| 1. |
- Johansson, Linda, 1978-, et al.
(författare)
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Using aggregated data from Swedish national quality registries as tools to describe health conditions of older adults with complex needs
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33:5, s. 1297-1306
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Tidskriftsartikel (refereegranskat)abstract
- Background: Combining National Quality Registries (NQRs) with existing National Health Registries (NHRs) might make it possible to get a wider picture of older adults health situation. The aim was to examine the feasibility of aggregating data across different NQRs and existing NHRs to explore the possibility to investigate trajectories and patterns of disease and care, specifically for the most ill older adults. Method: A Swedish twin population (N = 44,816) was linked to nine NQRs and four NHRs. A descriptive mixed-method study was performed. A manifest content analysis identified which health parameters were collected from each NQR. Factor analysis identified patterns in representation across NQRs. Two case studies illustrated individual trajectories of care by using NQRs and NHRs. Results: About 36% of the population was registered in one or more NQRs. NQRs included 1849 variables that were sorted into 13 categories with extensive overlap across the NQRs. Health and function variables were identified, but few social or cognitive variables. Even though most individuals demonstrated unique patterns of multi-morbidities, factor analysis identified three clusters of representation in the NQRs with sufficient sample sizes for future investigations. The two cases illustrated the possibility of following patterns of disease and trajectories of care. Conclusions: NQRs seem to be a significant source for collecting data about a population that may be underrepresented in most research on aging because of their age and poor health. However, NQRs are primarily disease related, and further development of the registries to maximize coverage and utility is needed.
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| 2. |
- Silverglow, Anastasia, et al.
(författare)
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What constitutes feeling safe at home? A qualitative interview study with frail older people receiving home care
- 2021
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 8:1, s. 191-199
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To highlight experiences of what constitutes feeling safe at home among frail older people receiving home care. Design: Qualitative descriptive study. Methods: The sample consists of 12 individual recorded interviews with frail older people in their homes. Interviews were transcribed verbatim and analysed using qualitative content analysis. The data collection was performed in spring 2018. Results: The analysis resulted in three categories: "Having a feeling of'at-homeness'" describes the older people's surrounding environment and their efforts to maintain independence; "being able to influence" describes the importance for older people to shape their care by being in control and having an opportunity for self-determination in the context of home care; and "being able to trust staff" relates to expecting staff's knowledge and skills and to appreciating the staff's ability to create positive relations.
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| 3. |
- Bergman, Penny, et al.
(författare)
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Age-related decline in senses and cognition : A Review
- 2021
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Ingår i: Senses and Sciences. - Rom : Eleven Senses Info. - 2284-2489. ; 8:2, s. 1264-1292
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Tidskriftsartikel (refereegranskat)abstract
- Background: Age-related decline in the senses is well-known, with a decline in the sensitivity of all senses having been observed. Decline in the senses can be connected to different neurological disorders and cognitive function and may even be a possible predictor of death. Aim: The aim of this narrative review was to find and explore recent literature on the covariation between age-related decline in the different senses and co-existing effects on cognitive ability and quality of life. Results and Discussion: Six themes could be identified, these were: “Decline due to normal ageing?”, “Technical aids and solutions”, “Wellbeing”, “Memory training”, “Verbal exercises” and “Sensory training”. Large differences between the different senses were obtained. However, the senses showed similar patterns in the different themes. Conclusion: It could be concluded that there are many similarities concerning the connections between the decline in individual senses and cognition and memory. Measurements of wellbeing and quality of life are common in the evaluation of the senses, and all types of decline have an impact on activities in daily life.
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| 4. |
- Gustafson, Deborah R., et al.
(författare)
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Obesity, vascular disease and frailty in aging women with HIV
- 2021
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Ingår i: Advances in Geriatric Medicine and Research. - : Hapres. - 2632-9921. ; 3:3
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Forskningsöversikt (refereegranskat)abstract
- Women with chronic HIV infection (WWH) living in the United States, experience a disproportionately high rate of obesity compared to uninfected populations. Both overweight and obesity, particularly central obesity, are major contributors to insulin resistance, hypertension, and dyslipidemia—the major components of metabolic syndromes, including type 2 diabetes, and leading to increased cardiovascular risk, including coronary heart disease, and cerebrovascular diseases. Notably, declining physical performance and frailty co-occur with vascular morbidities as well as changes in bone. These factors tend to exacerbate each other and accelerate the aging trajectory, leading to poorer quality of life, cognitive impairments, dementia, and eventually, death. In WWH, persistent HIV infection, sustained treatment for HIV infection, and concomitant obesity, may accelerate aging-related morbidities and poorer aging outcomes. Furthermore, health disparities factors common among some WWH, are independently associated with obesity and higher vascular risk. The purpose of this review is to describe the constellation of obesity, cardio- and cerebrovascular diseases, bone health and frailty among aging WWH, a 21st century emergence.
