| 1. |
- Amato, Bruno, et al.
(författare)
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Laparoscopic hepatectomy for HCC in elderly patients : risks and feasibility
- 2017
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 29:Suppl. 1, s. 179-183
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Tidskriftsartikel (refereegranskat)abstract
- Background: Laparoscopic liver resection (LLR) appears to be safe and effective as open liver resection (OLR) for hepatocellular carcinoma (HCC). However, studies comparing LLR with ORL in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of LLR versus OLR for HCC in elderly patients. Methods: A retrospective analysis was made comparing laparoscopic (n = 11) and open (n = 18) liver resections in elderly patients performed at the University of Naples “Federico II” between January 2010 and December 2014. Demographic data, operative and postoperative outcomes were analyzed. Results: Demographic and tumor characteristics of laparoscopic and OLRs were similar. There were also no significant differences in operating room time. Patients undergoing OLR had increased rate of minor complications (33 vs. 0%), longer lengths of stay (6 vs. 3 days) and higher blood loss (310 ± 84 vs. 198 ± 34 ml). There were no significant differences in major complication rates or 90-day mortality. Discussion: LLR is safe and feasible as OLR for treatment of HCC in selected elderly patients.
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| 2. |
- Aprea, Giovanni, et al.
(författare)
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Laparoscopic distal pancreatectomy in elderly patients : is it safe?
- 2017
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 29:Suppl. 1, s. 41-45
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Tidskriftsartikel (refereegranskat)abstract
- Background: Laparoscopic distal pancreatectomy (LDP) appears to be safe and effective as open distal pancreatectomy (ODP) for benign or borderline malignant lesion. However, studies comparing LDP with ODP in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of these two several approaches in elderly patients. Methods: A retrospective analysis was carried out by comparing laparoscopic (n = 7) and open (n = 15) distal pancreatectomy in elderly patients performed at the University of Naples “Federico II” and University of Perugia between January 2012 and December 2015. Demographic data, operative and postoperative outcomes were analyzed. Results: Demographic and tumor characteristics of laparoscopic and ODP were similar. There were also no significant differences in operating room time. Patients undergoing LDP had lower blood loss, first flatus time, diet start time and postoperative hospital stay. There were no significant differences in complication rates or 90-day mortality. Discussion: LDP is safe and feasible as ODP in selected elderly patients.
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| 3. |
- Blain, H., et al.
(författare)
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A comprehensive fracture prevention strategy in older adults : the European Union Geriatric Medicine Society (EUGMS) statement
- 2016
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:4, s. 797-803
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Tidskriftsartikel (refereegranskat)abstract
- Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
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| 4. |
- Bruyere, Olivier, et al.
(författare)
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How clinical practitioners assess frailty in their daily practice : an international survey
- 2017
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Ingår i: Aging Clinical and Experimental Research. - : SPRINGER. - 1594-0667 .- 1720-8319. ; 29:5, s. 905-912
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Various operational definitions have been proposed to assess the frailty condition among older individuals. Our objective was to assess how practitioners measure the geriatric syndrome of frailty in their daily routine.Methods: An online survey was sent to national geriatric societies affiliated to the European Union Geriatric Medicine Society (EUGMS) and to members of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).Results: A total of 388 clinicians from 44 countries answered to the survey. Most of them were medical doctors (93%), and their primary field of practice was geriatrics (83%). Two hundred and five clinicians (52.8%) always assessed frailty in their daily practice, 38.1% reported to "sometimes" measure it, and 9.1% never assess it. A substantial proportion of clinicians (64.9%) diagnose frailty using more than one instrument. The most widely used tool was the gait speed test, adopted by 43.8% of the clinicians, followed by clinical frailty scale (34.3%), the SPPB test (30.2%), the frailty phenotype (26.8%) and the frailty index (16.8%).Conclusion: A variety of tools is used to assess frailty of older patients in clinical practice highlighting the need for standardisation and guidelines.
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| 5. |
- Elavsky, Steriani, et al.
(författare)
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Behavioral correlates of depressive symptoms in older unlike-sex twin-pairs
- 2013
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 25:3, s. 257-264
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: This study examines gender-specific behavioral correlates of depressive symptoms using a secondary data analysis of a cross-sectional, population-based sample of older unlike-sex twins.Methods: Unlike-sex twins aged 69–88 were identified through a national Swedish registry and sent a survey about health, including depressive symptoms (CES-D) and the frequency of engaging in physical, social and mental activities. A total of 605 complete twin pairs responded.Results: Depressive symptom scores were associated with frequency of engagement in physical and mental activities, but only in men. No statistically significant associations with depressive symptom scores for any of the three types of activities were found in women.Conclusions: The results suggest that engaging in physical and mental activities may protect older men from developing depressive symptoms, but longitudinal data are needed to offer more conclusive findings on the role that physical, mental, and social activities play in the maintenance of psychological health in older men and women.
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| 6. |
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| 7. |
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| 8. |
- Elmståhl, Sölve, et al.
