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- Ahlner, Felicia, 1987, et al.
(författare)
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The effect of alcohol consumption on all-cause mortality in 70-year-olds in the context of other lifestyle risk factors: results from the Gothenburg H70 birth cohort study
- 2023
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Ingår i: BMC Geriatrics. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn this study, we examined the effect of alcohol, as well as the combined effect of seven lifestyle factors, on all-cause mortality in older adults (baseline age 70 years).MethodsData was derived from the population-based Gothenburg H70 Birth Cohort study, including 1124 participants from the 2014-16 examination. Risk consumption was defined as > 98 g alcohol per week, and hazardous drinking was based on the Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Cox regression models were used to examine the individual effect of alcohol consumption, as well as the combined effect of seven lifestyle risk factors (high alcohol consumption, lifetime smoking, unhealthy Body Mass Index, insufficient physical activity, sedentary behavior, insufficient/prolonged sleep, unhealthy dietary pattern) on all-cause mortality.ResultsDuring a mean follow-up of 7.7 years, 81 (7.2%) participants died. Neither risk consumption nor hazardous drinking were associated with elevated mortality, but hazardous drinking was associated with an increased risk of mortality in those with insufficient physical activity. Those with at least five lifestyle risk factors had an increased all-cause mortality compared to those fulfilling criteria for a maximum of one lifestyle risk factor. High alcohol consumption showed a relatively minor impact on this risk, while physical activity and unhealthy dietary pattern had an independent effect on mortality.ConclusionsIn this particular sample, there was no independent effect of alcohol on the risk of 8-year all-cause mortality. However, an interaction effect of physical activity was observed. It may be that high alcohol consumption per se is less important for mortality among older adults. However, a combination of several unhealthy lifestyle behaviors was linked to a substantial increase in the risk of mortality in Swedish older adults. Also, it has to be emphasized that high alcohol consumption may have other adverse health effects apart from mortality among older adults.
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- Falk Erhag, Hanna, et al.
(författare)
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Activities of daily living (ADL) and instrumental activities of daily living (IADL) disability in Swedish 85-year-olds born three decades apart-findings from the H70 study
- 2021
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 50:6, s. 2031-2037
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Older adults make up the fastest growing segment of the population, and disability rates increase with age. There is much debate whether later born cohorts of 85-year-olds will face the same disability rates as earlier born cohorts. This study aimed to examine ADL and IADL disability in three birth cohorts of Swedish 85-year-olds born three decades apart, examined in 1986-87, 2008-10 and 2015-16, as well as potential factors associated with ADL and IADL disability in these birth-cohorts. Methods: Systematically selected population-based birth cohorts of 85-year-olds (n= 1,551) from theGothenburg H70 Birth Cohort studies, Sweden, born in 1901-02 (n= 494), 1923-24 (n= 571) and 1930 (n= 486) and examined with identical methods. Disability was defined as a need for assistance in any ADL/IADL activities. Results: ADL/IADL disability decreased between cohorts in both men and women (from 76.7% in 1986-87, to 58.4% in 2008-10, and 48.4% in 2015-16, P-value trend <.001). Factors associated with ADL/IADL disability varied between cohorts, although dementia and depression increased the odds of disability in all three birth cohorts. Conclusion: Later born cohorts of 85-year-olds face less ADL/IADL disability compared to earlier born cohorts. As disability poses a significant financial burden on healthcare services, our findings might contribute to a more positive view on global ageing and the demographic challenges ahead. However, it might also be that in later born cohorts, ADL/IADL disability affects people at later ages, but due to increased longevity, the total number of years in late-life with a functional disability will remain the same.
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3. |
- Falk Erhag, Hanna, et al.
(författare)
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Alcohol use and drinking patterns in Swedish 85 year olds born three decades apart - findings from the Gothenburg H70 study
- 2023
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 52:3
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about alcohol consumption among the oldest old. Objective To compare alcohol use and drinking patterns among 85 year olds born three decades apart. Design Cross-sectional. Setting The Gothenburg H70 Birth Cohort Studies. Subjects About 1,160 85 year olds born in 1901-02, 1923-24, and 1930. Methods Self-reported questions about alcohol included how often study participants drank beer, wine, and spirits and how many centilitres in total/week. Risk consumption was defined as >= 100 g alcohol/week. Descriptive statistics and logistic regression were used to explore cohort characteristics, differences in proportions, factors associated with risk consumption and 3-year mortality. Results The proportion of at-risk drinkers increased from 4.3 to 14.9% (9.6-24.7% in men and 2.1-9.0% in women). The proportion of abstainers decreased from 27.7 to 12.9%, with the largest decrease observed among women (29.3-14.1%). Controlling for sex, education and marital status, 85 year olds in the later-born cohorts were more likely to be risk consumers than those in the earlier-born cohort [odds ratio (OR) 3.1, 95% confidence nterval (CI) 1.8-5.6]. The only factor associated with an increased likelihood was male sex (OR 3.7, 95% CI 1.0-12.7 and OR 3.2, 95% CI 2.0-5.1). There were no associations between risk consumption of alcohol and 3-year mortality in any of the cohorts. Conclusion Alcohol consumption and the number of risk consumers among 85 year olds have increased considerably. This could have large public health consequences since older adults are more sensitive to alcohol's adverse health effects. Our findings show the importance of detecting risk drinkers also in the oldest old.
