| 1. |
- Ek, Stina, et al.
(författare)
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Risk Factors for Injurious Falls in Older Adults : The Role of Sex and Length of Follow-Up
- 2019
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Ingår i: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 67:2, s. 246-253
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To identify sex-specific associations between risk factors and injurious falls over the short (<4 years) and long (4-10 years) term.DESIGN: Longitudinal cohort study between 2001 and 2011.SETTING: Swedish National Study on Aging and Care, Kungsholmen, Sweden.PARTICIPANTS: Community-dwelling adults aged 60 and older (N = 3,112).MEASUREMENTS: An injurious fall was defined as a fall that required inpatient or outpatient care. Information was collected on participant and exposure characteristics using structured interviews, clinical examinations, and physical function tests at baseline.RESULTS: The multivariate model showed that, in the short term, living alone (hazard ratio (HR)=1.83, 95% confidence interval (CI)=1.13-2.96), dependency in instrumental activities of daily living (IADLs) (HR=2.59, 95% CI=1.73-3.87), and previous falls (HR=1.71, 95% CI=1.08-2.72) were independently associated with injurious falls in women. Low systolic blood pressure (HR=1.96, 95% CI=1.04-3.71), impaired chair stands (HR=3.00, 95% CI=1.52-5.93), and previous falls (HR=2.81, 95% CI=1.32-5.97) were associated with injurious falls in men. Long-term risk factors were underweight (HR=2.03, 95% CI=1.40-2.95), cognitive impairment (HR=1.49, 95% CI=1.08-2.06), fall-risk increasing drugs (HR=1.67, 95% CI=1.27-2.20 for >= 2 drugs), and IADL dependency (HR=1.58, 95% CI=1.32-5.97) for women and smoking (HR=1.71, 95% CI=1.03-2.84), heart disease (HR=2.20, 95% CI=1.5-3.24), impaired balance (HR=1.68, 95% CI=1.08-2.62), and a previous fall (HR=3.61, 95% CI=1.98-6.61) for men.CONCLUSION: Men and women have different fall risk profiles, and these differences should be considered when developing preventive strategies. Some risk factors were more strongly predictive of injurious falls over shorter than longer periods and vice versa, suggesting that it may be possible to identify older men and women at short-and long-term risk of injurious falls.
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| 2. |
- Karlsson, Björn, et al.
(författare)
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Depression and Depression Treatment in a Population-Based Study of Individuals Over 60 Years Old Without Dementia
- 2016
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 24:8, s. 615-623
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To estimate the prevalence of depression in a population-based sample of older adults, and to identify the individual profile of people who received depression treatment. Design: Cross-sectional. Setting: Central area (Kungsholmen) in Stockholm, Sweden. Participants: A randomized population-based sample of individuals aged 60 years and older (N = 3,084) without dementia from the Swedish National Study of Aging and Care in Kungsholmen examined between 2001 and 2004. Measurements: Experienced physicians carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. Depression was diagnosed according to DSM-IV-TR and DSM-5 criteria. Information regarding drug treatment and psychotherapy was collected during the examination and is based on self-report. Results: The prevalence of depression was 5.9% (major depression: 0.8%, minor depression: 5.1%). In the total sample, 8.3% were prescribed an antidepressant and 0.9% were treated with psychotherapy. Among individuals with depression, fewer than one-third received treatment with psychotherapy or antidepressants, but almost half were prescribed anxiolytic or hypnotic drugs. Individuals with self-reported depression and anxiety were more likely to receive depression treatment whereas individuals with depression who reported insomnia were less likely to receive depression treatment. Conclusions: Our findings indicate that even in a central urban area of a country with an advanced healthcare system depression in old age is often unrecognized and untreated. In addition, almost half of those with depression received potentially inappropriate drug treatment with anxiolytics or hypnotics.
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| 3. |
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| 4. |
- McHugh Power, Joanna E., et al.