(författare)
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The association between medical diagnosis and caregiver burden : a cross-sectional study of recipients of informal support and caregivers from the general population study ‘Good Aging in Skåne’, Sweden
- 2018
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 30:9, s. 1023-1032
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Tidskriftsartikel (refereegranskat)abstract
- Background: Different kinds of chronic diseases might imply different dimensions of caregiver burden, not previously described among the caregivers to recipients from the general elder population. Aim: The main objective was to examine differences in burden between the 343 caregivers to persons with different diagnoses. Methods: A group of elderly recipients of informal care (n = 343) from the general population study ‘Good Aging in Skåne’ (GÅS) Sweden, were divided into five diagnostic groups: dementia (n = 90), heart and lung diseases (n = 48), stroke (n = 62), fractures (n = 66), depression (n = 40) and the group “other”, consisting of different diagnoses (n = 37) according to ICD-10. Differences in burden were analyzed using the Caregiver Burden Scale (CBS), a 22-item scale consisting of five dimensions: general strain, isolation, disappointment, emotional involvement and environmental burden. A total burden index comprises the mean of all the 22 items and a higher score indicates a higher burden. Results: The most common diagnosis associated to caregiving was dementia and fracture and the median hours weekly for informal support with instrumental ADL for the five diagnostic groups ranged from 7 to 45 h for spouses and from 4 to 7 h for parents. The highest proportion of caregivers scoring high total burden was seen among recipients with dementia (50%) and depression (38%); the OR for high total burden for the dementia group was 4.26 (2.29–7.92) and depression group 2.38 (1.08–5.24) adjusted for covariates like age, gender and ADL and these two groups had higher self-perception of burden in all the dimensions, especially the dimension’s emotional burden and strain. Conclusion: Informal support constitutes a substantial time for instrumental ADL for the diseased elders. Caregivers to persons with dementia and depression experience high burden.
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| 9. |
- Fagerström, Cecilia, et al.
(författare)
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Mobility, functional ability and health-related quality of life among people 60 years and older
- 2010
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Ingår i: Aging Clinical and Experimental Research. - : Editrice Kurtis. - 1594-0667 .- 1720-8319. ; 22:5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge about Health-Related Quality of Life (HRQoL) in advanced age is sparse. This study investigated to what extent mobility factors explained older people’s HRQoL when age, gender and functional ability (ADL) were controlled for. Methods: Subjects were 1128 people aged 60-96 participating in a Swedish longitudinal multi-center cohort study. Besides descriptive and correlation statistics, a three-tier multiple logistic regression analysis was performed, which included the ADL scale, mobility tests and items, with physical and mental HRQoL as outcome variables. Results: In the models containing the control variables, functional ability was found to be associated with both physical and mental HRQoL. In the models including both functional ability and mobility factors, the importance of functional ability remained for mental but not for physical HRQoL. The mobility factors were found to have a stronger negative influence on HRQoL, i.e., physical and mental, than functional ability in itself. Conclusions: For optimal identification of various types of disabilities and their impact on older people’s HRQoL, the ADL scale should be used together with more targetspecific tests of disabilities. However, in certain situations, it appears that one mobility factor alone – the ability to walk – has the capacity to pick up changes in both physical and mental HRQoL. Thus, it is important that healthcare professionals should focus activities toward maintaining older people’s mobility as a means of enhancing their HRQoL.
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| 10. |
- Grönstedt, Helena, et al.
(författare)
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Functional level, physical activity and wellbeing in nursing home residents in three Nordic countries
- 2011
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 23:5-6, s. 413-420
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to describe physical and cognitive function and wellbeing among nursing home residents in three Nordic countries. A second aim was to compare groups of different age, level of dependency in daily life activities (ADL), degree of fall-related self-efficacy, wellbeing and cognitive function. Methods: 322 residents from nursing homes in Sweden, Norway and Denmark were included. Physical and cognitive function, level of physical activity and wellbeing were assessed by means of reliable and valid instruments. Results: The mean age of the participants was 85 years. Sixty percent could rise from a chair and 64% could walk independently. Men were younger and more physically active than women. Participants with a high level of dependency in ADL had a lower physical and cognitive function, were less physically active and had a lower fall-related self-efficacy than others. Participants with a low level of cognitive function showed a high fall-related self-efficacy. Conclusion: These data demonstrate that elderly residents in nursing homes in Sweden, Norway and Denmark are frail but heterogeneous. Significant differences in physical activity, physical function and dependency in ADL were seen in relation to age, fall-related self-efficacy, wellbeing and cognitive function.
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| 11. |
- Haak, Maria, et al.
(författare)
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The influence of participation on mortality in very old age among community-living people in Sweden
- 2019
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 31:2, s. 265-271
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Tidskriftsartikel (refereegranskat)abstract
- Background: Participation in everyday life and society is generally seen as essential for health-related outcomes and acknowledged to affect older people’s well-being. Aims: To investigate if aspects of performance- and togetherness-related participation influence on mortality among very old single living people in Sweden. Methods: ENABLE-AGE Survey Study data involving single-living participants in Sweden (N = 314, aged 81–91 years), followed over 10 years were used. Multivariate Cox regression models adjusted for demographic and health-related variables were used to analyse specific items influencing mortality. Results: Participation in performance- or togetherness-oriented activities was found to significantly influence mortality [HR 0.62 (0.44–0.88), P value 0.006, and HR 0.72 (0.53–0.97), P value 0.031, respectively]. Talking to neighbours and following local politics had a protective effect on mortality, speaking to relatives on the phone (CI 1.10–2.02) and performing leisure activities together with others (CI 1.10–2.00) had the opposite influence. That is, those performing the latter activities were significantly more likely to die earlier. Discussion: The main contribution of this study is the facet of the results showing that aspects of performance- and togetherness-related participation have a protective effect on mortality in very old age. This is important knowledge for designing health promotion and preventive efforts for the ageing population. Moreover, it constitutes a contribution to the development of instruments capturing aspects of participation influencing on mortality. Conclusion: In the development of health promotion and preventive efforts the inclusion of participation facets could be considered in favour of potential positive influences on longevity.
