| 1. |
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| 2. |
- Baranowska-Rataj, Anna, 1980-, et al.
(författare)
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Number of Children and Social Contacts among Older People : the Moderating Role of Filial Norms and Social Policies
- 2019
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 16, s. 95-107
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Tidskriftsartikel (refereegranskat)abstract
- Social contacts offer opportunities for provision of emotional and instrumental support that enhance well-being throughout the life course, and the importance of these contacts is especially evident at advanced ages. In this paper, we take a cross-country comparative perspective to examine the association between the number of children and the frequency of social contacts among older people. Using data from the European Quality of Life Survey, we employ multilevel models with cross-level interactions between the number of children and macro-level indicators of filial norms and social policies supporting older people. Our results suggest that older adults with children are more likely than older adults without children to have frequent social interactions, but that the number of children does not affect social contact frequency. The magnitude of the association between having children and social contact frequency varies across European societies. The social contact frequency gap between older adults with children and older adults without children is larger in more familialistic countries with strong filial norms. Our results do not confirm that having children affects social contact frequency less in countries where the state provides more support for older people.
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| 3. |
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| 4. |
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| 5. |
- Batljan, Ilija, et al.
(författare)
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Population aging : the effect of change in educational composition
- 2009
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Ingår i: EUROPEAN JOURNAL OF AGEING. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 6:3, s. 201-211
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Tidskriftsartikel (refereegranskat)abstract
- We investigate how expected changes in the educational level composition of the older population may affect future prevalence of severe ill-health among older people in Sweden. Previous research has indicated that the number of older people, given educational differentials in mortality and expected changes in educational composition during the next decades, may increase more than expected following official population projections in Sweden. Eight alternative scenario projections for the possible development in the number of people with severe ill-health in Sweden between 2000 and 2035 are presented. Scenario projections, where both morbidity and mortality inequalities by educational level are taken into account, are compared with scenarios in which only age and gender are modelled. The projections are made with both constant and decreasing mortality. The calculations show that the expected increases in severe ill-health as a result from the ageing of the population in the period 2000-2035 might, to a large extent, be counteracted by the increase in the educational level of the Swedish population. We recommend therefore that in projections of the prevalence of ill-health, in addition to the ageing of the population, also changes in educational level should be taken into account.
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| 6. |
- Batljan, Ilija, et al.
(författare)
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The effect of change in educational composition on population ageing
- 2009
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Ingår i: EUROPEAN JOURNAL OF AGEING. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 6:3, s. 191-200
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Tidskriftsartikel (refereegranskat)abstract
- Official Swedish demographic projections have systematically underestimated the number of older people. One explanation behind the underestimation may be found in the fact that the demographic projections are not taking into account socio-economic mortality differentials. We performed alternative demographic scenarios based on assumptions of unchanged and continuing declining mortality, with and without taking into account socio-economic gradients in mortality. According to a scenario based on assumption on declining mortality rates per age group, sex and educational level, the number of older persons (65+) in Sweden will increase by 62% during the period 2000-2035. This can be compared to an increase by 54% in a scenario that does not take into account future structural differences in educational levels and the latest trends in socio-economic inequality in life expectancy (the method used by statistical offices). The socio-economic structure of the older population is significantly changing over the years. We project that by year 2035, only 20% of women 80 years and older will have a low educational level, compared to about 75-80% today. The change in socio-economic structure is similar for the older men. Standard demographic projections that do not take into account socio-economic mortality differentials, risk underestimating the number of older people and hiding dramatic changes in population composition. Taking into account socio-economic mortality differentials results in alternative projections giving us new information regarding the future size and socio-economic composition of the older population. We recommend use of this information in health care and long-term care human resources planning or when assessing financial sustainability of health care, long-term care and pension systems in the future.
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| 7. |
- Blusi, Madeleine, et al.
(författare)
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Older family carers in rural areas - experiences from using caregiver support services based on Information and Communication Technology (ICT)
- 2013
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 10:3, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this intervention study was to illuminate the meaning of ICT-basedcaregiver support as experienced by older family carers living in vast ruralareas, caring for a spouse at home. In order to access the support serviceparticipants were provided with a computer and high speed Internet in theirhomes. Semi structured webcam-interviews were carried out with 31 familycarers. A strategy for webcam interviewing was developed in order to ensurequality and create a comfortable interview situation for the family carers.Interviews were analyzed using content analyses, resulting in the themes: Adoptingnew technology with help from others and Regaining social inclusion.The results indicate that ICT-based support can be valuable for older familycarers in rural areas as it contributes to improve quality in daily life in anumber of ways. In order to fully experience the benefits, family carers needto be frequent users of the provided support. Adequate training andencouragement from others were essential in motivating family carers to use thesupport service. Access to Internet and webcamera contributed to reducingloneliness and isolation, strengthening relationships with relatives living faraway and enabled access to services no longer available in the area. Use of theICT-service had a positive influence on the relationship between the oldercarer and adult grandchildren. It also contributed to carer competence andpromote feelings of regaining independence and a societal role.
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| 8. |
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| 9. |
- Brändström, Anders, et al.
(författare)
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Determinants of home care utilization among the Swedish old : nationwide register-based study
- 2022
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Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 19, s. 651-662
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Tidskriftsartikel (refereegranskat)abstract
- Since the 1990s, Sweden has implemented aging-in-place policies increasing the share of older adults dependent on home care instead of residing in care homes. At the same time previous research has highlighted that individuals receive home care at a higher age than before. Consequently, services are provided for a shorter time before death, increasing reliance on family and kin as caregivers. Previous studies addressing how homecare is distributed rely primarily on small surveys and are often limited to specific regions. This study aims to ascertain how home care services are distributed regarding individual-level factors such as health status, living arrangements, availability of family, education, and socioeconomic position. To provide estimates that can be generalized to Sweden as a whole, we use register data for the entire Swedish population aged 65 + in 2016. The study's main findings are that home care recipients and the amount of care received are among the oldest old with severe co morbidities. Receiving home care is slightly more common among women, but only in the highest age groups. Childlessness and socioeconomic factors play a small role in who receives home care or not. Instead, the primary home care recipients are those older adults living alone who lack direct support from family members residing in the same household.
