’s handling of their medicines. Methods: Cross-sectional population-based study. Participants were 333, aged 84+ years, living in their own homes. Information on regular drug use was obtained from interviews. Descriptive statistics were used to describe the population, and logistic regression models were used to investigate the factors associated with receiving help in handling medicines. The Mini-Mental State Examination (MMSE) measured cognitive status, and the basic Activities of Daily Living (ADL) assessed functional status. Results: Most participants were women living alone. 88% of this population took medicines on a regular basis and 23% of them received help with medicine handling. Using logistic regression models controlling for sociodemographic variables, cognitive and functional status, female (OR=2.8, 95% CI=1.2–6.5) was the only variable associated with regular use of medicines. Older age and functional disability in ADL increased the risk of receiving help with medicines, while higher cognitive status decreased the odds of receiving help. The only factor related to receiving help from a family member was living alone (OR=0.05; 95% CI=0.01–0.40). Conclusions: This study indicates that cognitive and functional problems require increased help with handling medicines. These results stress the need for ongoing vigilance of, and support for, people with this high-risk profile.
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| 8. |
- Westerbotn, Margareta, et al.
(författare)
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How do older people experience their management of medicines?
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:5A, s. 106-15
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective. BACKGROUND: Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes. METHODS: This qualitative study involved audiotaped interviews with 25 very old persons. Inclusion criteria: aged >or=85 years, mini-mental state examination >or=24, living at home, taking medicines regularly. Data collected May-June 2005, analysed using content analysis. DESIGN: Descriptive study. RESULTS: Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up. CONCLUSION: Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes. RELEVANCE TO CLINICAL PRACTICE: Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health-care resource use.
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| 9. |
- Westerbotn, Margareta, et al.
(författare)
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Pain reporting by very old Swedish community dwellers : the role of cognition and function
- 2008
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 20:1, s. 40-46
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Pain is a common and unpleasant problem among elderly people and affects the possibility for them to remain living in their own homes. The aims of this study were therefore to report the prevalence of pain reporting and pain treatment, and their association with functional and cognitive status in a very old population. Methods: Cross-sectional population-based study. Participants were 333, aged 84 years or older, living at home alone or with someone in Kungsholmen, in central Stockholm, Sweden. Information on pain was obtained from interviews. The Mini-Mental State Examination (MMSE) measured cognitive status and the index of basic Activities of Daily Living (ADL) functional status. Descriptive statistics were used to describe the population and logistic regression models to investigate factors associated with pain reporting and pain treatment. Results: The prevalence of pain was 46%, and the prevalence of pain treatment 71%. Results from logistic regression analysis including all variables in the model showed that pain reporting was not associated with age, gender or living conditions. However, pain reporting was correlated with cognitive and functional status. There was no association between pain treatment and age, gender, living conditions, cognitive or functional status. Conclusions: Pain is common among the oldest old. Our results indicate that cognitive and functional status affect pain reporting. Poor cognitive status was associated with less pain reporting, whereas poor functional status was associated with more pain reporting.
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| 10. |
- Wimo, Anders, et al.
(författare)
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The magnitude of dementia occurrence in the world
- 2003
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Ingår i: Alzheimer Disease and Associated Disorders. - : Lippincott Williams & Wilkins. - 0893-0341 .- 1546-4156. ; 17:2, s. 63-67
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Tidskriftsartikel (refereegranskat)abstract
- In this study, the worldwide occurrence of dementia in 2000 and during the period 1950–2050 was estimated. The calculations were based on worldwide demographics of the elderly and age‐specific prevalence and incidence values of dementia, estimated from a meta‐analysis. In a sensitivity analysis, different prevalence sources were used. The worldwide number of persons with dementia in 2000 was estimated at about 25 million persons. Almost half of the demented persons (46%) lived in Asia, 30% in Europe, and 12% in North America. Fifty‐two percent lived in less developed regions. About 6.1% of the population 65 years of age and older suffered from dementia (about 0.5% of the worldwide population) and 59% were female. The number of new cases of dementia in 2000 was estimated to be 4.6 million. The forecast indicated a considerable increase in the number of demented elderly from 25 million in the year 2000 to 63 million in 2030 (41 million in less developed regions) and to 114 million in 2050 (84 million in less developed regions). In conclusion, the majority of demented elders live in less developed regions, and this proportion will increase considerably in the future.
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