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1.
  • Andersson, Eva A, 1958-, et al. (författare)
  • Maximal Aerobic Power versus Performance in Two Aerobic Endurance Tests among Young and Old Adults
  • 2011
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; :Aug, s. 1-11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Aerobic fitness is of great value for reducing risk of mortality and cardiovascular diseases. Objective: This study evaluated the performance in and correlations between a new test (five-minute pyramid test, 5MPT), the six-minute walk-test (6MWT) and maximal oxygen uptake (VO(2max)) among old and young adults. Methods: Forty-four habitually active adults (females and males), 23 old (64-79 years) and 21 young (20-32 years) participated. In the 5MPT, the participants moved back and forth along a short walkway (5.5 m) over boxes (height: 'old people' 0.42 m, 'young people' 0.62 m) arranged like an elongated step pyramid for 5 min. Power in the pyramid test (5MPT(power)) was calculated as the product of numbers of laps, body weight, gravity and highest box level divided by time. A 6MWT and a maximal cycle ergometer test for direct measurements of VO(2max) were also performed. In all tests heart rate, with on-line electrocardiography, and perceived exertion were recorded. Results: There was a strong correlation between the 5MPT(power) and VO(2max) for the entire group studied (r = 0.98), and each of the four subgroups old and young females and males separately (r = 0.78-0.98). Contrary to several earlier studies, especially involving people with various diseases, the present data showed that 6MWT cannot be used to predict VO(2max) among old females and young adults. The correlation with VO(2max) was weaker for the 6MWT than for the 5MPT(power). The relative performance values for the old compared to the young (ratio old/young × 100) were considerably lower in 5MPT(power) and VO(2max) (47-55%) than in distance and 'work' in the 6MWT (82-86%). Conclusions: The results, with age and gender variations, can be valuable information in health-fitness contexts, since measuring physical aerobic capacity is very significant in connection with risk evaluations of mortality and various diseases. The 5MPT is a rapid, functional, easy and inexpensive tool for predicting assessed maximal aerobic power.
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2.
  • Andersson, Staffan, et al. (författare)
  • Twenty-four-hour electrocardiography in a healthy elderly population
  • 1988
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 34:3, s. 139-144
  • Tidskriftsartikel (refereegranskat)abstract
    • Twenty-four hour electrocardiography was performed in fifteen 73-year-old and seventeen 82-year-old subjects without known cardiovascular disease. They were selected from a representative population of elderly people. All subjects showed supraventricular premature beats. Supraventricular tachycardia was seen in 63%. Eighty-four percent showed ventricular premature beats (VPBs), and more than two VPB configuration types were seen in 23% of the subjects. Episodes of intermittent atrial flutter and fibrillation, higher-degree atrioventricular blocks and ventricular tachycardia were absent or rare.
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  • Bergman, Daniel, et al. (författare)
  • Insulin-Like Growth Factor 2 in Development and Disease: A Mini-Review
  • 2013
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 59, s. 240-249
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Insulin-like growth factor 2 (IGF2) is a protein hormone known to regulate cell proliferation, growth, migration, differentiation and survival. The gene is parentally imprinted in the sense that transcripts are almost exclusively derived from the paternal allele. Loss of imprinting of the IGF2 gene is a recurrent observation in growth disorders that combine overgrowth with a variety of malignant tumours. Moreover, IGF2 has been proposed to play a role in the development of a variety of seemingly unrelated cancers that play an important role in geriatric medicine, e.g. breast cancer, colon cancer and lung cancer. Finally, IGF2 has been implicated in cardiovascular disease, since, for example, IGF2 has been shown to influence the size of atherosclerotic lesions. Objective: To summarize current knowledge about IGF2, its interactions with binding proteins and receptors and connections with key diseases. Methods: The contents of this paper were based on reviews of existing literature within the field. Results: There is a substantial amount of research linking IGF2 to growth disorders, cancer and to a much lesser degree cardiovascular disease. Some of the studies on IGF2 and tumour growth have yielded conflicting results, for instance regarding its effect on apoptosis. Conclusion: Today, our knowledge on how IGF2 is composed and interacts with receptors has come a long way. However, there is comparatively little information on how IGF2 affects tumour growth and cardiovascular diseases such as atherosclerosis. Thus, further research will be needed to elucidate the impact of IGF2 on key diseases. Copyright (C) 2012 S. Karger AG, Basel
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  • Bolam, Kate A, et al. (författare)
  • The Osteogenic Effect of Impact-Loading and Resistance Exercise on Bone Mineral Density in Middle-Aged and Older Men : A Pilot Study.
  • 2016
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 62:1, s. 22-32
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Regular exercise has been recommended as a potential strategy to counteract the age-related bone loss experienced by men; however, the optimal exercise prescription is not known.OBJECTIVE: To perform a pilot study to examine the osteogenic effect, safety and feasibility of a combined program of upper body resistance exercise and two doses of impact-loading exercise on bone mineral density (BMD) of middle-aged and older men.METHODS: Forty-two community-dwelling men aged 50-74 years were randomly assigned to either an exercise program of combined upper body resistance exercise and either high-dose impact-loading (HI; 80 jumps per session) or moderate-dose impact-loading (MOD; 40 jumps per session) or a control (CON) group. The 9-month intervention involved 4 sessions each week: 2 supervised clinic-based and 2 home-based. BMD of the lumbar spine, femoral neck, total hip, trochanter and whole body as well as lean and fat mass were assessed at baseline and 9 months by dual-energy X-ray absorptiometry. Bone turnover markers, hormone levels, physical function and muscle strength were also assessed.RESULTS: Following 9 months of training, significant differences in BMD among groups were found at the total hip (p = 0.010) and trochanter (p = 0.047) with BMD in the MOD group decreasing relative to the HI group. Although not significant, the HI group consistently preserved BMD, whereas BMD of the MOD and CON groups declined at the hip sites. Mean change for all groups at all skeletal sites was approximately within ±1%. There was no change in bone turnover markers. There were no adverse events as a result of the intervention; however, overall attendance for the HI and MOD groups was 53% (clinic: 68%, home: 38%) and 65% (clinic: 74%, home: 55%), respectively.CONCLUSIONS: This study indicates that while impact-loading exercise can be safely undertaken in middle-aged and older men, the current combined program did not elicit significant improvements in BMD. © 2015 S. Karger AG, Basel.
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8.
  • Bronge, William, et al. (författare)
  • Epidemiology and functional impact of early peripheral neuropathy signs in older adults from a general population
  • Ingår i: Gerontology. - 1423-0003.
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Peripheral neuropathy (PN) becomes more common with increasing life expectancy, but general population prevalence estimates are lacking. We investigated an epidemiological distribution of signs of PN among 2,996 community-dwelling participants in Good Aging in Skåne Study, age 60–97, and their impact on physical and autonomic function. Methods: Signs of PN were measured with Utah Early Neuropathy Scale (UENS). Associations between UENS and physical tests, pain, and dysautonomic phenomena were calculated for each sex, adjusted for age, with estimated marginal means (EMM) and odds ratios (ORs) in four UENS quantiles (Q1–Q4). Results: Participants in Q4 had worse EMM for: time to complete Timed Up and Go test (Q4–Q1: male 10.8–9.6 s; female 11.7–10.2 s), 15 m Walk test (Q4–Q1: male 11.1–9.9 s; female 11.2–10.4 s), and fewer repetitions in Step test (Q4–Q1: male 15.2–17.0 steps; female 14.5–15.8 steps). Higher OR of failing one-leg balance 60 s test {male 2.5 (confidence interval [CI] 95%: 1.7–3.8); female 2.1 (1.1–3.2)}, Foam Pad Balance test (male 4.6 [CI 95%: 3.2–6.7]; female 1.8 [1.3–2.6]), and lower physical quality of life were seen in Q4 compared to Q1. Participants in Q4 had higher OR for walking aid usage, falls, fear of falling, pain, and urinary incontinence, while in males, higher OR for orthostatic intolerance, fecal incontinence, and constipation. Conclusions: In a general population, 20–25% of older adults who have highest UENS scores, a sensitive measure of early PN, express slower gait, worse balance, lower quality of life, pain, falls and fear of falling, and autonomic symptoms.
