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  • Haak, Maria, et al. (författare)
  • The influence of participation on mortality in very old age among community-living people in Sweden
  • 2019
  • Ingår i: Aging clinical and experimental research. - : Kurtis. - 1594-0667 .- 1720-8319. ; 31:2, s. 265-271
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Participation in everyday life and society is generally seen as essential for health-related outcomes and acknowledged to affect older people’s well-being. Aims: To investigate if aspects of performance- and togetherness-related participation influence on mortality among very old single living people in Sweden. Methods: ENABLE-AGE Survey Study data involving single-living participants in Sweden (N = 314, aged 81–91 years), followed over 10 years were used. Multivariate Cox regression models adjusted for demographic and health-related variables were used to analyse specific items influencing mortality. Results: Participation in performance- or togetherness-oriented activities was found to significantly influence mortality [HR 0.62 (0.44–0.88), P value 0.006, and HR 0.72 (0.53–0.97), P value 0.031, respectively]. Talking to neighbours and following local politics had a protective effect on mortality, speaking to relatives on the phone (CI 1.10–2.02) and performing leisure activities together with others (CI 1.10–2.00) had the opposite influence. That is, those performing the latter activities were significantly more likely to die earlier. Discussion: The main contribution of this study is the facet of the results showing that aspects of performance- and togetherness-related participation have a protective effect on mortality in very old age. This is important knowledge for designing health promotion and preventive efforts for the ageing population. Moreover, it constitutes a contribution to the development of instruments capturing aspects of participation influencing on mortality. Conclusion: In the development of health promotion and preventive efforts the inclusion of participation facets could be considered in favour of potential positive influences on longevity.
  • Gustafsson, Susanne, et al. (författare)
  • Long-term outcome for ADL following the health-promoting RCT-Elderly persons in the risk zone
  • 2013
  • Ingår i: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 53:4, s. 654-663
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To examine independence in activities of daily living (ADL) at the 1- and 2-year followups of the health-promoting study Elderly Persons in the Risk Zone. Design and Method: A randomized, three-armed, single-blind, and controlled study. A representative sample of 459 independent and community-dwelling older adults, 80 years and older, were included. A preventive home visit was compared with four weekly multiprofessional senior group meetings including a follow-up home visit. Results: Analysis showed a significant difference in favor of the senior meetings in postponing dependence in ADL at the 1-year follow-up (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.19-3.10) and also in reducing dependence in three (OR = 0.52, 95% CI = 0.31-0.86) and four or more ADL (OR = 0.40, 95% CI = 0.22-0.72) at the 2-year follow-up. A preventive home visit reduced dependence in two (OR = 0.40, 95% CI = 0.24-0.68) and three or more ADL (OR = 0.37, 95% CI = 0.17-0.80) after 1 year. Implications: A long-term evaluation of Elderly Persons in the Risk Zone showed that both senior meetings and a preventive home visit reduced the extent of dependence in ADL after 1 year. The senior meetings were superior to a preventive home visit since additional significant effects were seen after 2 years. To further enhance the long-term effects of the senior meetings and support the process of self-change in health behavior, it is suggested that booster sessions might be a good way of reinforcing the intervention.
  • Granbom, Marianne, et al. (författare)
  • A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing
  • 2016
  • Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458 .- 1471-2458. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Housing environments that hinder performance of daily activities and impede participation in social life have negative health consequences particularly for the older segment of the population. From a public health perspective accessible housing that supports active and healthy ageing is therefore crucial. The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens. Particular attention was paid to differences between housing types and building periods and to identify environmental barriers generating the most accessibility problems for sub-groups of senior citizens.METHODS: Data on environmental barriers in dwellings from three databases on housing and health in old age was analysed (N = 1021). Four functional profiles representing large groups of senior citizens were used in analyses of the magnitude and severity of potential accessibility problems. Differences in terms of type of housing and building period were examined.RESULTS: High proportions of one-family houses as well as multi-dwellings had substantial numbers of environmental barriers, with significantly lower numbers in later building periods. Accessibility problems occurred already for senior citizens with few functional limitations, but more profound for those dependent on mobility devices. The most problematic housing sections were entrances in one-family houses and kitchens of multi-dwellings.CONCLUSIONS: Despite a high housing standard in the Swedish ordinary housing stock the results show substantial accessibility problems for senior citizens with functional limitations. To make housing accessible large-scale and systematic efforts are required.
