| 1. |
- Andersson, Magdalena, et al.
(författare)
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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
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 228-239
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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.
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| 2. |
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| 3. |
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| 4. |
- Bergh, Ingrid, et al.
(författare)
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An application of pain rating scales in geriatric patients
- 2000
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Ingår i: Aging Clinical and Experimental Research. - : Elsevier. - 1594-0667 .- 1720-8319. ; 12:5, s. 380-7
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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.
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| 5. |
- Bergh, Ingrid, 1956, et al.
(författare)
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Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.
- 2001
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Ingår i: Aging (Milan, Italy). - : Kurtis. - 0394-9532. ; 13:5, s. 355-361
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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.
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| 6. |
- Broman, Gi, et al.
(författare)
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Golf: a high intensity interval activity ofor elderly men
- 2004
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 16:5, s. 375-381
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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.
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| 7. |
- Dahl, Anna, et al.
(författare)
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Identification of dementia in epidemiological research : A study on the usefulness of various data sources
- 2007
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Ingår i: Aging Clinical and Experimental Research. - : Springer Nature Switzerland AG. - 1594-0667 .- 1720-8319. ; 19:5, s. 381-389
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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.
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| 8. |
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| 9. |
- Ernsth Bravell, Marie, 1973-, et al.
(författare)
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Sooner or later? : A study of institutionalization in late life
- 2009
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 21:4/5, s. 329-337
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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.
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| 10. |
- Frändin, Kerstin, et al.
(författare)
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A Nordic multi-center study on physical and daily activities for residents in nursing home settings : design of a randomized, controlled trial
- 2009
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 21:4-5, s. 314-322
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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.
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| 11. |
- Grahn Kronhed, Ann-Charlotte, et al.
(författare)
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Evaluation of an osteoporosis and fall risk intervention program for community-dwelling elderly. : a quasi-experimental study of behavioural modifications
- 2006
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 18:3, s. 235-241
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Osteoporosis and fall fractures are increasing problems amongst the elderly. The aim of this study was to explore whether combined population-based and individual interventions directed at risk factors for osteoporosis and falls result in behavioral changes in an elderly population. METHODS: A quasi-experimental design was used for the study. Persons aged >or=65 years were randomly selected in the intervention and control community. An intervention program was managed from the primary health care center and delivered to the community. Health education was designed to increase awareness of risk factors for the development of osteoporosis and falling. Questionnaires about lifestyle, health, previous fractures, safety behavior and physical activity level were distributed at baseline in 1989 and at the follow-ups in 1992 and 1994 in both communities. RESULTS: There was a difference of 17.7% between the dual intervention (receiving both population-based and individual interventions) and the control samples regarding the self-reported use of shoe/cane spikes, and a difference of 20.5% regarding the reported "moderate level" of physical activity in 1994. There was an increase in the number of participants in the dual intervention sample who, at baseline, had not reported equipping their homes with non-slip mats and removing loose rugs but who did report these changes in 1994. The increase in the reported use of shoe/cane spikes in the dual intervention sample was observed mainly for the period 1992-1994. CONCLUSIONS: A public health intervention model, including both population-based and individual interventions, can contribute to behavioral changes in the prevention of falls and changed physical activity patterns amongst elderly people.
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| 12. |
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| 13. |
- Jensen, Jane, et al.
(författare)
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Effects of a fall prevention program including exercise on mobility and falls in frail older people living in residential care facilities
- 2004
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 16:4, s. 283-92
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Impaired mobility is one of the strongest predictors for falls in older people. We hypothesized that exercise as part of a fall prevention program would have positive effects, both short- and long-term, on gait, balance and strength in older people at high risk of falling and with varying levels of cognition, residing in residential care facilities. A secondary hypothesis was that these effects would be associated with a reduced risk of falling. METHODS: 187 out of all residents living in 9 facilities, > or =65 years of age were at high risk of falling. The facilities were cluster-randomized to fall intervention or usual care. The intervention program comprised: education, environment, individually designed exercise, drug review, post-fall assessments, aids, and hip protectors. Data were adjusted for baseline performance and clustering. RESULTS: At 11 weeks, positive intervention effects were found on independent ambulation (FAC, p=0.026), maximum gait speed (p=0.002), and step height (> or =10 cm, p<0.001), but not significantly on the Berg Balance Scale. At 9 months (long-term outcome), 3 intervention and 15 control residents had lost the ability to walk (p=0.001). Independent ambulation and maximum gait speed were maintained in the intervention group but deteriorated in the control group (p=0.001). Residents with both higher and lower cognition benefited in most outcome measures. Noassociation was found between improved mobility and reduced risk of falling.CONCLUSIONS: Exercise, as part of a fall prevention program, appears to preserve the ability to walk, maintain gait speed, ambulate independently, and improve step height. Benefits were found in residents with both lower and higher cognitive impairment, but were not found to be associated with a reduced risk of falling
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| 14. |
- Jónsson, Pálmi V, et al.
(författare)
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Admission profile is predictive of outcome in acute hospital care.
