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  • Berner, Jessica, et al. (författare)
  • Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden
  • 2015
  • Ingår i: Health Informatics Journal. - : SAGE. - 1460-4582 .- 1741-2811. ; 21:3, s. 237-249
  • 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.
  • Turunen, Merita, et al. (författare)
  • Computer-based cognitive training for older adults : Determinants of adherence
  • 2019
  • Ingår i: PLoS ONE. - San Fransisco, USA : Public Library Science. - 1932-6203 .- 1932-6203. ; 14:7, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • The possibilities of computer-based cognitive training (CCT) in postponing the onset of dementia are currently unclear, but promising. Our aim is to investigate older adults ' adherence to a long-term CCT program, and which participant characteristics are associated with adherence to the CCT. This study was part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Participants were 60-77-year-old individuals with increased dementia risk, recruited from previous population-based studies. The participants included in this study (n = 631) had been randomized to receive a multi-domain lifestyle intervention, including CCT. The measure of adherence was the number of completed CCT sessions (max = 144) as continuous measure. Due to a substantial proportion of participants with 0 sessions, the zero inflated negative binomial regression analyses were used to enable assessment of both predictors of starting the training and predictors of completing a higher number of training sessions. Several cognitive, demographic, lifestyle, and health-related variables were examined as potential predictors of adherence to CCT. Altogether, 63% of the participants participated in the CCT at least once, 20% completed at least half of the training, and 12% completed all sessions. Previous experience with computers, being married or cohabiting, better memory performance, and positive expectations toward the study predicted greater odds for starting CCT. Previous computer use was the only factor associated with a greater number of training sessions completed. Our study shows that there is a large variation in adherence to a long-lasting CCT among older adults with an increased risk of dementia. The results indicate that encouraging computer use, and taking into account the level of cognitive functioning, may help boost adherence to CCT.
  • Lagergren, Mårten, et al. (författare)
  • Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden
  • 2016
  • Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 28:1, s. 147-158
  • 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.
  • Liljeroos, Maria, 1965-, et al. (författare)
  • Long-term effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure : a randomized controlled trial
  • 2017
  • Ingår i: Quality of Life Research. - Dordrecht : Springer Netherlands. - 0962-9343 .- 1573-2649. ; 26:2, s. 367-379
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPartners of patients with heart failure provide both practical and emotional support. Many partners assume caregiving responsibilities without being aware of the burden related with this role.ObjectiveOur work has established that a psycho-educational intervention has benefits at 3, but not at 12 months for patients with heart failure. Further we had not described the long-term effects in caregivers. This study aimed to determine the 24-months effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure and study factors associated with a change in caregiver burden.DesignA randomized controlled study design, with a follow-up assessment after 24 months.Setting and participantsPartners to patients with heart failure were recruited from two hospitals in the southeast of Sweden.InterventionA three session nurse-led psycho-educational program was tested and included psychosocial support to maintain the partners’ physical and mental functions, and perceived control. Several instrument were used to measure caregiver burden, perceived control, physical and mental health, depression and morbidity.ResultsOne hundred fifty-five partners were included. There were no significant differences in any index of caregiver burden or morbidity among the partners in the intervention and control groups after 24 months. Overall, the mean total caregiver burden was found to be significantly increased compared to baseline (36 ± 12 vs 38 ± 14, p < 0.05). A younger partner, less comorbidity, higher levels of perceived control, better physical health and less symptoms of depression in patients, and better mental health in the partners were factors associated with absence of increased caregiver burden over time.Discussion and conclusionOur intervention did not significantly decrease caregiver burden or morbidity. Over time, several aspects of burden increased in both groups. To improve outcomes, individualized and targeted interventions might be beneficial.
  • Gustafson, Deborah R. (författare)
  • Adipose Tissue Complexities in Dyslipidemias
  • 2019
  • Ingår i: Dyslipidemia. - London : IntechOpen. - 9781839680045 - 9781839680038 - 9781839680052 ; , s. 1-22
  • Bokkapitel (refereegranskat)abstract
    • Adipose tissue is the largest organ in the human body and, in excess, contributes to dyslipidemias and the dysregulation of other vascular and metabolic processes. Adipose tissue is heterogeneous, comprised of several cell types based on morphology, cellular age, and endocrine and paracrine function. Adipose tissue depots are also regional, primarily due to sex differences and genetic variation. Adipose tissue is also characterized as subcutaneous vs. visceral. In addition, fatty deposits exist outside of adipose tissue, such as those surrounding the heart, or as infiltration of skeletal muscle. This review focuses on adipose tissue and its contribution to dyslipidemias. Dyslipidemias are defined as circulating blood lipid levels that are too high or altered. Lipids include both traditional and nontraditional species. Leaving aside traditional definitions, adipose tissue contributes to dyslipidemias in a myriad of ways. To address a small portion of this topic, we reviewed (a) adipose tissue location and cell types, (b) body composition, (c) endocrine adipose, (d) the fat-brain axis, and (e) genetic susceptibility. The influence of these complex aspects of adipose tissue on dyslipidemias and human health, illustrating that, once again, that adipose tissue is a quintessential, multifunctional tissue of the human body, will be summarized.
