| 1. |
- Falk, Hanna, 1977, et al.
(author)
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Self-rated health and its association with mortality in older adults in China, India and Latin America - a 10/66 Dementia Research Group study
- 2017
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In: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 46:6, s. 932-939
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Journal article (peer-reviewed)abstract
- Background empirical evidence from high-income countries suggests that self-rated health (SRH) is useful as a brief and simple outcome measure in public health research. However, in many low- and middle-income countries (LMIC) there is a lack of evaluation and the cross-cultural validity of SRH remains largely untested. This study aims to explore the prevalence of SRH and its association with mortality in older adults in LMIC in order to cross-culturally validate the construct of SRH. Methods population-based cohort studies including 16,940 persons aged ≥65 years in China, India, Cuba, Dominican Republic, Peru, Venezuela, Mexico and Puerto Rico in 2003. SRH was assessed by asking ‘how do you rate your overall health in the past 30 days’ with responses ranging from excellent to poor. Covariates included socio-demographic characteristics, use of health services and health factors. Mortality was ascertained through a screening of all respondents until 2007. Results the prevalence of good SRH was higher in urban compared to rural sites, except in China. Men reported higher SRH than women, and depression had the largest negative impact on SRH in all sites. Without adjustment, those with poor SRH showed a 142% increase risk of dying within 4 years compared to those with moderate SRH. After adjusting for all covariates, those with poor SRH still showed a 43% increased risk. Conclusion our findings support the use of SRH as a simple measure in survey settings to identify vulnerable groups and evaluate health interventions in resource-scares settings.
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| 2. |
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| 3. |
- Gustafsson, Susanne, 1963, et al.
(author)
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A Cross-Cultural Adaptation of the ICECAP-O: Reliability and Validity in Swedish 70-Year-Old Persons
- 2017
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In: 21st International Association of Gerontology and Geriatrics (IAGG) World Congress, July 23-27, 2017 San Francisco, California. Innovation in Aging, 1 (S1), s. 752. - : Oxford University Press (OUP). - 2399-5300.
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Conference paper (other academic/artistic)abstract
- Few Quality of Life (QoL) measures tap into the concept of capability, i.e. genuine opportunities to 'do' and 'be' the things that a person deems important in life. The ICECAP-O is one such instrument. This presentation includes test-retest reliability, item relevance, face- and content validity, and accessibility of the ICECAP-O in a Swedish context. Thirty-nine 70-year-olds who took part in a population-based study completed the Swedish version of the ICECAP-O on two occasions, and another 18 partook in cognitive interviews. Test-retest reliability was analyzed for the index and separate items, and participants rated item relevance on a Visual Analogue Scale. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants’ experiences of completing the measure and perceptions of included attributes. Test-retest showed that the index score had good stability, ICC of 0.80 (95 % CI 0.62-0.90). However, Kappa was low for each separate item, and ranged from 0.18 (Control) to 0.41 (Role). Participants gave their highest relevance rating to Attachment and the lowest to Enjoyment. In the cognitive interviews, three participants (18%) had problems completing ICECAP-O, and out of 80 question segments, judged problems occurred for five (6%). Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older person.
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| 4. |
- Gustafsson, Susanne, 1963, et al.
(author)
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Face and content validity and acceptability of the Swedish ICECAP-O capability measure: Cognitive interviews with 70-year-old persons
- 2018
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In: Health Psychology Research. - : Open Medical Publishing. - 2420-8124 .- 2281-2075. ; 6:1, s. 1-8
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Journal article (peer-reviewed)abstract
- This study is part of a project that aims to culturally adapt the Investigating Choice Experiments for the Preferences of Older People-CAPability Index (ICECAP-O) for use in research and health and social care in Sweden. The objective was to evaluate face and content validity and acceptability. Eighteen 70-year-old community-dwelling persons participated in cognitive interviews. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants' perceptions of included attributes and experiences of completing the measure. The results show that three participants (18%) had problems completing ICECAP-O, and that judged problems occurred for five (6%) of participants responses in the standardized classification scheme. Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O seems to measure what it is supposed to measure, quality of life (QoL) with a capability approach, and acceptability is satisfactory. ICECAP-O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older persons.
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| 5. |
- Hörder, Helena M, et al.