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  • Bruton, M, et al. (författare)
  • Expression of High Mobility Group Protein B1 in Cardiac Tissue of Elderly Patients with Coronary Artery Disease with or without Inflammatory Rheumatic Disease
  • 2017
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 63:4, s. 337-349
  • Tidskriftsartikel (refereegranskat)abstract
    • <b><i>Background:</i></b> It is known from clinical practice and observational studies that elderly patients with a diagnosis of inflammatory rheumatic diseases (IRD) bear a significantly increased risk for cardiovascular diseases such as coronary artery disease (CAD) and heart failure. The molecular mechanism, however, is still not known. Recently, high mobility group protein B1 (HMGB1), a ubiquitous, highly conserved single polypeptide expressed in all mammal eukaryotic cells, has been identified to mediate myocardial dysfunction in vitro once released from the nuclei of cardiomyocytes. <b><i>Objective:</i></b> To investigate whether HMGB1 and its receptors are expressed in cardiac muscles of elderly patients with CAD with or without IRD. <b><i>Methods:</i></b> HMGB1 and its 3 well-known receptors, receptor for advanced glycation end products, Toll-like receptor 2 (TLR2), and TLR4, were examined by immunohistochemistry on myocardial biopsy specimens from 18 elderly patients with CAD (10 with IRD, 8 without IRD). Furthermore, total HMGB1 protein levels were measured by Western blot from the cardiac biopsies in 5 patients with and 5 without IRD. <b><i>Results:</i></b> Pathologic cytosolic HMGB1 in cardiomyocytes was massively recorded in all patients with IRD, but only slightly expressed in 1 patient without IRD. Total HMGB1 levels were also consistently lower in myocardial muscle biopsies of patients with IRD compared to those without IRD. Furthermore, all 3 HMGB1 receptors were expressed in cardiomyocytes of all patients. <b><i>Conclusion:</i></b> The increased cytosolic expression of HMGB1 in cardiomyocytes and the lower total amount of HMGB1 in the cardiac specimens of IRD patients is consistent with a greater release of HMGB1 from the myocardial nuclei in IRD than non-IRD individuals. Thus, the HMGB1 signaling pathways may be more easily activated in elderly CAD patients with concomitant IRD and trigger a detrimental inflammatory process causing severe cardiovascular problems. Therefore, targeting HMGB1 in IRD patients might reduce the risk for cardiovascular events.
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  • Butcher, L, et al. (författare)
  • Higher sRAGE Levels Predict Mortality in Frail Older Adults with Cardiovascular Disease
  • 2021
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 67:2, s. 202-210
  • Tidskriftsartikel (refereegranskat)abstract
    • <b><i>Introduction:</i></b> The evidence that blood levels of the soluble receptor for advanced glycation end products (sRAGE) predict mortality in people with cardiovascular diseases (CVD) is inconsistent. To clarify this matter, we investigated if frailty status influences this association. <b><i>Methods:</i></b> We analysed data of 1,016 individuals (median age, 75 years) from 3 population-based European cohorts, enrolled in the FRAILOMIC project. Participants were stratified by history of CVD and frailty status. Mortality was recorded during 8 years of follow-up. <b><i>Results:</i></b> In adjusted Cox regression models, baseline serum sRAGE was positively associated with an increased risk of mortality in participants with CVD (HR 1.64, 95% CI 1.09–2.49, <i>p</i> = 0.019) but not in non-CVD. Within the CVD group, the risk of death was markedly enhanced in the frail subgroup (CVD-F, HR 1.97, 95% CI 1.18–3.29, <i>p</i> = 0.009), compared to the non-frail subgroup (CVD-NF, HR 1.50, 95% CI 0.71–3.15, <i>p</i> = 0.287). Kaplan-Meier analysis showed that the median survival time of CVD-F with high sRAGE (&#x3e;1,554 pg/mL) was 2.9 years shorter than that of CVD-F with low sRAGE, whereas no survival difference was seen for CVD-NF. Area under the ROC curve analysis demonstrated that for CVD-F, addition of sRAGE to the prediction model increased its prognostic value. <b><i>Conclusions:</i></b> Frailty status influences the relationship between sRAGE and mortality in older adults with CVD. sRAGE could be used as a prognostic marker of mortality for these individuals, particularly if they are also frail.
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  • Carlsson, Lena, et al. (författare)
  • Reference Values for 27 Clinical Chemistry Tests in 70-Year-Old Males and Females
  • 2010
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 56:3, s. 259-265
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Reference values are usually defined based on blood samples from healthy men or nonpregnant women in the age range of 20-50 years. These values are not optimal for elderly patients, as many biological markers change over time and adequate reference values are important for correct clinical decisions. Objective: To validate NORIP (Nordic Reference Interval Project) reference values in a 70-year-old population. Methods: We studied 27 frequently used laboratory tests. The 2.5th and 97.5th percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry on the statistical treatment of reference values. Results: Reference values are reported for plasma alanine aminotransferase, albumin, alkaline phosphatase, pancreas amylase, apolipoprotein A1, apolipoprotein B, aspartate aminotransferase, bilirubin, calcium, chloride, cholesterol, creatinine, creatine kinase, C-reactive protein, glucose, gamma-glutamyltransferase, HDL-cholesterol, iron, lactate dehydrogenase, LDL-cholesterol, magnesium, phosphate, potassium, sodium, transferrin, triglycerides, urate and urea. Conclusion: Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% CI of a Scandinavian population (NORIP).
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  • Derwinger, A, et al. (författare)
  • Forgetting numbers in old age: strategy and learning speed matter
  • 2005
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 51:4, s. 277-284
  • Tidskriftsartikel (refereegranskat)abstract
    • <i>Background:</i> Memory intervention research with older adults has primarily focused on immediate effects of training. Little is known about whether memory training can prevent forgetting of a learned material over time. <i>Objective:</i> The main purpose of this study was to investigate the effects of memory training on forgetting of numerical information in old age. In addition, the effect of speed of learning on forgetting rate was examined. <i>Methods:</i> Two training programs were employed contrasting a number-consonant mnemonic strategy with a self-generated strategy. A non-practice control group was also included. There were 20 participants in each group (age range = 60–83 years). Following completion of training, participants memorized six 4-digit numbers to perfection. Retention was tested after 30 min, 24 h, 7 weeks, and 8 months. <i>Results:</i> The three groups showed equal rates of forgetting across the first two follow-up assessments. A different picture emerged for the last two occasions, with the self-generated strategy group remembering more items relative to the two other groups. Moreover, participants reaching the criterion in few trials exhibited less forgetting than slow learners. <i>Conclusions:</i> These data indicate that self-generated strategy training may have advantages over learning a classical mnemonic for preventing long-term forgetting of numeric materials in old age.
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  • Dukic Willstrand, Tania, 1975-, et al. (författare)
  • Driving Characteristics of Older Drivers and Their Relationship to the Useful Field of View Test
  • 2017
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 63:2, s. 180-188
  • Tidskriftsartikel (refereegranskat)abstract
    • To maintain the mobility of older people in later life, it is essential to sustain their autonomy; however, driving is a complex task, requiring a large range of visual, psychomotor and cognitive abilities. Subsequently, a key issue is to measure and evaluate the fitness to drive of older drivers. Several methods have been proposed, among them the useful field of view (UFOV) test.The present study aimed to identify driving characteristics in older drivers and the relationship between the UFOV test and the on-road driving results. A total of 80 drivers aged 70 years or older performed both the UFOV test and the on-road driving assessment. The ‘B On-Road' (Behaviour On-Road) protocol was used for the fitness-to-drive assessment. ‘Driving too fast' was the item reported most often during the on-road assessment, followed by problems with the manual gearbox and ‘attention to signs, road lines and traffic lights'. Overall, the results showed that the older the driver, the more errors were reported during the on-road driving assessment, as well as the slower the performance on the UFOV test. A significant relationship between the total number of on-road errors, as measured by the B On-Road protocol, and the UFOV 3, which stresses the capacity of selective attention, was found.The recommendation is still to use on-road driving assessment to fully assess fitness to drive for older drivers whose ability to drive requires assessment. However, to supplement this, the UFOV test, in particular the UFOV 3, is a valuable complement in selecting those drivers requiring to be assessed.