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| 10. |
- Burholt, Vanessa, et al.
(författare)
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A critical review and development of a conceptual model of exclusion from social relations for older people
- 2020
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 17:1, s. 3-19
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Tidskriftsartikel (refereegranskat)abstract
- Social exclusion is complex and dynamic, and it leads to the non-realization of social, economic, political or cultural rights or participation within a society. This critical review takes stock of the literature on exclusion of social relations. Social relations are defined as comprising social resources, social connections and social networks. An evidence review group undertook a critical review which integrates, interprets and synthesizes information across studies to develop a conceptual model of exclusion from social relations. The resulting model is a subjective interpretation of the literature and is intended to be the starting point for further evaluations. The conceptual model identifies individual risks for exclusion from social relations (personal attributes, biological and neurological risk, retirement, socio-economic status, exclusion from material resources and migration). It incorporates the evaluation of social relations, and the influence of psychosocial resources and socio-emotional processes, sociocultural, social-structural, environmental and policy contextual influences on exclusion from social relations. It includes distal outcomes of exclusion from social relations, that is, individual well-being, health and functioning, social opportunities and social cohesion. The dynamic relationships between elements of the model are also reported. We conclude that the model provides a subjective interpretation of the data and an excellent starting point for further phases of conceptual development and systematic evaluation(s). Future research needs to consider the use of sophisticated analytical tools and an interdisciplinary approach in order to understand the underlying biological and ecopsychosocial associations that contribute to individual and dynamic differences in the experience of exclusion from social relations.
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| 11. |
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| 12. |
- Dahl, Mats, et al.
(författare)
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The relation between personality and the realism in confidence judgements in older adults
- 2010
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 7:4, s. 283-291
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the relation between personality factors, as measured by the Swedish version of the NEO-FFI questionnaire, and the realism in older adults' (aged 60-93 years, n = 1,384) probability confidence judgements of their answers to general knowledge questions. The results showed very small effect sizes for the contribution of the personality variables to the fit between the proportion correct answers and the level of one's confidence judgements. Although personality differed somewhat within the age span studied and between the genders no differences were found in the relation between the dimensions of the NEO-FFI and the degree of realism in the confidence judgements as a function of age or gender. In total, the results show a significant but very small effect of personality on the realism in older adults' confidence judgements of their semantic knowledge.
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| 13. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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A social exclusion perspective on loneliness in older adults in the Nordic countries
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 175-188
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Tidskriftsartikel (refereegranskat)abstract
- Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.
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| 14. |
- Enroth, Linda, et al.
(författare)
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Are there educational disparities in health and functioning among the oldest old? Evidence from the Nordic countries
- 2019
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 16:4, s. 415-424
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Tidskriftsartikel (refereegranskat)abstract
- With the ageing of the population and recent pressures on important welfare state arrangements, updated knowledge on the linkage between socioeconomic status and health in old age is pertinent for shedding light on emerging patterns of health inequalities in the Nordic countries. This study examined self-rated health (SRH), mobility and activities of daily living (ADL) according to level of education in the three oldest old age groups 75-84, 85-94, and 95+, in four Nordic countries. Altogether, 6132 individuals from Danish Longitudinal Study of Ageing, Norwegian Life Course, Ageing and Generation study, Swedish Panel Study of Living Conditions of the Oldest Old, the 5-Country Oldest Old (Sweden) and Vitality 90 + Study were analysed. First, associations of education level with SRH, mobility, and ADL were estimated for each individual study by means of age- and gender-adjusted logistic regression. Second, results from individual studies were synthesized in a meta-analysis. Older adults with higher education level were more likely to report good SRH, and they were more often independent in mobility and ADL than those with basic education when all age groups were combined. In mobility and ADL, differences between education groups remained stable across the age groups but for SRH, differences seemed to be weaker in older ages. With only a few exceptions, in all age groups, individuals with higher education had more favourable health and functioning than those with basic education. This study shows remarkable persistence of health and functioning inequalities in the Nordic countries throughout later life.
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| 15. |
- Enroth, Linda, et al.
(författare)
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Changes in socioeconomic differentials in old age life expectancy in four Nordic countries : the impact of educational expansion and education-specific mortality
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 161-173
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Tidskriftsartikel (refereegranskat)abstract
- Overall progress in life expectancy (LE) depends increasingly on survival in older ages. The birth cohorts now reaching old age have experienced considerable educational expansion, which is a driving force for the social change and social inequality. Thus, this study examines changes in old age LE by educational attainment in the Nordic countries and aims to fnd out to what extent the change in national LEs is attributable to education-specifc mortality and the shifting educational composition. We used national register data comprising total 65+populations in Denmark, Finland, Norway and Sweden to create period life tables stratifed by fve-year age groups (65–90+), sex and educational attainment. Difference in LE between 2001 and 2015 was decomposed into the contributions of mortality changes within each educational group and changes in educational composition. Increasing LE at all ages and in all educational groups coincided with persistent and growing educational inequalities in all countries. Most of the gains in LE at age 65 could be attributed to decreased mortality (63–90%), especially among those with low education, the largest educational group in most countries. The proportion of the increase in LE attributable to improved education was 10–37%, with the highest contributions recorded for women in Norway and Sweden. The rising educational levels in the Nordic countries still carry potential for further gains in national LEs. However, the educational expansion has contributed to uneven gains in LE between education groups, which poses a risk for the future increase of inequalities in LE.
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| 16. |
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| 17. |
- Ericsson, Malin Christina, et al.
