| 1. |
- Andersson, Magdalena, et al.
(författare)
-
Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life
- 2007
-
Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 228-239
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS:Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it.METHODS:The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation.RESULTS:In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital.CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Bergh, Ingrid, et al.
(författare)
-
An application of pain rating scales in geriatric patients
- 2000
-
Ingår i: Aging Clinical and Experimental Research. - : Elsevier. - 1594-0667 .- 1720-8319. ; 12:5, s. 380-7
-
Tidskriftsartikel (refereegranskat)abstract
- This study examined the applicability of three different pain rating scales, the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numeric Rating Scale (NRS), in geriatric patients. Data collection was performed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age = 80.5 years). Patients rated their current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hurt (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r = 0.78-0.92; p < 0.001) (alternative-forms reliability), and between the test and retesting (r = 0.75-r = 0.83; p < 0.001) (test-retest reliability). A logistic regression analysis showed that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the VAS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was especially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p < 0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or distress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated experience of pain tended to decrease with advancing age. This indicates that the pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress.
|
|
| 5. |
- Bergh, Ingrid, 1956, et al.
(författare)
-
Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.
- 2001
-
Ingår i: Aging (Milan, Italy). - : Kurtis. - 0394-9532. ; 13:5, s. 355-361
-
Tidskriftsartikel (refereegranskat)abstract
- Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.
|
|
| 6. |
- Broman, Gi, et al.
(författare)
-
Golf: a high intensity interval activity ofor elderly men
- 2004
-
Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 16:5, s. 375-381
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: The aim was to quantify the time spent at different exercise intensities for male golfers, in relation to age, while walking a "normal' 18-hole golf course. Methods: 19 healthy male golfers (six 27 (5) years old, seven of 50 (7) and six of 75 (4) years) performed a maximal exercise test on a treadmill (maximal oxygen uptake and maximal heart rate were measured). Within one week, they played an "average" 18-hole course starting at 7.00 a.m. During the round, their heart rate was monitored with a Polar Vantage heart rate monitor, which sampled the heart rate every 5 seconds. Body weight was measured before and after the round. Blood glucose was taken at rest before the round and after each 3rd hole. Perceived exertion and perceived pain in muscles and joints were rated using the CR 10 Borg scale just before reaching each green and after a few selected uphill parts of the course. Results: High intensity of exercise was reached during 6% of the total playing time for the young, 30% for the middle-aged and 70% for the elderly golfers, playing 18 holes (p<0.05). The golfers’ heart rate was below 50% of their individual maximal heart rate, 18% of total time for young golfers, 16% for the middle-aged, and not at all for the elderly. Perceived exertion, breathlessness and leg fatigue were rated in a similar manner for all three groups. Perceived pain in joints and muscles was rated extremely weak except in a few players who had some known joint or muscle problem. The mean blood glucose level fell by 20% for the young (p<0.05), 10% for the middle-aged and 30% for the elderly players (p<0.05) after 18 holes of play. Body weight was reduced 0.7% similarly for all three groups (p<0.05). Conclusions: Walking an 18-hole golf course corresponds to an exercise intensity which is moderate and high for the elderly, mainly low to moderate for the middle-aged, and low for young male golfers. All golfers, regardless of age, perceived their exertion similarly as weak to moderate.
|
|
| 7. |
- Dahl, Anna, et al.