- 2008
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 20:6, s. 533-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: The purpose of this study is to describe predictors for discharge and one-year outcomes of acute-care hospital patients, 75 years of age or over, based on admission status information. We carried out a prospective study of a randomly selected patient population, from one urban acute-care hospital in each of the Nordic countries. 763 persons aged 75+ were randomly selected from acute admissions to the participating hospitals. 749 observations at discharge and 655 observations at one year were used in analyses. METHODS: Data were collected with the MDS-AC 1.1 instrument within 24 hours of admission, and at day 7 or discharge, whichever came first. Outcome information was collected either by interviewing the patient or from patient records or registers. Discharge and one-year outcome (home, institution, death) were modeled by multinomial logistic regression, with admission status variables as predictors. RESULTS: At discharge, 84% of subjects returned home, 11% went to an institution and 5.6% had died. At one year, 64% were still living at home, 24% had died, and 12% had moved to an institution. For discharge outcome, those having hospital admission due to a new problem or exacerbation of an old one had a higher risk of dying (OR 3.3) than returning home. Moderate to severe cognitive problems predicted death (OR 2.2) and institutionalization (OR 8.6) compared with discharge home. Problems in instrumental activities of daily living predicted death (OR 3.1) and institutionalization (OR 6.0). At one year, those with exacerbation of an old problem (OR 2.1) or with a new or exacerbated existing problem (OR 2.3) had a higher risk of dying than of institutionalization or discharge home. Having some cognitive problems (OR 2.8) or moderate to severe cognitive problems (OR 6.6) predicted institutionalization, but not dying or discharge home. Those with some problems in activities of daily living had a higher risk of both dying (OR 1.7) and of institutional care (OR 2.7). Those with moderate to severe problems in activities of daily living had also a higher risk of institutional care (OR 4.7) compared with those living at home. CONCLUSIONS: Evidence predictive of discharge and one-year outcomes in older acute hospital medical care patients seems to be visible from the beginning of the hospital stay. In order to increase the efficient use of health care services and quality of care, systematic standardized and streamlined assessment should be performed during the admission process.
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| 15. |
- Kallin, Kristina, et al.
(författare)
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Drugs and falls in older people in geriatric care settings.
- 2004
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 16:4, s. 270-276
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Tidskriftsartikel (refereegranskat)abstract
- ACKGROUND AND AIMS: Falls and their consequences constitute serious health problems in the older population. The aim was to study predisposing factors for falls among older people in geriatric care settings, focusing on drugs. METHODS: This population-based study, with a cross-sectional design, analysed all geriatric care settings, comprising 68 residential care facilities, 31 nursing homes, 66 group dwellings for people with dementia, seven rehabilitation/short-stay units, two somatic geriatric and two psychogeriatric clinics, in the county of Västerbotten; 3604 residents with a mean age of 83.3+/-7.0 (65-103) years (68% women) were included. The residents were assessed by means of the Multi-Dimensional Dementia Assessment Scale (MDDAS) that measures, for example, mobility, paresis, vision, hearing, functions of activities of daily living (ADL), and behavioural and psychiatric symptoms. Drug consumption and falls during the previous week were recorded. RESULTS: Three hundred and one residents (8.4%) had sustained a fall at least once during the preceding week. Multivariate analyses showed that a history of falls, the ability to get up from a chair, the need for a helper when walking, pain, cognitive impairment, and use of neuroleptics or antidepressants were all associated with being a faller. Among the antidepressants, selective serotonin reuptake inhibitors (SSRIs) but not serotonin and noradrenalin reuptake inhibitors (SNRIs) were associated with falls. Cholinesterase inhibitors were not associated with falls. CONCLUSIONS: Like functional and cognitive impairment, treatments with antidepressants and neuroleptics are predisposing factors for falls in older people in residential care. However, there seem to be differences between subgroups among these drugs and, from the perspective of fall prevention, SNRIs rather than SSRIs should perhaps be preferred in the treatment of depression in older people.
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| 16. |
- Krevers, Barbro, et al.
(författare)
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Development of the 'Patient perspective On Care and Rehabilitation process' instrument (POCR)
- 2002
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 14:5, s. 402-411
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: There is a lack of instruments for assessing patient-perceived quality of care developed from a process perspective and also from theoretical concepts based on a patient perspective. The objective was to develop an instrument for following-up the care and rehabilitation process of the elderly from the patients' perspective. Methods: The present instrument, the "Patient perspective On Care and Rehabilitation process" (POCR), is based on a theoretical framework for the patients' evaluation of the care process, i.e., an instrument-construction reflecting that the patients' needs differed during the care process. The POCR contains two scales, one measures the fulfilment of needs and the other the importance of the fulfilment of needs. Data collection took place via telephone interviews. Results: A factor analysis based on 306 cases resulted in seven factors reflecting the different phases in the care process and with an explained variance of 60.8. Assessed by Cronbach's alpha coefficient, the internal consistency was 0.83 for the total importance scale and between 0.55-0.71 for each factor. Conclusions: The POCR is a valid, reliable and useful multidimensional instrument for measuring patient-perceived outcome of the care and rehabilitation process in the elderly. (C) 2002, Editrice Kurtis.
