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- Akner, Gunnar, 1953-
(författare)
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Analysis of multimorbidity in individual elderly nursing home residents : development of a multimorbidity matrix
- 2009
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 49:3, s. 413-419
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Tidskriftsartikel (refereegranskat)abstract
- The chronic multimorbidity in individual elderly people is rarely documented in its entirety in present medical records, neither as cross-sectional overview nor as longitudinal time-course of various health problems. This obviously hampers an integrated clinical analysis. This work was aimed at evaluating the chronic multimorbidity in individual elderly patients and developing a method to map, quantify and grade the prevalence of the multimorbidity. An explorative study in 70 nursing home residents (55 women), mean age 85 was performed. Information on health problems was obtained through history, clinical examination and medical records. A 19-item multimorbidity matrix that maps, quantifies and grades the chronic morbidity in individual patients is presented. The 70 residents exhibited 275 different health problems; the top 3 items being neuropsychiatric, cardiovascular and gastrointestinal ones. The residents had a mean of 17 different chronic health problems and were prescribed a mean of 6.6 continuous medications per day. There was a significant correlation between the number of continuous drug prescriptions and both quantitative and graded multimorbidity-scores. The presented multimorbidity matrix provides a useful taxonomic overview over the health situation in individual multimorbid elderly and constitutes the basis for ongoing work to develop and renew the electronic health record into an "interactive health analysis system".
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- Almevall, Albin Dahlin, et al.
(författare)
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Accepting the inevitable : A mixed method approach with assessment and perceptions of well-being in very old persons within the northern Sweden Silver-MONICA study
- 2021
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 92
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAs the group of very old persons will form an increasing part of society, the study of how well-being is described and affected by specific factors will be of importance to meet the future needs of these persons. The aim of the study was to increase knowledge of well-being in very old persons by combining assessments and perceptions using the Philadelphia Geriatric Morale Scale (PGCMS).MethodIn a mixed method, convergent parallel design, 52 persons 80 years or older were assessed and interviewed using the PGCMS to combine assessment of morale and descriptions of perceptions of well-being using a mixed method approach.ResultsQuantitative and qualitative results converged in four areas: not feeling lonely and being included, rating and perceiving health as good, high physical function/ability and being physically active, living in own house and feeling at home. Areas perceived as important to well-being captured only in qualitative analysis were having freedom and engagement. An example of insights not achievable from the quantitative or qualitative analysis alone was that individuals with high morale expressed anxiety about losing their health due to potential ageing-related threats and that individuals with low morale struggled with acceptance. Acceptance was the key strategy for handling adverse consequences of ageing in all described areas.ConclusionWhen using standardized assessment scales in clinical practice, it could be useful to combine quantitative and qualitative data. Acceptance was key for well-being; however, acceptance could be resigned or reorienting in nature.
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- Almevall, Ariel, et al.
(författare)
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Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort
- 2024
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 122
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.
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- Andin, Ulla, et al.
(författare)
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Alzheimer's disease (AD) with and without white matter pathology-clinical identification of concurrent cardiovascular disorders.
- 2007
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Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 1872-6976 .- 0167-4943. ; 44, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- Clinical vascular features, either as manifest vascular disease or as cardiovascular risk factors were compared in AD with and without neuropathological white matter disease (WMD). The aim of the study was to investigate whether the presence of WMD and the severity of either AD pathology or WMD were associated with different cardiovascular profiles. A total of 44 AD cases were retrospectively studied. All the cases were neuropathologically diagnosed as AD with WMD (n = 22) and as AD without WMD (n = 22), respectively. The patients' medical records were studied with regard to their medical history and to somatic and neurological findings including arrhythmia, congestive heart failure, angina, myocardial infarctions, signs of TIA/stroke, diabetes mellitus, and blood pressure abnormalities, such as hypertension and orthostatic hypotension. In AD-WMD, hypertension, orthostatic hypotension as well as dizziness/unsteadiness were significantly more common than in AD without WMD. Cardiovascular symptoms were more frequent in AD-WMD than in the other group, though the difference did not reach statistical significance. Hypothetically, abnormal and unstable blood pressure levels underlie recurrent cerebral hypoperfusion, which may in turn leave room for the development of WMD. Furthermore, dizziness/unsteadiness may be a symptom reflecting the presence of WMD. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
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- Asplund, Ragnar
(författare)
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Sleep and hypnotic use in relation to perceived somatic and mental health among the elderly
- 2000
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Ingår i: Archives of gerontology and geriatrics (Print). - 0167-4943 .- 1872-6976. ; 31:3, s. 199-205
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the influence of somatic health, mental health and age on sleep and the use of sleep medication in a group of elderly men and women. Questionnaires were distributed to 9417 persons, and the response rare was 69%. The mean ages (s.d.) of the male and female participants were 73.9 (6.3) and 74.5 (6.8) years, respectively. Sleep disturbances were more common in women than in men at all ages and increased with age in both sexes. A stepwise regression analysis showed that in men, more severely sleep disturbances were associated with poorer somatic health (R-2 = 0.089; P < 0.0001), poorer mental health (R-2 = 0.106; P < 0.0001) and increasing age (R-2 = 0.109; P < 0.0001) and in the women worse somatic health (R-2 = 0.087; P < 0.0001), worse mental health (R-2 = 0.104; P < 0.0001) but no further deterioration of sleep with age. Sleep medication was more common in women than in men at all ages and increased with age in both sexes. The use of sleep medication was more strongly related to somatic health than to mental health and age in both sexes. In conclusion, both sleep complaints and sleep medication showed a stronger relation to somatic health than to mental health and age in this group of elderly men and women. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.