(author)
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A Cross-Cultural Adaptation of the ICECAP-O : Test–Retest Reliability and Item Relevance in Swedish 70-Year-Olds
- 2016
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In: Societies. - : MDPI. - 2075-4698. ; 6:4
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Journal article (peer-reviewed)abstract
- Background: While there is a plethora of Quality of Life (QoL) measures, the Investigating Choice Experiments for the Preferences of Older People—CAPability index (ICECAP-O) is one of the few that taps into the concept of capability, i.e., opportunities to 'do' and 'be' the things that one deems important in life. We aimed to examine test–retest reliability of the ICECAP-O in a Swedish context and to study item relevance.Methods: Thirty-nine 70-year-olds who took part in a population-based health study completed the Swedish version of the ICECAP-O on two occasions. We analyzed the test–retest reliability for the index and for the individual items. Participants also rated the relevance of each item on a visual analogue scale (0–100).Results: Test–retest reliability for the index score was in good agreement with an ICC of 0.80 (95% CI 0.62–0.90). However, Kappa was low for each item and ranged from 0.18 (control) to 0.41 (role). For attachment, we found a systematic disagreement with lower ratings at the second test occasion. Participants gave their highest relevance rating to attachment and lowest to enjoyment.Conclusion: The Swedish version of the ICECAP-O had good test–retest agreement, similar to that observed for the English version. Item level agreement was problematic, however, highlighting a need for future research.
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| 6. |
- Hörder, Helena M, et al.
(author)
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Midlife cardiovascular fitness and dementia A 44-year longitudinal population study in women
- 2018
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In: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 90:15
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Journal article (peer-reviewed)abstract
- Objective To investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years. A population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, a systematic subsample comprising 191 women completed a stepwise-increased maximal ergometer cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009. Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012. Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders. Compared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 (95% confidence interval [CI] 0.03-0.54) among those with high fitness and 1.41 (95% CI 0.72-2.79) among those with low fitness. High fitness delayed age at dementia onset by 9.5 years and time to dementia onset by 5 years compared to medium fitness. Among Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.
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| 7. |
- Hörder, Helena M, et al.
(author)
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Secular trends in frailty: a comparative study of 75-year-olds born 1911-12 and 1930
- 2015
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In: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 44:5, s. 817-822
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Journal article (peer-reviewed)abstract
- BACKGROUND: while there is a trend towards a compression of disability, secular trends in physiological frailty have not been investigated. The aim of this paper was to report physiological frailty in two cohorts of 75-year olds examined in 1987 and 2005. METHODS: a repeated cross-sectional study : Two population-based birth cohorts of community-dwelling 75-year olds from Gothenburg, Sweden, born in 1911-12 (n = 591) and 1930 (n = 637) were examined with identical methods in 1987 and 2005. Measures were three frailty criteria from Fried's frailty phenotype: low physical activity, slow gait speed and self-reported exhaustion. RESULTS: seventy-five-year olds examined in 2005 were less frail according to the criteria low physical activity compared with those examined in 1987 (3 versus 18%, P
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| 8. |
- Johansson, Lena, 1972, et al.
(author)
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Associations between Depression, Depressive Symptoms, and Incidence of Dementia in Latin America: A 10/66 Dementia Research Group Study
- 2019
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In: Journal of Alzheimers Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 69:2, s. 433-441
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Journal article (peer-reviewed)abstract
- Background: A growing body of evidence suggests that depression is related to dementia in older adults. Previous research has been done in high-income countries and there is a lack of studies in low- and middle income countries (LMICs). Objective: To examine the relationship between depressive symptoms and incidence of dementia in a population-based study of older adults in Latin America. Methods: The study is a part of the 10/66 Dementia Research Group's population survey and includes 11,472 older adults (baseline mean age 74 years) from Cuba, Dominican Republic, Mexico, Peru, Puerto Rico, and Venezuela. The baseline examinations were done in 2003-2007 and the follow-up examinations 4 years later. Semi-structured psychiatric interviews gave information about ICD-10 depression and sub-syndromal depression (i.e., >= 4 depressive symptoms) at baseline. Information on dementia were collected at the follow-up examination. Competing risk models analyzed the associations between depression and incidence of dementia and the final model were adjusted for age, sex, education, stroke, and diabetes. Separate analyses were conducted for each site and then meta-analyzed by means of fixed effect models. Results: At baseline, the prevalence of depression was 26.0% (n= 2,980): 5.4% had ICD-10 depression and 20.6% subsyndromal depression. During the follow-up period, 9.3% (n = 862) developed dementia and 14.3% (n = 1,329) deceased. In the pooled analyses, both ICD-10 depression (adjusted sub-hazard ratio (sHR) 1.63, 95% confidence interval (CI) 1.26-2.11) and sub-syndromal depression (adjusted sHR 1.28, 95% CI: 1.09-1.51) were associated with increased incidence of dementia. The Higging I-2 tests showed a moderate heterogeneity across the study sites. Conclusion: Our findings suggest that late-life depression is associated with the incidence of dementia in LMICs in Latin America, which support results from earlier studies conducted in high-income countries.