(författare)
-
Identification of dementia in epidemiological research : A study on the usefulness of various data sources
- 2007
-
Ingår i: Aging Clinical and Experimental Research. - : Springer Nature Switzerland AG. - 1594-0667 .- 1720-8319. ; 19:5, s. 381-389
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Prevalence and incidence ratios of dementia in epidemiological studies vary according to the data source used. Medical records, cognitive tests, and registry information are sources frequently used to differentiate dementia from normal aging. The aim of the present study was to compare the identification of dementia from these different sources with that from consensus diagnosis. Methods: 498 elderly people (age range 70–81 at baseline) enrolled in a Swedish population-based longitudinal twin study (Gender) were evaluated on physical and mental health and interviewed for their socio-demographic background three times during an eight-year period. Reviews of medical records and the Swedish Discharge Registry (DR) were conducted. The 10th percentile was used to differentiate between dementia and non-dementia in all cognitive tests. Scores of 24 or below on the Mini-Mental State Examination (MMSE) (range 1–30) indicated dementia. A consensus conference diagnosed dementia on the basis of total information. The consensus diagnosis was used as the gold standard. Results: MMSE scores (sensitivity 64%, specificity 96%, kappa 0.65) and the review of medical records (sensitivity 57%, specificity 99%, kappa 0.65) were good sources for dementia identification. The precision of medical records increased when recordings of cognitive impairment were included (sensitivity 83%, specificity 98%, kappa 0.84). The discharge registry had low sensitivity (26%) and kappa coefficient (0.31). Conclusions: The present study shows that both review of medical records and MMSE scores are good although not perfect identifiers of dementia. The discharge registry is an uncertain source of dementia identification.
|
|
| 8. |
|
|
| 9. |
- Ernsth Bravell, Marie, 1973-, et al.
(författare)
-
Sooner or later? : A study of institutionalization in late life
- 2009
-
Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 21:4/5, s. 329-337
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Existing information about institutionalization of elderly individuals is mainly based on cross-sectional data and does not address the cumulative risk of institutionalization. The purpose of the present study was to analyze longitudinal data prospectively and estimate the risk of placement in an elder care institution for individuals aged 70 years or older. Methods: The study was based on a longitudinal investigation (the H70 study) of a random sample of 70-year-olds living in Gothenburg, Sweden, in 1971. Individuals were followed from age 70-100 years. Three different analyses were performed: a descriptive prospective analysis, cross-sectional analyses at ages 70, 79 and 85 years, and a longitudinal analysis of predictors for institutionalization. Results: The prospective analysis indicated that 50% of the individuals eventually moved to an elder care institution. Significantly more women than men were institutionalized, although for women the move occurred later in life. Cross-sectional analyses demonstrated that various factors were important to institutionalization at different ages. The Cox regression model with time-varying covariates indicated that gender, socio-economic situation, marital status, number of symptoms, having children living nearby, and activities in daily life were related to institutionalization. Conclusions: The proportion of elderly persons relocating to institutions was significantly higher than that generally found in cross-sectional studies. It was possible to identify variables that predict institutionalization during a subsequent 30-year period, but different analyses revealed different effects from the factors evaluated.
|
|
| 10. |
- Frändin, Kerstin, et al.
(författare)
-
A Nordic multi-center study on physical and daily activities for residents in nursing home settings : design of a randomized, controlled trial
- 2009
-
Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 21:4-5, s. 314-322
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Nursing home residents constitute a frail, multi-diseased and heterogeneous group. As physical activity is essential for the preservation of function, personalized training and activities are of great importance, The main objective of this study was to describe the influence of an individually tailored intervention program, in a nursing home setting, on physical capacity, degree of dependence in Activities of Daily Living (ADL), long-term participation in physical and/or daily activities, and self-rated wellbeing. The aim of the present work is to describe the overall design of the study. Methods: Nursing homes in Sweden, Norway and Denmark were involved, and 322 residents were randomized to either Intervention or Control groups. The intervention lasted for three months and consisted of physical and daily activities, led by physiotherapists and occupational therapists, and was built on their evaluations and on the goals expressed by each resident. Tests of muscle strength, mobility, balance function and confidence, ADL, level of physical activity, wellbeing and cognitive function were performed at baseline, directly after the intervention period and three months later. Results: They will be presented in articles to follow. Conclusions: Although it is a great challenge to carry out an intervention study directed toward such a frail population, it is of great interest to find out whether individually tailored and enhanced activities can lead to decreased dependence in ADL and increased wellbeing.
|
|
