| 1. |
- Derwinger, A, et al.
(författare)
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Forgetting numbers in old age: strategy and learning speed matter
- 2005
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 51:4, s. 277-284
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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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| 2. |
- Ekvall-Hansson, Eva, et al.
(författare)
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Benign Paroxysmal Positional Vertigo among Elderly Patients in Primary Health Care.
- 2005
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Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 51:6, s. 386-389
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i>Dizziness influences well-being in old age, and benign paroxysmal positional vertigo (BPPV) is a common cause. The condition is diagnosed using the Hallpike maneuver and treated by the particle-repositioning maneuver or habituation exercises. <i>Objective:</i>To identify patients with BPPV among a variety of diagnoses represented by the ICD-10 diagnosis R42 in people 65 aged years and older who visited primary health care because of vertigo and dizziness. <i>Methods:</i>Searches were performed in the computerized medical records of 6 different health care centers over the period of 1 year for the ICD-10 diagnosis R42 and the age group 65 years and older. Letters were sent to the patients identified with an invitation for assessment and physical examination by a physiotherapist. Thirty-eight patients responded to the letter and were included in the study. All patients were assessed by physical examination including the Hallpike maneuver. <i>Results:</i> The study group included 13 men and 25 women, 65–94 (median 83) years of age. After physical examination, 15 patients were found to have BPPV (confidence interval 24–55%). <i>Conclusion:</i>In this study, 2 of 5 of the patients with ICD-10 diagnosis R42 (dizziness and giddiness) had BPPV. BPPV is probably an underestimated cause of dizziness/vertigo among elderly patients in primary health care.
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| 3. |
- Kristensson Ekwall, Anna, et al.
(författare)
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Dizzy - Why Not Take a Walk? Low Level Physical Activity Improves Quality of Life among Elderly with Dizziness
- 2009
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Ingår i: GERONTOLOGY. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 55:6, s. 652-659
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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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| 4. |
- Laurell, Helena, et al.
(författare)
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Acute abdominal pain among elderly patients
- 2006
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 52:6, s. 339-344
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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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| 5. |
- Lorefält, Birgitta, 1944-, et al.
(författare)
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Food habits and intake of nutrients in elderly patients with Parkinson's disease
- 2006
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 52:3, s. 160-168
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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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| 6. |
- Patel, Mitesh, et al.
(författare)
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Effects of Ageing on Adaptation during Vibratory Stimulation of the Calf and Neck Muscles.
- 2009
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Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 55, s. 82-91
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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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| 7. |
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| 8. |
- Söderqvist, Anita, et al.
(författare)
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Prediction of mortality in elderly patients with hip fractures : a two-year prospective study of 1,944 patients
- 2009
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 55:5, s. 496-504
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hip fracture patients are reported to have an increased mortality rate compared to the general population. In order to be able to reduce the morbidity and mortality after a hip fracture, our efforts to identify the patients at risk already upon admission to the hospital need to be increased. For such a risk assessment, robust, validated, and reproducible criteria are mandatory. OBJECTIVE: To determine preoperative factors associated with mortality and to evaluate the combined use of the American Society of Anesthesiologists (ASA) and the Short Portable Mental Status Questionnaire (SPMSQ) to identify patients with an increased mortality rate and to create a predictive model to assess the mortality risk after hip fracture surgery. METHODS: A total of 1,944 consecutive patients aged 66 years or older admitted for a hip fracture were included in a prospective cohort study with a 24-month follow-up. The patients were assessed with regard to gender, age, type of hip fracture, smoking habits, comorbidities, general physical health according to the ASA classification, and cognitive function according to the SPMSQ. A higher ASA score indicates an increasingly severe systemic disease and a lower SPMSQ score indicates an increasingly severe cognitive dysfunction. We used Cox proportional hazard models and classification trees to identify the factors associated with mortality. The predictive model was created based on factors that were significantly associated with death and all readily accessible upon admission. RESULTS: The mortality rate during the acute hospitalization period was 4%, at 4 months 16%, and at 24 months 38%. The most prominent factors associated with mortality were high ASA scores, low SPMSQ scores, high age and male gender. The SPMSQ score provided additional information about the survival time, compared to when the ASA score was used alone. CONCLUSION: The combined use of the ASA classification for assessing physical health and the SPMSQ for assessing cognitive function effectively identified hip fracture patients with an increased mortality rate. We present a predictive model including age, gender, ASA, and SPMSQ that can be used to assess the mortality risk after hip fracture surgery.
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| 9. |
- Zijlstra, A, et al.
(författare)
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Do dual tasks have an added value over single tasks for balance assessment in fall prevention programs? A mini-review.
- 2008
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Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 54:1, s. 40-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Prevention of Falls Network Europe (ProFaNE) aims to bring together European researchers and clinicians to focus on the development of effective falls prevention programs for older people. One of the objectives is to identify suitable balance assessment tools. Assessment procedures that combine a balance task with a cognitive task may be relevant since part of all falls occurs during dual-task performance of walking or other balance activities. OBJECTIVE: To evaluate whether dual-task balance assessments are more sensitive than single balance tasks in predicting falls and detecting changes in balance performance after fall interventions. METHODS: A systematic literature search was performed in the databases PubMed, EMBASE, CINAHL, AMED, PsycINFO and Cochrane. Articles were selected according to the following inclusion criteria: (1) population: older adults (mean age > or =65 years), (2) assessment tool: dual task combining gait or other balance task with a cognitive task, (3) design: prospective or retrospective data collection of falls, or intervention study. Analysis of papers focused on measures of predictive ability or sensitivity-to-change for both tasks during dual-task performance as well as for the single balance and cognitive task. RESULTS: Out of 114 dual-task studies in older people, 19 articles matched the inclusion criteria. Fourteen studies had sample sizes of 60 subjects or less; the studied populations, task combinations as well as other methodological aspects varied. None of the articles reported the same statistical measures for both tasks during dual-task performance as well as single balance and cognitive task. In two studies with prospective data collection of falls, higher odds ratios were found for the dual compared to the single balance task. CONCLUSIONS: Upon the available literature, conclusions for an added value of dual balance tasks for fall prediction or assessing fall intervention effects cannot be made due to incomplete comparisons of single and dual balance tasks. Nevertheless, two studies do provide an indication that dual balance tasks may have added value for fall prediction.
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| 10. |
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