  • Westerlind, Björn, 1961-, et al. (författare)
  • Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents : a longitudinal cohort study
  • 2019
  • Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 31:8, s. 1078-1095
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundFalls and related injuries are common among older people, and several drug classes are considered to increase fall risk.AimsThis study aimed to investigate the association between the use of certain drug classes and falls in older nursing home residents in Sweden, and relate these to different age groups.MethodsInformation on falls that occurred in the previous year and regular use of possible fall risk drugs including non-benzodiazepine hypnotics (zopiclone and zolpidem) was collected from 331 nursing home residents during 2008–2011. Over the following 6 months, the occurrence of serious falls, requiring a physician visit or hospital care, was registered. Association between serious falls and drug use was compared between an older (≥ 85 years) and a younger group.ResultsAn increased fall risk (Downton Fall Risk Index ≥ 3) was found in 93% of the study subjects (aged 65–101 years). Baseline data indicated an association between falls that occurred in the previous year and regular use of non-benzodiazepine hypnotics (p = 0.005), but not with the other studied drug classes. During the following 6 months, an association between use of non-benzodiazepine hypnotics and serious falls in the older group (p = 0.017, odds ratio 4.311) was found. No association was found between the other studied drug classes and serious falls.DiscussionThese results indicate an association between falls and the use of non-benzodiazepine hypnotics, compounds that previously have been considered generally well-tolerated in older people.ConclusionsCaution is advocated when using non-benzodiazepine hypnotics regularly in older people living in nursing homes.
  • Sköldunger, Anders, et al. (författare)
  • Impact of Inappropriate Drug Use on Hospitalizations, Mortality, and Costs in Older Persons and Persons with Dementia : Findings from the SNAC Study
  • 2015
  • Ingår i: Drugs & Aging. - 1170-229X .- 1179-1969. ; 32:8, s. 671-678
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Inappropriate drug use (IDU) is an important risk factor for adverse outcomes in older persons. We aimed to investigate IDU and the risk of hospitalizations and mortality in older persons and in persons with dementia and to estimate the costs of IDU-related hospitalizations.Methods: We analyzed 4108 individuals aged a parts per thousand yen60 years from the Swedish National Study on Aging and Care (SNAC) data from Kungsholmen and Nordanstig (2001-2004). IDU was assessed by indicators developed by the Swedish National Board of Health and Welfare. Hospitalizations and mortality data were collected from Swedish registers. Regression models were used to investigate associations between IDU, hospitalizations, and mortality in the whole population and in the subpopulation of persons with dementia (n = 319), after adjustment for sociodemographics, physical functioning, and co-morbidity. Costs for hospitalizations were derived from the Nord-Diagnose Related Group cost database. Results IDU was associated with a higher risk of hospitalization [adjusted odds ratio (OR) = 1.46; 95 % confidence interval (CI) 1.18-1.81] and mortality [adjusted hazard ratio (HR) = 1.15; 95 % CI 1.01-1.31] within 1 year in the whole study population and with hospitalization (adjusted OR = 1.88; 95 % CI 1.03-3.43) in the subpopulation of persons with dementia, after adjustment for confounding factors. There was also a tendency for higher costs for hospitalizations with IDU than without IDU, although this was not statistically significant.Conclusions: Our findings suggest that IDU is associated with an increased risk of hospitalization in older persons and in persons with dementia. IDU is also associated with mortality among older persons. These findings highlight the need for cautious prescribing of long-acting benzodiazepines, anticholinergic drugs, concurrent use of three or more psychotropic drugs and drug combinations that may lead to serious drug-drug interactions to older patients. Further studies are needed to investigate the association between IDU and costs for hospitalizations.
  • Wimo, Anders, et al. (författare)
  • Formal and informal care of community-living older people : a population-based study from the Swedish National study on Aging and Care
  • 2017
  • Ingår i: The Journal of Nutrition, Health & Aging. - : Springer. - 1279-7707 .- 1760-4788. ; 21:1, s. 17-24
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC).Design: Cross-sectional, population based cohort.Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County.Participants: 3,338 persons ≥72 years.Measurements: Patterns and amounts of informal and formal care by cognition and area of residence.Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole.Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.
  • Joseph, Kenth L, et al. (författare)
  • Osteoarthritis-related walking disability and arterial stiffness-results from a cross-sectional study
  • 2019
  • Ingår i: Arthritis care and research : the official journal of the Arthritis Health Professions Association. - : John Wiley and Sons. - 2151-4658. ; 71:2, s. 252-258
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To compare 6 minute walking distance (6MWD) in a population-based osteoarthritis (OA) cohort with matched peers from the general population, and to explore the associations between walking ability and CVD risk (arterial stiffness) in the OA cohort.DESIGN: This cross-sectional study included participants (40-80 years) who self-reported OA (n=500) in a population-based study and age- and gender-matched peers from the general population (n=235). Clinical examinations of the OA participants included classification according to the American College of Rheumatology criteria, blood samples and measuring arterial stiffness (pulse wave velocity, PWV). Group differences in 6MWD were calculated with t-tests. The association between walking ability and CVD risk in the OA cohort was explored in multivariate regression models.RESULTS: In age stratified analyses, the largest mean difference in 6MWD was observed in the youngest age groups (40-49 years); the OA group walked 84.6 meters (female; 579.4 m vs 663.9 m, p<0.001) and 88.3 meters (male; 619.9 m vs 708.3 m, p=0.001) shorter than the reference groups, respectively. In the OA group, the 6MWD was significantly associated to PWV in adjusted analysis (p=0.001); 100 m longer walking distance corresponded to 0.3 m/s reduction in arterial stiffness.CONCLUSION: Already from the age of forty, people with OA have significantly shorter mean walking distance compared to matched peers, underlining the importance of early clinical approach to OA. Further, in the OA-group, the 6MWD was significantly associated with arterial stiffness, suggesting that walking ability is important for the CVD risk profile in OA. This article is protected by copyright. All rights reserved.
  • Hagglund, Patricia, et al. (författare)
  • Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
  • 2017
  • Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318 .- 1471-2318. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.
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