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4. |
- Havstam Johansson, Lena, 1963, et al.
(författare)
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Vision-related quality of life and visual function in a 70-year-old Swedish population
- 2020
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 98:5, s. 521-529
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate vision-related quality of life (VRQoL), visual function and predictors of poor vision in a population of 70-year-olds. Methods Self-reported ocular morbidity and responses to the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) in a cross-sectional population study (N = 1203) in Gothenburg, Sweden, were compared with results from ophthalmic examination (N = 560). Results The most common self-reported ophthalmic morbidities were cataract (23.4%), age-related macular degeneration (AMD; 4.7%), glaucoma (4.3%) and diabetic retinopathy (1.4%). Cataract was more prevalent in women (p = 0.001). The composite score from NEI VFQ-25 for the entire cohort was 91.4 (standard deviation: 27.5). When comparing composite score for different eye diseases, persons with cataract or AMD exhibited lower scores (p = 0.029 and 0.018, respectively). Best-corrected visual acuity (BCVA) was normal (>= 0.5 decimal) in 98.9%; two individuals had low vision (<0.3). Men exhibited better BCVA (median: -0.08 logMAR) than women (-0.06; p = 0.005). Visual field defects were observed in 16.3% and uncorrected refractive errors in 61.5%. Poor vision was reported by 7.4% of participants with presenting visual acuity (PVA) >= 0.5 (decimal), while 66.7% with PVA PVA <0.5, 55.6% obtained a BCVA of >= 1.0 with the right correction. Low contrast sensitivity was a significant predictor of experiencing poor vision (p = 0.008), while PVA and visual field defects were not. Conclusions Low contrast sensitivity is a predictor of experiencing poor vision. There is a discrepancy between subjective/objective visual function and a high prevalence of uncorrected refractive errors. Women have more cataract, and men demonstrate slightly better visual acuity.
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- Jonson, Mattias, et al.
(författare)
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Time trends in depression prevalence among Swedish 85-year-olds: Repeated cross-sectional population-based studies in 1986, 2008, and 2015
- 2023
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Ingår i: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 53:6, s. 2456-2465
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Tidskriftsartikel (refereegranskat)abstract
- Background Octogenarians of today are better educated, and physically and cognitively healthier, than earlier born cohorts. Less is known about time trends in mental health in this age group. We aimed to study time trends in the prevalence of depression and psychotropic drug use among Swedish 85-year-olds. Methods We derived data from interviews with 85-year-olds in 1986-1987 (N = 348), 2008-2010 (N = 433) and 2015-17 (N = 321). Depression diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders. Symptom burden was assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). Information on psychotropic drug use, sociodemographic, and health-related factors were collected during the interviews. Results The prevalence of major depression was lower in 2015-2017 (4.7%, p < 0.001) and 2008-2010 (6.9%, p = 0.010) compared to 1986-1987 (12.4%). The prevalence of minor depression was lower in 2015-2017 (8.1%) compared to 2008-2010 (16.2%, p = 0.001) and 1986-1987 (17.8%, p < 0.001). Mean MADRS score decreased from 8.0 in 1986-1987 to 6.5 in 2008-2010, and 5.1 in 2015-2017 (p < 0.001). The reduced prevalence of depression was not explained by changes in sociodemographic and health-related risk factors for depression. While psychoactive drug use was observed in a third of the participants in each cohort, drug type changed over time (increased use of antidepressants and decreased use of anxiolytics and antipsychotics). Conclusions The prevalence of depression in octogenarians has declined during the past decades. The decline was not explained by changes in known risk factors for depression. The present study cannot answer whether changed prescription patterns of psychoactive drugs have contributed to the decline.
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7. |
- Järbrink, Hanna, et al.