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  • Eklund, Karin, et al. (författare)
  • Positive Experience of a Mobile Radiography Service in Nursing Homes.
  • 2012
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 58, s. 107-111
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: For elderly people living in nursing homes, a transport to hospital for a radiological examination can lead to increased anxiety, disorientation and other problems related to the new environment. Objective: To investigate the usefulness of a mobile radiography service for radiological assessment of patients in nursing homes from the patient and staff perspectives. Methods: Lightweight equipment with a digital flat-panel detector was used for mobile radiography on nursing home patients in their own rooms. Data on patient and staff experiences from the service were collected using a questionnaire with closed and open-ended questions. Image quality was evaluated by the radiographer and a radiologist. Results: The majority of 241 radiography examinations were of the musculoskeletal system (94%). Twelve of 123 patients had pathology that required hospital treatment, while 22 patients with radiographic pathology could be treated locally. The main beneficial factors were security and comfort, acceptance from the patients, no need for transportation, no need for staff to be absent from the nursing homes. Conclusion: Mobile radiography in nursing homes is technically feasible, with good image quality. The most beneficial results were that patients avoided unnecessary transport back and forth to the hospital, and that the majority of patients could be treated locally.
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  • Ekvall-Hansson, Eva, et al. (författare)
  • Benign Paroxysmal Positional Vertigo among Elderly Patients in Primary Health Care.
  • 2005
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 51:6, s. 386-389
  • 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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  • Ekvall-Hansson, Eva, et al. (författare)
  • Vestibular Rehabilitation Affects Vestibular Asymmetry among Patients with Fall-Related Wrist Fractures - A Randomized Controlled Trial.
  • 2015
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 61:4, s. 310-318
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Fall-related fractures are an increasing problem for society. Dizziness is identified as a risk factor for falls and vestibular asymmetry is often found among patients with fall-related fractures. An option to prevent fall-related fractures may be to identify patients with vestibular asymmetry and to improve their balance and asymmetry by exercise. Objective: To examine whether vestibular rehabilitation improves vestibular function, balance and self-rated health among patients with fall-related wrist fractures. Methods: Sixty-eight persons (65 women) with fall-related wrist fractures, mean age 72 years (54-89) participated in this randomized controlled trial. The following tests and measurements were performed: head shake test to evaluate vestibular asymmetry as primary outcome measure, five clinical balance measures, a force plate to measure postural sway, a tuning fork to measure vibration and the EQ5D questionnaire to measure self-rated health. The intervention comprised group-based vestibular rehabilitation sessions conducted twice a week for 9 weeks. Results: Nystagmus occurred in the head shake test in 65% (44 of 68) of the patients, indicating vestibular asymmetry. More patients in the intervention group (6 of 21) than in the control group (0 of 23) changed from having nystagmus in the head shake test at baseline (indicating vestibular asymmetry) to not having nystagmus at follow-up, and more patients in the control group (3 of 9) than in the intervention group (0 of 3) changed from not having nystagmus at baseline to have nystagmus at follow-up (p < 0.00). No other changes occurred between the two groups between baseline and follow-up. At baseline, patients with vestibular asymmetry had more balance deficits and increased postural sway compared to patients without (p = 0.00-0.05). Conclusion: Group sessions with vestibular rehabilitation twice a week for 9 weeks affected the occurrence of vestibular asymmetry positively among patients having vestibular asymmetry. Patients with vestibular asymmetry had more balance deficits and increased postural sway than patients without vestibular asymmetry. Vestibular assessment is important, and, in patients with diagnosed vestibular asymmetry, vestibular rehabilitation may prove beneficial on balance and possibly reduce the risk of future falls. © 2014 S. Karger AG, Basel.
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  • Erusalimsky, JD, et al. (författare)
  • In Search of 'Omics'-Based Biomarkers to Predict Risk of Frailty and Its Consequences in Older Individuals: The FRAILOMIC Initiative
  • 2016
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 62:2, s. 182-190
  • Tidskriftsartikel (refereegranskat)abstract
    • An increase in the number of older people experiencing disability and dependence is a critical aspect of the demographic change that will emerge within Europe due to the rise in life expectancy. In this scenario, prevention of these conditions is crucial for the well-being of older citizens and for the sustainability of our healthcare systems. Thus, the diagnosis and management of conditions like frailty, which identifies the people at the highest risk for developing those adverse outcomes, is of critical relevance. Currently, assessment of frailty relies primarily on measuring functional parameters, which have limited clinical utility. In this viewpoint article, we describe the FRAILOMIC Initiative, an international, large-scale, multi-endpoint, community- and clinic-based research study funded by the European Commission. The aim of the study is to develop validated measures, comprising both classic and ‘omics-based' laboratory biomarkers, which can predict the risk of frailty, improve the accuracy of its diagnosis in clinical practice and provide a prognostic forecast on the evolution from frailty to disability. The initiative includes eight established cohorts of older adults, encompassing >75,000 subjects, most of whom (∼70%) are aged >65 years. Data on function, nutritional status and exercise habits have been collected, and cardiovascular health has been evaluated at baseline. Subjects will be stratified as ‘non-frail' or ‘frail' using Fried's definition, all adverse outcomes of interest will be recorded and differentially expressed biomarkers associated with the risk of frailty will be identified. Genomic, proteomic and transcriptomic investigations will be carried out using array-based systems. As circulating microRNAs in plasma have been identified in the context of senescence, ageing and age-associated diseases, a miRNome-wide analysis will also be undertaken to identify a miRNA-based signature of frailty. Blood concentrations of secreted proteins known to be upregulated significantly in senescent endothelial cells and other hypothesis-driven biomarkers will be measured using ELISAs. The FRAILOMIC Initiative aims to issue a series of interim scientific reports as key results emerge. Ultimately, it is hoped that this study will contribute to the development of new clinical tools, which may help individuals to enjoy an old age that is healthier and free from disability.
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  • Frandin, Kerstin, et al. (författare)
  • Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents : A Randomized Controlled Trial
  • 2016
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 62:6, s. 571-580
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The preservation of physical functions such as muscle strength, balance and mobility is fundamental to maintaining independence in activities of daily living (ADL). The physical activity level of most nursing home residents is very low, which implies that they are often subject to a decline in health, mobility, autonomy and social contacts and are also at risk of suffering a decline in mental well-being. In a previous study, we demonstrated that transfers, balance and physical activity level improved after 3 months of individually tailored intervention in nursing home residents. Objective: To evaluate the long-term effects on ADL, balance function, physical activity level, physical performance, falls related self-efficacy, well-being and cognitive function 3 months after the completion of our intervention in nursing home residents. Methods: The study was a multicenter randomized, controlled clinical trial with a parallel-group design. It was conducted in nursing homes in Sweden, Norway and Denmark, with an intervention period lasting 3 months and a follow-up at 6 months. Initially, 322 nursing home residents with a mean age of 85 years were included; 85 from Sweden, 171 from Norway and 66 from Denmark. Of these, 241 [129 intervention group (IG), 112 control group (CG)] were eligible for the 6-month follow-up tests. The level of dependence in ADL, physical activity level, several dimensions of physical function, well-being, falls-related self-efficacy and cognitive function were assessed with reliable and valid instruments at baseline, immediately after 3 months of intervention and 3 months later at the 6-month follow-up.Results: After 3 months of intervention and an additional period of 3 months without intervention, only the following 2 variables demonstrated significant group differences: social and cognitive function, measured by the Functional Independence Measure n-r, where the IG deteriorated while the CG was almost stable. However, regarding transfers, the IG deteriorated significantly less than the CG. Conclusion: Without supervised physical exercise that challenged the individuals' capability, gains in ADL function, balance and transfer ability deteriorated during the 3 months following the intervention period. Thus, continuous, individually adjusted and supported physical activity seems crucial for the maintenance of physical functions in these vulnerable elderly persons.
