| 1. |
- Berner, Jessica, et al.
(författare)
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Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden
- 2015
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Ingår i: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 21:3, s. 237-249
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Tidskriftsartikel (refereegranskat)abstract
- Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.
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| 2. |
- Lagergren, Mårten, et al.
(författare)
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Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden
- 2016
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:1, s. 147-158
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Tidskriftsartikel (refereegranskat)abstract
- The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontal target efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001-2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70-90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40-50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern-it was almost 100 % in all areas for IADL dependency, but only 50-60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.
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| 3. |
- Rennemark, Mikael, 1951-, et al.
(författare)
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Relationships between frequency of moderate physical activity and longevity : an 11-year follow-up study
- 2018
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Ingår i: Gerontology and geriatric medicine. - : Sage Publications. - 2333-7214. ; 4, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Moderate physical activity gains survival. There are, however, several variables that may affect this relationship. In this study, the relationship between moderate physical activity and longevity was investigated, taking into account age, gender, smoking habits, cohabitation status, body mass index, leg strength and balance, education level and cognitive function. Method: A sample of 8,456 individuals aged 60 to 96 years, representative of the Swedish population, was included. Participants were followed from 2004 to 2015. Cox regression analyses were used to investigate the predictive value of physical activity on longevity. Results: Participants still alive in the follow-up measure were more physically active on a moderate level. Being active 2 to 3 times a week or more was related to a 28% lower risk of not being alive at the follow-up measure. Discussion: The low frequency of physical activity, necessary for survival benefits should be considered in public health programs.
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| 4. |
- Lindberg, Terese, et al.
(författare)
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Older individuals’ need for knowledge and follow-up about their chronic atrial fibrillation, lifelong medical treatment and medical controls
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:4, s. 1022-1030
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Tidskriftsartikel (refereegranskat)abstract
- Older individuals with chronic atrial fibrillation (AF) often experience physical symptoms and feel psychologically unwell. In addition, these persons are prescribed lifelong medical treatment that requires regular monitoring. Through 11 individual interviews, this interpretive description study aimed to explore and describe lifelong medical treatment and the need for medical controls as experienced from the perspective of older individuals living with chronic AF. The interviews were performed during 2014–2015; furthermore, they were recorded, transcribed verbatim and analysed for thematic patterns using thematic analysis inspired by Braun and Clarke. Ethical standards were followed throughout the study. The findings revealed one main theme: ‘ambivalence in the need of knowledge’ showing that lifelong medical treatment and the need for medical controls, in general, meant experiencing feelings of ‘it doesn't matter, but it does matter’ and ‘being in the hands of the healthcare system’. The older persons lacked knowledge about their condition, which generated poor insight into their medical treatment and this in turn affected their daily life. They had thoughts and questions about their medication, but did not have an opportunity to ask the questions because of lack of follow-up from the healthcare system. The findings underscore the negative impact chronic AF has on older people's life and emphasises the need for follow-up and providing information from health care to these individuals.
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| 5. |
- Nilsson, Erik D., et al.
(författare)
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Copeptin, a Marker of Vasopressin, Predicts Vascular Dementia but not Alzheimer's Disease
- 2016
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Ingår i: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 52:3, s. 1047-1053
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Copeptin is a reliable surrogate marker for the neurohypophyseal hormone vasopressin. Elevated plasma level of copeptin has been associated with cardiovascular and metabolic disease risk.OBJECTIVE: To investigate the association between copeptin and risk of dementia.METHODS: In all, 18,240 individuals from Malmö, Sweden, were examined between 2002 and 2006 (mean age 69.3 years, 69.8% men). Incident cases of dementia until 31 December 2009 were identified by linkage with the Swedish National Patient Register. To validate the dementia diagnoses, medical records as well as laboratory and neuroimaging data were carefully reviewed. Baseline level of copeptin was measured in frozen plasma in: (1) all participants who were diagnosed with dementia during follow-up, (2) a random sample of 5100 individuals of the cohort.RESULTS: During a median follow-up of 4.2 years, there were 374 incident dementia cases (age range 60-83 years at baseline): 120 were classified as Alzheimer's disease (AD), 84 as vascular dementia (VaD), and 102 as mixed dementia. In logistic regressions adjusted for cardiovascular risk factors, baseline level of copeptin predicted incident VaD (Odds ratio (OR) 1.30 per 1 SD increase in log copeptin, 95% CI 1.03-1.64). Copeptin did not predict incidence of all-cause dementia (OR 1.05, 95% CI 0.94-1.18), AD (OR 0.97, 95% CI 0.79-1.18), or mixed dementia (OR 0.85, 95% CI 0.68-1.05).CONCLUSION: Elevated plasma level of copeptin is a risk marker for incident VaD, but not for incident AD. This suggests that the vasopressin hormonal system might be involved in the development of VaD.
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| 6. |
- Cai, Gui-Hong, et al.