(författare)
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Comparisons of the discrepancy between loneliness and social isolation across Ireland and Sweden : findings from TILDA and SNAC-K
- 2019
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 54:9, s. 1079-1088
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Loneliness may have different cultural meanings in different countries. This may manifest as differing levels of Social Asymmetry-the discrepancy between loneliness and social isolation. Since loneliness is thought to be low in Sweden relative to more southerly countries, we hypothesised that more number of individuals would also fall into the discordant robust category of Social Asymmetry, i.e. that more individuals in Sweden would have lower loneliness levels relative to social isolation than in Ireland. We also explored the clinical relevance of Social Asymmetry in both countries, by examining its association with cognitive functioning.Methods We derived Social Asymmetry metrics in two representative cohort studies: the Irish Longitudinal Study on Ageing (TILDA) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Data pertaining to a dementia-free sample of 4565 Irish participants and 3042 Swedish participants, all aged over 60 years, were analysed using a multilevel modelling approach, with country as a higher-order variable.Results Contrary to the expected, more individuals in Ireland were discordant robust than in Sweden. We also found evidence for superior performance in global cognitive functioning among those in the discordant robust category relative to those in the discordant susceptible (i.e. those with higher levels of loneliness than social isolation) category, beta = 0.61, p < .001, across both countries.Conclusions Irish older adults may be more robust to the impact of social isolation on loneliness than those in the Swedish cohort. Social Asymmetry was related to cognitive functioning in both countries, suggesting that Social Asymmetry is a clinically relevant construct.
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| 5. |
- Sjöberg, Linnea, 1989, et al.
(författare)
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DEVELOPMENT OF A PROTOTYPE FOR REFEREES TO MONITOR WHIP USE IN HORSE RACING
- 2017
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Ingår i: ISES 2017 Down Under. - 9781864673067
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Konferensbidrag (refereegranskat)abstract
- There is no standard surveillance system for modern flat horse racing in Sweden, so the surveillance camera placement and image quality varies between tracks. Reported whip misuse and unauthorised whipping often occur outside of the camera’s view and are therefore unrecorded. Thorough investigation of the current monitoring system used in Sweden revealed concerns about whether the stewards have enough time to estimate the number of whip strikes per horse, even when camera quality is sufficient, and has led to the development of an enhanced whip system. The system prototype offers a technical solution for the supervision of whip use in modern horse racing, and it would be useful in countries where there are regulations limiting the number of strikes. Current specifications allow the system to record the attributes and number of strikes and to relay the data contemporaneously to the stewards. The system does not interfere with the operation of the camera monitoring system. Since the number of strikes is reported with total accuracy, stewards are afforded more time to focus on matters of interference and actions that are important to the final result list. The prototype is a whip with a custom-made force sensor placed on both sides of the cushion pad. The sensors measure an area 24mm wide by 275mm long and cover the entire padded part of the approved race whip. The sensor is constructed of polyester that is 0.203mm thick. The force sensor is connected to a microcontroller mounted in the handle of the whip. The microcontroller processes the sensor data and sends the information via radio waves up to 1.7km in outdoor conditions to a second microcontroller located in the steward’s office. The whip strike sensor prototype is able to distinguish between a wave of the arm that leads to no impact and a strike. The software allows the force of each strike impact to be recorded. The intention is to embed the whip strike sensor within the body of whips used in a range of equestrian disciplines in which whip use is permitted. The possibility to register the properties of whip strikes will help to safeguard the welfare of horses used in these disciplines and provide information to the equestrian community that could change the way whips are used in training and racing. Lay person message: The whipping of horses in racing leads to concerns about animal welfare globally. A whip strike sensor prototype has been developed that will facilitate detailed exploration of the effect whips have on horses and allow stewards to accurately assess the number of strikes made and forces used. It is intended to integrate strike sensors into whips used in disciplines where whipping is allowed; this will help to safeguard the welfare of horses used in these disciplines.