(författare)
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Validation of abridged mini-mental state examination scales using population-based data from Sweden and USA
- 2017
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 14:2, s. 199-205
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study is to validate two abridged versions of the mini-mental state examination (MMSE): one intended for use in face-to-face interviews, and the other developed for telephonic interviews, using data from Sweden and the US to validate the abridged scales against dementia diagnoses as well as to compare their performance to that of the full MMSE scale. The abridged versions were based on eight domains from the original MMSE scale. The domains included in the MMSE-SF were registration, orientation, delayed recall, attention, and visual spatial ability. In the MMSE-SF-C, the visual spatial ability item was excluded, and instead, one additional orientation item was added. There were 794 participants from the Swedish HARMONY study [mean age 81.8 (4.8); the proportion of cognitively impaired was 51 %] and 576 participants from the US ADAMS study [mean age 83.2 (5.7); the proportion of cognitively impaired was 65 %] where it was possible to compare abridged MMSE scales to dementia diagnoses and to the full MMSE scale. We estimated the sensitivity and specificity levels of the abridged tests, using clinical diagnoses as reference. Analyses with both the HARMONY and the ADAMS data indicated comparable levels of sensitivity and specificity in detecting cognitive impairment for the two abridged scales relative to the full MMSE. Receiver operating characteristic curves indicated that the two abridged scales corresponded well to those of the full MMSE. The two abridged tests have adequate validity and correspond well with the full MMSE. The abridged versions could therefore be alternatives to consider in larger population studies where interview length is restricted, and the respondent burden is high.
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| 18. |
- Erlandsson, Sara, 1979-, et al.
(författare)
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Choice models in nordic long-term care : care managers' experiences of privilege and disadvantage among older adults
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 211-220
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Tidskriftsartikel (refereegranskat)abstract
- Consumer choice models have been introduced in eldercare services in several Western welfare societies. Choice models in eldercare emphasise the importance of individuals’ abilities to make informed choices and therefore entail a risk for increased inequalities among older adults with care needs. In the Nordic countries, such inequality risks are in stark contrast to universal policy ambitions of equal access to care services. Care managers, who are responsible for needs assessment for eldercare services, have a central role in implementing policies and, thus, have first-hand experience of their impact on older adults’ access to care. The aim of this study was to explore care managers’ experiences of how user choice affects older adults’ access to care services in three Nordic cities: Copenhagen, Tampere, and Stockholm. These cities were purposely selected as forerunners in marketisation, with different ways of implementing choice models. Semi-structured interviews with care managers were conducted in Copenhagen, Tampere, and Stockholm and analysed thematically. The findings indicate there are difficulties related to older adults’ ability to access information needed to make informed choices, as well as limitations in choice related to available services and personal finances. Further, care managers find that older adults’ abilities to overcome these difficulties are shaped by their health, education, language skills, and assistance from relatives. In order to reduce the risk of choice models increasing the gap between older adults with different resources and capabilities, there is a need to develop accessible information, as well as models for professional guidance.
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| 19. |
- Eyjólfsdóttir, Harpa S., et al.
(författare)
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Physical functioning as a predictor of retirement : Has its importance changed over a thirty-year period in Sweden?
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:4, s. 1417-1428
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Tidskriftsartikel (refereegranskat)abstract
- Many countries, including Sweden, are implementing policies aimed at delaying retirement and encouraging older workers to remain on the labour market for longer. During recent decades, there have been several major reforms to the pension and social security systems in Sweden. Moreover, the nature of occupations has shifted towards more non-manual and sedentary activities, older women are today almost as active in the labour market as men in Sweden, and physical functioning has improved over time. In this study, we investigate whether the importance of physical functioning as a predictor for retirement has changed over time, for women and men, respectively. We used four waves of nationally representative data from The Swedish Level of Living Survey from 1981, 1991, 2000, and 2010, together with income register data. We found that greater severity of musculoskeletal pain and mobility limitations increased the likelihood of retirement in all waves. Results from logistic regression models with average marginal effects and predictive margins showed that there is a trend towards physical functioning becoming less important for retirement towards the end of the study period, especially for women, when controlling for occupational-based social class, age, adverse physical working conditions, and job demands. People, especially women, reporting impaired physical functioning did not retire to the same extent as in previous decades. This indicates that people stayed longer in the labour market despite impaired physical functioning, which may have repercussions on well-being and quality of life.
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| 20. |
- Ferring, Dieter, et al.
(författare)
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Life satisfaction of older people in six European countries: Findings from the European study on adult wellbeing.
- 2004
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9380 .- 1613-9372. ; 1:1, s. 15-25
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Tidskriftsartikel (refereegranskat)abstract
- The European Study on Adult Well-being (ESAW), funded by the European Union, was conducted during 2002 and 2003 in Austria, Italy, Luxembourg, The Netherlands, United Kingdom and Sweden. The aim of the interdisciplinary study was the conceptual clarification and the identification of factors contributing to life satisfaction for older people. Five key components were included in the study: (1) physical health and functional status; (2) self-resources; (3) material security; (4) social support resources; and (5) life activity. A representative population of adults aged 50–90 years living independently (not institutionalised) was selected in each participating country, and the actual sample size came very close to the target of 2,000, ranging from 1,854 to 2,417. The total European sample comprised 12,478 respondents. In this paper, mean differences in general and domain-specific life satisfaction between the six countries including age groups and gender are reported and discussed with respect to contextual national characteristics. In general the findings showed a high level in all chosen indicators of life satisfaction across the six countries. National differences depended on the domain under consideration, but the results showed in general that The Netherlands, United Kingdom, Luxembourg and Austria had higher values of life satisfaction compared to Sweden and Italy.
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| 21. |
- Fischl, Caroline, et al.
(författare)
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Older adults’ perceptions of contexts surrounding their social participation in a digitalized society—an exploration in rural communities in Northern Sweden
- 2020
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Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 17:3, s. 281-290
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Tidskriftsartikel (refereegranskat)abstract
- Social participation and digital engagement can contribute to health and well-being among older adults. Because of older adults’ decline in abilities, coupled with complex technology and its perceived insufficient relevance to daily life, there is a need to create and tailor social opportunities and services that are supported by digital technologies for older adults to continue participating in society. Thus, it becomes relevant to explore older adults’ perceptions about contexts surrounding their social participation in a digital society. This exploration used a qualitative research design with focus group interviews and qualitative content analysis. Eighteen older adults, aged 66–81 years, from rural communities in Northern Sweden, participated in this study. The analysis resulted in three categories: experiencing conditions for social participation in a state of flux, perceiving drawbacks of urbanization on social participation, and welcoming digital technology that facilitates daily and community living. These categories were encapsulated in the theme—the juxtaposition of narrowing offline social networks and expanding digital opportunities for social participation. The findings suggested that co-creating usable digitalized services and facilitating satisfactory use of digital technologies could support older adults’ social participation through activities that they find relevant in their lives, and subsequently, might enable them to live longer at home.