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| 17. |
- Lagergren, M., et al.
(författare)
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A longitudinal study integrating population, care and social services data : The Swedish National study on Aging and Care (SNAC)
- 2004
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Ingår i: Aging Clinical and Experimental Research. - Milano : Kurtis. - 1594-0667 .- 1720-8319. ; 16:2, s. 158-168
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: A large, national, long-term, longitudinal, multi-purpose study has been launched in Sweden - the Swedish National study on Aging and Care (SNAC). The study involves four research centers collecting data in four different areas of Sweden.Methods: The study consists of two parts: the population part and the care and services part. In the population part, a large, representative panel of elders in different age cohorts is followed over time to record and describe the aging process from different aspects. In the care and services part, a systematic, longitudinal, individually-based collection of data is performed concerning provision of care and services together with functional ability, specific health care problems, and living conditions of the recipients living in the area.Resuits: The data collection in the population part of the SNAC is not yet completed. In the present article, some preliminary results are reported from the care and services part. These pertain to comparisons between the participating areas with respect to the prevalence of disability among those receiving care and social services in their ordinary homes and those receiving care in special accommodation. A comparison is also presented with regard to the amount of home help provided to subjects with a given disability.Conclusions: This project has several advantages. It is expected to generate a rich data base relevant for future research on aging and care and to have a direct impact on the future Swedish system of care and services for the elderly.
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| 18. |
- Lindemann, Ulrich, et al.
(författare)
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Maximum step length as a potential screening tool for falls in non-disabled older adults living in the community.
- 2008
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 20:5, s. 394-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Identification of the risk of falls in a cohort of interest is a prerequisite for a targeted fall prevention study. Motor tasks are widely used as baseline assessment in such studies, but there are only a few well-evaluated tests of motor performance to predict falls prospectively. This study was conducted to find out if the potential of the maximum step length (MSL) test can predict future falls in non-disabled older persons. METHODS: A modified version of the MSL test was used for baseline assessment in 56 community-dwelling, non-disabled elderly persons (mean age 67.7 yrs, SD 6 yrs; 57% women). During a follow-up of 1 year, falls were recorded in a daily calendar. RESULTS: During the follow-up, 30 persons (54%) fell, with no gender difference in reporting of falls between men and women. The adjusted mean valid step length and adjusted maximum valid step length were predictive of future falls with a sensitivity/specificity of 77%/62% and 70%/69%, respectively. Combining MSL test results with fall history increased sensitivity to 93% and 90%, respectively, but decreased specificity to 54% and 58%, respectively. CONCLUSIONS: The MSL test is a feasible tool, with low requirements in space, predicting future falls in community-dwelling older persons. In combination with history of falls, the sensitivity of the test increased considerably.
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| 19. |
- Lundin-Olsson, Lillemor, et al.
(författare)
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Predicting falls in residential care by a risk assessment tool, staff judgement, and history of falls
- 2003
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 15:1, s. 51-59
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: It is of great importance to consider whether a tool's predictive value is generalizable to similar samples in other locations. Numerous fall prediction systems have been developed, but very few are evaluated over a different time period in a different location. The purpose of this study was to validate the predictive accuracy of the Mobility Interaction Fall (MIF) chart, and to compare it to staff judgement of fall risk and history of falls. METHODS: The MIF chart, staff judgement, and fall history were used to classify the risk of falling in 208 residents (mean age 83.2 +/- 6.8 years) living in four residential care facilities in northern Sweden. The MIF chart includes an observation of the ability to walk and simultaneously interact with a person or an object, a vision test, and a concentration rating. Staff rated each resident's risk as high or low and reported the resident's history of falls during the past 6 months. Falls were followed up for 6 months. RESULTS: During the follow-up period, 104 residents (50%) fell at least once indoors. Many of the factors commonly associated with falls did not differ significantly between residents who fell at least once and residents who did not fall. In this validating sample the predictive accuracy of the MIF chart was notably lower than in the developmental sample. A combination of any two of the MIF chart, staff judgement, and history of falls was more accurate than any approach alone; more than half of the residents classified as 'high risk' by two approaches sustained a fall within 3 months. CONCLUSIONS: Residents classified as 'high risk' by any two of the MIF chart, staff judgement, and history of falls should be regarded as particularly prone to falling and in urgent need of preventive measures.
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| 20. |
- Lundström, Maria, et al.
(författare)
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Postoperative delirium in old patients with femoral neck fracture : a randomized intervention study.