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| 6. |
- Sjöberg, Linnea, et al.
(författare)
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Prevalence of depression : Comparisons of different depression definitions in population-based samples of older adults
- 2017
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 221, s. 123-131
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Tidskriftsartikel (refereegranskat)abstract
- Background: Depression prevalence in older adults varies largely across studies, which probably reflects methodological rather than true differences. This study aims to explore whether and to what extent the prevalence of depression varies when using different diagnostic criteria and rating scales, and various samples of older adults. Methods: A population-based sample of 3353 individuals aged 60-104 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were examined in 2001-2004. Point prevalence of depression was estimated by: 1) diagnostic criteria, ICD-10 and DSM-IV-TR/DSM-5; 2) rating scales, MADRS and GDS-15; and 3) self-report. Depression prevalence in sub-samples by dementia status, living place, and socio-demographics were compared. Results: The prevalence of any depression (including all severity grades) was 4.2% (moderate/severe: 1.6%) for ICD-10 and 9.3% (major: 2.1%) for DSM-IV-TR; 10.6% for MADRS and 9.2% for GDS-15; and 9.1% for selfreport. Depression prevalence was lower in the dementia-free sample as compared to the total population. Furthermore, having poor physical function, or not having a partner were independently associated with higher depression prevalence, across most of the depression definitions. Limitations: The response rate was 73.3% and this may have resulted in an underestimation of depression. Conclusion: Depression prevalence was similar across all depression definitions except for ICD-10, showing much lower figures. However, independent of the definition used, depression prevalence varies greatly by dementia status, physical functioning, and marital status. These findings may be useful for clinicians when assessing depression in older adults and for researchers when exploring and comparing depression prevalence across studies.
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| 7. |
- Sjöberg, Linnea
(författare)
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Using a life-course approach to better understand depression in older age
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This doctoral thesis aimed to explore the prevalence of depression, and to identify risk factors, secular changes, and consequences of depression in late adulthood from a life-course perspective. The four studies in this thesis were based on data from the H-70 study, the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), and the Kungsholmen Project (KP). The major findings of these studies are summarized below. Study I: This study used five-year follow-up data from the H-70 study to examine whether the association between social factors and depression has changed between the 1970s and 2000s in two birth cohorts of septuagenarians. Feelings of loneliness were related to higher depression risk in both of the cohorts. However, infrequent visits with others than children or neighbors (once per month or less), and the perception of having too little contact with others, were related to an increased risk of depression in 75-year-olds examined in the 1970s, but not in those examined in the 2000s. Study II: This study used SNAC-K data to examine to what extent the prevalence of depression varies when using different depression definitions and sub-samples of the population of adults aged 60−104 years. The prevalence of any depression ranged between 4.2% to 9.3% according to the diagnostic criteria (DSM-IV-TR and ICD-10); 9.2% to 10.6% for the rating scales (MADRS and GDS15); and was 9.1% for self-report. Depression prevalence was lower when excluding those having dementia, as compared to the total population. Moreover, being physically dependent or not having a partner were related to higher depression prevalence across the majority of the depression definitions. Study III: This study used nine-year follow-up data from SNAC-K and KP to explore whether low mood was related to an increased risk of dementia in two birth cohorts of adults above 70 years of age, and whether marital status and living situation modify this relationship. Those having low mood at baseline were at an increased risk of dementia in both cohorts combined (hazard ratio [HR] 1.2, 95% confidence interval [CI] 1.0-1.4), compared to those without low mood. However, the higher risk was detected only in those who did not have a partner (HR 1.5, 95% CI 1.2-1.9), or lived alone (HR 1.5, 95% CI 1.2-1.9), but not among those who had a partner or lived with someone (HR 0.8, 95% CI 0.5-1.2). Study IV: This study used six-year follow-up data from SNAC-K to explore whether the experience of negative life events across the life span was related to an increased depression risk later in life. The total number of negative life events was associated with an increased risk of any depression. When further examining timing of the events, the experience of negative events (≥90th percentile) in early- (0−18 years, odds ratio [OR] 2.4, 95% CI 1.2-5.0) or late-life (>65 years, OR 2.1, 95% CI 1.1-4.4) were associated with an increased risk of any depression, but not those occurring in early-adulthood (19−40 years, OR 1.4, 95% CI 0.7-2.7) or middle-adulthood (41−65 years, OR 1.3, 95% CI 0.6-3.1). Conclusions: Depression prevalence was similar independent of the depression definitions used, except for ICD-10, showing much lower prevalence. Moreover, the quantity and quality of social contacts with others were related to depression in older adults examined in the 1970s, but not in those examined 30 years later. In addition, marital status and living situation have the possibility to buffer the detrimental effects of low mood on dementia onset. Finally, there are critical time periods in early-life (0−18 years) and late-life (>65 years), when the experience of negative life events exacerbates depression risk in later life.