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| 22. |
- Fors, Stefan, 1976-, et al.
(författare)
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Cohort-specific disability trajectories among older women and men in Europe 2004–2017
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:4, s. 1111-1119
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Tidskriftsartikel (refereegranskat)abstract
- As the population of Europe grows older, one crucial issue is how the incidence and prevalence of disabilities are developing over time in the older population. In this study, we compare cohort-specific disability trajectories in old age across subsequent birth cohorts in Europe, during the period 2004–2017.We used data from seven waves of data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Mixed effects logistic regression models were used to model trajectories of accumulation of ADL limitations for subsequent birth cohorts of older women and men in different European regions. The results showed that there were sex differences in ADL and IADL limitations in all regions for most cohorts. Women reported more limitations than men, particularly in Eastern and Southern rather than Northern and Western Europe. Among men in Eastern, Northern and Western Europe, later born cohorts reported more disabilities than did earlier born birth cohorts at the same ages. Similar patterns were observed for women in Northern and Western Europe. In contrast, the risk of disabilities was lower in later born cohorts than in earlier born birth cohorts among women in Eastern Europe. Overall, results from this study suggest that disability trajectories in different cohorts of men and women were by and large similar across Europe. The trajectories varied more depending on sex, age and region than depending on cohort.
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| 23. |
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| 24. |
- Fritzell, Johan, 1954-, et al.
(författare)
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Social inequalities in ageing in the Nordic countries
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 155-159
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Genbäck, Minna, 1985-, et al.
(författare)
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Predictors of decline in self-reported health : addressing non-ignorable dropout in longitudinal studies of ageing
- 2018
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Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 15:2, s. 211-220
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Tidskriftsartikel (refereegranskat)abstract
- Predictors of decline in health in older populations have been investigated in multiple studies before. Most longitudinal studies of aging, however, assume that dropout at follow-up is ignorable (missing at random) given a set of observed characteristics at baseline. The objective of this study was to address non-ignorable dropout in investigating predictors of declining self-reported health (SRH) in older populations (50 years or older) in Sweden, the Netherlands, and Italy. We used the SHARE panel survey, and since only 2895 out of the original 5657 participants in the survey 2004 were followed up in 2013, we studied whether the results were sensitive to the expectation that those dropping out have a higher proportion of decliners in SRH. We found that older age and a greater number of chronic diseases were positively associated with a decline in self-reported health in the three countries studies here. Maximum grip strength was associated with decline in self-reported health in Sweden and Italy, and self-reported limitations in normal activities due to health problems were associated with decline in self-reported health in Sweden. These results were not sensitive to non-ignorable dropout. On the other hand, although obesity was associated with decline in a complete case analysis, this result was not confirmed when performing a sensitivity analysis to non-ignorable dropout. The findings, thereby, contribute to the literature in understanding the robustness of longitudinal study results to non-ignorable dropout while considering three different population samples in Europe.
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| 26. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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Suffering in silence : a qualitative study of older adults’ experiences of living with long-term musculoskeletal pain at home
- 2021
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Ingår i: European Journal of Ageing. - Basel : Springer. - 1613-9372 .- 1613-9380. ; 18:1, s. 55-63
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Tidskriftsartikel (refereegranskat)abstract
- Long-term musculoskeletal pain is a major, disabling, and often undertreated health problem among the increasing number of older adults worldwide. However, there is limited knowledge of community-dwelling older adults’ experiences of living with this type of pain. The aim of the study was to deepen the understanding of the phenomenon: how older adults experience living with long-term musculoskeletal pain at home. The study design was an inductive qualitative Reflective Lifeworld Research approach grounded in phenomenological epistemology. Data were obtained from 20 community-dwelling older adults, aged 72–97 years. Data were collected through open-ended interviews and analyzed to understand the meanings of the phenomenon. The essence of the phenomenon entailed suffering in silence and encompassed the following constituents: loneliness and restrictions in daily living; ways to endure and distract from pain; not being taken seriously; fear of the future; and valuing joy and meaning in life. Living with long-term musculoskeletal pain restricts access to the world and leads to a suffering in silence. Finding ways to endure and distract from pain and to focus on issues that give joy and meaning in life is predominant in efforts to balance restraints from pain in life. Suffering is reinforced by loneliness, a sense of not being taken seriously by health care providers and fear of an uncertain future. It is necessary to foster increased attentiveness and sensitivity in meeting the needs of each older adult and provide a care that alleviates suffering and preserves and promotes health and well-being. © 2020, The Author(s).
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| 27. |
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| 28. |
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| 29. |
- Hacic, Kozma, et al.
(författare)
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Aging in disguise : age, period and cohort effects in mobility and edentulousness over three decades
- 2007
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Ingår i: European journal of ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 4:2, s. 83-91
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Tidskriftsartikel (refereegranskat)abstract
- By corroborating cross-sectional with longitudinal analyses, this study illustrates how cohort effects can confound trends over age and time. Mobility (walking difficulties) and edentulousness (toothlessness) were studied from 1968 to 2002 in a nationally representative panel aged 18-75 (5 waves, n approximate to 5,000) and ages 77+ at later waves (2 waves, n approximate to 500). Three analyses were done: cross-sectional 10-year age group differences in 5 waves, time-lag differences between waves (shifts across time) for age groups, and within-cohort differences between waves for 10-year birth cohorts followed over time. Complementary age-period-cohort models using logistic regression analysis evaluated differences. Both mobility and edentulousness have earlier been shown to be strongly related to age cross-sectionally. For mobility, cross-sectional and longitudinal analyses showed large changes, whereas time-lag analysis indicated no or marginal changes. Both cross-sectional and longitudinal results showed an exponential curvilinear age dependency for mobility limitations, with limitations becoming more usual in older ages. In contrast, cross-sectional and time-lag analyses of edentulousness showed large differences, whereas longitudinal analysis indicated no or marginal changes. Rates of edentulousness became increasingly lower for successively later cohorts in a curvilinear fashion. These patterns demonstrate that age effects dominated mobility, whereas cohort effects dominated edentulousness. Age-period-cohort models confirmed these findings. The cohort effect of edentulousness implies that the cohorts' movement through time gives a false impression of age and period effects in cross-sectional data.