- 2007
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 178-186
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Delirium is a common postoperative complication in elderly patients which has a serious impact on outcome in terms of morbidity and costs. We examined whether a postoperative multi-factorial intervention program can reduce delirium and improve outcome in patients with femoral neck fractures.METHODS: One hundred and ninety-nine patients, aged 70 years and over (mean age+/-SD, 82+/-6, 74% women), were randomly assigned to postoperative care in a specialized geriatric ward or a conventional orthopedic ward. The intervention consisted of staff education focusing on the assessment, prevention and treatment of delirium and associated complications. The staff worked as a team, applying comprehensive geriatric assessment, management and rehabilitation. Patients were assessed using the Mini Mental State Examination and the Organic Brain Syndrome Scale, and delirium was diagnosed according to DSM-IV criteria.RESULTS: The number of days of postoperative delirium among intervention patients was fewer (5.0+/-7.1 days vs 10.2+/-13.3 days, p=0.009) compared with controls. A lower proportion of intervention patients were delirious postoperatively than controls (56/102, 54.9% vs 73/97, 75.3%, p=0.003). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (p<0.001). Intervention patients suffered from fewer complications, such as decubitus ulcers, urinary tract infections, nutritional complications, sleeping problems and falls, than controls. Total postoperative hospitalization was shorter in the intervention ward (28.0+/-17.9 days vs 38.0+/-40.6 days, p=0.028).CONCLUSIONS: Patients with postoperative delirium can be successfully treated, resulting in fewer days of delirium, fewer other complications, and shorter length of hospitalization.
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| 22. |
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| 24. |
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| 25. |
- Rosendahl, Erik, et al.
(författare)
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A randomised controlled trial of fall prevention by a high-intensity functional exercise program for older people in residential care facilities
- 2008
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Ingår i: Aging Clinical and Experimental Research. - Milan : Editrice Kurtis SRL. - 1594-0667 .- 1720-8319. ; 20:1, s. 67-75
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Falls are particularly common among older people living in residential care facilities. The aim of this randomized controlled trial was to evaluate the effectiveness of a high-intensity functional exercise program in reducing falls in residential care facilities.METHODS: Participants comprised 191 older people, 139 women and 52 men, who were dependent in activities of daily living. Their mean+/-SD score on the Mini-Mental State Examination was 17.8+/-5.1 (range 10-30). Participants were randomized to a high-intensity functional exercise program or a control activity, consisting of 29 sessions over 3 months. The fall rate and proportion of participants sustaining a fall were the outcome measures, subsequently analysed using negative binominal analysis and logistic regression analysis, respectively.RESULTS: During the 6-month follow-up period, when all participants were compared, no statistically significant differences between groups were found for fall rate (exercise group 3.6 falls per person years [PY], control group 4.6 falls per PY), incidence rate ratio (95% CI) 0.82 (0.49-1.39), p=0.46, or the proportion of participants sustaining a fall (exercise 53%, control 51%), odds ratio (95% CI) 0.95 (0.52-1.74), p=0.86. A subgroup interaction analysis revealed that, among participants who improved their balance during the intervention period, the exercise group had a lower fall rate than the control group (exercise 2.7 falls per PY, control 5.9 falls per PY), incidence rate ratio (95% CI) 0.44 (0.21-0.91), p=0.03.CONCLUSIONS: In older people living in residential care facilities, a high-intensity functional exercise program may prevent falls among those who improve their balance.
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| 26. |
- Rosendahl, Erik, et al.
(författare)
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Prediction of falls among older people in residential care facilities by the Downton index
- 2003
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 15:2, s. 142-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Falls are frequent among older people living in residential care facilities. The aim of this study was to investigate the prediction accuracy of the Downton fall risk index among older people living in residential care facilities at 3, 6 and 12 months, and with two different definitions of falls. METHODS: Seventy-eight residents in one residential care facility, 56 women and 22 men, mean +/- SD age 81 +/- 6 years, participated in this study. Forty-seven percent of participants had dementia, 45% depression, and 32% previous stroke. Forty-one percent of participants used a walking device indoors, and the median score of the Barthel ADL Index was 16. At baseline, the Downton fall risk index was scored for each individual. A score of 3 or more was taken to indicate high risk of falls. Participants were followed up prospectively for 12 months, with regard to falls indoors. RESULTS: At 3, 6 and 12 months, and using a fall definition including all indoor falls, sensitivity ranged from 81 to 95% with the highest value at 3 months, and specificity ranged from 35 to 40%. The prognostic separation values ranged from 0.26 to 0.37. Within 3 months, the risk of falling was 36% in the high-risk group (index score > or = 3) and 5% in the low-risk group. The accuracy of predictions did not improve when applying a fall definition in which falls precipitated by acute illness, acute disease, or drug side-effects were excluded. CONCLUSIONS: Already after 3 months, the Downton fall risk index appears to be a useful tool for predicting falls, irrespective of their cause, among older people in residential care facilities
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| 27. |
- Rosendahl, Erik, et al.