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| 12. |
- Heikkinen, E., et al.
(författare)
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Survival and its predictors from age 75 to 85 in men and women belonging to cohorts with marked survival differences to age 75: a comparative study in three Nordic populations
- 2016
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:3, s. 541-550
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims While predictors of survival in older people have been examined in depth in a large number of studies, a literature search revealed no cross-national comparative prospective cohort studies on this issue. This study investigated survival and its predictors from age 75 to 85 among three local Nordic populations using survival data on national cohorts as background information. Methods The data were derived from national registers and from samples of 75-year old living in Denmark, Sweden, and Finland. The subjects were invited to take part in interviews and examinations focusing on different domains of health, functional capacity, and physical and social activities. Results The proportion of survivors to age 75 was markedly smaller among the Finnish men and women than Danish or Swedish subjects. In the local population no marked differences in survival from age 75 to 85 were observed between the groups of men, while women survived longer than men and longer in Goteborg than in Glostrup or Jyvaskyla. Univariate models revealed 12 predictors of survival. In the multivariate models, the significant predictors among men related to physical fitness, whereas among women they pertained to social activities and morbidity. Conclusions Despite great differences in the proportions of survivors to age 75, and excepting the survival advantage of women, only minor differences were present in the subjects' further survival to age 85. In the univariate analyses, many of the factors predictive of survival from age 75 to 85 were the same in the examined populations, whereas in the multivariate analyses differences between the sexes emerged.
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| 13. |
- Hägglund, Patricia, et al.
(författare)
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Swallowing dysfunction as risk factor for undernutrition in older people admitted to Swedish short-term care : a cross-sectional study
- 2019
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 31:1, s. 85-94
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Swallowing dysfunction and risk of undernutrition increase the risk of pneumonia, morbidity, and mortality. Short-term care is an unexplored care context, where many older people stay yearly.AIM: This cross-sectional study aimed to describe and analyze the relationship between swallowing dysfunction and risk of undernutrition among older people in short-term care, including potential gender-related differences.METHODS: In total, 391 people (209 women), aged ≥ 65 years (median age 84 years) and admitted to short-term care in five Swedish counties participated. They went through a timed water swallow test to assess swallowing dysfunction, including abnormal swallowing capacity and signs of aspiration (i.e., cough and voice change). Risk for undernutrition was assessed using the Minimal Eating Observation and Nutrition Form-version II.RESULTS: Swallowing dysfunction was observed in 248 of 385 (63%) participants, including abnormal swallowing capacity in 213 of 385 (55%) and aspiration signs in 127 of 377 (34%). Abnormal swallowing capacity was more frequent among women (p = 0.030), whereas men with normal swallowing capacity exhibited signs of aspiration more frequently (cough p = 0.038, voice change p = 0.004). Risk of undernutrition was found in 91 of 390 (23%) participants, more frequently among women (p = 0.007). A logistic regression model revealed an increased risk of undernutrition among older people with abnormal swallowing capacity (OR 1.74, 95% CI 1.04-2.92, p = 0.034).CONCLUSIONS: The high prevalence of swallowing dysfunction and risk of undernutrition highlight the need for a systematic screening program and feasible treatment to improve swallowing function for adequate and safe food intake among older people in short-term care.CLINICAL TRIAL REGISTRATION: This study was registered with ClinicalTrials.gov on July 4, 2016, under NCT02825927.
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| 14. |
- Kollén, Lena, 1960-, et al.
(författare)
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Benign paroxysmal positional vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds
- 2012
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Ingår i: Aging Clinical and Experimental Research. - New York, USA : Springer. - 1594-0667 .- 1720-8319. ; 24:4, s. 317-323
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Studies have shown that 65% of people with dizziness may have a vestibular etiologic diagnosis, possibly benign paroxysmal positional vertigo (BPPV). The diagnosis of BPPV is based on medical history and findings after the Dix-Hallpike test. It is sometimes difficult to perform the Dix-Hallpike test in elderly persons, due to the limited range of motion when extending the neck. In this study, we used a side-lying test to stimulate the posterior semicircular canal, while the head and neck were fully supported on the examination table. The aims of this study were to investigate the prevalence of dizziness and/or impaired balance and BPPV in a population of 75-year-olds by means of a questionnaire and clinical tests, and to compare elderly persons with and without BPPV.Methods: A representative population sample of 675 persons completed a questionnaire about dizziness and 571 persons underwent side-lying, static balance and dynamic walking tests.Results: Subjective dizziness and/or impaired balance were found in 36% of subjects, especially when walking outdoors. A significant gender difference was found, with a higher prevalence in women (40%) compared with men (30%) (p<0.01). BPPV was found in 11% and was significantly more common in women (p<0.01). Elderly individuals with BPPV also displayed significantly impaired balance in static and dynamic balance tests compared with persons without BPPV (p<0.01). Persons with BPPV reported significantly more subjective problems with dizziness and balance compared with persons without BPPV (p<0.001).Conclusions: Subjective and objective unsteadiness, dizziness and BPPV are common in the elderly.
