| 1. |
- Andersson, Lena B., et al.
(författare)
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Health-related quality of life and activities of daily living in 85-year-olds in sweden
- 2014
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Ingår i: Health and Social Care in the Community. - : John Wiley & Sons. - 0966-0410 .- 1365-2524. ; 22:4, s. 368-374
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have examined health-related quality of life (HRQoL) with respect to daily living and health factors for relatively healthy elderly individuals. To this end, this study examines 85-year-olds’ reported HRQoL in relation to social support, perceived health, chronic diseases, health care use and instrumental activities of daily living. Data were collected from 360 participants (55% response rate) between March 2007 and March 2008 using a postal questionnaire and a home visit interview. HRQoL was assessed using the EQ-5D-3L. For the items in the EQ-5D-3L, more problems were related to lower HRQoL. Restricted mobility and occurrence of pain/discomfort was common. Lower HRQoL was associated with increased risk for depression, increased use of medication, increased number of chronic diseases, and more problems with instrumental activities of daily living (IADL). Health care use and health care costs was correlated to lower HRQoL. HRQoL is of importance to health care providers and must be considered together with IADL in the elderly population when planning interventions. These should take into account the specific needs and resources of the older individuals.
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| 2. |
- Dong, Huan-Ji, et al.
(författare)
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Health Consequences Associated with Being Overweight or Obese: A Swedish Population-Based Study of 85-Year-Olds
- 2012
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Ingår i: Journal of The American Geriatrics Society. - : Wiley-Blackwell. - 0002-8614 .- 1532-5415. ; 60:2, s. 243-250
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine whether being overweight or obese is associated with significant health outcomes in an 85-year-old population. less thanbrgreater than less thanbrgreater thanDESIGN: A cross-sectional population-based study. less thanbrgreater than less thanbrgreater thanSETTING: Linkoping, Sweden. less thanbrgreater than less thanbrgreater thanPARTICIPANTS: Three hundred thirty-eight people born in 1922 were identified using the local authoritys register. less thanbrgreater than less thanbrgreater thanMEASUREMENTS: Data related to sociodemographic characteristics, health-related quality of life (HRQoL), assistance use, and the presence of diseases were collected using a postal questionnaire. Anthropometry and functional status were assessed during home and geriatric clinic visits. Diseases were double-checked in the electronic medical records, and information about health service consumption was obtained from the local healthcare register. less thanbrgreater than less thanbrgreater thanRESULTS: Overweight (body mass index (BMI) 25.0-29.9 kg/m(2)) and obese (BMI andgt;= 30.0 kg/m(2)) participants perceived more difficulty performing instrumental activities of daily living (IADLs) and had more comorbidity than their normal-weight counterparts (BMI 18.5-24.9 kg/m(2)), but their overall HRQoL and health service costs did not differ from those of normal-weight participants. After controlling for sociodemographic factors, being overweight did not influence IADLs or any comorbidity, but obese participants were more likely to perceive greater difficulty in performing outdoor activities (odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.1-4) and cleaning (OR = 2.2, 95% CI = 1.2-4.2) than their normal-weight counterparts. Although obesity was also associated with multimorbidity (OR = 3, 95% CI = 1.2-8), the health service cost of each case of multimorbidity (n = 251) was highest in normalweight participants and nearly three times as much as in obese participants (ratio: 2.9, 95% CI = 1.1-8.1). less thanbrgreater than less thanbrgreater thanCONCLUSION: For 85-year-olds, being obese, as opposed to overweight, is associated with self-reported activity limitations and comorbidities. Overweight older adults living in their own homes in this population had well-being similar to that of those with normal weight.
