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- af Sillén, Ulrika, et al.
(författare)
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Self-rated health in relation to age and gender: influence on mortality risk in the Malmö Preventive Project.
- 2005
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 33:3, s. 9-183
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Tidskriftsartikel (refereegranskat)abstract
- Aims: A study was undertaken to examine whether poor self-rated health (SRH) can independently predict all-cause mortality during 22-year follow-up in middle-aged men and women. Subjects and methods: Data are derived from a population-based study in Malmo¨ , Sweden. This included baseline laboratory testing and a self-administered questionnaire. The question on global SRH was answered by 15,590 men (mean age 46.4 years) and 10,089 women (49.4 years). Social background characteristics (occupation, marital status) were based on data from national censuses. Mortality was retrieved from national registers. Results: At screening 4,261 (27.3%) men and 3,085 (30.6%) women reported poor SRH. Among subjects rating their SRH as low, 1,022 (24.0%) men and 228 (7.4%) women died during follow-up. Corresponding figures for subjects rating their SRH as high were 1801 (15.9%) men and 376 (5.4%) women. An analysis of survival in subjects reporting poor SRH revealed an age-adjusted hazard risk ratio (HR, 95%CI) for men HR 1.5 (1.4–1.7), and for women HR 1.4 (1.2–1.6). The corresponding HR after adjusting for possible social confounders was for men HR 1.3 (1.1–1.4), and women HR 1.1 (0.9–1.4). When additional adjustment was made for biological risk factors the association for men was still significant, HR 1.2 (1.1–1.3). Conclusion: Poor SRH predicts increased long-term mortality in healthy, middle-aged subjects. For men the association is independent of both social background and selected biological variables. The adjustment for biological variables can be questioned as they might represent mediating mechanisms in a possible causal chain of events.
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| 4. |
- Ekvall-Hansson, Eva, et al.
(författare)
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Benign Paroxysmal Positional Vertigo among Elderly Patients in Primary Health Care.
- 2005
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Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 51:6, s. 386-389
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i>Dizziness influences well-being in old age, and benign paroxysmal positional vertigo (BPPV) is a common cause. The condition is diagnosed using the Hallpike maneuver and treated by the particle-repositioning maneuver or habituation exercises. <i>Objective:</i>To identify patients with BPPV among a variety of diagnoses represented by the ICD-10 diagnosis R42 in people 65 aged years and older who visited primary health care because of vertigo and dizziness. <i>Methods:</i>Searches were performed in the computerized medical records of 6 different health care centers over the period of 1 year for the ICD-10 diagnosis R42 and the age group 65 years and older. Letters were sent to the patients identified with an invitation for assessment and physical examination by a physiotherapist. Thirty-eight patients responded to the letter and were included in the study. All patients were assessed by physical examination including the Hallpike maneuver. <i>Results:</i> The study group included 13 men and 25 women, 65–94 (median 83) years of age. After physical examination, 15 patients were found to have BPPV (confidence interval 24–55%). <i>Conclusion:</i>In this study, 2 of 5 of the patients with ICD-10 diagnosis R42 (dizziness and giddiness) had BPPV. BPPV is probably an underestimated cause of dizziness/vertigo among elderly patients in primary health care.
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| 6. |
- Ekvall-Hansson, Eva, et al.
(författare)
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Effects of specific rehabilitation for dizziness among patients in primary health care. A randomized controlled trial.
- 2004
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 18:5, s. 558-565
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether specific rehabilitation for patients with dizziness has any effect on clinical balance measures and/or the apprehension of dizziness measured with a visual analogue scale (VAS). Design: Randomized controlled trial. Subjects: Forty-two patients, 50 years or older with dizziness of central or agerelated origin, identified in primary health care. Method: The patients were randomized to either an intervention or a control group. The intervention included balance training and vestibular rehabilitation in group sessions twice a week for six weeks. All patients were assessed at baseline, after six weeks and after three months with five different balance measures and visual analogue scale. Results: Statistically significant differences were found between the two groups comparing results at baseline and after six weeks regarding standing one leg eyes closed (SOLEC) on right foot (p 0.011). Results of SOLEC right foot after three months differed significantly between the groups (p -0.033) as did SOLEC left foot (p -0.035). No difference between the groups were found in the Romberg test, figure of eight, walking heel to toe, ‘stops walking when talking’, standing one leg eyes open or estimating the experience of dizziness measured with visual analogue scale. Conclusions: Balance training and vestibular rehabilitation improved the ability to stand on one leg with eyes closed in persons with dizziness aged 50 years or over.
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| 8. |
- Ekvall-Hansson, Eva, et al.
(författare)
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Treatment for benign paroxysmal positional vertigo - a case study
- 2005
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1651-1948 .- 1403-8196. ; 7:4, s. 183-186
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Tidskriftsartikel (refereegranskat)abstract
- Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo and can be successfully treated with particle-repositioning procedures or habituation exercises. However, some patients do not tolerate this treatment. The aim of the study was to investigate the possibility of treating patients with BPPV, where treatment at first seemed too demanding for the patients, using a descriptive study in a primary health care centre setting. Three patients, aged 79, 81 and 89, with BPPV, who could not tolerate common treatment, were studied. The main outcome measure was the Dix-Hallpike manoeuvre. The patients were successfully treated with versions of manoeuvre treatment and habituation exercises, including rolling from supine to side-lying, performing habituation exercises more slowly than recommended and use of sedation. The results show that, with a few adjustments, it is possible to successfully treat patients for whom the treatment at first seems too demanding. Since BPPV is possible to treat, every opportunity to minimize vertigo among the elderly is valuable, irrespective of factors such as fear, reduced mobility, concomitant or multiple diseases.
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| 9. |
- Ekvall-Hansson, Eva, et al.
(författare)
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What happens with the dizzy patient in primary health care? Does education influence treatment?
- 2004
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1651-1948 .- 1403-8196. ; 6:2, s. 93-96
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Tidskriftsartikel (refereegranskat)abstract
- Dizziness is a common symptom, and recent research shows that physical activity and specific treatment of vertigo and dizziness are effective. The management of dizzy patients requires assessment and, when appropriate, treatment by a physiotherapist. We have therefore studied how general practitioners (GPs) handle patients with vertigo and dizziness, to find out whether treatment follows current research, emphasizing the importance of physical activity and vestibular rehabilitation. We also wanted to find out whether information and education concerning the importance of physiotherapy and rehabilitation had any influence on the choice of treatment. Searches were performed in medical records at two health care centres on two occasions, in 1998 and 2000. In 1999, an intervention in the form of education was given to the staff. Records from the 311 patients with dizziness/vertigo identified in the searches were read and measures taken by the GPs were registered. The most common procedures - blood tests, control of blood pressure and ECG - were more common in 2000 than in 1998. No patients were left without any measure in 2000, which was the case in 1998. Only a few patients were referred to physiotherapy (8% in 1998 and 12% in 2000). It seems that the intervention did not affect the ratio of patients referred to physiotherapy.
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