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| 15. |
- Kollén, Lena, 1960-, et al.
(författare)
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Physical functioning in older persons with dizziness : a population-based study
- 2017
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 29:2, s. 197-205
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dizziness is one of the most prevalent symptoms in old age and tends to increase with age.Aims: To report physical functioning, health-related aspects and gender differences in elderly persons with and without dizziness in a population-based sample of 75-year-olds.Methods: A cross-sectional sample of 75-year-olds from Gothenburg, Sweden (n = 675, 398 women and 277 men) was examined by means of questionnaires and functional tests. The questions concerned dizziness/imbalance, physical activity level, walking habits, falls efficacy, number of falls, subjective health or general fatigue and medication. The tests included were self-selected and maximum gait speed, stair climbing capacity, one leg stance and grip strength.Results: More women than men reported dizziness/imbalance (40 vs 30 %, p < 0.001). Persons with dizziness, compared to those without dizziness, less often regularly exercised at a moderate intensity level (summer: 62 vs 74 %, p < 0.001; winter: 41 vs 51 %, p < 0.001), less often took a daily walk (p < 0.05), had lower scores on the FES(S) (p < 0.001), more often reported general fatigue (p < 0.001), more often had fallen in the previous year (40 vs 23 %, p < 0.001) and had a higher intake of medical drugs (4.6 vs 3.3, p < 0.001). They also performed worse regarding gait speed, stair climbing and one leg stance (p < 0.001), but there was no difference in grip strength.Conclusion: Older persons with dizziness are less physically active, have worse lower extremity function, are more often fallers and report lower self-rated health than persons without dizziness.
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| 16. |
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| 17. |
- Lagergren, Mårten, et al.
(författare)
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Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden
- 2016
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:1, s. 147-158
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Tidskriftsartikel (refereegranskat)abstract
- The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontal target efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001-2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70-90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40-50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern-it was almost 100 % in all areas for IADL dependency, but only 50-60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.
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| 18. |
- Liberman, Keliane, et al.
(författare)
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Thirteen weeks of supplementation of vitamin D and leucine-enriched whey protein nutritional supplement attenuates chronic low-grade inflammation in sarcopenic older adults : the PROVIDE study
- 2019
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Ingår i: Aging Clinical and Experimental Research. - : SPRINGER. - 1594-0667 .- 1720-8319. ; 31:6, s. 845-854
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Tidskriftsartikel (refereegranskat)abstract
- Background A chronic low-grade infammatory profle (CLIP) is associated with sarcopenia in older adults. Protein and Vitamin (Vit)D have immune-modulatory potential, but evidence for efects of nutritional supplementation on CLIP is limited. Aim To investigate whether 13 weeks of nutritional supplementation of VitD and leucine-enriched whey protein afected CLIP in subjects enrolled in the PROVIDE-study, as a secondary analysis. Methods Sarcopenic adults (low skeletal muscle mass) aged ≥ 65 years with mobility limitations (Short Physical Performance Battery 4–9) and a body mass index of 20–30 kg/m2 were randomly allocated to two daily servings of active (n=137, including 20 g of whey protein, 3 g of leucine and 800 IU VitD) or isocaloric control product (n=151) for a double-blind period of 13 weeks. At baseline and after 13 weeks, circulating interleukin (IL)-8, IL-1 receptor antagonist (RA), soluble tumor-necrosis-factor receptor (sTNFR)1, IL-6, high-sensitivity C-reactive protein, pre-albumin and 25-hydroxyvitamin(OH) D were measured. Data-analysis included repeated measures analysis of covariance (corrected for dietary VitD intake) and linear regression. Results IL-6 and IL-1Ra serum levels showed overall increases after 13 weeks (p=0.006 and p<0.001, respectively). For IL-6 a signifcant time × treatment interaction (p=0.046) was observed, with no signifcant change over time in the active group (p=0.155) compared to control (signifcant increase p=0.012). IL-8 showed an overall signifcant decrease (p=0.03). The change in pre-albumin was a signifcant predictor for changes in IL-6 after 13 weeks. Conclusions We conclude that 13 weeks of nutritional supplementation with VitD and leucine-enriched whey protein may attenuate the progression of CLIP in older sarcopenic persons with mobility limitations.
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| 19. |
- Ljungqvist, Olle, 1954-, et al.
(författare)
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Enhanced recovery after surgery-ERAS-principles, practice and feasibility in the elderly
- 2018
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 30:3, s. 249-252
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Forskningsöversikt (refereegranskat)abstract
- This is a short overview of the principles of a novel development in surgery called enhanced recovery after surgery (ERAS) programs. This is an evidence-based approach to perioperative care that has shown to reduce complications and recovery time by 30-50%. The main mechanism is reduction of the stress reactions to the operation. These principles have been shown to be particularly well suited for the compromised patient and hence very good for the elderly people who often have co-morbidities and run a higher risk of complications.