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| 3. |
- Dong, Huan-Ji, 1981-
(författare)
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Health Maintenance in Very Old Age : Medical Conditions, Functional Outcome and Nutritional Status
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to provide better understanding of the underlying factors related to health maintenance in very old people, with a focus on medical conditions, functional outcome and nutritional status. Data were gathered from the ELSA 85 project (Elderly in Linköping Screening Assessment). The ELSA 85 project was started in 2007 with a population-based survey of 85-year-old individuals (n = 650) residing in Linköping municipality, Sweden. During the study period from 2007 to 2010, we conducted surveys by postal questionnaire, home visits, geriatric clinic visits, and reviews of electronic medical records as well as the database of health service consumption. A series of cross-sectional analyses were performed on multimorbidity, health service consumption, activities of daily living (ADLs), physical functioning and nutritional status.Of 650 eligible individuals, 496 (78% of those alive) completed the questionnaire (Paper I). Despite the prevalence of multimorbidity (68%) and frequent use of assistive technology for mobility (40%), the majority managed self-care (85%), usual activities (74%) and had high self-rated health (>60/100, visual analogue scale). Factors associated with in-patient care were an increased number of general practitioner visits, more use of assistive technology, community assistance, multimorbidity (≥2 chronic diseases) and/or heart failure and arrhythmia.Cluster analyses (n = 496, Paper II) revealed five clusters: vascular, cardiopulmonary, cardiac (only for men), somatic–mental (only for men), mental disease (only for women), and three other clusters related to ageing (one for men and two for women). Heart failure in men (odds ratio [OR], 2.4; 95% confidence interval [CI], 1–5.7) and women (OR, 3; 95% CI, 1.3–6.9) as a single morbidity explained more variance than morbidity clusters in models of emergency room visits. Men’s cardiac cluster (OR, 1.6; 95% CI, 1–2.7) and women’s cardiopulmonary cluster (OR, 1.7; 95% CI, 1.2–2.4) were significantly associated with hospitalization. The combination of the cardiopulmonary cluster with the men’s cardiac cluster (OR, 1.6; 95% CI, 1–2.4) and one of the women’s ageing clusters (OR, 0.5; 95% CI, 0.3–0.8) showed interaction effects on hospitalization.In Paper III, overweight (body mass index [BMI], 25–29.9 kg/m2) and obese (BMI, ≥30 kg/m2) individuals (n = 333) perceived more difficulty performing instrumental ADL (IADL) and had more comorbidities than their normal weight counterparts (BMI, 18.5–24.9 kg/m2). After controlling for socio-demographic factors, obese but not overweight individuals were more likely to perceive increased difficulty in performing outdoor activities (OR, 2.1; 95% CI, 1.1–4) and cleaning (OR, 2.2; 95% CI, 1.2–4.2) than their normal weight counterparts. Although obesity was also associated with multimorbidity (OR, 3; 95% CI, 1.2–8), the health service cost of each case of multimorbidity (n = 251) was highest in individuals of normal weight and nearly three times as much as in obese individuals (ratio, 2.9; 95% CI, 1.1–8.1).In Paper IV, 88-year-old obese women (n = 83) had greater absolute waist circumference, fat mass (FM) and fat-free mass (FFM), and lower handgrip strength (HS) corrected for FFM and HS-based ratios (HS/weight (Wt), HS/BMI, HS/FFM and HS/FM) than their normal weight and overweight counterparts. After adjusting for physical activity levels and the number of chronic diseases, the HS-based ratios explained more variance in physical functioning in Short Form-36 (R2, 0.52–0.54) than other single anthropometric or body composition parameters (R2, 0.45–0.51). Waist circumference, HS, and two HS-based ratios (HS/Wt and HS/FFM) were also associated with the number of IADL with no difficulty.In conclusion, the ELSA 85 population showed a fairly positive image of healthy perception, good functional ability as well as low use of health care among the majority of participants. Patterns of cardiac and pulmonary conditions were better associated than any single morbidity with hospitalization. Heart failure as a single morbidity was better associated than multimorbidity patterns with emergency room visits. For 85-year-olds, being obese, as opposed to overweight, was associated with self-reported activity limitations and comorbidities. Overweight elderly living in their own homes in this population had similar well-being to those of normal weight. In the cohort of 88-year-olds, obese women had high waist circumference, but their HS was relatively low in relation to their Wt and FFM. These parameters were better than BMI for predicting physical function and independent daily living.
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| 4. |
- Dong, Huan-Ji, et al.
