| 1. |
- Sidenvall, Birgitta, et al.
(författare)
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Elderly patients' meal patterns : A retrospective study
- 1996
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Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 9:4, s. 263-272
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty-five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficiency.
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| 2. |
- Holst, Göran, et al.
(författare)
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The relationship of vocally disruptive behavior and previous personality in severely demented institutionalized patients.
- 1997
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Ingår i: Archives of Psychiatric Nursing. - 1532-8228. ; 11:3, s. 147-154
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the previous personalities of patients, their behavior during the course of the disease, and the relationship between the previous personality and vocally disruptive behavior of severely demented patients. Twenty-one severely demented patients identified as vocally disruptive and 19 severely demented control subjects who were matched for gender and ward were studied. A family member or close relative who knew the patient very well described the patient's personal characteristics from what they judged to be the “best” period in the patient's life and responded, on behalf of the patient, to the 57 items in a modified version of the Eysenck Personality Inventory. The results of this study can be interpreted to indicate that a previous personality described as introverted, rigid, and with a tendency to control emotions, as remembered retrospectively by a close family member, may correlate to current disruptive behavior. Despite the limitations of this study, the findings indicated that a patient's previous personality characteristics need to be taken into consideration because they may partially explain vocal activity and are therefore important for the provision of nursing care. Further research has to be performed to highlight the impact of previous personality characteristics on various kinds of behavior during the course of the disease.
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| 3. |
- Fäldt, Roger, et al.
(författare)
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Prevalence of thyroid hormone abnormalities in elderly patients with symptoms of organic brain disease.
- 1996
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 8:5, s. 347-357
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Tidskriftsartikel (refereegranskat)abstract
- Analysis of the serum concentrations of free thyroid hormones (fT3, fT4) and thyrotropin (TSH) in 173 psychogeriatric patients (94 females and 79 males, mean age 79 +/- 8 years) disclosed that the hormone levels were related to sex, psychiatric diagnosis, medication and the presence of nonthyroid illness (NTI). Subnormal concentrations of thyroid hormones and/or TSH were found in 25% of the patients. In addition, fT3 and fT4 concentrations were significantly lower (p < 0.05 and p < 0.001, respectively) in demented males compared with demented females although the levels were within the reference limits. Strongly negative correlations between fT3 and age (p < 0.001), and between fT3 and the sedimentation rate (SR) (p < 0.01) were found in demented but not in non-demented patients. These correlations were most pronounced in (age) or restricted to (SR) demented males. In addition, the correlation between fT3 and Hb was strongly positive (p < 0.001) in demented as well as in nondemented patients, particularly in males. The concentration of fT4 was positively correlated to Hb in demented males (p < 0.001), whereas TSH concentration was positively correlated to Hb in demented females (p < 0.05). The results show that TSH is not sufficient as the sole screening assay for evaluation of possible thyroid dysfunction in psychogeriatric patients. In addition, central (hypothalamic?) hypothyroidism may be present in a substantial amount of psychogeriatric patients, as we found an adequate TSH response to exogenous thyrotropin-releasing hormone (TRH) also in patients with decreased fT3/fT4 and no signs of non thyroid diseases. Furthermore, there was an apparent lack of correlation between thyroid hormone levels and dementia (or subgroups of dementia), even though thyroid hormone abnormalities seemed to be rather common in frontotemporal dementia (38%) and non specified dementia (36%).
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| 4. |
- Minthon, Lennart, et al.
(författare)
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Somatostatin and neuropeptide Y in cerebrospinal fluid: correlations with severity of disease and clinical signs in Alzheimer's disease and frontotemporal dementia
- 1997
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 8:4, s. 232-239
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Tidskriftsartikel (refereegranskat)abstract
- Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common types of progressive neurodegenerative disorder in our catchment area. The distribution of cortical degeneration in FTD is mainly the reverse of that in AD, while there are both differences and similarities in the clinical characteristics. Somatostatin and neuropeptide Y (NPY) are neuropeptides with a widespread distribution in the human cerebral cortex. Somatostatin is involved in the regulation of hormone release from the anterior pituitary and may act as a neurotransmitter-modulator. NPY is a potent anxiolytic neuropeptide. Somatostatin and NPY coexist in the cerebral cortex, basal ganglia and in amygdaloid complexes. The present study of AD (n = 34) and FTD (n = 22) analyses the cerebrospinal-fluid (CSF) levels of somatostatin-like immunoreactivity and NPY-like immunoreactivity and correlates their levels to 54 different clinical items, such as restlessness, anxiety, irritability and depression. The CSF levels of the two neuropeptides somatostatin and NPY were significantly correlated in FTD (p < 0.02), but not in AD. Several significant correlations to the clinical signs were found: in AD disorientation and dyspraxia, and in FTD agitation, irritability and restlessness. Somatostatin showed a significant negative correlation with severity of dementia in AD (p < 0.013).