(författare)
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Prediction of falls among older people in residential care facilities by the Downton index
- 2002
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 15:2, s. 142-147
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Falls are frequent among older people living in residential care facilities. The aim of this study was to investigate the prediction accuracy of the Downton fall risk index among older people living in residential care facilities at 3, 6 and 12 months, and with two different definitions of falls. METHODS: Seventy-eight residents in one residential care facility, 56 women and 22 men, mean +/- SD age 81 +/- 6 years, participated in this study. Forty-seven percent of participants had dementia, 45% depression, and 32% previous stroke. Forty-one percent of participants used a walking device indoors, and the median score of the Barthel ADL Index was 16. At baseline, the Downton fall risk index was scored for each individual. A score of 3 or more was taken to indicate high risk of falls. Participants were followed up prospectively for 12 months, with regard to falls indoors. RESULTS: At 3, 6 and 12 months, and using a fall definition including all indoor falls, sensitivity ranged from 81 to 95% with the highest value at 3 months, and specificity ranged from 35 to 40%. The prognostic separation values ranged from 0.26 to 0.37. Within 3 months, the risk of falling was 36% in the high-risk group (index score > or = 3) and 5% in the low-risk group. The accuracy of predictions did not improve when applying a fall definition in which falls precipitated by acute illness, acute disease, or drug side-effects were excluded. CONCLUSIONS: Already after 3 months, the Downton fall risk index appears to be a useful tool for predicting falls, irrespective of their cause, among older people in residential care facilities.
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| 28. |
- Rydwik, Elisabeth, et al.
(författare)
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Effects of a physical and nutritional intervention program for frail elderly people over age 75 : a randomized controlled pilot treatment trial
- 2008
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Ingår i: Aging Clinical and Experimental Research. - Milano, Italy : Editrice Kurtis. - 1594-0667 .- 1720-8319. ; 20:2, s. 159-170
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: There are few studies published that combine the interventions of physical training and nutrition. The aim of the present study was to describe the impact of a physical and nutritional intervention program for frail community- dwelling elderly people over the age of 75. METHODS: Ninety-six community-dwelling elderly people (58 women) were randomized to four different groups: i) a physical training program (aerobic, muscle strength, balance), ii) a nutritional intervention program (individually targeted advice and group sessions), iii) a combination of these interventions, and iv) a control group. At baseline subjects were screened for physical performance such as muscle strength, balance, mobility and activities of daily living, as well as nutritional aspects such as energy intake, body weight and fat-free mass. These measurements were repeated immediately after the intervention, which lasted for 12 weeks, and after another 6 months. RESULTS: The intention-to-treat analysis indicated significant improvements in lower- extremity muscle strength in both training groups compared with the nutrition group at 1st follow-up. There were small significant changes for some of the balance measurements in the training group without nutrition treatment. The nutrition intervention did not show any significant results. CONCLUSIONS: This study shows the positive effect on lower-extremity muscle strength directly after the intervention. Balance training most probably needs to be more individualized in order to be effective for frail elderly people. Further studies are needed, with larger sample sizes, to investigate the effects of these types of interventions before any further conclusions can be drawn.
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| 29. |
- Sundman-Eriksson, Ingrid, et al.
(författare)
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Age-correlated decline in [3H]tiagabine binding to GAT-1 in human frontal cortex.
- 2006
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 18:3, s. 257-60
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: In spite of the fact that GABA is a significant transmitter, little is known about the GABA system in aging, compared with other transmitter systems. [(3)H]tiagabine is a ligand for GABAergic neurons, which binds with 10-fold higher affinity to the GABA uptake site than [(3)H]nipecotic acid. The aim of this study was to study the binding of [(3)H]tiagabine to the GABA transporter 1, GAT-1, in human frontal cortex and cingulate cortex from individuals of varying ages. METHODS: [(3)H]tiagabine binding experiments were conducted on post-mortem brain tissue from 19 individuals (age range 17-78 years) without known neurological or psychiatric disorders. Binding data vs age and postmortem interval was analysed by Pearson correlation. RESULTS: The density of [(3)H]tiagabine binding to GAT- 1 decreased significantly with increasing age in the frontal cortex, whereas binding affinity was unchanged. No significant alterations in binding parameters were observed in the cingulate cortex. No correlation was found between post-mortem delay and the number of [(3)H]tiagabine binding sites. CONCLUSIONS: According to the present study, presynaptical alterations in the GABA system are correlated with aging in the frontal cortex of the human brain. Further studies involving a broader range of brain regions seem warranted, to confirm the present findings and to enlarge knowledge about the GABA system in aging.
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| 30. |
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| 31. |
- Törner, Anna, et al.
(författare)
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Renal function in community-dwelling frail elderly : comparison between measured and predicted glomerular filtration rate in the elderly and proposal for a new cystatin C-based prediction equation
- 2008
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Ingår i: Aging Clinical and Experimental Research. - Milano : Editrice Kurtis. - 1594-0667 .- 1720-8319. ; 20:3, s. 216-225
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: There is a great need to evaluate renal function regularly in elderly people. This study aimed at analyzing renal function in stable, community-dwelling elderly people of 75 years and over, to compare measured and predicted glomerular filtration rates (GFR) and to develop an accurate prediction equation for this age group. METHODS: Forty-five ambulatory elderly people in stable health in ordinary living were randomly selected into four age-classes, aged 75-95. Demographic data, personal activities of daily living, continuous drug prescriptions, body composition, blood pressure and blood chemistry were analysed. GFR was measured as Iohexol clearance based on three time-points 3, 4 and 7 hours after Iohexol injection. RESULTS: Mean GFR was well preserved in all four age-classes. The GFR range was 18-83 mL/min and declined with age. The Cockcroft-Gault prediction equation systematically underestimated measured GFR. A new 'GFRA' prediction equation is presented, based on the inverse of serum cystatin C and independent of gender, body surface area, body weight, lean body mass or serum creatinine. The proposed equation underestimated measured GFR with a mean of only 0.1 mL/min, had better precision compared with the Cockcroft-Gault equation, and was evaluated by the method of cross-validation. CONCLUSIONS: GFR exhibits extensive heterogeneity in frail, community-dwelling elderly people. The proposed GFRA was clearly more precise than the Cockcroft-Gault prediction equation in the study group. However, it needs to be validated in a larger population of elderly subjects, including more individuals in stable health with substantially reduced renal function in whom GFR is measured by a reference method with adequate sampling time.