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  • Gerdhem, Paul, et al. (författare)
  • Bone mass cannot be predicted by estimations of frailty in elderly ambulatory women.
  • 2003
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 49:3, s. 168-172
  • Tidskriftsartikel (refereegranskat)abstract
    • <i>Background/Methods:</i> High biological age, or frailty, a possible risk factor for fragility fracture, and its relation to known risk factors for fracture (low bone mineral density (BMD), low muscle strength, poor gait performance and poor balance, previous falls, previous fractures and future risk of falls) were investigated in 993 randomly selected 75-year-old women. Frailty, which has no accepted definition, was here defined as a subjective immediate impression of an individual’s general health appearance and was transferred into an arbitrary scale. 993 individuals were scored by at least one of four observers. <i>Results:</i> The frailty score and BMD were not correlated. A high frailty score was significantly correlated to poor gait (r = 0.53–0.59, p < 0.0001), poor balance (r = –0.49, p < 0.0001), low muscle strength (r = –0.25 to –0.41, p < 0.0001), low activity level (r = –0.43, p < 0.0001) and a high risk of falling (r = 0.24, p < 0.0001). The group of women who had experienced at least one fall the previous year had a higher frailty score (p < 0.0001) compared to those who had not. Women who had sustained a hip or femoral fracture after the age of 70 had a higher frailty score than women with no earlier fracture at all. <i>Conclusions:</i> Bone mass cannot be predicted by our subjective frailty score in elderly, ambulant women. Since a high frailty score correlates with factors that affect or are likely to affect fall propensity, this could indicate that a high frailty score is a risk factor for fracture, independent of bone mass. Frailty may be regarded as a complex risk factor, including several assessments that can be objectively measured. Whether estimation of frailty is a method to improve the assessment of the patient at risk for a fragility fracture is yet to be proven and can only be shown in a prospective study of fracture occurrence.
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24.
  • Gerdhem, Paul, et al. (författare)
  • Just one look, and fractures and death can be predicted in elderly ambulatory women.
  • 2004
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 50:5, s. 309-314
  • Tidskriftsartikel (refereegranskat)abstract
    • <i>Background:</i> The chronological age is clearly the strongest risk factor for fractures or death. Age as a concept can be described exactly as chronological age. Age in relative terms can be described as biological age. <i>Objective:</i> We postulated that, even without taking into account known or unknown comorbidity, an immediate and totally subjective evaluation of an individual’s biological age is predictive of forthcoming fractures and death. <i>Methods:</i> At baseline the biological age was estimated in 1,004 randomly recruited ambulatory 75-year-old women. All women were of the same ethnic background. Two independent observers estimated the biological age within 15 s of first sight of each woman. Based on this estimation of the biological age, the women were divided into tertiles. The women were then followed prospectively for a mean of 4.6 (range 3.0–6.5) years. All retrospective fractures and prospective fractures and deaths were registered. <i>Results:</i> When the tertile of the biologically oldest women was compared with all other women, their odds ratio for sustaining any type of prospective fracture was 1.71 (95% confidence interval 1.22–2.39), for hip fractures 2.69 (1.42–5.11), for clinical vertebral fractures 2.83 (1.57–5.11), and for multiple fractures 3.17 (1.64–6.10). Also, when retrospectively sustained fractures were included, the predictive ability for biological age remained. The death rate amongst the tertile of biologically oldest women was increased when compared with the rest of the women (odds ratio 4.33, CI 3.62–5.17). <i>Conclusions:</i> In ambulatory elderly women, without specific consideration of comorbidity, a subjective estimate of the biological age is predictive of future fractures and death. Subjective estimation of the biological age, in relation to the chronological age, is a valuable indicator of health, conveying additional information that merits its use in clinical practice.
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25.
  • Godhe, Manne, et al. (författare)
  • Reliability in Novel Field-Based Fitness Measurements and Postexercise Scores from a Physical Fitness Test Battery in Older Adults.
  • 2024
  • Ingår i: Gerontology. - : S. Karger. - 0304-324X .- 1423-0003. ; 70:6, s. 639-660
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Physical fitness is strongly associated with daily physical function, health, and longevity in older adults. Field-based tests may provide a reasonable alternative compared to advanced laboratory testing. Separating postexercise test scores from reactivity measurements requires sufficient test-retest reliability. Postexercise test scores with reliability analyses of field-based fitness tests in older adults are lacking. The present study aimed to examine the test-retest reliability of some novel easily accommodated fitness test measurements and compare pretest scores with postexercise results in these tests along with other field-based fitness tests in older adults.METHODS: Totally 1,407 community-dwelling older adults (69% female), x̄ = 71.5 ± 5.0 (65-84 years), performed twelve field-based fitness tests at pretest 1, pretest 2 and a posttest after an 8-week exercise period (twice weekly 1 h of combined strength and aerobic training). T tests, intra-class correlation, limits of agreement, standard error of measurement, and coefficient of variance were performed between pre-1 and pre-2 tests, and repeated measures ANOVA and partial eta squared effect size for postexercise differences for men and women in 5-year age groups ranging from 65 to 84 years.RESULTS: Between pre-1 and pre-2 tests a significant difference was noted in some of the novel fitness test measurements but generally not, e.g., in isometric trunk flexion and step-up height on either leg among all sex and age groups. In most of these novel fitness test measurements, no significant differences occurred between the two pretests. Examples of results from the pre-2 test to the posttest were isometric trunk flexion 45° endurance and isometric trunk extension endurance improved significantly for both sexes in age groups 65-74 years. Women, but not men, improved the maximal step-up height for both legs in most age groups. The speed in the 50 sit-to-stand improved significantly for most age groups in both sexes. Six-min walk distance improved significantly for most age groups in women but among men only in 65-69 years. In the timed-up-and-go test, significant improvements were seen for all age groups in women and in men 70-79 years. No postexercise improvements were generally observed for grip strength or balance.CONCLUSIONS: In most of the novel fitness test measures, no significant difference was noted between the two pretests in the assessed sex and age groups. Results after the 8-week exercise period varied between sex and age groups, with significant improvements in several of the twelve studied fitness tests. These findings may be valuable for future projects utilizing easily accommodated physical fitness tests in older adults.
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26.
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27.
  • Gronstedt, Helena, et al. (författare)
  • Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level : A Randomized Controlled Trial
  • 2013
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 59:3, s. 220-229
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Nursing home residents are extremely inactive and deterioration in health and an increasing dependence in activities of daily living (ADL) are common. Physical activity and exercise play a major role in the preservation of physical function and quality of life late in life. However, evidence for the benefit of rehabilitation in nursing home residents is conflicting and inconclusive. Objective: To evaluate the effect of an individually tailored intervention program of 3 months, for nursing home residents, on ADL, balance, physical activity level, mobility and muscle strength. Methods:In this single-blind randomized clinical trial with parallel groups, nursing home residents >64 years of age from three Nordic countries were included. The intervention group (IG) was assigned to individually tailored physical and daily activities, while the control group (CG) received ordinary care. Primary outcomes were ADL and balance, and secondary outcomes physical activity level, mobility and muscle strength. Results: At baseline, 322 nursing home residents were included, of whom 266 were assessed after 3 months of intervention. Following the intervention, a significant difference was found between participants in the IG and CG on measures of balance, physical activity and transfers. The IG significantly improved walking/wheelchair speed and functional leg muscle strength. The CG had significantly deteriorated in ADL, balance and transfers. Persons who had taken part in the intervention for more than 150 min/week significantly improved their balance and physical activity level. Participation in more than 10 weeks of intervention significantly improved physical activity and walking/wheelchair speed, while a deterioration was seen in those who had participated less. Conclusion: Individually tailored intervention in nursing home residents focusing on physical and daily activities is effective in improving transfers, balance and physical activity level compared to usual care. The effect of the intervention is dependent on the total activity time.