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| 20. |
- Mazya, Amelie Lindh, et al.
(författare)
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Outpatient comprehensive geriatric assessment : effects on frailty and mortality in old people with multimorbidity and high health care utilization
- 2019
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Ingår i: Aging clinical and experimental research. - Milan, Italy : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 31:4, s. 519-525
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multimorbidity and frailty are often associated and Comprehensive Geriatric Assessment (CGA) is considered the gold standard of care for these patients. Aims: This study aimed to evaluate the effect of outpatient Comprehensive Geriatric Assessment (CGA) on frailty in community-dwelling older people with multimorbidity and high health care utilization. Methods: The Ambulatory Geriatric Assessment—Frailty Intervention Trial (AGe-FIT) was a randomized controlled trial (intervention group, n = 208, control group n = 174) with a follow-up period of 24 months. Frailty was a secondary outcome. Inclusion criteria were: age ≥ 75 years, ≥ 3 current diagnoses per ICD-10, and ≥ 3 inpatient admissions during 12 months prior to study inclusion. The intervention group received CGA-based care and tailored interventions by a multidisciplinary team in an Ambulatory Geriatric Unit, in addition to usual care. The control group received usual care. Frailty was measured with the Cardiovascular Health Study (CHS) criteria. At 24 months, frail and deceased participants were combined in the analysis. Results: Ninety percent of the population were frail or pre-frail at baseline. After 24 months, there was a significant smaller proportion of frail and deceased (p = 0.002) and a significant higher proportion of pre-frail patients in the intervention group (p = 0.004). Mortality was high, 18% in the intervention group and 26% in the control group. Conclusion: Outpatient CGA may delay the progression of frailty and may contribute to the improvement of frail patients in older persons with multimorbidity.
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| 21. |
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| 22. |
- McKee, Kevin
(författare)
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Frailty falls and the Body Drop
- 2011
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 23:Suppl. 1, s. 80-
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Tidskriftsartikel (refereegranskat)
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| 23. |
- Obermeyer, Sven, et al.
(författare)
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Learning to recognize younger faces at an older age
- 2017
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 29:2, s. 191-196
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Processing of horizontal face cues has been shown to be an important element in face recognition of adults aged up to 30 years. In contrast, horizontally aligned facial features do not appear to contribute to older adults’ (60–75 years) recognition in a similar way. To this end, we investigated potential learning effects on the ability to recognize faces based on horizontal features. Previous research suggests face recognition based on all face information experiences an accelerated decline after the age of 70. However, recognition based only on horizontal face information has not yet been studied in old age (75+ years of age). Thus, we investigated whether older adults (aged up to as well as starting at 75 years) can learn to recognize faces based on horizontal face cues alone.Method: One younger and two older adult groups (20–30, 60–75, and 75+ years) were familiarized with a high and a low amount of previously unfamiliar faces—some containing all face cues and others containing only horizontal face cues (reduced information). Subsequently, all groups received a recognition test.Results: Repeated learning increased natural face recognition for all three age groups when all face cues were available. However, increases in face recognition were only observed for younger adults when horizontal face cued were only available.Discussion: The importance of horizontally aligned spatial frequencies for recognizing human faces is lessened before the age of 60 (and plateaus thereon), whereas recognition of stimuli containing all face cues is still capable of improvement.
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| 24. |
- Pauelsen, Mascha, et al.
(författare)
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Both psychological factors and physical performance are associated with fall-related concerns
- 2018
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 30:9, s. 1079-1085
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Tidskriftsartikel (refereegranskat)abstract
- Background Fall-related concern strongly correlates to activity avoidance in older people. In this complex phenomenon, different terminology and instruments are often used interchangeably. Three main concepts make up fall-related concerns: fear-of-falling, consequence concern, and falls self-efficacy. It is suggested that fall-related concerns are mediated by psychological and physical factors.Aims Our aims were to describe the prevalence of fall-related concerns and find explanatory factors for its most studied concept – falls self-efficacy – in an older population.Methods We executed a cross sectional study on a random sample of 153 community dwelling older people (70 years or older). We used validated and reliable instruments as well as structured interviews to gather data on the three concepts of fall-related concerns and possible mediating factors. We then calculated descriptive statistics on prevalence and regression models for the total group, and men and women separately.Results 70% of the total sample (80% of women and 53% of men) reported at least one of the three concepts of fall-related concern. For the total sample, fear-of-falling, morale and physical performance were associated factors with falls self-efficacy. For women, number of prescription medications was added. For men, physical performance and concerns for injury were associated.Conclusion Fall-related concern is prevalent in large proportions with higher prevalence for women than for men. Important factors are fear of falling, morale, and physical performance. Gender differences in the emergence and variance of fall-related concern and the relation between physical performance and fall-related concern should be targeted in future research endeavors.
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| 25. |
- Polistena, Andrea, et al.