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| 8. |
- Tuvesson, Hanna, et al.
(författare)
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Life weariness and suicidal thoughts in older adults : a multi-center study in Sweden
- 2016
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Ingår i: Presented at the 23rd Nordic Congress of Gerontology (23 NKG), Tampere, Finland, June 20-22, 2016.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aims: Suicidality in late life is a public health concern worldwide and suicidal thoughts may be an important risk factor for suicide in old age. The overall aim of the present study was to investigate the possible importance of demographic characteristics, especially sex and age, for suicidal thoughts in a Swedish population-based cohort of older adults aged 60+ years.Methods: In this multicenter study, data from 7913 individuals aged 60+ years from the Swedish National Study on Aging and Care (SNAC) were used. One item of the Montgomery-Åsberg Depression Rating Scale was used to measure life weariness and suicidal thoughts. Logistic regression models were used to determine the relationship between socio-demographic characteristics and suicidal thoughts.Findings: Multivariate analysis showed that suicidal thoughts independently increased with age. Sex was, however, found to be unrelated to suicidal thoughts after controlling for other socio-demographic factors. Living in an urban or midsize geographical area, being widowed/unmarried/divorced, born in an European country other than the Nordic countries, in a residential care facility and having financial difficulties was related to suicidal thoughts.Conclusions: Taking these socio-demographic characteristics into consideration may aid in the design of prevention programs for late life suicidality.
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| 9. |
- Zuidersma, Marij, et al.
(författare)
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A bi-factor model of the Montgomery Åsberg depression rating scale and future cognitive impairments in older adults : A 6-year follow-up study.
- 2019
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Ingår i: Journal of Psychiatric Research. - : Elsevier. - 0022-3956 .- 1879-1379. ; 109, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Depression has been found to be associated with cognitive decline. This study evaluated the association of general depressive symptoms and motivational-related symptoms with cognitive impairment 6 years later and to explore the role of potential underlying mechanisms. In 2690 cognitively healthy persons aged ≥60 from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) depressive symptoms were derived from the Montgomery Åsberg Depression Rating Scale (MADRS). Cognitive performance was assessed at baseline and 6 years later in 1810 persons with the Mini Mental State Examination (global cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Clock-test (visuospatial construction), and the 5-item test (immediate and delayed recall). Bi-factor analysis on the MADRS yielded a General Depression factor and an unrelated Motivational factor. After adjusting for demographics, the General Depression factor was only associated with 6-year impairment in delayed recall (OR (95% CI): 1.18 (1.04-1.34)). This association was no longer significant after adjusting for demographics, cardiovascular risk, lifestyle factors and medication use. The Motivational factor was not significantly associated with future cognitive impairments after adjusting for demographics. Concluding, almost all associations of general depressive symptoms and motivational-related symptoms with future cognitive impairments appeared to be confounded by demographics. Only the association of general depressive symptoms with future memory impairments appeared to be explained by a combination of demographics, cardiovascular risk, lifestyle and medication use.
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