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| 5. |
- Möller U, Olsson, et al.
(författare)
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Modern technology against falls – A description of the MoTFall project
- 2021
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Ingår i: Health Informatics Journal. - : SAGE Publications Ltd. - 1460-4582 .- 1741-2811. ; 27:2
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Tidskriftsartikel (refereegranskat)abstract
- To meet future challenges from an older and physically less active population innovative solutions are needed. Modern Technology against Falls (MoTFall) aims to prevent falls, increase physical activity and improve self-rated health among older people by means of an information and communication technology based system. The project has developed technology-based solutions, focusing on person-centred care. A participatory research design was applied in the development of a mobile application, a wearable inertial movement measurement unit (IMMU), called the Snubblometer (‘snubbla’ is ‘stumble’ in Swedish) and a web-based education programme for health care professionals. The mobile application includes a fall risk index, exercises and information related to falls prevention. By linking the app to the IMMU, person-centred interventions can be developed and implemented in various health care settings and with different target populations. The IMMU has shown good validity and reliability for measuring postural sway and high sensitivity and specificity for measuring a near fall. The education programme is directed at non-graduate health care professionals in nursing homes and home care. The technical solutions have potential for use in research and in clinical practice. © The Author(s) 2021.
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| 6. |
- Johansson, Yvonne A, 1956-, et al.
(författare)
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Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting
- 2021
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Delirium is common in older hospitalized patients. It has serious consequences e.g., poor health outcomes, mortality and increased costs. Despite that, many cases are undetected. Early detection of delirium is important in improving outcomes and use of assessment tools improves detection rates. The 4AT is a brief screening tool for delirium detection, which has not previously been translated into Swedish. The study aim was to evaluate diagnostic accuracy and clinical applicability of a Swedish version of the screening tool 4AT for delirium detection. Method This diagnostic test accuracy study used a quantitative and a qualitative approach and evaluated the patients' and the health care professionals' experiences of the tool. Study included 200 patients >= 65 years from a university hospital and a county hospital in two Swedish regions. Medical specialties were geriatric stroke/neurology, geriatric multimorbidity, severe cognitive impairment, orthopaedic, and urology. The translated 4AT was tested against the reference standard DSM-IV-TR criteria, based on the Organic Brain Syndrome scale and patient records. The 4AT was assessed simultaneously and independently by two assessors. Additionally, data was collected through patient record reviews, and questions about applicability to the patients (n = 200) and the assessors (n = 37). Statistical analyses, and qualitative content analyses were conducted. Results By reference standard 18% had delirium, and by 4AT 19%. The overall percent agreement was 88%, AUROC 0.808, sensitivity 0.70 (95% CI 0.51-0.84) and specificity 0.92 (95% CI 0.87-0.96). In the ward for severe cognitive impairment (n = 63) the 4AT was less sensitive and less specific. In the other wards (n = 132) sensitivity was 0.77 (95% CI 0.50-0.93), specificity 0.93 (95% CI 0.87-0.97), and AUROC 0.848. Interrater reliability (Kappa) was 0.918, p = < 0.001 (n = 144). The 4AT was well tolerated by patients, easy to use for health care professionals, and took a few minutes to conduct. Conclusion The Swedish version of 4AT is an accurate and applicable tool to use in clinical practice for detecting delirium in hospitalized patients across different medical specialities, and to use by different professionals and levels of seniority. To improve patient outcomes, we recommend the 4AT to be incorporated in clinical practice in health care settings in Sweden.
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| 7. |
- Olivo, G., et al.
(författare)
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Immediate effects of a single session of physical exercise on cognition and cerebral blood flow: A randomized controlled study of older adults
- 2021
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Ingår i: Neuroimage. - : Elsevier BV. - 1053-8119 .- 1095-9572. ; 225
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Tidskriftsartikel (refereegranskat)abstract
- Background: Regular physical activity is beneficial for cognitive performance in older age. A single bout of aerobic physical exercise can transiently improve cognitive performance. Researchers have advanced improvements in cerebral circulation as a mediator of long-term effects of aerobic physical exercise on cognition, but the immediate effects of exercise on cognition and cerebral perfusion are not well characterized and the effects in older adults are largely unknown. Methods: Forty-nine older adults were randomized to a 30-min aerobic exercise at moderate intensity or relaxation. Groups were matched on age and cardiovascular fitness (VO2 max). Average Grey Matter Blood Flow (GMBF), measured by a pulsed arterial-spin labeling (pASL) magnetic resonance imaging (MRI) acquisition, and working memory performance, measured by figurative n-back tasks with increasing loads were assessed before and 7 min after exercising/resting. Results: Accuracy on the n-back task increased from before to after exercising/resting regardless of the type of activity. GMBF decreased after exercise, relative to the control (resting) group. In the exercise group, higher n-back performance after exercise was associated with lower GMBF in the right hippocampus, left medial frontal cortex and right orbitofrontal cortex, and higher cardiovascular fitness was associated with lower GMBF. Conclusion: The decrease of GMBF reported in younger adults shortly after exercise also occurs in older adults and relates to cardiovascular fitness, potentially supporting the link between cardiovascular fitness and cerebrovascular reactivity in older age.
