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- Agahi, Neda, et al.
(author)
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Social integration and alcohol consumption among older people : A four-year follow-up of a Swedish national sample
- 2019
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In: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 196, s. 40-45
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Journal article (peer-reviewed)abstract
- Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.
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- Dahlberg, Lena, 1970-
(author)
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Ageing in a changing place : a qualitative study of neighbourhood exclusion
- 2019
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In: Ageing & Society. - 0144-686X .- 1469-1779. ; 40:10, s. 2238-2256
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Journal article (peer-reviewed)abstract
- An inclusive neighbourhood is a key facilitator enabling older adults to age in place. Neighbourhoods have been identified as a dimension of social exclusion important to older adults, and it has been argued that older adults are particularly vulnerable to neighbourhood change. The aim of this study was to explore older adults’ experiences of neighbourhood exclusion within the context of neighbourhood change. Focus groups were undertaken in the urban and rural areas of a metropolitan borough in England involving a total of 41 older adults, with data analysed via thematic analysis. Urban areas in the borough studied have transformed following the closure of the mining industry, with a high level of deprivation in many areas, while some rural areas have undergone gentrification. Within the context of structural neighbourhood change, four themes were identified: community cohesion, political agency, feelings of safety and the physical environment. The themes were interlinked, which calls for collaboration across traditional lines of professional responsibility, and for research that encompasses different aspects of neighbourhood exclusion. This study contributes with knowledge on older adults’ experiences of exclusion, including novel findings on the importance of political agency and collective memory, and identifies actions to combat exclusion. An active involvement of older adults in the development of initiatives to tackle social exclusion is recommended.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Living on the edge : Social exclusion and the receipt of informal care in older people
- 2016
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In: Journal of Aging Research. - : Hindawi Limited. - 2090-2204 .- 2090-2212. ; , s. 1-10
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Journal article (peer-reviewed)abstract
- Older people have been identified as being at risk of social exclusion. However, despite the fact that care is commonly required in later life and the majority of that care provided by informal carers, a connection between social exclusion and informal care-receipt has rarely been considered. The aim of this study was to examine how informal care-receipt is related to social exclusion.A face-to-face questionnaire survey on social exclusion and informal care-receipt was carried out among older people (n=1255) living in Barnsley, United Kingdom. Multivariable analyses examined the association between social exclusion and categories of informal care-receipt: care receiver; assurance receiver; non-receiver with no need; non-receiver with need.Compared to being a non-receiver with no need participants were more likely to be a care receiver or assurance receiver if they had higher levels of social exclusion. The highest level of social exclusion, however, was found in non-receivers with need. Despite a lack of informal care and support, formal practical support and personal care was also low in this latter group. Findings are discussed in relation to the conceptualisation of care-receipt and how contact with medical services could be an opportunity for identification and appropriate referral of non-receivers with need.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Lonelier than ever? Loneliness of older people over two decades
- 2018
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In: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 75, s. 96-103
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Journal article (peer-reviewed)abstract
- To live with feelings of loneliness has negative implications for quality of life, health and survival. This study aimed to examine changes in loneliness among older people, both with regard to prevalence rates, and socio-demographic, social and health-related correlates of loneliness. This study had a repeated cross-sectional design and was based on the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Analyses of trends in loneliness covered the years 1992, 2002, 2004, 2011 and 2014, and included people aged 77 years or older (n = 2 572). Analyses of correlates of loneliness covered 2004 and 2014, and included people aged 70 years or older (n = 1 962). Logistic regression analyses were conducted with findings presented as average marginal effects. Contrary to what is often assumed, there has been no increase in loneliness among older people over time (1992-2014). Regression analyses for 2004 and 2014 showed that social and health-related correlates were more strongly associated with loneliness than socio-demographic correlates. Psychological distress was most strongly associated with loneliness, followed by widowhood. Most associations between the correlates and loneliness were stable over time.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Long-term predictors of loneliness in old age : results of a 20-year national study
- 2018
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In: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 22:2, s. 190-196
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The understanding of social phenomena is enhanced if individuals can be studied over longer periods. Regarding loneliness in old age, there is a general lack of longitudinal research. The aim of this study was to examine whether there is an association between loneliness in old age and social engagement 20 years earlier, as stated by life course theory and the convoy model.METHOD: Data from the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (2002 and 2011 data collection waves) and the Swedish Level of Living Survey (1981 and 1991 data collection waves) were used. The sample included 823 individuals with an average age of 62.2 years at baseline and 82.4 years at follow-up.RESULTS: Each form of social engagement in old age was significantly associated with the same form of social engagement 20 years earlier. Close forms of social engagement were associated with loneliness in old age; as were more distant forms of social engagement, but only when they were considered solely in old age.CONCLUSION: Patterns of social engagement in old age were established at least 20 years earlier and close forms of social engagement are long-term predictors of loneliness, although current social engagement tended to be more influential on loneliness. The study underlines the importance of interventions targeted at close relationships that can provide social support in old age.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Planned and Unplanned Hospital Admissions and Their Relationship with Social Factors : Findings from a National, Prospective Study of People Aged 76 Years or Older