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| 9. |
- Kollén, Lena, 1960-, et al.
(author)
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Physical functioning in older persons with dizziness : a population-based study
- 2017
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In: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 29:2, s. 197-205
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Journal article (peer-reviewed)abstract
- Background: Dizziness is one of the most prevalent symptoms in old age and tends to increase with age.Aims: To report physical functioning, health-related aspects and gender differences in elderly persons with and without dizziness in a population-based sample of 75-year-olds.Methods: A cross-sectional sample of 75-year-olds from Gothenburg, Sweden (n = 675, 398 women and 277 men) was examined by means of questionnaires and functional tests. The questions concerned dizziness/imbalance, physical activity level, walking habits, falls efficacy, number of falls, subjective health or general fatigue and medication. The tests included were self-selected and maximum gait speed, stair climbing capacity, one leg stance and grip strength.Results: More women than men reported dizziness/imbalance (40 vs 30 %, p < 0.001). Persons with dizziness, compared to those without dizziness, less often regularly exercised at a moderate intensity level (summer: 62 vs 74 %, p < 0.001; winter: 41 vs 51 %, p < 0.001), less often took a daily walk (p < 0.05), had lower scores on the FES(S) (p < 0.001), more often reported general fatigue (p < 0.001), more often had fallen in the previous year (40 vs 23 %, p < 0.001) and had a higher intake of medical drugs (4.6 vs 3.3, p < 0.001). They also performed worse regarding gait speed, stair climbing and one leg stance (p < 0.001), but there was no difference in grip strength.Conclusion: Older persons with dizziness are less physically active, have worse lower extremity function, are more often fallers and report lower self-rated health than persons without dizziness.
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| 10. |
- Rydberg Sterner, Therese, et al.
(author)
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The Gothenburg H70 Birth cohort study 2014-16: design, methods and study population.
- 2019
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In: European journal of epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 34:2, s. 191-209
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Journal article (peer-reviewed)abstract
- To improve health care for older persons, we need to learn more about ageing, e.g. identify protective factors and early markers for diseases. The Gothenburg H70 Birth Cohort Studies (the H70 studies) are multidisciplinary epidemiological studies examining representative birth cohorts of older populations in Gothenburg, Sweden. So far, six birth cohorts of 70-year-olds have been examined over time, and examinations have been virtually identical between studies. This paper describes the study procedures for the baseline examination of the Birth cohort 1944, conducted in 2014-16. In this study, all men and women born 1944 on specific dates, and registered as residents in Gothenburg, were eligible for participation (n=1839). A total of 1203 (response rate 72.2%; 559 men and 644 women; mean age 70.5years) agreed to participate in the study. The study comprised sampling of blood and cerebrospinal fluid, psychiatric, cognitive, and physical health examinations, examinations of genetics and family history, use of medications, social factors, functional ability and disability, physical fitness and activity, body composition, lung function, audiological and ophthalmological examinations, diet, brain imaging, as well as a close informant interview, and qualitative studies. As in previous examinations, data collection serves as a basis for future longitudinal follow-up examinations. The research gained from the H70 studies has clinical relevance in relation to prevention, early diagnosis, clinical course, experience of illness, understanding pathogenesis and prognosis. Results will increase our understanding of ageing and inform service development, which may lead to enhanced quality of care for older persons.
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