  • Pettersson, Cecilia, et al. (författare)
  • Mobility Device Use and Exploration of Housing Accessibility for Powered Mobility Device Users among People Ageing with Spinal Cord Injury
  • 2013
  • Ingår i: Assistive Technology : From Research to Practice - From Research to Practice. - : IOS Press. - 1383-813X .- 1879-8071. - 9781614993049 - 9781614993032 ; 33, s. 226-231, s. 226-232
  • Bokkapitel (refereegranskat)abstract
    • Aim: To describe the use of mobility devices among people ageing with spinal cord injury (SCI), with a specific focus on use of powered mobility devices (PMD) and housing accessibility. Method: Data on the use of walking aids (cane, crutch/es or rollator), manual wheelchair and powered wheelchair/scooter were utilized. To describe functional limitations, environmental barriers and the magnitude of accessibility problems in the home and the closest exterior surroundings for each individual, the Housing Enabler instrument was used. Descriptive statistics were used for data analysis. Results: Mobility devices: Among participants with paraplegia, the manual wheelchair was the most frequently used mobility device indoors, and among participants with tetraplegia, it was the PMD. The PMD was the most common mobility device used outdoors among those with tetraplegia, and among participants with paraplegia. Housing accessibility: In exterior surroundings, refuse bin difficult to reach was the environmental barrier that generated the most accessibility problems, while at entrances doors that cannot be fastened in open position was identified as the most severe environmental barrier. Indoors, the environmental barrier that generated the most accessibility problems was wall-mounted cupboard and shelves placed high. Conclusion: To enable optimal use of the PMD in the home and close neighborhoods, and support everyday activity and participation for people ageing with SCI, it is vital to take into account not only personal and environmental aspects but also the mobility device in question. Though, it could be discussed if all the environmental barriers identified in this study, actually are problems for users of a PMD, since some of them might be possible to overcome. © 2013 The authors and IOS Press. All rights reserved.
  • Winberg, C., et al. (författare)
  • The Use of Apps for Health in Persons with Multiple Sclerosis, Parkinson's Disease and Stroke - Barriers and Facilitators
  • 2017
  • Ingår i: Harnessing the Power of Technology to Improve Lives. - : IOS Press. - 0926-9630 .- 1879-8365. - 9781614997979 ; 242, s. 638-641, s. 638-641
  • Bokkapitel (refereegranskat)abstract
    • Introduction: The importance of mobile health has increased during recent years but few studies have described the use of apps among persons with neurological disabilities. Aim: The aim of this paper was to describe how persons ageing with a neurological disability experience barriers and facilitators in relation to using apps in everyday life. Method: A qualitative approach was used. 16 persons with neurological disorders participated in two group discussions. Data were analyzed by content analysis. Results: The analysis formed four categories; Impairments make apps harder to use, Use of apps is increased by learnability and sharing, Valuating the information in an app, and Apps act supportive and motivating. Conclusion: The participants used apps in the same way as persons without disabilities. Impairments and trustworthiness were perceived as barriers, which need to be acknowledged when developing apps for this population. Use of apps was facilitated by the possibility to share data and to connect with others. Apps may have the potential to improve self-management for persons ageing with disabilities but further research is needed.