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| 32. |
- von Heideken Wågert, Petra, et al.
(författare)
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Health status in the oldest old : Age and sex differences in the Umeå 85+ Study.
- 2006
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 18:2, s. 116-126
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: With an increasing population aged 85 years and over, the aim of this study was to describe health status and living conditions in the oldest old and to estimate age and sex differences in a Northern European population. METHODS: A population-based cross-sectional study, The Umeå 85+ Study, was carried out in the municipality of Umeå in northern Sweden. Out of 319 eligible participants aged 85, 90 and 95 years and over, 253 participated. Structured interviews and assessments were conducted with the participants in their homes, and data were also collected from relatives, caregivers and medical charts. Cognition was screened with the Mini-Mental State Examination (MMSE), depressive symptoms with the Geriatric Depression Scale-15 (GDS-15) and nutritional status with the Mini Nutritional Assessment (MNA). Activities of daily living (ADL) were assessed applying the Staircase of ADL (including Katz' Index of ADL) and morale with the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants also rated their own health. RESULTS: Over half of the participants had hypertension, one out of four was depressed, and the same proportion had had a hip fracture; the mean number of drugs taken was 6.4+/-4.0. Younger participants had lower rates of diagnoses and prescribed drugs, and were less dependent in ADL and other functional variables; men had lower rates of diagnoses and reported symptoms. The majority of participants rated their general health and morale as good. CONCLUSIONS: There were large variations in social, medical and functional variables within and between age and sex groups. This northern population of the oldest old seems to have a very high prevalence of hypertension, depression, hip fractures, and many prescribed drugs.
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| 33. |
- Werntoft, Elisabet, et al.
(författare)
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Older people's views of prioritization in health care
- 2005
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Ingår i: Aging Clinical and Experimental Research. - : Kurtis. - 1594-0667 .- 1720-8319. ; 17:5, s. 402-411
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: The aim of this study was to investigate and compare older people's views of prioritization in health care with specific regard to age, gender and HRQoL. METHODS: The sample was collected from a prospective longitudinal cohort study, the GAS project (Good Ageing in Skane) that is in progress in Sweden. For this study, 902 persons, 424 men and 478 women, aged between 60 and 93 years, were invited consecutively over a period of 17 months to participate in an additional structured interview based on an interview manual. Socio-demographic and HRQoL data were collected from the GAS project. For the analysis, the sample was divided into age groups: young-old, old-old, and oldest-old. RESULTS: Older people in general did not want age as a criterion for prioritization in health care. When pain was added as a criterion, age became even less important than when it was the sole criterion. The oldest-old, to a higher degree than the other age groups, prioritized younger patients, as did men, while women, more than men, preferred "old age" as an indicator for prioritization. The respondents' views on prioritization were also more associated with age and gender than HRQoL. CONCLUSIONS: Older people's views of priorities seem to differ from previous population-based studies, in that age per se as a criterion for selection between patients was not favored; health and wellbeing were more important. Differences were, however, found within the group of older people, as regards both age and gender.
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| 34. |
- Westerbotn, Margareta, et al.
(författare)
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Factors influencing the handling of medicines among very old people living at home in an urban area
- 2006
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 18:6, s. 497-502
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Elderly people in Sweden live longer in their own homes, some of them with good health, and others with chronic conditions that require medical treatment. Thus, the aim of this study was to investigate factors influencing elderly people’s handling of their medicines. Methods: Cross-sectional population-based study. Participants were 333, aged 84+ years, living in their own homes. Information on regular drug use was obtained from interviews. Descriptive statistics were used to describe the population, and logistic regression models were used to investigate the factors associated with receiving help in handling medicines. The Mini-Mental State Examination (MMSE) measured cognitive status, and the basic Activities of Daily Living (ADL) assessed functional status. Results: Most participants were women living alone. 88% of this population took medicines on a regular basis and 23% of them received help with medicine handling. Using logistic regression models controlling for sociodemographic variables, cognitive and functional status, female (OR=2.8, 95% CI=1.2–6.5) was the only variable associated with regular use of medicines. Older age and functional disability in ADL increased the risk of receiving help with medicines, while higher cognitive status decreased the odds of receiving help. The only factor related to receiving help from a family member was living alone (OR=0.05; 95% CI=0.01–0.40). Conclusions: This study indicates that cognitive and functional problems require increased help with handling medicines. These results stress the need for ongoing vigilance of, and support for, people with this high-risk profile.