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28.
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29.
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30.
  • Herr, Marie, et al. (författare)
  • Frailty and Associated Factors among Centenarians in the 5-COOP Countries
  • 2018
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 64:6, s. 521-531
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The global number of centenarians is still strongly growing and information about the health and healthcare needs of this segment of the population is needed. This study aimed to estimate the prevalence of frailty among centenarians included in a multinational study and to investigate associated factors. Methods: The 5-COOP study is a cross-sectional survey including 1,253 centenarians in 5 countries (Japan, France, Switzerland, Denmark, and Sweden). Data were collected using a standardized questionnaire during a face-to-face interview (73.3%), telephone interview (14.5%), or by postal questionnaire (12.2%). The 5 dimensions of the frailty phenotype (weight loss, fatigue, weakness, slow walking speed, and low level of physical activity) were assessed by using self-reported data. Factors associated with frailty criteria were investigated by using multivariate regression models. Results: Almost 95% of the participants had at least 1 frailty criterion. The overall prevalence of frailty (3 criteria or more) was 64.7% (from 51.5% in Sweden to 77.6% in Switzerland), and 32.2% of the participants had 4 or 5 criteria. The most frequent criteria were weakness (84.2%), slow walking speed (77.6%), and low level of physical activity (72.5%), followed by fatigue (43.8%) and weight loss (23.8%). Factors associated with frailty included data collection modes, country of residence, gender, living in institution, depression, dementia, disability, falls, and sensory impairments. Conclusions: This study shows that reaching 100 years of age rarely goes without frailty and sheds light on factors associated with frailty at a very old age.
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31.
  • Hoff, Maria, 1981, et al. (författare)
  • Hearing loss and cognitive function in early old age: comparing subjective and objective hearing measures.
  • 2023
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 69:6, s. 694-705
  • Tidskriftsartikel (refereegranskat)abstract
    • Population-based research has consistently shown that people with hearing loss are at greater risk of cognitive impairment. We aimed to explore the cross-sectional association of both subjective and objective hearing measures with global and domain-specific cognitive function. We also examined the influence of hearing aid use on the relationship.A population-based sample (n=1105, 52% women) of 70-year-olds that were representative of the inhabitants of the city of Gothenburg, Sweden completed a detailed cognitive examination, pure-tone audiometry and a questionnaire regarding perceived hearing problems. A subsample (n=247, 52% women) also completed a test of speech-recognition-in-noise (SPRIN). Multiple linear regression analyses were conducted to explore the association of hearing with cognitive function adjusting for sex, education, cardiovascular factors, and tinnitus.Global cognitive function was independently associated with the better ear pure-tone average across 0.5-4 kHz (PTA4, β=-0.13, 95% CI, -0.18, -0.07), the better ear SPRIN score (β=0.30, 95% CI, 0.19, 0.40), but not with the self-reported hearing measure (β=-0.02, 95% CI, -0.07, 0.03). Both verbally loaded and non-verbally loaded tasks, testing a variety of cognitive domains, contributed to the association. Hearing aid users had better global cognitive function than non-users with equivalent hearing ability. The difference was only significant in the mild hearing loss category.In a population-based sample of 70-year-old persons without dementia, poorer hearing was associated with poorer global and domain-specific cognitive function, but only when hearing function was measured objectively and not when self-reported. The speech-in-noise measure showed the strongest association. This highlights the importance of including standardized hearing tests and controlling for hearing status in epidemiological geriatric research. More research is needed on the role that hearing aid use plays in relation to age-related cognitive declines.
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32.
  • Irving, GF, et al. (författare)
  • Nutritional and cognitive status in elderly subjects living in service flats, and the effect of nutrition education on personnel
  • 1999
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 45:4, s. 187-194
  • Tidskriftsartikel (refereegranskat)abstract
    • <i>Background:</i> There is limited knowledge about the nutritional and cognitive status in elderly and chronically ill subjects living in sheltered housing. <i>Objective:</i> To perform a 6-month follow-up study in order to investigate (1) nutritional status and its relationship to cognitive function in elderly people living in service flats, and (2) the effect of a 9-hour educational program given to personnel working in the service flats. <i>Methods:</i> Of 93 eligible subjects, 28 agreed to participate (age 81 ± 7 years, 75% women). Body mass index (BMI), triceps skin fold (TSF), arm muscle circumference (AMC), appetite, Subjective Global Assessment (SGA), serum albumin, serum insulin-like growth factor-1 (IGF-1) and Mini Mental Test (MMT) were assessed on two occasions with a 6-month interval. The staff of the service flats answered a questionnaire before and 6 months after an educational program. <i>Results:</i> At the start, BMI, TSF and AMC were within the normal ranges, e.g. BMI 26.6 ± 3.1 for men and 25.6 ± 3.2 for women. Three subjects were suspected to be malnourished and 2 were malnourished according to SGA. Among 20 randomly selected subjects who chose not to participate in the investigation, age, sex, BMI, weight loss and appetite were not significantly different from those values in participants. However, none of the latter had a BMI <20 compared to 10% in non-participants. The MMT results suggested cognitive dysfunction in 41% of the subjects. On the first test occasion, MMT correlated with BMI (r = 0.43, p < 0.03), weight loss (r = 0.4, p < 0.05) and age (r = –0.38, p < 0.05). The ability of the personnel to suggest suitable nutrition for fictitious patient cases appeared to have improved after the educational program. At the 6-month follow-up, the BMI in men rose to 27.0 ± 3.4 (p < 0.05), while other anthropometric measurements remained unchanged. Serum IGF-1 lay within the normal range, as did serum albumin which, however, rose from 39.1 ± 2.9 to 41.2 ± 3.5 g/l (p < 0.01). <i>Conclusion:</i> Fifteen to twenty percent of the individuals studied in the service flats displayed definite or possible signs of malnutrition. Cognitive function correlated with BMI, weight loss and age. The educational program appeared to increase the nutritional knowledge in personnel working in the service flats. At the 6-month follow-up, the nutritional status of the residents had not deteriorated.
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33.
  • Jakic, Bojana, et al. (författare)
  • Lymphatic Capillaries in Aging
  • 2020
  • Ingår i: Gerontology. - : KARGER. - 0304-324X .- 1423-0003. ; 66:5, s. 419-426
  • Tidskriftsartikel (refereegranskat)abstract
    • The lymphatic system is responsible for fluid drainage from almost every organ in the body. It sustains tissue homeostasis and is also a central part of the immune system. With the discovery of cell-specific markers and transgenic mouse models, it has become possible to gain some insight into the developmental and functional roles of lymphatic endothelial cells (LECs). Only recently, a more direct regulatory role has been assigned to LECs in their functions in immunity responses and chronic diseases. Here, we discuss the changes occurring in aged lymphatic system and the role of lymphatic capillaries in some age-related diseases and experimental animal models.(c) 2020 The Author(s) Published by S. Karger AG, Basel
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34.