  • Berner, Jessica, et al. (författare)
  • Maintaining cognitive function with internet use : a two-country, six-year longitudinal study
  • 2019
  • Ingår i: International psychogeriatrics. - : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 31:7, s. 929-936
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Maintaining good cognitive function with aging may be aided by technology such as computers, tablets, and their applications. Little research so far has investigated whether internet use helps to maintain cognitive function over time.Design: Two population-based studies with a longitudinal design from 2001/2003 (T1) to 2007/2010 (T2).Setting: Sweden and the Netherlands.Participants: Older adults aged 66 years and above from the Swedish National Study on Ageing and Care (N = 2,564) and from the Longitudinal Aging Study Amsterdam (N = 683).Measurements: Internet use was self-reported. Using the scores from the Mini-Mental State Examination (MMSE) from T1 and T2, both a difference score and a significant change index was calculated. Linear and logistic regression analysis were performed with difference score and significant change index, respectively, as the dependent variable and internet use as the independent variable, and adjusted for sex, education, age, living situation, and functional limitations. Using a meta-analytic approach, summary coefficients were calculated across both studies.Results: Internet use at baseline was 26.4% in Sweden and 13.3% in the Netherlands. Significant cognitive decline over six years amounted to 9.2% in Sweden and 17.0% in the Netherlands. Considering the difference score, the summary linear regression coefficient for internet use was-0.32 (95% CI:-0.62,-0.02). Considering the significant change index, the summary odds ratio for internet use was 0.54 (95% CI: 0.37, 0.78).Conclusions: The results suggest that internet use might play a role in maintaining cognitive functioning. Further research into the specific activities that older adults are doing on the internet may shine light on this issue.
  • Bökberg, Christina, et al. (författare)
  • Utilisation of formal and informal care and services at home among persons with dementia : a cross-sectional study
  • 2018
  • Ingår i: Scandinavian Journal of Caring Sciences. - Chichester : Wiley-Blackwell Publishing Inc.. - 0283-9318 .- 1471-6712. ; 32:2, s. 843-851
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThe progression of dementia disease implies increasing needs for both informal and formal care and services but also risk of institutionalisation. To better adjust care and services in the phase preceding institutionalisation it is important to find out whether utilisation of formal and informal care and services is determined by increased needs and by who meets the needs.AimThe aim was to compare persons with dementia (65+) with different levels of cognitive impairment, regarding utilisation of formal and informal care and service at home.MethodsThe participants consisted of 177 persons with dementia ≥65 years old and at risk of nursing home admission, divided into groups according to their cognitive function. Structured interviews were conducted based on questionnaires about type and amount of formal and informal care utilised, as well as questions regarding cognitive impairment, dependency in activities of daily living (ADLs) and neuropsychiatric symptoms. To analyse the data, descriptive and comparative statistics were used.ResultsThe findings revealed that the group with severe dementia used significantly more help with ADLs and supervision in terms of time (number of hours and days) provided by the informal caregiver, compared with the group with moderate dementia. Utilisation of formal care and services was highest in the group with the most severe cognitive impairments (Standardized Mini-Mental State Examination score of <9). The group with severe dementia were more dependent in ADLs and had more neuropsychiatric symptoms (hallucinations and motor disturbances). They were younger and more often cohabitated with the informal caregiver, compared with the group with moderate dementia.ConclusionThis study shows that in the phase preceding institutionalisation the ADL and supervision needs due to progression of dementia appear to tend to be met first and foremost by the informal caregivers. © 2017 Nordic College of Caring Science.
  • Elmståhl, Sölve, et al. (författare)
  • The life satisfaction index-a (LSI-A) : Normative data for a general swedish population aged 60 to 93 years
  • 2020
  • Ingår i: Clinical Interventions in Aging. - : Dove Medical Press Ltd. - 1176-9092 .- 1178-1998. ; 15, s. 2031-2039
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose of Study: To gain Swedish norm value for the Life Satisfaction Index-A (LSI-A) in a population 60–93+ years old stratified for sex and age and to relate these norm values with respect to number of chronic diseases and functional impairment. Materials and Methods: The study population included a random sample of 2656 men (45.7%) and 3159 (54.3%) women from the longitudinal national studies’ “Good Aging in Skåne” (GÅS) and SNAC-B, both part of the Swedish National Study on Aging and Care (SNAC). Data on Neugartens Life Satisfaction Index-A (LSI-A), medical history, activities of daily life (ADL) and socio-demographics were collected through structured interviews and questionnaires. Results: Men scored significantly higher than women; 28.5, sd=6.9, and 27.3, sd=6.6, respectively, out of maximum 40 points. For both genders the scores decreased with age, mean score 6.0 points, lower for men and 7.1 points lower for women between 60 and 93+ years. The highest score was noted for healthy individuals where both men and women scored 29.5 points, sd=6.2. Increased number of chronic diseases and dependency in ADLs were associated with lower LS. Conclusion: Norm values here presented may facilitate assessments and evaluation of life satisfaction in the general elder population and as reference values to clinical trials. Female sex, rising age, morbidity and impaired functional ability were all associated with impaired LS. © 2020 Elmståhl et al.