(författare)
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Recovering from physical trauma in late life, a struggle to recapture autonomy: A grounded theory study
- 2023
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; , s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The study aimed to explore the experiences of care and recovery among older patients treated for physical trauma. Design: A qualitative study with a constructivist grounded theory design. Methods: Fifteen in-depth interviews with older adults recovering from physical trauma were conducted and analysed between 2019 and 2023, in accordance with grounded theory methodology. Results: The findings show that for older patients who suffered physical trauma, the core category was the strive to recapture autonomy. This was achieved by means of Adaptation, Reflection and Interactions, which constitute the three main categories. Recovery involves facing and navigating various new life challenges, such as increased dependency on others, managing difficult symptoms and adapting in various ways to everyday life. The recovery process was influenced by fear, hope and the attitude towards new challenges. Conclusion: Older adults being cared for after a traumatic event have a difficult path to recovery ahead of them. Dealing with increased unwanted dependency on others was a main concern for the participants. Undertreated symptoms can lead to undesired isolation, delayed recovery and further increase unwanted dependency. On the other hand, hope, which was defined as having a positive approach to life and longing for the future, was a strong accelerating factor in the recovery process. Impact: As a result of this study, we have established that older patients experience the initial period after trauma as difficult and that support in the initial phase can be helpful when returning home. As healthcare services are under increasing pressure because of an ageing population, this study contributes by addressing an understudied population and clarifying their concerns. Reporting Method: Reporting adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. Patient or Public Contribution: No patient or public involvement
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8. |
- Lindell, Ellen, 1979, et al.
(författare)
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Benign paroxysmal positional vertigo, dizziness, and health-related quality of life among older adults in a population-based setting
- 2021
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 278:5, s. 1637-1644
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Dizziness may affect quality of life in a negative way and contribute to falls. The aim of this study was to investigate and compare 75 years old with dizziness caused by benign paroxysmal positional vertigo (BPPV) to those with general dizziness/impaired balance (non-BPPV related) and to those reporting no dizziness, regarding health-related quality of life (HRQL), falls, tiredness, and walking speed in a population-based setting. Method A cross-sectional population-based sample, including 671 75 years old (398 women, 273 men), was investigated for BPPV, dizziness symptoms, falls, and walking speed. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36). Result A total of 67 persons (10%) had symptoms of BPPV with 11 (1.6%) having nystagmus when tested for BPPV. Having BPPV as well as general dizziness/impaired balance was associated with reduced HRQL, more tiredness, enhanced number of falls, and lower walking speed. Furthermore, the risk of having BPPV increased fourfold if symptoms of dizziness when turning in bed was reported. Conclusion Having problems with dizziness is common among senior citizens where BPPV can be an unrecognized cause of dizziness that may impact HRQL and overall well-being. As BPPV is common among older adults, and is potentially curable through reposition maneuvers, it is important to liberally test for, and treat the condition. Information about dizziness when turning in bed can help to pinpoint persons with enhanced risk for BPPV also on a population-based level.
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9. |
- Rydén, Lina, 1982, et al.
(författare)
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Attrition in the Gothenburg H70 birth cohort studies, an 18-year follow-up of the 1930 cohort
- 2023
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Ingår i: Frontiers in Epidemiology. - 2674-1199. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Longitudinal studies are essential to understand the ageing process, and risk factors and consequences for disorders, but attrition may cause selection bias and impact generalizability. We describe the 1930 cohort of the Gothenburg H70 Birth Cohort Studies, followed from age 70 to 88, and compare baseline characteristics for those who continue participation with those who die, refuse, and drop out for any reason during follow-up. Methods: A population-based sample born 1930 was examined with comprehensive assessments at age 70 (N = 524). The sample was followed up and extended to increase sample size at age 75 (N = 767). Subsequent follow-ups were conducted at ages 79, 85, and 88. Logistic regression was used to analyze baseline characteristics in relation to participation status at follow-up. Results: Refusal to participate in subsequent examinations was related to lower educational level, higher blood pressure, and lower scores on cognitive tests. Both attrition due to death and total attrition were associated with male sex, lower educational level, smoking, ADL dependency, several diseases, poorer lung function, slower gait speed, lower scores on cognitive tests, depressive symptoms, and a larger number of medications. Attrition due to death was also associated with not having a partner. Conclusions: It is important to consider different types of attrition when interpreting results from longitudinal studies, as representativeness and results may be differently affected by different types of attrition. Besides reducing barriers to participation, methods such as imputation and weighted analyses can be used to handle selection bias.
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- Wallengren, Ola, et al.
(författare)
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Comparison of the 2010 and 2019 diagnostic criteria for sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP) in two cohorts of Swedish older adults.
- 2021
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Ingår i: BMC geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores.Two birth cohorts, 70 and 85-years-old (n=884 and n=157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below -2.0 and-2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen's kappa. All-cause mortality was analyzed with the Cox-proportional hazard model.Sarcopenia prevalence was 1.4-7.8% in 70-year-olds and 42-62% in 85years-old's, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9-1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P<0.005). The prevalence was doubled (15.0 vs. 7.5%) using the -2.0 vs. -2.5T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P<0.001) in the 70-year-olds and 17.8% (P<0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at -2.5T-score was associated with increased mortality (hazard ratio 2.4-2.8, P<0.05) but not at T-score-2.0.The prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition.
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