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| 5. |
- Gustafson, Lars, et al.
(författare)
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Apolipoprotein E genotyping in Alzheimer’s disease and frontotemporal dementia
- 1997
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 8:4, s. 240-243
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Tidskriftsartikel (refereegranskat)abstract
- Alzheimer's disease (AD) and frontotemporal dementia (FTD) are characterized by progressive neuronal loss and microvacuolization, although with different distributions of cortical involvement. In contrast to AD there is no amyloid, senile plaques or tangles in FTD. The involvement of chromosome 19 in AD has been associated with apoliprotein E (ApoE) and the epsi4 gene frequency has been related to increased risk and early onset of AD. Our analysis of frequency of the ApoE alleles in 38 patients with AD, 21 patients with FTD and 29 normal controls indicates an association of both AD and FTD with an increased frequency of the epsi4 allele and in AD also with homozygosity for epsi4. Our results might indicate that ApoE epsi4 is an important aggravating and pathoplastic factor in the presence of genetic and other determinants for the development of AD or FTD. A significantly higher epsi2 frequency in our FTD material compared to AD and normals might also indicate a connection with the distribution of cortical degeneration.
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| 6. |
- Edberg, Anna-Karin, et al.
(författare)
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Effects of clinical supervision on nurse-patient cooperation quality - A controlled study in dementia care.
- 1996
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Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 5:2, s. 127-146
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Tidskriftsartikel (refereegranskat)abstract
- An intervention consisting of individualized planned care for patients and regular clinical systematic supervision for nurses was carried out on a ward for dementia care (the experimental ward, EW). On a similar control ward (CW), no changes were made. Observations of nurse-patient cooperation during morning care were collected at both wards, before and during the intervention. The observations (N = 107) were analyzed blindly and sorted into already-developed categories. The distribution of the cooperation-style categories was then analyzed statistically. The patients who survived throughout the study period (N = 18) were also compared over time. Nurse-patient cooperation at the EW improved significantly during the intervention period, whereas, at the CW, it deteriorated (p = .02). Status of surviving patients followed the same pattern (p = .001). The findings indicate that such interventions can improve the quality of nurse-patient cooperation in dementia care.
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| 7. |
- Elmståhl, Sölve, et al.
(författare)
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How should a group living unit for demented elderly be designed to decrease psychiatric symptoms?
- 1997
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Ingår i: Alzheimer Disease and Associated Disorders. - : Ovid Technologies (Wolters Kluwer Health). - 0893-0341. ; 11:1, s. 47-52
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Tidskriftsartikel (refereegranskat)abstract
- The main objectives were to study relationships between the design of group living (GL) units and psychiatric symptoms in demented patients before, 6 months after, and 1 year after admission to GL units. The study population comprised 105 demented elderly (83 ± 6 years), 37% with dementia of Alzheimer's type and 58% with vascular dementia. The patients were relocated by the municipal care planning team after clinical examination. An observational scale (the Organic Brain Syndrome scale) was used to assess confusional symptoms and disorientation. The physical environment was assessed by an architect using the Therapeutic Environment Screening Scale, which evaluates general design, space, lighting, noise, communication area, floor plan, and related factors. Less than 15% of the patients had no signs of dyspraxia, hallucinosis, dysphasia, or depression at admission, whereas 66% or more reported lack of vitality, aggressiveness, or restlessness. Fourteen out of 18 units had a corridor-like design (group A), one unit an L-shaped design (group B), and the others a square or H-shaped design (group C). Patients living in the B unit had less disorientation than the others at the 6-month follow-up. After 1 year, the patients in the A units had more dyspraxia, lack of vitality, and disorientation of identity. The communication areas in the units were negatively associated with 'disorientation for recent memory' and 'lack of vitality,' adjusted for type of dementia (r = -0.13 to -0.16). The size of the activity area, indoor public rooms in square meters, was not correlated to confusional reactions and disorientation. In conclusion, a GL unit design that facilitates perception without reducing the communication area is to be preferred.