(författare)
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Surgical treatment of secondary hyperparathyroidism in elderly patients : an institutional experience
- 2017
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 29:suppl. 1, s. 23-28
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Tidskriftsartikel (refereegranskat)abstract
- Background: Secondary hyperparathyroidism in elderly fragile patients presents clinical difficulties due to severity of symptoms and related comorbidity. The optimal surgical approach for this group of patients is still debated. Aim: The aim of the study was to define the optimal technique of parathyroidectomy in elderly patients with secondary hyperparathyroidism. Methods: Retrospective analysis in a series of 253 patients including 35 elderly individuals at a single institution was carried out. Postoperative parathyroid hormone decrease, surgical complications and symptoms control were analyzed for all patients in relation to the types of parathyroidectomy performed. Results: In elderly patients, total parathyroidectomy was the most used approach. Subtotal parathyroidectomy was mostly reserved for younger patients suitable for kidney transplantation. No elderly patients treated with total parathyroidectomy were autotransplanted. No significant difference in surgical complications was observed between younger and elderly patients and considering the different procedures. Adequate symptom control after surgery was achieved in almost 90% of patients. A limited rate of recurrence requiring repeat surgery was observed only after subtotal parathyroidectomy. Discussion: Considering the features of all types of parathyroidectomy, very low recurrence rate, contained postoperative hypocalcemia and limited complications following total parathyroidectomy, might represent specific advantages for elderly patients. Conclusions: Total parathyroidectomy without parathyroid transplantation is safe for elderly patients with secondary hyperparathyroidism and a good alternative to the well-established total parathyroidectomy with autografting.
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| 26. |
- Rydwik, Elisabeth, et al.
(författare)
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Effects of physical training on aerobic capacity in frail elderly people (75+ years). Influence of lung capacity, cardiovascular disease and medical drug treatment : a randomized controlled pilot trial
- 2010
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 22:1, s. 85-94
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Frail elderly people often suffer from a combination of unintentional weight loss and/or low body mass index, as well as a low physical activity level. No studies have investigated the effect of physical training alone or in combination with nutritional intervention on aerobic capacity in frail elderly people. The aim of this pilot study was to determine if a physical training program can affect aerobic capacity in frail elderly people.METHODS: Ninety-six community-dwelling frail elderly people (58 women) were included in the study. Subjects were randomized to four different groups: i) 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 aerobic capacity, leg muscle strength, spirometry, heart disease and cardiovascular drugs. Aerobic capacity and leg muscle strength were analyzed immediately after the 3-month intervention period (1st follow-up), and after another 6 months (2nd follow-up).RESULTS: Subjects mean age was 83 years. The mean compliance rate with the physical training program was 65%. There were no observed effects on aerobic capacity measured as maximal workload, or work time, with or without beta-receptor blockade. Subjects in the training groups without lung disease significantly increased maximal work time when compared with subjects with lung disease. Physical training significantly increased lower extremity muscle strength compared with nutrition alone at the 1st follow-up. No serious adverse events occurred during assessment or physical training.CONCLUSIONS: Further studies with larger sample sizes and a more specific aerobic component in the training program are necessary before any further conclusions can be drawn.
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| 27. |
- Schön, Pär, 1971-, et al.
(författare)
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Gender differences in associations between ADL and other health indicators in 1992 and 2002
- 2011
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 23:2, s. 91-98
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Research has shown increased prevalence rates over time in several health indicators in the older population. These increases have not been accompanied by corresponding increases in ADL and IADL disability. Given that disability and other health indicators follow different trends, the associations between them may change. Since both health and disability appear to follow different trends for men and women, we can also expect gender differences in the associations. We examined gender differences in how objective tests of function as well as self-reported health and function indicators were associated with ADL/IADL in 1992 and 2002.Methods: Data were from the Swedish Panel Study of Living Conditions among the Oldest Old (SWEOLD), a nationally representative interview survey of persons aged 77+.Results: Compared to men, women had significantly higher prevalence rates for most health indicators both survey years, but there were no significant gender differences in ADL/IADL limitations. Prevalence rates increased significantly between 1992 and 2002 for all health indicators, but not for ADL/IADL. Most of the associations between ADL/IADL and other health indicators were stronger for men than for women. The overall pattern was that associations have become weaker for women over time; for men, the picture was mixed.Conclusions: The changing associations between ADL/IADL and other health indicators may reflect a complex interplay between changes in a range of social and environmental factors, some of which may be modifiable. ADL/IADL appear to reflect different dimensions of health and different kinds of needs for men and women.
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| 28. |
- Toebes, Marcel, et al.
(författare)
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Measurement strategy and statistical power in studies assessing gait stability and variability in older adults
- 2016
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:2, s. 257-265
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gait variability and stability measures might be useful to assess gait quality changes after fall prevention programs. However, reliability of these measures appears limited.Aims: The objective of the present study was to assess the effects of measurement strategy in terms of numbers of subjects, measurement days and measurements per day on the power to detect relevant changes in gait variability and stability between conditions among healthy elderly.Methods: Sixteen healthy older participants (65.6 (SD 5.9) years), performed two walking trials on each of two days. Required numbers of subjects to obtain sufficient statistical power for comparisons between conditions within subjects (paired, repeated-measures designs) were calculated (with confidence intervals) for several gait measures and for different numbers of trials per day and for different numbers of measurement days.Results: The numbers of subjects required to obtain sufficient statistical power in studies collecting data from one trial on one day in each of the two compared conditions ranged from 7-13 for large differences but highly correlated data between conditions, up to 78-192 for data with a small effect and low correlation.Discussion: Low correlations between gait parameters in different conditions can be assumed and relatively small effects appear clinically meaningful. This implies that large numbers of subjects are generally needed.Conclusion: This study provides the analysis tools and underlying data for power analyses in studies using gait parameters as an outcome of interventions aiming to reduce fall risk.