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- Asplund, R., et al.
(författare)
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Sleep and sleepiness 1 and 9 months after cataract surgery
- 2004
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 38:1, s. 69-75
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Tidskriftsartikel (refereegranskat)abstract
- This study was undertaken to analyze sleep development in a group of patients during the first 9 months after cataract extraction. Men and women (n=407) undergoing cataract surgery at the Department of Ophthalmology, Sundsvall Hospital during two periods in 2000-2002 were asked to complete a questionnaire on the state and change of sleep and sleepiness 1 and 9 months after the operation. The response rate was 90.8%. The mean ages of the participating men and women were 74.5 and 75.6 years, respectively. One week after cataract extraction the visual acuity in the treated eye was 0.67 (+/-0.31) in men and 0.69 (+/-0.28) in women (NS), and showed an inverse relationship to age in both men (P<0.01) and women (P<0.0001). One month after cataract extraction 28.3% of the men and 37.5% of the women experienced poor sleep, and after 9 months the figures were 15.8 and 31.4%, respectively. Frequent awakenings and difficulty in falling asleep after nocturnal awakenings improved correspondingly. Being well rested in the morning increased and daytime sleepiness decreased. The results indicate that in elderly persons with cataract sleep is improved 1 month after cataract extraction and further improvement during the first 9 months may be experienced.
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| 10. |
- Asplund, Ragnar
(författare)
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Sleep, health and visual impairment in the elderly
- 2000
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Ingår i: Archives of gerontology and geriatrics (Print). - 0167-4943 .- 1872-6976. ; 30:1, s. 7-15
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Tidskriftsartikel (refereegranskat)abstract
- This study was undertaken in order to analyse the relationship between visual impairment and sleep in an elderly population. All 10 216 members of the pensioners' association in two Swedish counties were asked to participate in a questionnaire survey. The questionnaire included questions on civil status, the general state of health, the occurrence of somatic diseases and symptoms, sleep, medication and vision. 6143 evaluable questionnaires were received, of which 39.5% were from men. The mean (s.d.) ages of the male and female participants wc:re 73.0 (6.0) and 72.6 (6.7) years, respectively. Visual impairment was reported by 20.9% of the men and 32.9% of the women. The proportion of visual impairment increased with;Ige and was more common in women in each age group. Poor sleep occurred in 14.4% of the men and 27.9% of the women. Among subjects with visual. impairment, poor sleep, frequent awakenings and difficulties to fall asleep after awakening at night were all more common in both men and women. In a multiple logistic regression analysis, significant independent correlates of poor night's sleep among the men were: visual impairment (odds ratio (OR) 1.3 95%, confidence interval (CI) 1.0-1.8) and poor health (OR 2.2, CI 1.6-3.0). Age, circulatory organ disease and diabetes were deleted by the logistic model. The significant independent correlates in women were: visual impairment (OR 1.6, CI 1.3-2.0) poor health (OR 2.6, CI 2.1-3.3) and circulatory organ diseases (OR 1.5 CI, 1.2-1.8). Age and diabetes were deleted by the logistic model. The results suggest that visual impairment could be an underestimated cause of sleep deterioration in the elderly. (C) 2000 Elsevier Science Ireland Ltd. Al rights reserved.
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