| 11. |
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| 12. |
- Elmståhl, Sölve, et al.
(författare)
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Body composition and dietary habits in 80-year-old smoking men without cardiovascular disease
- 1991
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 3:3, s. 77-269
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Tidskriftsartikel (refereegranskat)abstract
- Eighty-year-old male residents in the community of Malmö were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). Of 1,280 subjects, 122 were selected for further studies and allocated into 4 groups: 1) no CVD, non-smokers; 2) no CVD, smokers; 3) CVD, smokers; and 4) CVD, non-smokers. The smokers had consumed on the average 13 g of tobacco daily for 59 years. Lean body mass (LBM), body fat (BF), % body fat (%BF), and total body water (TBW) were estimated by means of bioelectrical impedance analysis. The mean body weight (BW), LBM, and %BF for all subjects were 74.1 +/- 10.2 kg, 58.0 +/- 6.8 kg, and 21.3 +/- 5.9 kg, respectively. There were no significant differences between all subjects with and without CVD. A lower BW among smokers than in non-smokers was explained by lower BF and %BF in the former. Smokers who had lived predominantly in rural areas had lower BW (6.9 kg) and LBM (5.2 kg) than those from an urban area. A positive correlation was noted between the degree of physical activity and LBM and TBW. Seventeen percent of the smokers exercised regularly. The CVD group had higher plasma cholesterol concentrations than the non-CVD group. Plasma triglycerides showed a positive correlation with BF, %BF and BW, whereas HDL cholesterol was negatively correlated with BF, %BF and BW. It is concluded that smoking is one of several important factors related to body composition, and the penetrance of this factor is still apparent in elderly men.
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| 13. |
- Sällström, Christina, 1950-
(författare)
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Spouses' experiences of living with a partner with Alzheimer's disease
- 1994
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the study was to gain some understanding of the lived experience of the care-giving spouses regarding their experiences of the manifestations of the disease, perception of their own health, the possibility of influencing the interpretation of the past, the present and future, outlook on life, surrounding contacts and intimate relationships with their sick partners. The spouses (n=13) of Alzheimer victims were followed with the help of personal interviews, diaries and telephone interviews during a two-years period. The texts was analysed according to a phenomenological-hermeneutic method. The main findings in the study showed that the spouses own health remained quite stable over time. Their perception of the development of their own health seemed to be influenced by how they saw their power to influence their situation, which seemed to be determined by how they interpreted the cause of their health problems.The social network was another important factor for understanding the spouses' experiences. The findings imply that spouses' images of themselves in relation to others were important for their perception of the overall social network. The spouses mostly regarded their relationships positively and their social networks were described as quite stable over time. The spouse's marital relationships, in most cases, seemed to undergo changes with the progress of the disease. Some spouses could maintain feelings of love but mostly the relationships were transformed into ones of tenderness, pity and estrangement. The spouses' valuation of their demented partner was mostly in the form of one of two divergent perspectives. On the one hand, spouses who seemed to perceive their partner as a person separate from the disease, could function as complementary ego aids. On the other hand some spouses were unable to make a distinction between the spouse as a person and the disease.The spouses' experiences regarding their previous relationship with parents, value system, philosophy of life, competence and autonomy seemed to be critical in their experiences of their caring situation. It appears that there is a sub-group of vulnerable carers, as suggested by the concurrence of psychological, physical, and social morbidity, along with deterioration in their marital relationship.The findings are discussed in relation to searching for meaning, the importance of significant others, perceiving and valuing the other, and caring relationships within a life-span perspective.
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| 14. |
- Elmståhl, Sölve, et al.
(författare)
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A study of regional cerebral blood flow using 99mTc-HMPAO-SPECT in elderly women with senile dementia of alzheimer’s type
- 1994
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 5:6, s. 302-309
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Tidskriftsartikel (refereegranskat)abstract
- Thirteen women with senile dementia of Alzheimer’s type (SDAT) according to NINCDS-ADRDA and 21 age-matched control women, aged 75-96 years, were investigated with clinical examination, dementia rating scales and single photon emission computed tomography (SPECT) using99mTc-hexamethylpropyleneamine oxime (HM-PAO) as a tracer of regional cortical blood flow. The aim was to study whether typical SPECT findings of SDAT were seen also in the very old having the disease for a longer period. Neuropsychological assessment with vocabulary and spatial tests was performed in the control women, and the results were divided in three subgroups, normal, borderline and abnormal. Regional perfusion values, expressed as a ratio between cortical and cerebellar HM-PAO uptake, were lower in frontal, temporoparietal and occipital cortices in SDAT patients than in controls. The SDAT patients had the lowest uptake in the posterior temporoparietal region (0.67 ± 0.06) and the corresponding value in the controls (0.79 ± 0.05) differed significantly, p < 0.0001. The interhemispheric ratio between right and left posterior temporoparietal regions was 0.99 ± 0.05. Nine of the control women (43%) had pathological SPECT with hemispheric asymmetries in 6 cases and bilateral temporooccipital reductions in 3 women. The neuropsychological assessment matched the findings in 7 of these women. One of the control women was judged as pathological and 10 women as borderline according to the spatial and vocabulary tests. Four of the 10 women with borderline results had normal SPECT. The sensitivity of the assessment to detect abnormalities compared to SPECT was 78% if borderline and abnormal results were expressed as true-positive cases. The specificity was 67%. The results showed a high degree of pathological findings according to SPECT and neuropsychological assessment in otherwise healthy elderly women.