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| 29. |
- Welmer, Anna-Karin, 1976-, et al.
(författare)
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Can chronic multimorbidity explain the age-related differences in strength, speed and balance in older adults?
- 2012
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 24:5, s. 480-489
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: It is known that physical performance declines with age in general, however there remains much to be understood in terms of age-related differences amongst older adults across a variety of physical components (such as speed, strength and balance), and particularly in terms of the role played by multimorbidity of chronic diseases. We aimed to detect the age-related differences across four components of physical performance and to explore to what extent chronic diseases and multimorbidity may explain such differences.Methods: We analyzed cross-sectional data from a population-based sample of 3323 people, aged 60 years and older from the SNAC-K study, Stockholm, Sweden. Physical performance was assessed by trained nurses using several tests (grip strength, walking speed, balance and chair stands). Clinical diagnoses were made by the examining physician based on clinical history and examination.Results: Censored normal regression analyses showed that the 72- 90+ year-old persons had 17-40% worse grip strength, 44-86% worse balance, 30-86% worse chair stand score, and 21-59% worse walking speed, compared with the 60-66 year-old persons. Chronic diseases were strongly associated with physical impairment, and this association was particularly strong among the younger men. However, chronic diseases explained only some of the age-related differences in physical performance. When controlling for chronic diseases in the analyses, the age-related differences in physical performance changed 1-11 percent.Conclusion: In spite of the strong association between multimorbidity and physical impairment, chronic morbidities explained only a small part of the age-related differences in physical performance.
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| 30. |
- Welmer, Anna-Karin, et al.
(författare)
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Impact of tooth loss on walking speed decline over time in older adults : a population-based cohort study
- 2017
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 29:4, s. 793-800
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTooth loss has been linked to poor health such as chronic diseases and mobility limitations. Prospective evidence on the association between tooth loss and walking speed decline is however lacking.AimsTo examine the impact of tooth loss on walking speed over time and explore whether inflammation may account for this association.MethodsThis study included 2695 persons aged 60 years and older, who were free from severe mobility limitation at baseline. Information on dental status was assessed through self-report during the nurse interview at baseline. Walking speed baseline and at 3- and 6-year follow-ups was assessed when participants walked at their usual pace. Covariates included age, sex, education, lifestyle-related factors, and chronic diseases. Blood samples were taken, and C-reactive protein (CRP) was tested.ResultsAt baseline, 389 (13.1 %) participants had partial tooth loss and 204 (6.9 %) had complete tooth loss. Mixed-effects models showed that tooth loss was associated with a greater decline in walking speed over time after adjustment for lifestyle-related factors and chronic diseases (p = 0.001 for interaction between time and tooth loss on walking speed decline); however, when further adjusting for inflammation (CRP), the association was attenuated and no longer significant.ConclusionTooth loss was associated with an accelerated decline in walking speed in older adults. Inflammation may play a role in the association between tooth loss and walking speed decline.
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| 31. |
- Werner, Karin, et al.
(författare)
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Cystatin C and creatinine-based eGFR levels and their correlation to long-term morbidity and mortality in older adults
- 2019
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 31:10, s. 1461-1469
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevailing diagnostic criteria for CKD are age-independent, but have been challenged in light of the eGFR decline associated with normal aging. The stages of CKD communicate magnitude of risk of ESRD, cardiovascular morbidity, and mortality. Aims: This study aims to provide more insight into the morbidity and mortality associated with eGFR levels corresponding to the current CKD stages in older adults. Methods: The 2931 older adults in the Good Aging in Skåne study were randomized from the general population. The exposure variable used was eGFR level (CKD-EPI based on creatinine and cystatin C) with eGFR 60–89 mL/min/1.73 m2 as a reference; the outcomes were mortality, acute cardiovascular disease, congestive heart failure, and rapid kidney function decline (RKFD; defined as a decline in eGFR by 3 mL/min/1.73 m2 per year or more). Results: The mean age at baseline was 73 (SD 11) and mean follow-up time 11 (SD 5) years. Mortality was higher at lower eGFR levels with adjusted HR (95% CI) being 1.58 (1.34–1.88), 1.22 (1.05–1.41), 1 (reference), and 0.90 (0.67–1.21) for eGFR < 45, 45–59, 60–89 and ≥ 90 mL/min/1.73 m2, respectively. For acute CVD the adjusted HR (95% CI) were 1.23 (0.81–1.87), 1.21 (0.87–1.69), 1 (reference), and 0.53 (0.28–1.00) for the same eGFR levels. Conclusions: This study confirms that mortality in older adults increases with decreasing eGFR at eGFR levels below today’s threshold for CKD. The correlation was less certain for lower eGFR and incident cardiovascular disease.
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| 32. |
- Westerlind, Björn, 1961-, et al.