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| 8. |
- Sandin Wranker, Lena, et al.
(författare)
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The Health of Older Family Caregivers - A 6-Year Follow-up
- 2021
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Ingår i: Journal of Gerontological Social Work. - : Informa UK Limited. - 1540-4048 .- 0163-4372. ; 64:2, s. 190-207
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Tidskriftsartikel (refereegranskat)abstract
- It is unclear whether caregiving has an impact on the physical, mental and functional health of older caregivers. This study aimed to describe physical, mental and functional health in relation to family caregiving in old age (60+) over a six-year period. The study comprised 2,294 randomly selected individuals (60-96 years) from the Swedish National Study on Aging and Care, who answered the question on whether they were caregivers and who were followed up six years later. The prevalence of family caregivers was 13.1% and the incidence was 12.4%. Four tracks (T) were identified; T1) Family caregiver both at baseline and follow-up (n = 74), T2) Family caregiver at baseline but not at follow-up (n = 226), T3) non-caregiver at baseline but family caregiver at follow-up (n = 218), T4) non-caregiver both at baseline and follow-up (1,776). Only non-caregivers (T4) reported a decline in mental health, p < .036. Worries about health increased significantly in T2 and T4. The prevalence of caregivers was 13.1% with a high turnover. There are differences between family caregivers and non-caregivers in deterioration in physical and mental health as well as physical function over a six-year period.
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| 9. |
- Li, Peishun, 1988, et al.
(författare)
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Metabolic Alterations in Older Women With Low Bone Mineral Density Supplemented With Lactobacillus reuteri
- 2021
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Ingår i: JBMR Plus. - : Wiley. - 2473-4039. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. Osteoporosis and its associated fractures are highly prevalent in older women. Recent studies have shown that gut microbiota play important roles in regulating bone metabolism. A previous randomized controlled trial (RCT) found that supplementation with Lactobacillus reuteri ATCC PTA 6475 (L.reuteri) led to substantially reduced bone loss in older women with low BMD. However, the total metabolic effects of L. reuteri supplementation on older women are still not clear. In this study, a post hoc analysis (not predefined) of serum metabolomic profiles of older women from the previous RCT was performed to investigate the metabolic dynamics over 1 year and to evaluate the effects of L. reuteri supplementation on human metabolism. Distinct segregation of the L. reuteri and placebo groups in response to the treatment was revealed by partial least squares-discriminant analysis. Although no individual metabolite was differentially and significantly associated with treatment after correction for multiple testing, 97 metabolites responded differentially at any one time point between L. reuteri and placebo groups (variable importance in projection score >1 and p value <0.05). These metabolites were involved in multiple processes, including amino acid, peptide, and lipid metabolism. Butyrylcarnitine was particularly increased at all investigated time points in the L. reuteri group compared with placebo, indicating that the effects of L. reuteri on bone loss are mediated through butyrate signaling. Furthermore, the metabolomic profiles in a case (low BMD) and control population (high BMD) of elderly women were analyzed to confirm the associations between BMD and the identified metabolites regulated by L. reuteri supplementation. The amino acids, especially branched-chain amino acids, showed association with L. reuteri treatment and with low BMD in older women, and may serve as potential therapeutic targets. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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| 10. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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En utbildnings-intervention med simulering i äldredräkt i Skaraborgs Hälsoteknikcentrum för ökad insikt och förståelse för att åldras och leva med åldersrelaterade hälsoproblem
- 2021
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Ingår i: DAL-21 Det akademiska lärarskapet. - Skövde : Högskolan i Skövde. ; , s. 30-31
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Konferensbidrag (refereegranskat)abstract