- 2018
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In: Health Services Research. - : Wiley. - 0017-9124 .- 1475-6773. ; 53:6, s. 4248-4267
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Journal article (peer-reviewed)abstract
- Objective Data Sources/Study Setting To examine the relationship between social factors and planned and unplanned hospital admissions among older people. 2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012. Study Design Data Collection The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors). Data were collected via interviews with people aged 76+ (n = 931). Principal Findings Conclusions Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09-0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15-2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13-2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis. Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Predictors of loneliness among older women and men in Sweden : A national longitudinal study
- 2015
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In: Aging & Mental Health. - : Routledge. - 1360-7863 .- 1364-6915. ; 19:5, s. 409-417
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Journal article (peer-reviewed)abstract
- Objectives: Longitudinal research on loneliness in old age has rarely considered loneliness separately for men and women, despite gender differences in life experiences. The objective of this study was to examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: (a) changes in reported loneliness as people age, and (b) which factors predict loneliness.Method: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey, was used (n = 587). The prediction of loneliness in 2011 by variables measured in 2004 and 2004–2011 variable change scores was examined in three logistic regression models: total sample, women and men. Variables in the models included: gender, age, education, mobility problems, depression, widowhood and social contacts.Results: Older people moved into and out of frequent loneliness over time, although there was a general increase in loneliness with age. Loneliness at baseline, depression increment and recent widowhood were significant predictors of loneliness in all three multivariable models. Widowhood, depression, mobility problems and mobility reduction predicted loneliness uniquely in the model for women; while low level of social contacts and social contact reduction predicted loneliness uniquely in the model for men.Conclusion: This study challenges the notion that feelings of loneliness in old age are stable. It also identifies important gender differences in prevalence and predictors of loneliness. Knowledge about such differences is crucial for the development of effective policy and interventions to combat loneliness in later life.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Receipt of Formal and Informal Help with Specific Care Tasks among Older People Living in their Own Home. National Trends over Two Decades
- 2018
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In: Social Policy & Administration. - : Wiley. - 0144-5596 .- 1467-9515. ; 52:1, s. 91-110
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Journal article (peer-reviewed)abstract
- Sweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care-receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care-receipt were examined in relation to gender, living alone, having children and socio-economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care-receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care-receipt, associated with a greater likelihood of formal care-receipt and a lower likelihood of informal care-receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Social exclusion and well-being among older adults in rural and urban areas
- 2018
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In: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 79, s. 176-184
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Journal article (peer-reviewed)abstract
- Background: Social exclusion (SE) is a process that limits participation in society across life domains, and is associated with poor quality of life. Neighbourhood exclusion has been identified as particularly important for older adults. This paper examines the association between SE and well-being in older adults from urban and rural areas, focusing on neighbourhood exclusion. Methods: Using a cross-sectional survey design with a stratified sampling frame, participants (aged 65+) from rural (n = 628) and urban (n = 627) areas of Barnsley, United Kingdom, completed a questionnaire containing indicators of five SE domains: civic activity, material resources, social relationships, services and neighbourhood. Sequential multiple regression models were developed for 1) total sample; 2) rural areas; and 3) urban areas, with well-being regressed on SE indicators after controlling for self-reported health. Results: SE indicators explained 13.4% of the variance in well-being in the total sample (of which neighbourhood exclusion explained 1.2%); corresponding figures for the rural model were 13.8% (3.8%) and for the urban model 18.0% (1.7%); the addition of neighbourhood exclusion significantly improved all three models. Five SE indicators were significant in the rural model, compared with seven in the urban model, with four common to both. Discussion: Neighbourhood exclusion explained more variance in well-being in rural than urban areas, whereas exclusion from services explained more variance in urban than rural areas. Area characteristics and the role of neighbourhood should be considered in policy initiatives to reduce SE and promote well-being.
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- Dahlberg, Lena, 1970-, et al.
(author)
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Trends in social exclusion among older women and men in Sweden
- 2018
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Conference paper (peer-reviewed)abstract
- Background: Social exclusion is a framework for understanding the complexity of disadvantage across various domains of life such as material resources, social relations, civic activities and services. Reviews have identified a lack of gender perspective in social exclusion research. This paper will introduce the framework of social exclusion, and examine trends over time in the levels of social exclusion across different life domains for older women and men in Sweden.Methods: Data on indicators of social exclusion were analysed from respondents aged 76+ years who participated in the 1992, 2002 and 2011 waves of the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).Results: There was evidence of a gender different in exclusion from material resources and civic activities, from which women were more often excluded than men. Regardless of gender there were improvements in access to material resources, such as owning a house/apartment. Social contacts (visiting or being visited by friends) decreased over time, while engagement in cultural activities and going to restaurants increased.Conclusions: Trends in social exclusion in older adults over the last 20 years are dependent on the domain considered. Over a range of indicators, older women were more vulnerable to exclusion than men, which needs to be taken into account in policy to combat exclusion.
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- McKee, Kevin, 1961-, et al.