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| 35. |
- Westerbotn, Margareta, et al.
(författare)
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Pain reporting by very old Swedish community dwellers : the role of cognition and function
- 2008
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 20:1, s. 40-46
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Pain is a common and unpleasant problem among elderly people and affects the possibility for them to remain living in their own homes. The aims of this study were therefore to report the prevalence of pain reporting and pain treatment, and their association with functional and cognitive status in a very old population. Methods: Cross-sectional population-based study. Participants were 333, aged 84 years or older, living at home alone or with someone in Kungsholmen, in central Stockholm, Sweden. Information on pain was obtained from interviews. The Mini-Mental State Examination (MMSE) measured cognitive status and the index of basic Activities of Daily Living (ADL) functional status. Descriptive statistics were used to describe the population and logistic regression models to investigate factors associated with pain reporting and pain treatment. Results: The prevalence of pain was 46%, and the prevalence of pain treatment 71%. Results from logistic regression analysis including all variables in the model showed that pain reporting was not associated with age, gender or living conditions. However, pain reporting was correlated with cognitive and functional status. There was no association between pain treatment and age, gender, living conditions, cognitive or functional status. Conclusions: Pain is common among the oldest old. Our results indicate that cognitive and functional status affect pain reporting. Poor cognitive status was associated with less pain reporting, whereas poor functional status was associated with more pain reporting.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
- Andersson, Magdalena, et al.
(författare)
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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
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Ingår i: Aging clinical and experimental research. - 1720-8319. ; 19:3, s. 228-239
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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. (Aging Clin Exp Res 2007; 19: 228-239) ©2007, Editrice Kurtis
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| 40. |
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| 41. |
- Bergland, A, et al.
(författare)
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Predictors of falls in the elderly by location
- 2003
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Ingår i: Aging clinical and experimental research. - 1720-8319. ; 15:1, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: In the elderly, balance and walking impairments are assumed to play an important role in causing falls. We have assessed prospectively the predictive ability of health, function and balance variables regarding falls and their location. Methods: Falls which occurred during one year in a random sample of 307 women aged 75 years and over (mean 80.8 years, response rate 74.5%) living in the community were recorded and related to baseline registrations of health, medication and tests of walking and balance. Results: In all, 155 women (50.5%) reported 308 falls. Outdoor falls were significantly more frequent than indoor falls (57.5 vs 42.5%). The variables having had a fall before the start of the study, osteoporosis, hypertension, feeling depressed, unable to climb 40 cm high steps and walking slowly, all independently predicted a higher number of falls overall. Regarding fall location, having experienced a fall before study start was associated with more falls indoors as well as outdoors. Vision impairment, symptoms of depression, a faster comfortable walking speed, and being able to cope with higher steps were all independent predictors of more outdoor falls also after adjustment for outdoor exposure. A slower comfortable walking speed, a higher amplitude of the center of pressure movements in the frontal plane, a poorer score on the Timed Up & Go test, multi-morbidity, poor cognition and hypertension were independent risk factors for indoor falls. Neither number of drugs used nor any specific medication appeared as independent risk factors for falls in this study. Conclusions: The findings of this study suggest that risk factors for indoor and outdoor falls are different. Location of fall may be an important confounder in studies of predictors of falls in the elderly which should encompass this type of information.
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| 42. |
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| 43. |
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| 44. |
- Caap-Ahlgren, Marianne, et al.
(författare)
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Factors of importance to the caregiver burden experienced by family caregivers of Parkinson's disease patients
- 2002
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Ingår i: Aging clinical and experimental research. - 1720-8319. ; 14:5, s. 371-377
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Caregivers of Parkinson's disease patients are vulnerable to detrimental factors related to caregiving because of the progressive course of the disease. Studies of care-givers of these patients are scarce. The aim of this study was to examine the caregiver burden in Parkinson's disease by analyzing caregiver and patient-related factors. Methods: Every 3(rd) patient with Parkinson's disease registered at the outpatient clinic of the Neurology Department was invited to participate. One year after the first investigation, a follow-up was performed with a study of caregiver burden. A total of 65 caregivers took part. In-home interviews with patients and caregivers were performed. Assessments: a) caregiver burden, 22 items, comprising five indices: general strain, isolation, disappointment, emotional involvement, and environment; b) sense of coherence, 13 items, with the components comprehensibility, manageability and meaningfulness; c) depressive symptoms, using the Geriatric Depression Scale, 15 items; d) social contacts, 6 items; e) patient subjective health, assessed with the Parkinson's disease questionnaire, 39 items; and f) patient functional status. Results: Bivariate analyses showed significant correlations between caregiver burden and sense of coherence in caregivers, patient functional status, depressive symptoms in caregiver and patient, patient subjective health and time since diagnosis. Multivariate analysis showed depressive symptoms and sense of coherence in caregiver, and functional status in patient to be the most important variables for caregiver burden. Conclusions: To ease the caregiver burden, attention should be paid to patient functional status and caregivers depressive symptoms. The sense of coherence in caregivers is probably more difficult to influence. (C) 2002, Editrice Kurtis.