- Världshälsoorganisationen, [1] belyser utmaningen att ge en vård som stödjer ett hälsosamt åldrande. Ett centralt hinder är den höga förekomsten av negativa attityder gentemot åldrandet, äldre personer och vård av äldre, särskilt bland vårdpersonal [2-4]. Vidare påvisas att sjuksköterskestudenter kan bära på negativa attityder till att vårda äldre och därför inte ser arbete inom äldrevård som ett önskvärt och framtida arbetsfält [5, 6]. Otillräcklig forskning avseende ålderism tillsammans med bristande utbildning inom området äldre, det normala åldrandet samt åldrandets hälsoproblem beskrivs som en bidragande faktor till ålderism [4]. Trots att interventioner kontinuerligt genomförs för att ändra attityder och minska ålderism i vården kvarstår dessa i betydande omfattning [3]. Det finns således ett behov av att skapa innovativa lösningar som bidrar till en ökad och hållbar förståelse för åldrandet, äldre och åldersrelaterade hälsoproblem. Detta adresseras i en ny utbildningsintervention med simulering i äldredräkt som utformats och genomförs i Skaraborgs Hälsoteknikcentrum (SHC), Högskolan i Skövde. Forskning [7] lyfter fram att simulering i utbildning, särskilt genom användande av utrustning som äldredräkt, är en framgångsrik väg att ändra studenters attityder gentemot äldre. Simulering i SHC ger även möjlighet att testa hälso- och välfärdsteknik vilket ytterligare kan inverka positivt på uppfattningar om dess nytta vid implementering av teknik i vården [8].Pågående utbildningsmoment i utbildning till sjuksköterska och distriktssköterskaUnder läsåret 2019-2020 har grupper av studerande inom omvårdnad deltagit i simulering i SHC. Vid denna simulering har äldredräkt använts för att återspegla upplevelsen av normalt åldrande och vanligt förekommande hälsoproblem. De studerande tilldelas en personas och genomför olika scenarier i SHC. I samband med detta besvaras enkät [9], före simulering samt efter simulering för att ta del av synen på åldrandet och att vårda äldre samt eventuell förändring efter genomgången simulering. Efter simuleringen reflekterar studenterna i grupp över upplevelsen av simuleringen, åldrandet och den vård som ges. Reflektionerna relateras sedan till centrala begrepp i omvårdnad samt sjuksköterskans kärnkompetenser. Vidare reflekterar de studerande över hur simuleringen påverkat deras insikt och förståelse samt hur det kommer att visa sig i den vård som ges.ForskningsprojektUtbildningsinterventionen beforskas som en del i ett longitudinellt projekt med övergripande syfte att studera hur en utbildningsintervention med simulering i äldredräkt inverkar på insikt och förståelse för åldrandet, att vara äldre och att leva med åldersrelaterade hälsoproblem i kontexten samt vård av äldre personer. Vidare är syftet att longitudinellt studera studenters syn på åldrandet, äldre och att vårda äldre personer. De hittills genomförda simuleringarna visar tecken på att studenters insikt och förståelse avseende åldrandet, att åldras och att leva med åldersrelaterade hälsoproblem förändras på ett positivt sätt. Det finns därför ett behov av att systematiskt utvärdera effekten och nyttan av den intervention som nu genomförs i SHC. Externa medel söktes hos Familjen Kamprads stiftelse och 3,5 miljoner erhölls för att genomföra projektet och att anställa en doktorand.Referenser1. WHO, Integrated care for older people (ICOPE) implementation framework: guidance for systems and services. 2019, Geneva: World Health Organization.2. Wyman, M.F., S. Shiovitz-Ezra, and J. Bengel, Ageism in the Health Care System: Providers, Patients, and Systems, in Contemporary Perspectives on Ageism, L. Ayalon and C. Tesch-Römer, Editors. 2018, Springer International Publishing: Cham. p. 193-212.3. Burnes, D., et al., Interventions to Reduce Ageism Against Older Adults: A Systematic Review and Meta-Analysis.American Journal of Public Health, 2019. 109(8): p. e1-e9.4. Wilson, D.M., et al., A critical review of published research literature reviews on nursing and healthcare ageism. Journal of Clinical Nursing, 2017. 26(23-24): p. 3881-3892.5. Szadowska-Szlachetka, Z., et al., Attitudes of students of nursing major towards people of geriatric age. Polish Journal of Public Health, 2019. 129(3): p. 95.6. Naughton, C., K.L. O’Shea, and N. Hayes, Incentivising a career in older adult nursing: The views of student nurses. International Journal of Older People Nursing, 2019. 14(4): p. e12256.7. Giner Perot, J., et al., Aging-simulation experience: impact on health professionals’ social representations. BMC Geriatrics, 2020. 20(1): p. 14.8. Frennert, S. and K. Baudin, The concept of welfare technology in Swedish municipal eldercare. Disability and Rehabilitation, 2019: p. 1-8.9. Burbank, P.M., G.J. Burkholder, and J. Dugas, Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses. Applied Nursing Research, 2018. 43: p. 98-104
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