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| 30. |
- Halleröd, Björn, 1960, et al.
(författare)
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Leaving the labour market: the impact of exit routes from employment to retirement on health and wellbeing in old age
- 2013
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 10:1, s. 25-35
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Tidskriftsartikel (refereegranskat)abstract
- The study analyses whether and to what degree specific routes into retirement affect older people, i.e. the relationship between heterogeneous exit patterns and post-retirement health and wellbeing. We used longitudinal data from two points in time; data related to t (0) were collected in 1993, 1994, 1995 and 1996 and data related to t (1) were collected in 2002 and 2003 (N = 589). We focused on older people (55+ at t (1)) who were employed at t (0) and retired at t (1). We used confirmative factor analysis to identify identical measures of health and wellbeing at both t (0) and t (1). Hence, we were able to control for pre-retirement health and wellbeing when evaluating the effects of different exit routes. These routes were defined as dependence on incomes from sickness benefit, disability pension, part-time pension, unemployment insurance and active labour market programmes. Our initial structural equation model showed a clear relation between exit routes and post-retirement wellbeing. People who prior to retirement were pushed into social benefit programmes related to health and unemployment were significantly worse off as retirees, especially those with health-related benefits. However, these relationships disappeared once pre-retirement wellbeing was added to the model. Our main conclusion is that post-retirement wellbeing first and foremost is a consequence of accumulation of advantages and disadvantages during the life course. Both labour market exit routes and post-retirement wellbeing can be seen as outcomes of this process. There are no independent effects of the retirement process. Judging from our findings, there is no reason to believe that involvement in social security programmes allowing early retirement on health grounds has any additional negative consequences for health and wellbeing.
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| 31. |
- Hovbrandt, Pia, et al.
(författare)
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Very old people’s use of the pedestrian environment: functional limitations, frequency of activity and environmental demands
- 2007
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9380 .- 1613-9372. ; 4:4, s. 201-211
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Tidskriftsartikel (refereegranskat)abstract
- Due to decreased functional capacity as well as high environmental demands there is a risk of diminishing activity outside home in very old age (age 80+). In order to explore differences according to functional limitations (FL) among very old people with respect to frequency of activity, perceived health, overall perception of neighbourhood environment, and perceived problems in the pedestrian environment, data derived from a postal questionnaire survey to very old people living in an urban area in Sweden were used. This explorative study is based on the sub-sample of people aged 80+ who reported outdoor activities (n = 97). Four groups of respondents with different types of FL were identified: with no FL (n = 23), with only movement-related FL (n = 26), with only perception/cognition-related FL (n = 16), and with both movement- and perception/ cognition-related FL (n = 32). The majority of the respondents reported rather high frequency of activity outside home. When examining differences between the four groups, the analysis indicated how the complexity of FL and perceived problems in the pedestrian environment impacted on their activity performance. Persons with both movement- and perception/cognition-related FL were less satisfied with their frequency of activity, experienced their health more negatively and experienced more problems in the pedestrian environment than in the other groups. The findings from this study indicate the importance of considering combinations of FL in creating supportive environments for activity and health.
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| 32. |
- Hörnsten, Carl, et al.
(författare)
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Measurement error of the Mini-Mental State Examination among individuals with dementia that reside in nursing homes
- 2021
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Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 18:1, s. 109-115
-
Tidskriftsartikel (refereegranskat)abstract
- Few studies have investigated the measurement error of the Mini-Mental State Examination (MMSE) in the same unit of measurement, also known as absolute reliability. This measurement can help determine whether an observed score change for an individual is likely to represent true change. The aim of this study was to investigate the absolute reliability of the MMSE among individuals with dementia that reside in nursing homes. Among 88 participants, 19 (21.6%) were men, 35 (39.8%) had Alzheimer's disease, 35 (39.8%) had vascular dementia, and the mean age was 84.0 years (range 65-98). The participants were tested and retested with the MMSE within 1-6 days. Both tests were administered by the same assessor at the same time of day. The mean MMSE score was 13.7 (range 0-28). The absolute difference between MMSE scores varied from 0 to 6 points, and the differences did not correlate with the corresponding score means (p = 0.874). The smallest detectable change (SDC) between two measurements was 4.00. The SDC was independent of depression, impaired vision and hearing, delirium within the last week, dementia type and age. However, the SDC was 5.56 among men and 3.50 among women (p = 0.003). In conclusion, for individuals with dementia that reside in nursing homes, it seems like their MMSE score needs to change by four or more points between two measurements in order for their score change to be reliably higher than the measurement error.
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| 33. |
- Ilinca, Stefania, et al.
(författare)
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Gender differences in access to community-based care : a longitudinal analysis of widowhood and living arrangements
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:4, s. 1339-1350
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Tidskriftsartikel (refereegranskat)abstract
- Persistent inequalities in access to community-based support limit opportunities for independent living for older people with care needs in Europe. Our study focuses on investigating how gender, widowhood and living arrangement associate with the probability of receiving home and community-based care, while accounting for the shorter-term associations of transitions into widowhood (bereavement) and living alone, as well as the longer-term associations of being widowed and living alone. We use comparative, longitudinal data from the Survey of Health, Ageing and Retirement in Europe (collected between 2004 and 2015 in 15 countries) specifying sex-disaggregated random-effects within-between models, which allow us to examine both cross-sectional and longitudinal associations among widowhood, living arrangements and community-based care use. We find widowhood and living alone are independently associated with care use for both older women and men, while bereavement is associated with higher probability of care use only for women. Socio-economic status was associated with care use for older women, but not for men in our sample. The gender-specific associations we identify have important implications for fairness in European long-term care systems. They can inform improved care targeting towards individuals with limited informal care resources (e.g. bereaved older men) and lower socio-economic status, who are particularly vulnerable to experiencing unmet care needs. Gender differences are attenuated in countries that support formal care provision, suggesting gender equity can be promoted by decoupling access to care from household and family circumstances.