(författare)
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Both weight at age 20 and weight gain have an impact on sleep disturbances later in life : Results of the EpiHealth study
- 2018
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 41:1
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: Obesity is often associated with impaired sleep, whereas the impact of body mass index (BMI) at younger age and previous weight gain on sleep problems remains unknown. Methods: The present study utilized data from the Swedish EpiHealth cohort study. A total of 15845 participants (45–75 years) filled out an internet-based questionnaire. BMI was calculated from both measured data at study time and self-reported data at age 20 from the questionnaire. Results: Sleep-related symptoms were most common among obese individuals (BMI > 30 kg/m2). An association between weight gain and sleep problems was found and those with a low BMI at age 20 were most vulnerable to weight gain when it came to risk of sleep problems. Among those who were underweight (BMI < 18.5 kg/m2) at age 20, weight gain (kg/year) was associated with difficulties initiating sleep with an adjusted OR of 2.64 (95% CI: 1.51–4.62) after adjusting for age, sex, smoking, alcohol consumption, physical activity, education, and civil status. The corresponding adjusted OR’s among those who had been normal weight (BMI 18.5–24.99) and overweight (BMI 25–29.99 kg/m2) at age 20 were 1.89 (1.47–2.45) and 1.02 (0.48–2.13), respectively. Also difficulties maintaining sleep and snoring were most strongly related to weight gain among those who were underweight at age 20 with decreasing odds with increasing BMI at that age. Conclusions: Sleep problems are related to weight gain and obesity. The impact of weight is most pronounced among those who had a low BMI when young.
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| 7. |
- Lindberg, Terese, et al.
(författare)
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Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG
- 2016
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 11, s. 1083-1090
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: With longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom®. Methods: Two hundred elderly persons aged 66–93 years were recruited from the Swedish National Study on Aging and Care in 2010–2013, and data were collected via wireless LTR ECG-BodyKom. Results: Screening with the LTR ECG revealed that persistent atrial fibrillation (AF) occurred in 10% of the outpatient population aged ≥66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60–80 years) and older (≥80 years) elderly participants. Furthermore, all patients with paroxysmal AF had a CHA2DS2VASc score of ≥2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it. Conclusion: The increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment.
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| 8. |
- Nilsson, Erik, et al.
(författare)
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Associations of central and brachial blood pressure with cognitive function : a population-based study
- 2016
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Ingår i: Journal of Human Hypertension. - : Nature Publishing Group. - 0950-9240 .- 1476-5527. ; 30:2, s. 95-99
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Tidskriftsartikel (refereegranskat)abstract
- Previous observational studies on the association between brachial blood pressure (BP) and cognition have reported conflicting results. Central BP has been hypothesized to be more strongly related to cognition than brachial BP. The aim of this study was to assess the association between brachial as well as central BP and cognitive function, both cross-sectionally and with brachial BP measured 17 years before cognitive testing. The study population comprised 2548 individuals aged 61-85 years at follow-up (61.4% women). The cognitive tests administered were A Quick Test of cognitive speed and the Mini Mental State Examination. In fully adjusted linear regressions, small but significant cross-sectional associations were found between higher BP (systolic, diastolic and pulse pressure) and worse results on both of the cognitive tests (P-values <0.05). No significant prospective associations were found. Central BP did not show a stronger association than brachial BP did. After stratification, significant results were mainly found in the group taking BP-lowering drugs at follow-up. In summary, these findings add to existing evidence on the relationship between BP and cognition, but they do not support a superior role of central compared with brachial BP in the elderly.
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| 9. |
- Luoto, Johannes, et al.
(författare)
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Incidence of airflow limitation in subjects 65-100 years of age.
- 2016
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 47:2, s. 461-472
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Tidskriftsartikel (refereegranskat)abstract
- The true incidence of chronic obstructive pulmonary disease is largely unknown, because the few longitudinal studies performed have used diagnostic criteria no longer recommended by either the European Respiratory Society or the American Thoracic Society (ATS).We studied the incidence and significance of airflow limitation in a population-based geriatric sample using both an age-dependent predicted lower limit of normal (LLN) value and a fixed-ratio spirometric criterion.Out of 2025 subjects with acceptable spirometry at baseline, 984 subjects aged 65-100 years completed a 6-year follow-up visit. Smoking habits were registered at baseline. Exclusion criteria were non-acceptable spirometry performance according to ATS criteria and inability to communicate. Airflow limitation was defined both according to forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio <0.7 and
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| 10. |
- Luoto, Johannes, et al.
(författare)
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Relative and absolute lung function change in a general population aged 60-102 years
- 2019
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 53:3
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Tidskriftsartikel (refereegranskat)abstract
- Data on longitudinal lung function change in the elderly are scarce. Uncertainty remains about whether to use absolute or relative change and how it relates to subject demographics.We studied absolute and relative forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) change in a population-based geriatric sample using a repeated measurements model adjusted for age, sex, smoking habits, heart failure, hypertension, diabetes, coronary heart disease, educational level, occupation, alcohol consumption, C-reactive protein (CRP) and body mass index. 3736 participants aged 60-102 years completed between one and five spirometries during 13.5 years of follow-up. Lung volumes, FEV1 quotient (Q) and Global Lung Initiative (GLI)-2012 and National Health and Nutrition Examination Survey (NHANES) III z-scores were presented from 6932 spirometries.Adjusted absolute change per year (95% CI) was -51.7 (-63.7--39.9) mL for FEV1 and -56.2 (-73.6--38.8) mL for FVC. Adjusted relative change per year was -2.97 (-3.53--2.40)% for FEV1 and -2.46 (-3.07--1.85)% for FVC. Risk factors for increased relative FVC and FEV1 decline were female sex, higher age, current smoking habits, elevated CRP (nonsignificant for FEV1, p=0.057) and low educational level. For increased absolute decline the risk factors were male sex and being a current smoker for FEV1 and low education for FVC.Relative but not absolute change correlated significantly with clinically relevant markers of functional status and may be superior to absolute change in risk factor analysis. Cross-sectional reduction in terms of FEV1Q was ∼1 unit per 10 years for both sexes. Proportions of subjects with results below lower limit of normal using NHANES III were close to anticipated, but were two to four times higher than expected using GLI-2012.
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