(author)
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Five Years From Now : Correlates of Older People's Expectation of Future Quality of Life
- 2015
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In: Research on Aging. - : SAGE Publications. - 0164-0275 .- 1552-7573. ; 37:1, s. 18-40
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Journal article (peer-reviewed)abstract
- Few studies have explored older people's expected future quality of life (QoL), despite evidence that perceptions of one's future influence healthy aging. Research on this topic should embrace a range of potential influences, including perceptions of one's neighborhood and region. This study examined expected QoL in a random sample of the population of Dalarna, a Swedish region. A self-completion questionnaire assessed demographic characteristics, current neighborhood and regional evaluations, self-evaluations, expectations for the future, and current and expected QoL. In total, 786 people aged 65 years participated. A sequential multiple regression model explained 44% of the variance in older people's expected QoL, with self-reported health (sr(2) = .03), Expected Regional Opportunity (sr(2) = .03), and Perceived Regional Status (sr(2) = .02) having the strongest associations with expected QoL. Research on the importance of one's neighborhood to QoL in older people should encompass people's perceptions of their region, to better inform social policy for healthy aging.
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- Naseer, Mahwish, et al.
(author)
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Health related quality of life and emergency department visits in adults of age >= 66 years : a prospective cohort study
- 2018
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In: Health and Quality of Life Outcomes. - : BioMed Central. - 1477-7525. ; 16
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Journal article (peer-reviewed)abstract
- Background: Age increases the risk of emergency department [ED] visits. Health related quality of life (HRQoL) is often estimated as an outcome of ED visits, but it can be a risk factor of ED visits. This study aims to assess the association of HRQoL with time to first ED visit and/or frequent ED use in older adults during four-year period and if this association differs in 66-80 and 80+ age groups. Methods: Data from the Swedish National Study on Aging and Care-Blekinge of wave 2007-2009 was used in combination with electronic health records on ED visits. The analytical sample included 673 participants of age 66 years and older with information on HRQoL. Cox proportional hazard model was used to assess the association between HRQoL and time to first ED visit. Logistic regression analysis was performed to estimate the association of HRQoL with frequent ED use. Results: During the study period, 55.3% of older adults visited the ED and 28.8% had a frequent ED use. Poor physical HRQoL was independently associated with first ED visit both in total sample (p < 0.001) and in 66-80 (p < 0. 001) and 80+ (p = 0.038) age groups. Poor mental HRQoL had no significant association with first ED visit and frequent ED use. Conclusion: Findings suggest that poor physical HRQoL is associated with time to first ED visit in older adults. Therefore, physical HRQoL should be considered while planning interventions on the reduction of ED utilisation in older adults. Explanatory factors of frequent ED use may differ in age groups. Further studies are needed to identify associated factors of frequent ED visits in 80+ group.
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- Olsen, Marie, 1967-, et al.
(author)
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Older people’s views on the important values in home help provision: a Swedish study
- 2018
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Conference paper (peer-reviewed)abstract
- Little is known about the values that older people consider important in receipt of home help. Therefore, this study aimed to explore which values older people hold in relation to home help services and their experiences of how these values are reflected in the delivery of help. Interviews were conducted from November 2015 to March 2016 with 16 older persons (age ≥65 years) who received home help at the time of the study. Data were analysed using qualitative content analysis. Results identified values that older people find important in home help and suggest behaviours that should underpin home help, such as supporting the older person’s independence, building a reciprocal relationship and promoting a sense of safety and security (e.g., by providing information about what home help entails for the recipient). We conclude that it is important that care staff recognise and integrate these values into their actions on an interpersonal level in daily care, adopting a relation-oriented rather than a task-focused approach in the provision of home help for older people.
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- Vethanayagam, Natalie, et al.
(author)
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Understanding help-seeking in older people with urinary incontinence : an interview study
- 2017
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In: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 25:3, s. 1061-1069
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Journal article (peer-reviewed)abstract
- The prevalence of urinary incontinence (UI) increases with age and can negatively affect quality of life. However, relatively few older people with UI seek treatment. The aim of this study was to explore the views of older people with UI on the process of seeking help. Older people with UI were recruited to the study from three continence services in the north of England: a geriatrician-led hospital outpatient clinic (n = 18), a community-based nurse-led service (n = 22) and a consultant gynaecologist-led service specialising in surgical treatment (n = 10). Participants took part in semi-structured interviews, which were transcribed and underwent thematic content analysis. Three main themes emerged: Being brushed aside, in which participants expressed the feeling that general practitioners did not prioritise or recognise their concerns; Putting up with it, in which participants delayed seeking help for their UI due to various reasons including embarrassment, the development of coping mechanisms, perceiving UI as a normal part of the ageing process, or being unaware that help was available; and Something has to be done, in which help-seeking was prompted by the recognition that their UI was a serious problem, whether as a result of experiencing UI in public, the remark of a relative, the belief that they had a serious illness or the detection of UI during comprehensive geriatric assessment. Greater awareness that UI is a treatable condition and not a normal part of ageing is needed in the population and among health professionals. Comprehensive geriatric assessment appeared an important trigger for referral and treatment in our participants. Screening questions by healthcare professionals could be a means to identify, assess and treat older people with UI.
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