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| 8. |
- Elmståhl, Sölve, et al.
(författare)
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Bias in diet assessment methods - Consequences of collinearity and measurement errors on power and observed relative risks
- 1997
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 26:5, s. 1071-1079
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Tidskriftsartikel (refereegranskat)abstract
- Background. If several risk factors for disease are considered in a regression model and these factors are affected by measurement errors, the observed relative risk will be attenuated. In nutritional epidemiology, several nutrient variables show strong correlation, described as collinearity. The observed relative risk will then depend not only on the validity of the chosen diet assessment method but also on collinearity between variables in the model. Methods. The validity of different diet assessment methods are compared. The correlation coefficients between common nutrients and foods are given using data from the Malmo Food Study. Intake of nutrients and foods were assessed with a modified diet history method, combining a 2-week food record for beverages and lunch/dinner meals and a food frequency questionnaire for other foods. The study population comprised 165 men and women aged 50-65 years. A multivariate logistic regression model is used to illustrate the effect of collinearity on observed relative risk (RRo). Results. A moderate to high correlation between risk factors will substantially influence RRo even when using diet assessment methods with high validity. Methods with low validity might even give inverse RRo. Conclusion. It is stressed that caution must be exercised and only a selected number of variables should be included in the model, especially when they are highly intercorrelated, since RRo might be severely biased.
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| 9. |
- Elmståhl, S., et al.
(författare)
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Increased incidence of fractures in middle-aged and elderly men with low intakes of phosphorus and zinc
- 1998
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 8:4, s. 333-340
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to determine dietary risk factors for fracture in men aged 46-68 years. Six thousand five hundred and seventy-six men were randomly invited using the Municipal Registry to a diet and health study. The diet was assessed using a combined 7-day menu book for hot meals, beverages and dietary supplements and a quantitative food frequency questionnaire for other foods. The fracture incidence was 103/10,000 person-years during a mean follow-up of 2.4 years. Zinc and phosphorus intake were associated with fracture risk and showed a threshold effect. The zinc intake in the lowest decentile, 10 mg daily, was associated with almost a doubled risk of fracture compared with the fourth and fifth quintiles (RR = 0.47; 95% confidence interval, 27-82) of zinc intake adjusted for energy, previous fractures, lifestyle factors and co-morbidity. Energy-adjusted phosporus intake in the lowest quintile, mean level 1357 mg, was associated with an increased fracture risk compared with subjects in the second quintile. Smoking, martial status and physical activity were independently associated with fracture risk. Calcium, retinol and vitamin D showed no associations with fracture risk. We conclude that inadequate intakes of zinc and phosporus are important risk factors for fracture.
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| 10. |
- Lundström, Maria, et al.
(författare)
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Reorganization of nursing and medical care to reduce the incidence of postoperative delirium and improve rehabilitation outcome in elderly patients treated for femoral neck fractures
- 1999
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 13:3, s. 193-200
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effectiveness of a nursing and medical intervention programme for the prevention and treatment of delirium in elderly patients treated for femoral neck fractures. Forty-nine patients consecutively admitted to an orthogeriatric rehabilitation unit in a county hospital in northern Sweden were compared with historical cohorts of corresponding patients in the same and other hospitals. There was a total reorganization of nursing and medical care of patients with femoral neck fractures. The intervention programme consisted of staff education, co-operation between orthopaedic surgeons and geriatricians, individual care and planning of rehabilitation, improved ward environment, active nutrition, improved continuity of care and prevention and treatment of complications associated with delirium. The main result of the study was that the incidence of delirium was significantly lower than in all previously published studies. The incidence of other postoperative complications was also lower, and a larger proportion of the patients regained independent walking ability and could return to their previous living conditions on discharge. It can be concluded that the intervention programme reduced the incidence and duration of delirium and improved functional outcome for elderly patients treated for femoral neck fractures.
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