(författare)
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Multimorbidity patterns of and use of health services by Swedish 85-year-olds: an exploratory study
- 2013
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 13:120
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAs life expectancy continues to rise, more elderly are reaching advanced ages (≥80 years). The increasing prevalence of multimorbidity places additional demands on health-care resources for the elderly. Previous studies noted the impact of multimorbidity on the use of health services, but the effects of multimorbidity patterns on health-service use have not been well studied, especially for very old people. This study determines patterns of multimorbidity associated with emergency-room visits and hospitalization in an 85-year-old population.MethodsHealth and living conditions were reported via postal questionnaire by 496 Linköping residents aged 85 years (189 men and 307 women). Diagnoses of morbidity were reviewed in patients’ case reports, and the local health-care register provided information on the use of health services. Hierarchical cluster analysis was applied to evaluate patterns of multimorbidity with gender stratification. Factors associated with emergency-room visits and hospitalization were analyzed using logistic regression models.ResultsCluster analyses revealed five clusters: vascular, cardiopulmonary, cardiac (only for men), somatic–mental (only for men), mental disease (only for women), and three other clusters related to aging (one for men and two for women). Heart failure in men (OR = 2.4, 95% CI = 1–5.7) and women (OR = 3, 95% CI = 1.3–6.9) as a single morbidity explained more variance than morbidity clusters in models of emergency-room visits. Men's cardiac cluster (OR = 1.6; 95% CI = 1–2.7) and women's cardiopulmonary cluster (OR = 1.7, 95% CI = 1.2–2.4) were significantly associated with hospitalization. The combination of the cardiopulmonary cluster with the men’s cardiac cluster (OR = 1.6, 95% CI = 1–2.4) and one of the women’s aging clusters (OR = 0.5, 95% CI = 0.3–0.8) showed interaction effects on hospitalization.ConclusionIn this 85-year-old population, patterns of cardiac and pulmonary conditions were better than a single morbidity in explaining hospitalization. Heart failure was superior to multimorbidity patterns in explaining emergency-room visits. A holistic approach to examining the patterns of multimorbidity and their relationships with the use of health services will contribute to both local health care policy and geriatric practice.
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| 5. |
- Eek, Martina, et al.
(författare)
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Everyday technology and 86-year-old individuals in Sweden
- 2011
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Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 1748-3107 .- 1748-3115. ; 2:6, s. 123-129
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim was to investigate everyday technology use in the homes of 86-year-old individuals in Sweden regarding usage, benefits or perceived problems and to study their perception of the technical development and its influence on daily living. MethodThe design was both quantitative and qualitative. An interview was conducted at a home visit performed by an occupational therapist using a questionnaire including questions on demographics and everyday technology. In addition, a qualitative part was performed based on an interview guide. Two hundred seventy four people participated. ResultsThe results indicate that watching TV was important for almost all 86-year-old individuals. This medium, combined with reading newspapers, was important for obtaining news. The most common problems in usage of everyday technology were related to visual or hearing impairments or operating difficulties. References to the Internet for further information were perceived as problematic for individuals without access to a computer. Another difficulty was automated telephone services. Cognitive deficits impeded everyday technology use and increased perceived problems. ConclusionsAccess to information and services are important elements in order to be an active participant in the society. Everyday technology is an area that should be addressed by occupational therapists in order to facilitate daily living.
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| 6. |
- Johansson, Maria, et al.
(författare)
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Clinical Utility of Cognistat in Multiprofessional Team Evalutations of Patients with Cognitive Impairment in Swedish Primary Care
- 2014
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Ingår i: International Journal of Family Medicine. - : Hindawi Publishing Corporation. - 2090-2042 .- 2090-2050. ; 2014, s. 649253-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Diagnostic evaluations of dementia are often performed in primary health care (PHC). Cognitive evaluation requires validated instruments.Objective. To investigate the diagnostic accuracy and clinical utility of Cognistat in a primary care population.Methods. Participants were recruited from 4 PHC centres; 52 had cognitive symptoms and 29 were presumed cognitively healthy. Participants were tested using the Mini-Mental State Examination (MMSE), the Clock Drawing Test (CDT), and Cognistat. Clinical diagnoses, based on independent neuropsychological examination and a medical consensus discussion in secondary care, were used as criteria for diagnostic accuracy analyses.Results. The sensitivity, specificity, positive predictive value, and negative predictive value were 0.85, 0.79, 0.85, and 0.79, respectively, for Cognistat; 0.59, 0.91, 0.90, and 0.61 for MMSE; 0.26, 0.88, 0.75, and 0.46 for CDT; 0.70, 0.79, 0.82, and 0.65 for MMSE and CDT combined. The area under the receiver operating characteristic curve was 0.82 for Cognistat, 0.75 for MMSE, 0.57 for CDT, and 0.74 for MMSE and CDT combined.Conclusions. The diagnostic accuracy and clinical utility of Cognistat was better than the other tests alone or combined. Cognistat is well adapted for cognitive evaluations in PHC and can help the general practitioner to decide which patients should be referred to secondary care.
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| 7. |
- Johansson, Maria M., et al.