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| 15. |
- Elmståhl, S., et al.
(författare)
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Increased sweat sodium concentration in patients with Alzheimer's disease
- 1993
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Ingår i: Dementia (Switzerland). - 1013-7424. ; 4:1, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Sweat sodium concentration was estimated with pilocarpine iontophoresis in I 15 women with Alzheimer's disease (AD) and 29 healthy control women. The age ranged from 76 to 96 years with a mean age of 85 years in both groups. The mean sodium concentration of 91 ± 41 mmol/l (n = 11) in the Alzheimer patients was significantly higher than in the control group (62 ± 29 mmol/l, n=27, p=0.0011). 27% of AD patients and 7% of the control women did not respond to stimulation. The impaired sweating in AD patients make them more vulnerable to heat stress. Further studies are needed to reveal whether the neurophysiological mechanism involved is located in the hypothalamus, in cortical projections to the hypothalamus or in postganglionic sympathetic fibers.
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| 16. |
- Gustafson, Yngve, 1949-
(författare)
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Acute confusional state (delirium) : clinical studies in hip-fracture and stroke patients
- 1991
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Acute confusional state (ACS) or delirium according to DSM-III-R holds a central position in the medicine of old age. ACS is a common and sometimes the only symptom of diseases and medical complications in the elderly patient.The aim of this study was to elucidate ACS in patients with femoral neck fractures and patients with acute stroke with regard to frequency, predictors, possible pathogenetic mechanisms, associated complications, assessment and documentary routines and the clinical outcome for the patients. An intervention program to prevent postoperative ACS based on our results was developed and evaluated.The main findings of the study were high frequencies of ACS in elderly patients with femoral neck fractures (61 %) and in patients with acute stroke (48 %). The main risk factors for ACS in patients with femoral neck fractures were old age, diseases and drug treatment interfering with cerebral cholinergic metabolism. There was no link between anaesthetic technique and ACS but the connection between peroperative hypotension, early postoperative hypoxia and ACS was close.In stroke patients the degree of extremity paresis and old age were independent ACS risk factors. ACS was commonly associated with post stroke complications such as myocardial infarction, pneumonia, urinary infection and urinary retention. In stroke patients there was a close connection between high hypothalamic-pituitary-adrenal axis (HPA-axis) activity and ACS. High HPA-axis activity and disturbances in the cerebral cholinergic system may be two important ACS mechanisms.A correct diagnosis is a prerequisite for proper treatment of ACS and its underlying causes. In the orthopaedic wards both physicians and nurses diagnosed and documented ACS poorly and therefore associated complications were insufficiently treated.The intervention program for postoperative ACS, aimed mainly at protecting the cerebral oxidative metabolism and thereby the cerebral cholinergic metabolism which is especially sensitive to hypoxia. Postoperative complications associated with ACS were also treated. The intervention resulted in reduced frequency, duration and severity of postoperative ACS and in shorter orthopedic ward stay for patients with femoral neck fractures.Key words: Acute confusional state, delirium, elderly
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| 17. |
- Herlitz, Agneta, 1962-
(författare)
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Remembering in Alzheimer's disease : utilization of cognitive support
- 1991
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present doctoral thesis was to investigate the ability of patients with Alzheimer's disease (AD) to utilize cognitive support in order to improve episodic remembering. A review of previous research indicated that most studies have failed to find beneficial effects of encoding support on memory in AD patients. The ability to utilize cognitive support (i.e., motoric activities, semantic organization, and semantic knowledge) for episodic remembering was investigated in five studies (Bäckman & Herlitz, 1990; Herlitz, Adolfsson, Bäckman, & Nilsson, in press; Herlitz & Bäckman, 1990; Herlitz & Viitanen, in press; Karlsson et al., 1989). Patients with mild, moderate, or severe AD, and normal older adults participated in the studies. On the basis of the results from these studies and the review of the literature, it was concluded that (a) AD patients, irrespective of dementia severity, perform at a lower level than normal older adults in episodic memory tasks; (b) provided that support is supplied at retrieval, AD patients may be sensitive to manipulations at encoding; (c) the strength of the encoding manipulation determines the size of the memory improvement in AD patients; and (d) depending on dementia severity, the type of encoding support also determines the magnitude of memory improvement obtained.