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| 34. |
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| 35. |
- Jones, J. W., et al.
(författare)
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Longitudinal correspondence between subjective and objective memory in the oldest old: A parallel process model by gender
- 2019
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 16:3, s. 317-326
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Tidskriftsartikel (refereegranskat)abstract
- Subjective memory and objective memory performance have predictive utility for clinically relevant outcomes in older adults. Previous research supports certain overlap between objective performance and subjective ratings of memory. These studies are typically cross-sectional or use baseline data only to predict subsequent change. The current study uses a parallel process model to examine concurrent changes in objective memory and subjective memory. We combined data from two population-based Swedish studies of individuals aged 80 + years, assessed every 2years (OCTO—3 measurement occasions, OCTO-Twin—5 measurement occasions) yielding 607 participants (66% female). The results confirmed that both objective and subjective memory declined over time. The association between the slope of objective memory and subjective memory was statistically significant for women but not for men. This pattern remained after accounting for age and depressive symptoms. Our findings suggest that, in population-based samples of the oldest old, women seem to show better metacognitive abilities in detecting and reporting changes in memory. Memory changes for men may be better identified by objective performance as their self-assessment of memory changes is not associated with actual change in memory performance. © 2019, Springer Nature B.V.
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| 36. |
- Kazemi, Ali, 1976-, et al.
(författare)
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Understanding client satisfaction in elderly care : new insights from social resource theory
- 2021
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 18, s. 417-425
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Tidskriftsartikel (refereegranskat)abstract
- Social resource theory suggests that social interaction can be conceived as resource transaction or exchange with behaviours falling within six fundamental resource categories (i.e. love, status, information, money, goods, and services) organised along two underlying dimensions: particularism–universalism and concreteness–abstractness. With the purpose of extending knowledge about quality of care, this study adopts a novel approach in that it describes and categorises care behaviours using social resource theory instead of using single instances of care behaviour. The categorisation is further used to predict client satisfaction in care services targeting older people. Daily interactions between care staff and older persons were observed in two different residential care facilities using a structured non-participant observation design. The data were analysed using principal component analysis, correlation, and regression analysis. The results confirmed the hypothesis that satisfaction with care services is predicted by resource transactions that are high on the underlying dimensions of particularism and abstractness. Thus, the resource categories of love and status (resource categories high on particularism and abstractness) were shown to be strong predictors of client satisfaction. The use of social resource theory is a novel and appropriate approach to examine person-centred care and satisfaction with care. Also, in addition to addressing potential problems in previous self-report studies on care staff behaviour, the observational technique was highly practical to this service area where dealing with clients not always able to provide feedback directly.
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| 37. |
- Kelfve, Susanne, et al.
(författare)
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Length of the period with late life dependency : Does the age of onset make a difference?
- 2023
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Ingår i: European Journal of Ageing. - : SPRINGER. - 1613-9372 .- 1613-9380. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- There is a gap in knowledge about factors associated with the duration of late life dependency. In this study, we measured how the age at onset of late life dependency relates to the time spent with late life dependency. Using Swedish register data, we identified people 70 + who entered the period of late life dependency (measured by entering long-term care for help with PADLs) between June and December 2008. We followed this cohort (n = 17,515) for 7 years, or until death. We used Laplace regression models to estimate the median number of months with late life dependency by age group, gender, level of education and country of birth. We also calculated the crude percentiles (p10, p25, p50, p75 and p90) of month with late life dependency, by age group, gender and cohabitation status. Results show that the majority spent a rather long period with dependency, the median number of months were 40.0 (3.3 years) for women and 22.6 (1.9 year) for men. A higher age at entry was associated with a shorter duration of dependency, an association that was robust to adjustment for cohabiting at baseline, gender, education and country of birth. Our results suggest that older adults who postpone the start of dependency also compress the time with dependency, this lends support to the ambitions of public health initiatives and interventions targeting maintained independence in older adults.
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| 38. |
- Kelfve, Susanne, et al.
(författare)
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Length of the period with late life dependency: Does the age of onset make a difference?
- 2023
-
Ingår i: European Journal of Ageing. - : SPRINGER. - 1613-9372 .- 1613-9380. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- There is a gap in knowledge about factors associated with the duration of late life dependency. In this study, we measured how the age at onset of late life dependency relates to the time spent with late life dependency. Using Swedish register data, we identified people 70 + who entered the period of late life dependency (measured by entering long-term care for help with PADLs) between June and December 2008. We followed this cohort (n = 17,515) for 7 years, or until death. We used Laplace regression models to estimate the median number of months with late life dependency by age group, gender, level of education and country of birth. We also calculated the crude percentiles (p10, p25, p50, p75 and p90) of month with late life dependency, by age group, gender and cohabitation status. Results show that the majority spent a rather long period with dependency, the median number of months were 40.0 (3.3 years) for women and 22.6 (1.9 year) for men. A higher age at entry was associated with a shorter duration of dependency, an association that was robust to adjustment for cohabiting at baseline, gender, education and country of birth. Our results suggest that older adults who postpone the start of dependency also compress the time with dependency, this lends support to the ambitions of public health initiatives and interventions targeting maintained independence in older adults.
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| 39. |
- Kelfve, Susanne, et al.
(författare)
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Sampling and non-response bias on health-outcomes in surveys of the oldest old
- 2013
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 10:3, s. 237-245
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Tidskriftsartikel (refereegranskat)abstract
- Surveys of the oldest old population are associated with several design issues. Place of residence and possible physical or cognitive impairments make it difficult to maintain a representative study population. Based on a Swedish nationally representative survey among individuals 77+, the present study analyze the potential bias of not using proxy interviews and excluding the institutionalized part of the population in surveys of the oldest old. The results show that compared to directly interviewed people living at home, institutionalized and proxy interviewed individuals were older, less educated and more likely to be female. They had more problems with health, mobility and ADL, and a significantly increased mortality risk. If the study had excluded the institutionalized part of the population and/or failed to use proxy interviews, the result would have been severely biased and resulted in underestimated prevalence rates for ADL, physical mobility and psychologic problems. This could not be compensated for weighting the data by age and sex. The results from this study imply that accurate population estimates require a representative study population, in which all individuals are included regardless of their living conditions, health status, and cognitive ability.