(författare)
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Cognition, daily living, and health-related quality of life in 85-year-olds in Sweden
- 2012
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Ingår i: Aging, Neuropsychology and Cognition. - : Taylor & Francis. - 1382-5585 .- 1744-4128. ; 19:3, s. 421-432
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates how cognition influences activities of daily living and health-related quality of life in 85-year-olds in Sweden (n = 373). Data collection included a postal questionnaire comprising demographics and health-related quality of life measured by the EQ-5D. The ability to perform personal activities of daily living (PADL) was assessed during a home visit that included administering the Mini Mental State Examination (MMSE). Cognitive impairment was shown in 108 individuals (29%). The majority were independent with respect to PADL. A larger number of participants with cognitive impairment reported that they needed assistance in instrumental activities of daily living (IADL) compared to the group without cognitive impairment. Impaired cognition was significantly related to problems with IADL. Significant but low correlations were found between cognition and health-related quality of life – higher ratings on perceived quality of life correlated with higher results on the MMSE.
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| 8. |
- Johansson, Maria M., et al.
(författare)
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Validation of the Neurobehavioral Cognitive Status Examination and the Rivermead Behavioural Memory Test in investigations of dementia
- 2012
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 19:3, s. 282-287
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this retrospective study was to validate two commonly used instruments, Cognistat and the Rivermead Behavioural Memory Test, RBMT, for detection of MCI and mild dementia. Two different diagnosis groups, mild cognitive impairment (MCI) and Alzheimer's disease combined with mixed dementia representing mild dementia (MD), were compared with a group of patients who did not receive a diagnosis of dementia. All patients were assessed at a specialized outpatient memory clinic in a university hospital in Sweden using the Mini Mental State Examination (MMSE), Cognistat, and RBMT. Sensitivity, specificity, predictive value, and likelihood ratio were calculated for the tests. The Cognistat and RBMT have moderate validity in the detection of MCI and mild dementia. On their own, none of the tests used is sufficient for diagnosing MCI or mild dementia. A combination of the Cognistat and RBMT provides additional information in early stage dementia; in this regard the RBMT is better than the Cognistat, which also has other limitations. The RBMT can be helpful for distinguishing between MCI and mild dementia. There is a need for a more sensitive screening test to capture early cognitive impairment related to patients' occupational performance and problems in daily life.
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| 9. |
- Kalldalen, Anette, et al.
(författare)
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Occupational Performance Problems in 85-Year-Old Women and Men in Sweden
- 2012
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Ingår i: OTJR (Thorofare, N.J.). - : Slack. - 1539-4492 .- 1938-2383. ; 32:2, s. 30-38
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Tidskriftsartikel (refereegranskat)abstract
- An area of concern for occupational therapy is to increase preventive interventions among relatively healthy elderly individuals. The purpose of this study was to explore occupational performance problems among 85-year-old women and men in relation to demographic data, mental health, and health-related quality of life. Participants completed a postal questionnaire including the EuroQoL health-related quality of life measurement. Instruments used during a home visit were the Canadian Occupational Performance Measure, the Mini-Mental State Examination, and the Geriatric Depression scale. The sample comprised 380 individuals. Women experienced poorer health and more occupational performance problems in community management, household management, and quiet leisure than men. Impaired cognitive function, lower self-rated health, and higher risk of depression correlated with a larger number of occupational performance problems. Intervention planning should be based on individual perceptions of meaningful occupations and environmental considerations.
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| 10. |
- Källdalen, Anette, et al.
(författare)
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Interests among older people in relation to gender, function and health-related quality of life
- 2013
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Ingår i: British Journal of Occupational Therapy. - : College of Occupational Therapists. - 0308-0226 .- 1477-6006. ; 76:2, s. 87-93
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Tidskriftsartikel (refereegranskat)abstract
- AbstractIntroduction: Older people should have opportunities to be active participants in society as aspects such as lifestyle, physical and social environment and physical and mental status have influence on active ageing. The purpose was to explore the interests pursued by 85-year-old people living in ordinary housing in relation to gender, cognition, depression and health-related quality of life. Method: A sample of 240 participants completed a postal questionnaire including the EuroQoL health-related quality of life measurement. Additional instruments used during a subsequent home visit were the Canadian Occupational Performance Measure, Mini Mental State Examination and Geriatric Depression scale. Results: Women experienced poorer health than men, lived alone to a greater extent and used more mobility devices. Compared to men, women had a larger number of interests within household management, but no gender differences in the leisure area. Lower number of interests in active recreation was associated with lower cognitive function, poorer health-related quality of life and a higher risk of depressive symptoms. Conclusion: The main finding is that engaging in active recreation interests is associated with better cognition, less depression and higher health-related quality of life in these 85-year-old people and is therefore a concern of occupational therapists.
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