  • Fristedt, Sofi, et al. (författare)
  • Physical functioning associated with life-space mobility in later life among men and women
  • 2022
  • Ingår i: BMC Geriatrics. - London, United Kingdom : BioMed Central (BMC). - 1471-2318. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Life-space mobility is defined as the ability to access different areas extending from the room where the person sleeps to places outside one’s hometown. Life-space mobility is vital to support performance of daily life activities and autonomous participation in social life. However, there is a dearth of research that investigates a wider range of physical functions and functioning in relation to life-space mobility rather than just single aspects. Thus, the purpose of the present study was to identify and describe several measures of physical functioning associated with life-space mobility among older men and women. Methods: Data used in this study was derived from the OCTO 2 study, a population-based study of health, functioning and mobility among older persons (n = 312) in Sweden. Associations between Life-Space Assessment (LSA) total score and age, sex, Short Physical Performance Battery (SPPB), dizziness, lung function i.e. Peak Expiratory Flow (PEF), grip strength, self-rated vision and hearing were analysed through bivariate and multivariate regression models. Results: The bivariate models showed that life-space mobility was significantly associated with sex, but also age, SPPB, PEF and grip strength in the total group as well as among men and women. In addition, hearing was significantly associated with life-space mobility among women. Those factors that were statistically significant in the bivariate models were further analysed in multivariable models for the total group, and for men and women separately. In these models, sex, grip strength and SPPB remained significantly associated with life-space mobility in the total group, as well as SPPB among both men and women. Conclusion: Sex, physical function in terms of physical performance measured by SPPB (balance, gait speed and chair stand), and grip strength are associated with life-space mobility. Consequently, these factors need to be considered in assessments and interventions aiming to maintain mobility in old age.
  • Gardner, Michael, et al. (författare)
  • Gender and telomere length : Systematic review and meta-analysis
  • 2014
  • Ingår i: Experimental Gerontology. - : Elsevier. - 0531-5565 .- 1873-6815. ; 51, s. 15-27
  • Forskningsöversikt (refereegranskat)abstract
    • Background: It is widely believed that females have longer telomeres than males, although results from studies have been contradictory. Methods: We carried out a systematic review and meta-analyses to test the hypothesis that in humans, females have longer telomeres than males and that this association becomes stronger with increasing age. Searches were conducted in EMBASE and MEDLINE (by November 2009) and additional datasets were obtained from study investigators. Eligible observational studies measured telomeres for both females and males of any age, had a minimum sample size of 100 and included participants not part of a diseased group. We calculated summary estimates using random-effects meta-analyses. Heterogeneity between studies was investigated using sub-group analysis and meta-regression. Results: Meta-analyses from 36 cohorts (36,230 participants) showed that on average females had longer telomeres than males (standardised difference in telomere length between females and males 0.090, 95% CI 0.015, 0.166; age-adjusted). There was little evidence that these associations varied by age group (p = 1.00) or cell type (p = 0.29). However, the size of this difference did vary by measurement methods, with only Southern blot but neither real-time PCR nor Flow-FISH showing a significant difference. This difference was not associated with random measurement error. Conclusions: Telomere length is longer in females thanmales, although this difference was not universally found in studies that did not use Southern blot methods. Further research on explanations for the methodological differences is required. (C) 2013 Published by Elsevier Inc.
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