  • Jakic, B, et al. (författare)
  • The Effects of Endurance Exercise and Diet on Atherosclerosis in Young and Aged ApoE-/- and Wild-Type Mice
  • 2019
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 65:1, s. 45-56
  • Tidskriftsartikel (refereegranskat)abstract
    • <b><i>Background:</i></b> Atherosclerosis is the leading cause of death worldwide. The disease development is by and large driven by old age and lifestyle factors, such as diet, physical activity, and smoking. In the present study, we have investigated the effect of exercise and diet on the development of atherosclerosis in young and aged mice. <b><i>Objective:</i></b> This study aimed at comparing multiple age-dependent factors that may influence atherosclerosis in a transgenic mouse model. <b><i>Methods:</i></b> Young (14 weeks) and aged (49–52 weeks) C57BL/6 wild-type (WT) and atherosclerosis-prone ApoE<sup>–/–</sup> mice were subjected to physical endurance exercise on a treadmill, with or without a high-fat diet. Five weeks later, the frequencies of regulatory T cells (T<sub>REGs</sub>) in lymph nodes were assessed by flow cytometry, plasmatic cytokines (interleukin [IL]-1β, IL-6, IL-10, IL-17, interferon-γ, tumor necrosis factor-α, and transforming growth factor [TGF]-β<sub>1</sub>) levels were determined by Luminex assay. Lipids (cholesterol and triglycerides) and anti-heat shock protein 60 (HSP60) autoantibodies were measured by ELISA. Aortic lesion sizes were assessed by <i>en face</i> imaging. Microarray analysis and qPCR of skeletal muscle gene expression were also performed. <b><i>Results:</i></b> Exercise leads to a reduction of aortic lesions in young ApoE<sup>–/–</sup> and aged WT mice independent of diet. In most groups, this reduction was followed by an increased proportion of T<sub>REGs</sub> and TGF-β<sub>1</sub> levels. Moreover, gene expression analysis showed that exercise seems to affect the AMPK signaling pathway. In particular, PGC-1α<sub>1</sub> mRNA was induced in aged WT mice, whereas it was reduced in young ApoE<sup>–/–</sup> mice. In addition, GSEA analysis showed a marked reduction in the insulin signaling pathway in aged ApoE<sup>–/–</sup> mice. <b><i>Conclusion:</i></b> Practicing endurance exercise seems to be enough for reducing early aortic lesion formation, independent of diet. However, this was only true in mice with smaller aortic lesions, since mice with large, advanced, complicated atherosclerotic plaques did not show any reduction in lesion size with exercise training.
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35.
  • Jiang, Y, et al. (författare)
  • Falls and Fall-Related Consequences among Older People Living in Long-Term Care Facilities in a Megacity of China
  • 2020
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 66:6, s. 523-531
  • Tidskriftsartikel (refereegranskat)abstract
    • <b><i>Introduction:</i></b> Falls are currently the top safety problem in long-term care facilities (LTCFs) in China. Due to the increasing number of residents living in LTCFs, more evidence is needed to give a foundation for fall prevention. <b><i>Objective:</i></b> This study aimed to explore the epidemiological characteristics of falls in LTCFs in central Shanghai. <b><i>Methods:</i></b> The study was conducted in 21 LTCFs in a central district in Shanghai, with a capacity of 3,065 residents. A two-stage sampling method was applied in participant recruitment. Falls were recorded by LTCF staff over a 12-month period. Details of falls were obtained by face-to-face interviews. The χ<sup>2</sup> test was used in data analyses. <b><i>Results:</i></b> The incidence of falls was 13.5%; 64.0% falls resulted in injuries, with 32.0% involving fractures. Women had a significantly higher incidence of injurious falls than men (χ<sup>2</sup> = 4.066, <i>p</i> = 0.044). Residents aged 80–89 years or in level 1 care had the highest incidence of falls with severe consequences. The incidence of falls was significantly higher at small- or medium-sized LTCFs, public LTCFs, and LTCFs with higher environmental risk levels compared to their counterparts. Most falls occurred when walking on a flat floor (28.9%) and rising up or sitting down (24.0%); 40.9% occurred during the night. Of those injured, 54.8% were treated in hospitals, and only 53.7% completely recovered. <b><i>Conclusions:</i></b> Though the average incidence of falls in LTCFs in Shanghai was relatively low, great variation was observed between LTCFs, and severe consequences occurred frequently. Fall prevention programmes should be evidence-based with applicable devices and individualized care services and supports. The roles of personal and institutional factors on falls warrant further study.
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36.
  • Kangas, Maarit, et al. (författare)
  • Sensitivity and false alarm rate of a fall sensor in long-term fall detection in the elderly
  • 2015
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 61:1, s. 61-68
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: About a third of home-dwelling older people fall each year, and institutionalized older people even report a two- or threefold higher rate for falling. Automatic fall detection systems have been developed to support the independent and secure living of the elderly. Even though good fall detection sensitivity and specificity in laboratory settings have been reported, knowledge about the sensitivity and specificity of these systems in real-life conditions is still lacking. Objective: The aim of this study was to evaluate the long-term fall detection sensitivity and false alarm rate of a fall detection prototype in real-life use. Methods: A total of 15,500 h of real-life data from 16 older people, including both fallers and nonfallers, were monitored using an accelerometry-based sensor system with an implemented fall detection algorithm. Results: The fall detection system detected 12 out of 15 real-life falls, having a sensitivity of 80.0%, with a false alarm rate of 0.049 alarms per usage hour with the implemented real-time system. With minor modification of data analysis the false alarm rate was reduced to 0.025 false alarms per hour, equating to 1 false fall alarm per 40 usage hours. Conclusion: These data suggest that automatic accelerometric fall detection systems might offer a tool for improving safety among older people.
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37.
  • Kristensson Ekwall, Anna, et al. (författare)
  • Dizzy - Why Not Take a Walk? Low Level Physical Activity Improves Quality of Life among Elderly with Dizziness
  • 2009
  • Ingår i: GERONTOLOGY. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 55:6, s. 652-659
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Dizziness is a very common complaint. The frequency of dizziness increases with age. It affects quality of life negatively for older persons in several ways. Objectives: This study intended to investigate which variables (physical activity, loneliness, health complaints, need of help for daily living and falls) differed between those with and without dizziness and also to investigate which factors affected quality of life among older persons with dizziness. Method: An age-stratified, randomised sample of senior citizens-aged 75 or older - living in the south of Sweden (n = 4,360) answered a questionnaire concerning demographic data, social network, health complaints and diseases, feelings of loneliness, quality of life (Short Form 12), frequency of falls and activities. Results: Dizziness was associated with an increased risk of falling. Falls in the last 3 months were reported in 31% of the subjects with dizziness compared to 15% among those without (p andlt; 0.001). Dizziness also correlated with depression, with 42.5% feeling depressed among the elderly reporting dizziness as compared with 13.2%. Exercise, both light (i.e. go for a walk) or heavy (i.e. work in the garden), correlated with reduced risk of low quality of life among older, dizzy persons, both mental (light exercise OR 0.58; heavy OR 0.48) and physical (light OR 0.62; heavy OR 0.21). The proportion of dizzy persons doing light exercise was 75.6% versus 87.4% among the not dizzy (p andlt; 0.001). Exercise reduces the risk of falling and the risk of being depressed, and increases quality of life. Conclusion: Even light exercise seems beneficial both for improving quality of life and to decrease the risk of falling, which in turn will lower the mortality rate. Older persons reporting dizziness should be encouraged and perhaps helped to exercise. If one could increase physical activity among the elderly, it would reduce the number of falls, diminish medical costs, suffering for the individual, and be of paramount medicosocial importance for society.
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38.
  • Laurell, Helena, et al. (författare)
  • Acute abdominal pain among elderly patients
  • 2006
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 52:6, s. 339-344
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Diagnosis of acute abdominal pain in older persons is a challenge, with the age-related increase in concurrent diseases. In most western countries the number of elderly people is constantly rising, which means that an increasing proportion of patients admitted for abdominal pain at the emergency department are elderly. Objective: To characterize differences in clinical presentation and diagnostic accuracy between younger and more elderly patients with acute abdominal pain. Methods: Patients admitted to Mora Hospital with abdominal pain of up to seven days' duration were registered according to a detailed schedule. From 1st February 1997 to 1st June 2000, 557 patients aged 65-79 years and 274 patients aged ≥80 years were registered. Patients aged 20-64 years (n = 1,458) served as a control group. Results: A specific diagnosis, i.e. other than 'non-specific abdominal pain', was established in 76 and 78% of the patients aged 65-79 and ≥80 years respectively, and in 64% of those aged 20-64 (p < 0.001). Pain duration before admission increased with age (p < 0.003), as did frequency and duration of hospitalization (p < 0.0001). Hospital stay increased from 170 days per 100 emergency admissions in the control group to 320 and 458 days in the younger and older study groups, respectively. At the emergency department, older patients were more often misdiagnosed than control patients (52 vs. 45%; p = 0.002). At discharge the diagnosis was more accurate in the control group (86 vs. 77%; p < 0.0001). Hospital mortality was higher among older patients (23/831 vs. 2/1,458; p < 0.001). The admission-to-surgery interval was increased (1.8 vs. 0.9 days, p < 0.0001) in patients ≥65 years. Rebound tenderness (p < 0.0001), local rigidity (p = 0.003) and rectal tenderness (p = 0.004) were less common in the older than in the control patients with peritonitis. In patients ≥65 years, C-reactive protein did not differ between patients operated on and those not, contrary to the finding in patients <65 years (p<0.0001). Conclusion: Both the preliminary diagnosis at the emergency department and the discharge diagnosis were less reliable in elderly than in younger patients. Elderly patients more often had specific organic disease and arrived at the emergency department after a longer history of abdominal pain compared to younger patients.