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| 40. |
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| 41. |
- Kvist, Elin, 1972-
(författare)
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Changing social organizations of care : a comparison of European policy reforms encouraging paid domestic work
- 2012
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Ingår i: European Journal of Ageing. - Heidelberg : Springer Berlin/Heidelberg. - 1613-9372 .- 1613-9380. ; 9:2, s. 111-117
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Tidskriftsartikel (refereegranskat)abstract
- In many European countries different types of policy reforms intending to encourage growth in the domestic service sector have been introduced. The methods and reforms differ but mainly the reforms intend to stimulate growth of a ‘new’ legal labour market sector within private households. This potential growth sector in combination with insufficient or declining welfare states, inclining female labour market participation and ageing populations could be viewed as explanatory factors to the increased demand for domestic services. A growing amount of those performing paid domestic work in European homes are migrant women with or without papers. The aim of this article is to create a model that enables comparisons of these reforms, with a special focus on changing social organizations of care for elders, children and other dependent persons. Included in the analysis are Euro- pean countries that have introduced wide domestic service policy reforms as measurement to encourage growth in the domestic service sector, i.e. Austria, Belgium, Denmark, Finland, France, Germany and Sweden.
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| 42. |
- Kylén, Maya, et al.
(författare)
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Meaning of home and health dynamics among younger older people in Sweden
- 2019
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 16:3, s. 305-315
-
Tidskriftsartikel (refereegranskat)abstract
- Research has shown that positive evaluations of home are important for very old people’s health, well-being and independence in daily life. The rationale for the present study derives from our survey study findings, confirming such associations also in a younger cohort (N = 371). The purpose of this study was to further increase the understanding of the dynamics of meaning of home and health among community-living healthy younger older people, in the present and in a projected future. Data were collected through semi-structured interviews with 13 persons aged 67–70 years living in ordinary housing in Sweden, followed by a qualitative content analysis. Findings suggest that the home becomes progressively important after retirement. Not only the immediate home environment but also local neighbourhoods influence perceptions about home. Home brings emotional and social benefits but also worries about how to cope with complex home ambivalence when reflecting upon future housing arrangements. The findings suggest that it is important to consider the role of perceived aspects of home for health and well-being in early phases of the ageing process. The findings could be used to raise awareness among policymakers, housing authorities and professionals involved in housing-related counselling.
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| 43. |
- König, Stefanie
(författare)
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Career histories as determinants of gendered retirement timing in the Danish and Swedish pension systems
- 2017
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 14:4, s. 397-406
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Author(s) After reforms in pension systems had taken place in most European countries within the last two decades, the concern was raised that women may be disadvantaged by these reforms. It is suggested that they are faced with a higher financial need to work longer. Retrospective data from SHARELIFE are used to run an event history analysis on the timing of the final employment exit, separately for gender, country and exit cohort. This study aims to disentangle the influence of gendered labour markets and pension regulations on retirement timing by investigating conditions in Denmark and Sweden. Some evidence was found that women compensate for lower labour market attachment due to long part-time periods by working longer, especially in younger cohorts. This seems to depend on the pension system. In countries with broad basic pensions, high replacement rates for low-income groups and fewer penalties for early retirement, the compensation is suggested to be less frequent. This study indicates the growing importance of the “compensation hypothesis” compared to the “status maintenance hypothesis” of previous careers in relation with retirement timing.
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| 44. |
- Lampinen, Josefine, et al.
(författare)
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Loneliness among very old people with and without dementia : prevalence and associated factors in a representative sample
- 2022
-
Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 19, s. 1441-1453
-
Tidskriftsartikel (refereegranskat)abstract
- Loneliness and dementia are common among very old (aged ≥ 80 years) people, but whether the prevalence of loneliness differs between very old people with and without dementia is unknown and few studies have investigated associated factors. The aims of the present study were to compare the prevalence of loneliness between people with and without dementia in a representative sample of very old people, and to investigate factors associated with loneliness in the two groups separately. This population-based study was conducted with data on 1176 people aged 85, 90, and ≥ 95 years (mean age 89.0 ± 4.47 years) from the Umeå 85 + /Gerontological Regional Database study conducted in northern Sweden, during year 2000–2017. Structured interviews and assessments were conducted during home visits. Loneliness was assessed using the question “Do you ever feel lonely?.” Multivariable logistic regression analysis was conducted to identify factors associated with loneliness in participants with and without dementia. The prevalence of loneliness did not differ between people with and without dementia (50.9% and 46.0%, respectively; p = 0.13). Seven and 24 of 35 variables were univariately associated with the experience of loneliness in participants with and without dementia, respectively. In the final models, living alone and having depressive symptoms were associated with the experience of loneliness in both study groups. In participants without dementia, living in a nursing home was associated with the experience of less loneliness. These findings contribute with important knowledge when developing strategies to reduce loneliness in this growing age group.
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| 45. |
- Larsson, Kristina, et al.
(författare)
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Are public care and services for older people targeted according to need? : Applying the Behavioural Model on longitudinal data of a Swedish urban older population
- 2006
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 3:1, s. 22-33
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Tidskriftsartikel (refereegranskat)abstract
- The objectives were to identify factors that predict the use of home help services and transition into institutional care and to study to what extent care services were targeted according to the individuals’ needs. A further objective was to study whether people who had moved into institutional care facilities had received home help prior to institutionalisation. A community-dwelling sample (n=502) aged 81–100 was twice interviewed and assessed with medical examinations. Their use of public elderly care between 1994/1996 and 2000 was studied using survival analyses. Need factors, according to the Andersen Behavioural Model, were the most important predictors for the use of elderly care. Among people living alone, dementia, functional limitations, and depressive symptoms predicted the use of home help services and institutionalisation. Among non-demented cohabiting people, depressive symptoms and dependence in ADLs increased the likelihood of both home help and institutionalisation. Among cohabiting people with dementia, the effect of dementia was difficult to separate from the effects of ADL limitations and depression. Enabling factors were of importance among cohabiting people. A high level of education increased the likelihood of moving into institutional care, and informal extra-residential care increased the likelihood of both outcomes indicating that elderly care resources had not been targeted solely according to need. Predisposing factors such as age and gender were of importance only among people living alone. Basically the same factors predicted both the receipt of home help and institutionalisation. Only 4% of people living alone and 5% of those cohabiting moved to institutions without previously receiving home help.