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| 18. |
- Lexell, Jan, et al.
(författare)
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Effects of strength training in elderly women
- 1992
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Ingår i: Journal of the American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 40:2, s. 190-191
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Tidskriftsartikel (refereegranskat)
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| 19. |
- Styrborn, Karin, et al.
(författare)
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Outcomes of geriatric discharge planning. A quality assurance study from a geriatric rehabilitation ward
- 1994
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Ingår i: Scandinavian Journal of Rehabilitation Medicine. - Oslo, Norway : Scandinavian University Press. - 0036-5505 .- 1940-2228. ; 26:3, s. 167-176
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Tidskriftsartikel (refereegranskat)abstract
- The outcome of a discharge planning procedure at a geriatric rehabilitation ward was studied with an interdisciplinary and multidimensional approach, where medical, nursing, functional and psychosocial factors were included. The patient's own expectations and attitude to functional performance and outcome were explored in an interview at the day of discharge and one month later in a follow-up telephone interview. Data were also collected from registers and medical and professional records. All the 36 patients discharged to their own homes, mostly after home assessment, or to old people's homes were followed up. The median rehabilitation stay was 30 days. Their medical status was stable over time and nursing interventions remained frequent. The functional level was unchanged for 18, and further enhanced for 10 patients. Most patients felt secure at home and received the home help they anticipated. Worries were expressed by one-third on realistic grounds, mainly medical or ideas on the accommodation. Some interventions were required and carried out by the team. Home living was as expected or better for two-thirds of the patients. The timing and the patient's situation at discharge seemed to have been well assessed, with an overall positive outcome after a month at home. Further development of practical multidimensional evaluations adapted to elderly patients is necessary in a quality assurance perspective.
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| 20. |
- Österlind, Per Olov, 1947-
(författare)
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Medical and social conditions in the elderly gender and age differences : the Umeå longitudinal study
- 1993
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In 1981, no representative study of the medical and social conditions among elderly persons in northern Scandinavia was performed. Nor was there such a study in a smaller Swedish town than Gothenburg. This study was initiated to fill that knowledge gap. The aim of the study was to evaluate gender and age differences in medical and social conditions among elderly people, including the reference intervals of clinical chemistry parameters and characteristic features of the 24-hour electrocardiogram (ECG) in healthy elderly. By way of longitudinal design with birth cohorts stratified by gender, it was assumed that the effects could be demonstrated. Also, the death risk of various social and medical variables was to be assessed.During the study period 1981 to 1990, the subjects were between 70 and 88 years of age. The proportion of persons living in private housing decreased from almost all at the age of 70 to slightly more than half at 88 years of age. The number of socially active persons decreased considerably during the period. The need of help increased from almost none to 60 % of the persons.The proportions of persons with normal sight and hearing decreased from two thirds to around one tenth The most frequent symptoms were general tiredness, pains, dyspnoea, constipation and dryness of the mouth. Cardiovascular diseases were the most frequent. Hypertensive disease became less, and congestive heart failure more frequent with age. The frequency of dementia increased steeply among the oldest persons; at 88 years of age, 40 % were demented.Drug consumption increased; the oldest persons in both age cohorts used 5 different drugs or more per person regularly. The consumption increase was mainly due to the increasing morbidity accompanying age. The most common drugs taken were cardiovascular preparations, psychoactive agents, drugs to alleviate gastrointestinal symptoms, and analgesics. Drug intake and symptom prevalence were generally higher in women, despite the fact that there was no gender difference in the number of diseases.The reference intervals of many blood components in healthy elderly were shown to be broader than those of younger persons. The intervals of P(lasma)-folate and P- potassium were on a lower and those of the erythrocyte sedimentation rate, P-creati- nine and, in women, S(erum)-cholesterol, were on a higher level than among younger persons.Several features of the 24-hour ECG, e.g. the number of episodes of supraventricular tachycardia as well as supraventricular and ventricular premature beats in healthy elderly were more frequent than among younger persons.Between 80 and 88 years of age, many functions crucial to the chances of living a rich and vital life were found deteriorating in the elderly persons. High age, male sex, dementia, congestive heart failure, and low values of S-creatinine were shown to be independent factors connected with an increased death risk.
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