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39.
  • Lorefält, Birgitta, 1944-, et al. (författare)
  • Food habits and intake of nutrients in elderly patients with Parkinson's disease
  • 2006
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 52:3, s. 160-168
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Weight loss is reported frequently in patients with Parkinson´s disease also early during the disease.Objective: To investigate food habits and nutrient intake in elderly Parkinson´s disease patients compared with matched controls, as well as to compare PD patients with and without weight loss.Methods: Twenty-six elderly free-living patients with PD, and 26 sex- and age-matched healthy controls, were assessed twice with one year interval between. All food consumed was recorded over 3 consecutive days. Food habits were assessed with the Food Based Concept for Classification of Eating Episodes and intakes of energy and nutrients were calculated. PD symptoms, olfaction, swallowing function, daily activities and serum concentration of different nutri ents were investigated.Results: After 1 year, the PD patients decreased their intakes of daily high quality snacks from 0.5 ± 0.7 to 0.3 ± 0.3 (p < 0.05) and their prepared complete meals from 0.8 ± 0.3 to 0.6 ± 0.3 (p < 0.05), while their daily number of prepared incomplete meals increased from 0.2 ± 0.2 to 0.3 ± 0.3 (p < 0.01). PD patients with weight loss increased their daily intakes of fat by 12 ± 34 g and their energy intake per kg body weight increased by 21 ± 31 kJ (p < 0.05), respectively, and this was higher than in those without weight loss (p < 0.01). PD patients required more help with buying and cooking food compared with the controls.Conclusions: PD patients’ food habits changed so that they consumed a lower number of prepared complete meals. PD patients with weight loss had a higher intake of fat and energy than those without weight loss, although this was obviously not sufficient to prevent weight loss. Impaired absorption of fat in PD should be discussed.
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40.
  • Maddock, Jane, et al. (författare)
  • Social health and change in cognitive capability among older adults : findings from four European longitudinal studies
  • 2023
  • Ingår i: Gerontology. - 0304-324X .- 1423-0003. ; 69:11, s. 1330-1346
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: In this study we examine whether social health markers measured at baseline are associated with differences in cognitive capability and in the rate of cognitive decline over an 11-to-18-year period among older adults and compare results across studies. Methods: We applied an integrated data analysis approach to 16,858 participants (mean age 65 years; 56% female) from the National Survey for Health and Development (NSHD), the English Longitudinal Study of Aging (ELSA), the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), and the Rotterdam Study. We used multilevel models to examine social health in relation to cognitive capability and the rate of cognitive decline. Results: Pooled estimates show distinct relationships between markers of social health and cognitive domains e.g., a large network size (& GE;6 people vs none) was associated with higher executive function (0.17 SD[95%CI:0.0, 0.34], I2=27%) but not with memory (0.08 SD[95%CI: -0.02, 0.18], I2=19%). We also observed pooled associations between being married or cohabiting, having a large network size and participating in social activities with slower decline in cognitive capability, however estimates were close to zero e.g., 0.01SD/year [95%CI: 0.01 to 0.02] I2=19% for marital status and executive function. There were clear study-specific differences: results for average processing speed were the most homogenous and results for average memory were the most heterogenous. Conclusion: Overall, markers of good social health have a positive association with cognitive capability. However, we found differential associations between specific markers of social health and cognitive domains and differences between studies. These findings highlight the importance of examining between study differences and considering context specificity of findings in developing and deploying any interventions
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41.
  • Mak, Jonathan K. L., et al. (författare)
  • Two Years with COVID-19 : The Electronic Frailty Index Identifies High-Risk Patients in the Stockholm GeroCovid Study
  • 2023
  • Ingår i: Gerontology. - : S. Karger. - 0304-324X .- 1423-0003. ; 69:4, s. 396-405
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Frailty, a measure of biological aging, has been linked to worse COVID-19 outcomes. However, as the mortality differs across the COVID-19 waves, it is less clear whether a medical record-based electronic frailty index (eFI) that we have previously developed for older adults could be used for risk stratification in hospitalized COVID-19 patients. Objectives: The aim of the study was to examine the association of frailty with mortality, readmission, and length of stay in older COVID-19 patients and to compare the predictive accuracy of the eFI to other frailty and comorbidity measures. Methods: This was a retrospective cohort study using electronic health records (EHRs) from nine geriatric clinics in Stockholm, Sweden, comprising 3,980 COVID-19 patients (mean age 81.6 years) admitted between March 2020 and March 2022. Frailty was assessed using a 48-item eFI developed for Swedish geriatric patients, the Clinical Frailty Scale, and the Hospital Frailty Risk Score. Comorbidity was measured using the Charlson Comorbidity Index. We analyzed in-hospital mortality and 30-day readmission using logistic regression, 30-day and 6-month mortality using Cox regression, and the length of stay using linear regression. Predictive accuracy of the logistic regression and Cox models was evaluated by area under the receiver operating characteristic curve (AUC) and Harrell's C-statistic, respectively. Results: Across the study period, the in-hospital mortality rate decreased from 13.9% in the first wave to 3.6% in the latest (Omicron) wave. Controlling for age and sex, a 10% increment in the eFI was significantly associated with higher risks of in-hospital mortality (odds ratio = 2.95; 95% confidence interval = 2.42-3.62), 30-day mortality (hazard ratio [HR] = 2.39; 2.08-2.74), 6-month mortality (HR = 2.29; 2.04-2.56), and a longer length of stay (beta-coefficient = 2.00; 1.65-2.34) but not with 30-day readmission. The association between the eFI and in-hospital mortality remained robust across the waves, even after the vaccination rollout. Among all measures, the eFI had the best discrimination for in-hospital (AUC = 0.780), 30-day (Harrell's C = 0.733), and 6-month mortality (Harrell's C = 0.719). Conclusion: An eFI based on routinely collected EHRs can be applied in identifying high-risk older COVID-19 patients during the continuing pandemic.
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42.
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43.
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44.
  • Nilsson, Magnus, 1975- (författare)
  • Ageing and masculinity in the rural
  • 2011
  • Ingår i: Gerontology. - : Oxford University Press. - 0304-324X .- 1423-0003. ; 51, s. 339-339
  • Tidskriftsartikel (refereegranskat)
  •  
45.
  • Patel, Mitesh, et al. (författare)
  • Change of Body Movement Coordination during Cervical Proprioceptive Disturbances with Increased Age.
  • 2010
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 56, s. 284-290
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To date, there are very few studies on postural stability in older adults using body movement recordings to capture the postural movement pattern. Moreover, the importance of proprioception at key areas such as the calf or neck on the postural movement pattern in older adults has rarely been investigated. Objective: To investigate whether the body movement coordination strategy to calf or neck vibration was affected by aging. Methods: Body movement measurements were taken at five locations (ankle, knee, hip, shoulder and head) from 18 younger (mean age 29.1 years) and 16 older (mean age 71.5 years) adult subjects using a 3D movement measuring system while subjected to 50 s of pseudo-random calf or neck vibratory stimulation pulses with eyes open or closed. The positions from the knee, hip, shoulder and head markers were correlated against one another to give an indication of the body coordination. Results: During quiet standing, older adults had greater correlation between the head and trunk than the young. There was an age effect in the body movement coordination strategy. Older adults had a different movement pattern with neck vibration involving mainly more independent knee movements, indicating balance difficulty. Conclusions: Neck vibration affects the movement pattern in older adults more compared with younger adults and calf vibration, suggesting that, the regulation of body orientation in older adults is more difficult, especially during cervical proprioceptive disturbances.