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| 46. |
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| 47. |
- Larsson, Kristina, et al.
(författare)
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Care utilisation in the last years of life in Sweden: the effects of gender and marital status differ by type of care
- 2014
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 11:4, s. 349-359
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Tidskriftsartikel (refereegranskat)abstract
- The effects of gender and marital status on care utilisation in the last years of life are highly correlated. This study analysed whether gender differences in use of eldercare (home help services or institutional care) or hospital care in the last 5 years of life, and the place of death, could be attributed to differences in marital status and thereby to potential access to informal care. A longitudinal Swedish study provided register data on 567 participants (aged 83 +) who died between 1995 and 2004. A higher proportion of unmarried than married people used home help services; this was true of both men and women. The likelihood of receiving home help was lower for those living with their spouse (OR = 0.38) and for those with children (OR = 0.60). In the 2 years preceding death, the proportion receiving home help services decreased and the proportion in institutional care increased. Women were significantly more likely to die in institutional care (OR = 1.88) than men. Although men were less likely to live in institutional care than women and more likely to be inpatients in the 3 months preceding death, after controlling for residence in institutional care, neither gender nor marital status was statistically significant when included in the same model. In summary, the determining factor for home help utilisation seemed to be access to informal care, whereas gender differences in health status could explain women’s higher probability of dying in institutional care.
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| 48. |
- Liljas, AEM, et al.
(författare)
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The influence of sociodemographic factors and close relatives at hospital discharge and post hospital care of older people with complex care needs: nurses' perceptions on health inequity in three Nordic cities
- 2022
-
Ingår i: European journal of ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 189-200
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Tidskriftsartikel (refereegranskat)abstract
- Hospital discharge of older people in need of both medical and social care following their hospital stay requires extensive coordination. This study aims to examine and compare the views of nurses in three Nordic cities on the influence of sociodemographic factors and having close relatives, for the hospital discharge and post hospital care of older people with complex health and social care needs. Thirty-five semi-structured interviews (Copenhagen n = 11, Tampere n = 8, Stockholm n = 16) with nurses were conducted. The nurses were identified through the researchers’ networks, invitation and snowball sampling, and recruited from hospitals, primary care practices, home care units, home nursing units, and geriatric departments. The interviews were transcribed and analysed using thematic analysis. Interpretations were discussed and agreed within the team. Four main themes and 13 sub-themes were identified. Across the cities, informants reported that the patient’s health status, rather than their gender or ethnicity, steered the discharge date and further care. Care costs, commonly reported in Tampere but also in Copenhagen and Stockholm including costs for medications and home help, were considered barriers for disadvantaged older people. Home situation, local arrangements and differences in collaboration between healthcare professionals at different sites also influenced the hospital discharge. Generally, the patient’s health status steered the hospital discharge and post-hospital care. Close relatives were regarded important and a potential advantage. Some informants tried to compensate for the absence of close relatives, highlighting the importance of care systems that can compensate for this to minimise avoidable inequity.
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| 49. |
- Mark, Ruth E., et al.
(författare)
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Preclinical Alzheimer's dementia : a useful concept or another dead end?
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:4, s. 997-1004
-
Forskningsöversikt (refereegranskat)abstract
- The term, preclinical dementia, was introduced in 2011 when new guidelines for the diagnosis of Alzheimer’s dementia (AD) were published. In the intervening 11 years, many studies have appeared in the literature focusing on this early stage. A search conducted in English on Google Scholar on 06.23.2022 using the term “preclinical (Alzheimer’s) dementia” produced 121, 000 results. However, the label is arguably more relevant for research purposes, and it is possible that the knowledge gained may lead to a cure for AD. The term has not been widely adopted by clinical practitioners. Furthermore, it is still not possible to predict who, after a diagnosis of preclinical dementia, will go on to develop AD, and if so, what the risk factors (modifiable and non-modifiable) might be. This Review/Theoretical article will focus on preclinical Alzheimer’s dementia (hereafter called preclinical AD). We outline how preclinical AD is currently defined, explain how it is diagnosed and explore why this is problematic at a number of different levels. We also ask the question: Is the concept ‘preclinical AD’ useful in clinical practice or is it just another dead end in the Holy Grail to find a treatment for AD? Specific recommendations for research and clinical practice are provided.
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| 50. |
- Meinow, Bettina, et al.
(författare)
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Complex health problems among the oldest old in Sweden : increased prevalence rates between 1992 and 2002 and stable rates thereafter
- 2015
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 12:4, s. 285-297
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Tidskriftsartikel (refereegranskat)abstract
- Studies of health trends in older populations usually focus on single health indicators. We include multiple medical and functional indicators, which together indicate the broader impact of health problems experienced by individuals and the need for integrated care from several providers of medical and long-term care. The study identified severe problems in three health domains (diseases/symptoms, mobility, and cognition/communication) in three nationally representative samples of the Swedish population aged 77+ in 1992, 2002, and 2011 (n a parts per thousand 1900; response rate > 85 %). Institutionalized people and proxy interviews were included. People with severe problems in two or three domains were considered to have complex health problems. Results showed a significant increase of older adults with complex health problems from 19 % in 1992 to 26 % in 2002 and no change thereafter. Changes over time remained when controlling for age and sex. When stratified by education, complex health problems increased significantly for people with lower education between 1992 and 2002 and did not change significantly between 2002 and 2011. For higher-educated people, there was no significant change over time. Among the people with severe problems in the symptoms/disease domain, about half had no severe problems in the other domains. People with severe mobility problems, on the other hand, were more likely to also have severe problems in other domains. Even stable rates may imply an increasing number of very old people with complex health problems, resulting in a need for improved coordination between providers of medical care and social services.
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