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| 45. |
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| 46. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(författare)
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Changes in the use of assistive devices among 90-year-old persons.
- 2005
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Ingår i: Aging clinical and experimental research. - 1594-0667. ; 17:3, s. 246-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: The growing numbers of elderly people are expected to lead to an increasing demand for assistive devices. The purpose of this study was to examine changes in the use of assistive devices over time and their relation to dependence in daily activities among 90-year-old persons living at home. METHODS: This retrospective longitudinal study examined the 90-year-old population at the ages of 85 and 90, and 195 persons participated. RESULTS: 92% of the 90-year-old population used assistive devices at the age of 90, compared with 74% at the age of 85. Between this interval, 19% became new users, 73% were permanent users, and 7% did not make any use of assistive devices. There was a significantly higher proportion of device-users among those who were dependent in both personal daily activities (PADL) and instrumental activities of daily living (IADL) (98.5%, p < 0.001) and among those who were dependent in IADL (94%, p < 0.001) compared with those who were independent in ADL (72%). At the age of 90, bathing and mobility devices were the most frequently used. Mobility devices such as walking-frames and wheel-chairs were the most widely distributed devices in this group. CONCLUSIONS: The use of assistive devices increases with age, very few 90-year-olds remain nonusers at age 90, and the multiple use of assistive devices at 90 years of age is very common. This complexity put great demands on health care services, and highly skilled professionals are needed to meet these demands.
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| 47. |
- Dehlin, Ove, et al.
(författare)
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Monochromatic phototherapy: effective treatment for grade II chronic pressure ulcers in elderly patients.
- 2007
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Ingår i: Aging clinical and experimental research. - 1720-8319. ; 19:6, s. 478-483
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Monochromatic pulsating light may have effects on wound healing. In an earlier study of grade II ulcers, there was a tendency toward better healing in the phototherapy group (p=0.06). The present study on patients with grade II ulcers was performed to verify these findings. Data from this study were pooled with data from the earlier study. METHODS: Ninety-four patients were offered participation in the new study and 76 patients were evaluated. They were pooled with 87 patients from the earlier study, bringing the total to 163. All patients were treated with monochromatic pulsating light or placebo over the ulcerated area, according to a specified program up to 12 weeks. RESULTS: The mean normalized reduction in pressure ulcer size at week 12 was 0.79 for the phototherapy group and 0.50 for the placebo group (95% confidence interval 0.01-0.53; p=0.039). No serious side-effects were noted. CONCLUSIONS: Monochromatic pulsating light accelerates healing in grade II pressure ulcers in elderly patients.
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| 48. |
- Dehlin, Ove, et al.
(författare)
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Monochromatic phototherapy in elderly patients: A new way of treating chronic pressure ulcers?
- 2003
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Ingår i: Aging clinical and experimental research. - 1720-8319. ; 15:3, s. 259-263
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Monochromatic pulsating light may have effects of importance for wound healing, and promising results were obtained in an open study on the healing of pressure ulcers, which motivated the present study. Methods: One hundred and sixty-four in- and outpatients with grade II and III ulcers were treated with monochromatic pulsating light or placebo over the ulcerated area, according to a specific therapeutic program. Results: No significant effects were observed in the total material. In a sub-analysis of grade II ulcers, there was a tendency toward better healing in the monochromatic light group (p=0.06). A significantly larger reduction in pressure ulcer size was noted among patients in the treatment group with low body weight (BMI<20). Conclusions: Monochromatic pulsating light may have effects on pressure ulcer healing, and a new study focusing only on grade II ulcers is under way. (C)2003, Editrice Kurtis
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| 49. |
- Gosman-Hedström, Gunilla, 1947, et al.
(författare)
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Gender perspective on informal care for elderly people one year after acute stroke.
- 2005
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Ingår i: Aging clinical and experimental research. - 1594-0667. ; 17:6, s. 479-85
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: The aim of the one-year follow-up was to evaluate formal care and the situation of informal caregivers from a gender perspective. METHODS: The present study targeted elderly persons (n = 147) living in their own homes 12 months after acute stroke, 94 women and 53 men. The median age of the women was 81 years and the men 80 years. RESULTS: A statistically significant gender difference was seen in living conditions. Eighty percent of the women were living alone compared with 28% of the men (CI 48-56%). The informal care given far exceeded that provided by the community: 65% of these elderly people had some kind of informal care and 44% received formal care from the community. There was a gender difference in daily informal personal care, 24% of men and 16% of women (CI 2-18%), and in daily informal household assistance (CI 15-43%). Formal care was provided by the community significantly more frequently to women (56%) than men (23%) (CI 21-45%). The women more frequently had community-based help with house-cleaning (CI 23-39%) and they also more frequently received help with personal care (CI 1-10%). CONCLUSIONS: This study showed statistically significant gender differences in the use of informal and formal care. Elderly caregivers' situations must be given greater attention, since informal care to stroke survivors represents a far greater burden than the care that is provided by the community. Most of the caregivers were elderly women, and preventive intervention measures should be developed in order to enable them to manage their everyday lives.
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| 50. |
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