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46.
  • Patel, Mitesh, et al. (författare)
  • Effects of Ageing on Adaptation during Vibratory Stimulation of the Calf and Neck Muscles.
  • 2009
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 55, s. 82-91
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The ability to adapt and habituate based on prior experiences is important for human movement control, fall prevention and for the ability to enhance performance during various human activities. However, little is known about the ability for the elderly to adapt to balance perturbations in the lateral direction. Objective: To determine whether adaptation, i.e., the ability to adjust postural control to handle balance perturbations better over time, differed in the elderly subjects compared with young subjects in the anteroposterior and lateral directions, and whether the site of the balance perturbation or the presence or absence of vision affected the response. Methods: Postural stability was measured as anteroposterior and lateral torque variance in a young group (n = 18 (9 female and 9 male), average age = 29.1 years) and an elderly group (n = 16 (5 female and 11 male), average age = 71.5 years) with eyes open and closed during balance perturbations from calf and neck vibrations. After a 30-s period of quiet stance, these vibrations were repeated over a period of 200 s, so the adaptive responses could be analyzed by splitting the data into 50-s periods. Results: The adaptive responses in the anteroposterior and lateral directions were different. Adaptation in the anteroposterior direction occurred to an almost equal extent in the elderly and young, whereas adaptation in the lateral direction was markedly larger in the elderly in all tests except for neck vibration with eyes closed. Age, vision and vibration site were all influential factors for recorded body movements, but no significant combined effects were found. Conclusion: Balance perturbation instigates an adaptive response in the elderly in both the anteroposterior and lateral directions. However, during perturbation, age and vision are both very influential factors for the stability, thus associating the previously documented age-related decline in visual functioning with a higher risk of falls in this age range.
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47.
  • Rehnberg, Johan, et al. (författare)
  • Divergence and Convergence : How Do Income Inequalities in Mortality Change over the Life Course?
  • 2019
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 65:3, s. 313-322
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Do inequalities in health by income increase or decrease with age? The empirical evidence is not conclusive and competing theories arrive at different conclusions.OBJECTIVE: This study examined inequality in mortality by income over the adult life course with longitudinal data on people aged 30-99 between the years 1990 and 2009. Each person was followed for 19 years.METHODS: We used Swedish total population data with 5,011,414 individual observations. We calculated the probability of having died for ages between 31 and 99. This approach to calculating death risk incorporates selective mortality during the follow-up period into the measure. Age and year standardized income positions were calculated for all individuals. Inequality was assessed by comparing the top 10% income group and the bottom 10% income group. Relative inequality was measured by risk ratios (RR) and absolute inequality by percentage point differences.RESULTS: The results showed that the highest relative income inequality in mortality was at age 56 for men (RR: 4.7) and at age 40 for women (RR: 4.1) with differing patterns across the younger age categories between the sexes. The highest absolute income inequality in mortality was found at age 78 for men (19% difference) and at age 89 for women (14% difference) with similar patterns for both sexes. Both measures of inequality decreased after the peak, with small or no inequalities above age 95. Income inequality in mortality remained in advanced age, with larger absolute inequalities in older ages and larger relative inequalities in younger ages.CONCLUSION: The results for absolute and relative measures of inequality differed substantially; this highlights the importance of discussing and making an active choice of inequality measure. To explain and understand the patterns of inequality in mortality over the adult life course, we conclude that the "age-as-leveler" and "cumulative disadvantage" theories are best applied to an absolute measure of inequality.
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48.
  • Rehnberg, Johan, 1986-, et al. (författare)
  • The Association between Education and Cognitive Performance Varies at Different Levels of Cognitive Performance : A Quantile Regression Approach
  • 2024
  • Ingår i: Gerontology. - 0304-324X .- 1423-0003. ; 70:3, s. 318-326
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Educational differences in cognitive performance among older adults are well documented. Studies that explore this association typically estimate a single average effect of education on cognitive performance. We argue that the processes that contribute to the association between education and cognitive performance are unlikely to have equal effects at all levels of cognitive performance. In this study, we employ an analytical approach that enables us to go beyond averages to examine the association between education and five measures of global and domain-specific cognitive performance across the outcome distributions. Methods: This cross-sectional study included 1,780 older adults aged 58–68 years from the Longitudinal Aging Study Amsterdam. Conditional quantile regression was used to examine variation across the outcome distribution. Cognitive outcomes included Mini-Mental State Examination (MMSE) score, crystallized intelligence, information processing speed, episodic memory, and a composite score of global cognitive performance. Results: The results showed that the associations between education and different cognitive measures varied across the outcome distributions. Specifically, we found that education had a stronger association with crystallized intelligence, MMSE, and a composite cognitive performance measure in the lower tail of performance distributions. The associations between education and information processing speed and episodic memory were uniform across the outcome distributions. Conclusion: Larger associations between education and some domains of cognitive performance in the lower tail of the performance distributions imply that inequalities are primarily generated among individuals with lower performance rather than among average and high performers. Additionally, the varying associations across some of the outcome distributions indicate that estimating a single average effect through standard regression methods may overlook variations in cognitive performance between educational groups. Future studies should consider heterogeneity across the outcome distribution.
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49.
  • Ringsberg, Karin A.M., et al. (författare)
  • The impact of long-term moderate physical activity on functional performance, bone mineral density and fracture incidence in elderly women
  • 2001
  • Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 47:1, s. 15-20
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Earlier studies have shown that physical exercise and a higher workload increase muscle strength and improve gait and balance at all ages for both sexes. Published studies have, so far, failed to investigate the functional performance of elderly individuals concerning their long-term physical activity and variables of daily living. OBJECTIVE: To compare elderly women who participate in long-term, moderate exercise programmes with two age-matched groups of women from an urban and a rural community. METHODS: All participants answered a questionnaire about health, social circumstances and fractures. We measured the vibration threshold of the lower extremities, bone mineral density of the distal radius and functional performance such as muscle strength, balance and gait. RESULTS: The elderly, active groups performed significantly better in all functional tests and had sustained fewer fractures than the urban control group. When the comparison was made with the rural control group the differences were less obvious. The active group rated their health as better than both the control groups. CONCLUSION: Elderly women, who continue with moderate exercise programmes over many years, sustain fewer fractures and have better muscle strength, balance, gait and health ratings than women in general. Whether this is the result of the exercise or inherited characters, remains to be proved.
  •  
50.
  • Rizzuto, Debora, et al. (författare)
  • Lifestyle Factors Related to Mortality and Survival : A Mini-Review
  • 2014
  • Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 60:4, s. 327-335
  • Forskningsöversikt (refereegranskat)abstract
    • As the world's population ages, elderly people are becoming an increasingly important group that merits special attention with regard to health and social issues. Lifestyles affect health and survival at all ages, but the consequences of poor lifestyle behaviors may be different for elderly people than for younger adults. They can also be heavily dependent on exposure earlier in life. Our current state of knowledge is based predominantly on studies conducted among middle-aged adults or young elderly people. Moreover, studies are sparse throughout the entire older age spectrum, from 65 to 90 years. This article summarizes the evidence regarding the impact of lifestyle behaviors on mortality among elderly people. It focuses on behaviors modifiable by individual actions and public health interventions, such as smoking, obesity and sedentary behavior, which predispose numerous people to diseases that rank among the leading causes of death, including heart disease, cancer, stroke, diabetes and dementia. These factors not only shorten life but, when they occur together, also have a major impact on survival beyond that associated with each single lifestyle factor. We propose an integrated life course model to guide research on longevity to answer questions that remain open and to find new strategies to ensure a longer and healthier life for future generations. (C) 2014 S. Karger AG, Basel
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