(författare)
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Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents : a longitudinal cohort study
- 2019
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 31:8, s. 1078-1095
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundFalls and related injuries are common among older people, and several drug classes are considered to increase fall risk.AimsThis study aimed to investigate the association between the use of certain drug classes and falls in older nursing home residents in Sweden, and relate these to different age groups.MethodsInformation on falls that occurred in the previous year and regular use of possible fall risk drugs including non-benzodiazepine hypnotics (zopiclone and zolpidem) was collected from 331 nursing home residents during 2008–2011. Over the following 6 months, the occurrence of serious falls, requiring a physician visit or hospital care, was registered. Association between serious falls and drug use was compared between an older (≥ 85 years) and a younger group.ResultsAn increased fall risk (Downton Fall Risk Index ≥ 3) was found in 93% of the study subjects (aged 65–101 years). Baseline data indicated an association between falls that occurred in the previous year and regular use of non-benzodiazepine hypnotics (p = 0.005), but not with the other studied drug classes. During the following 6 months, an association between use of non-benzodiazepine hypnotics and serious falls in the older group (p = 0.017, odds ratio 4.311) was found. No association was found between the other studied drug classes and serious falls.DiscussionThese results indicate an association between falls and the use of non-benzodiazepine hypnotics, compounds that previously have been considered generally well-tolerated in older people.ConclusionsCaution is advocated when using non-benzodiazepine hypnotics regularly in older people living in nursing homes.
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| 33. |
- Windhaber, Thomas, et al.
(författare)
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Educational strategies to train health care professionals across the education continuum on the process of frailty prevention and frailty management : a systematic review
- 2018
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 30:12, s. 1409-1415
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Forskningsöversikt (refereegranskat)abstract
- Background In addition to the normal process of ageing, frailty, defined as a geriatric syndrome, is becoming more prevalent. Around 10% of people over 65years and 25-50% of those aged over 85years are frail. Frail elderly are more vulnerable to external stressors and have an increased risk of adverse health outcomes. To tackle these challenges, European Union (EU) member states need to develop a health work force capable of the right skills mix. A goal-centred education and training of professionals is crucial for effective and efficient health care delivery for Europe's greying population.Aims The aim of this study was to systematically collect, review and critically appraise studies carried out to investigate the efficacy and effectiveness of comprehensive educational programmes for health professionals related to frailty prevention and/or frailty management.Methods A systematic review was carried out searching the databases PubMed, CINAHL, Cochrane CENTRAL, Medline, Up to date and Embase. Additionally, a manual search of the reference lists and searches via Google Scholar and greylit.org was done.Results No relevant publications addressing the evidence and sustainability of educational/training programmes for frailty prevention and/or frailty management were identified.Discussion The result of an empty review is surprising because several educational programmes in different countries are currently run.Conclusions A significant knowledge gap exists in the scientific literature regarding education and training of health care workers regarding prevention and management of frailty. Further research is needed to identify effective educational strategies for health professionals to prevent and manage frailty.
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| 34. |
- Benzinger, P., et al.
(författare)
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The association between the home environment and physical activity in community-dwelling older adults
- 2014
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1720-8319. ; 26:4, s. 377-385
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity (PA) decreases with increasing age despite the fact that PA exerts beneficial effects on many age-related diseases and conditions. Consequently, there is an interest in modifiable factors that may influence PA among older persons. The purpose of this study was to examine the association between PA and the home environment in wellfunctioning older community-dwelling persons. Method This study used a person-environment (P-E) fit perspective to the home environment, operationalized by means of assessment of functional limitations in 81 community- dwelling persons (median age 79 years) as well as environmental barriers in their home environments and the nearby exterior surroundings. The interaction between functional limitations and environmental barriers generated a score expressing the magnitude of P-E fit problems in their home environment. PA was rated with a questionnaire covering household-related and recreational activities. Results We found a significant association between PA and the magnitude of P-E fit problems that explained 3.9 % of the variance of PA. The number of environmental barriers per se was not significantly associated with PA, while functional limitations explained 6.8 % of the variance of PA. Conclusion In well-functioning older persons living in the community environmental aspects of housing demonstrated a weak association with PA.
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| 35. |
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| 36. |
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
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| 43. |
- Slaug, Björn, et al.
(författare)
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Patterns of functional decline in very old age: an application of latent transition analysis.
- 2016
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1720-8319. ; 28:2, s. 267-275
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Tidskriftsartikel (refereegranskat)abstract
- There is a scarcity of longitudinal studies examining how functional decline develops among very old people. The aim of the current study was to detect and characterize typical patterns of functional decline in a sample of very old people.
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| 44. |
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| 45. |
- Tomsone, Signe, et al.
(författare)
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Aspects of housing and perceived health among ADL independent and ADL dependent groups of older people in three national samples.
- 2013
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Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1720-8319. ; 25:3, s. 317-328
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Tidskriftsartikel (refereegranskat)abstract
- Good housing solutions are important for the ageing population in order to promote health and maintain functional ability. The objective of this study was to investigate whether and how objective and perceived aspects of housing were related to perceived health among ADL independent and ADL dependent groups of older, single-living people within three national samples.
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| 46. |
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| 47. |
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