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1.	Iwarsson, Susanne, et al. (author) Understanding User Involvement in Research in Aging and Health 2019 In: Gerontology and Geriatric Medicine. - : SAGE Publications. - 2333-7214. ; 5 Journal article (peer-reviewed)abstract User involvement in research is advocated as an avenue for efficient societal developments. In this article, we identify potentials, problems, and challenges related to research on aging and health, and identify and illustrate research priorities using an evolving research program as an example. Involving user representatives in the development phase, the UserAge program engages researchers at four universities in Sweden. The program builds upon previous and ongoing research with user involvement. The goals are to maximize the impact of user involvement, enhance the execution of high-quality research, increase the knowledge about what difference user involvement can make, and evaluate the impact of research about and with user involvement. Taken together and communicated in the international scientific community as well as in a wide range of public arenas, the empirical results, capacity-building, and modeling efforts of UserAge will have an impact not only on the present situation but also on the future.
2.	Hultqvist, Sara, 1977-, et al. (author) Conditions for uptake of evidence-based knowledge in municipal care for older people in Sweden : a developmental evaluation 2022 In: BMC Research Notes. - London : BioMed Central. - 1756-0500. ; 15 Journal article (peer-reviewed)abstract Objective: The objective of this paper is to describe the initial phase of a long-term collaboration initiative between a municipality and the Faculty of Medicine at a university in Sweden. The overall ambition of the collaboration is to strengthen the quality of care for older people. The concrete goal is to equip academically trained registered health care professionals (HCP) with tools for transferring evidence-based knowledge into practice. As municipal healthcare for older people is mainly carried out by staff lacking academic education, reg. HCP are key actors to bring in and consolidate an evidence-based approach in this setting. Developmental evaluation (DE) has been used to evaluate four separate activities in the initial phase. The activities where sequenced in a cumulative design to provide knowledge for further development of adequate tools.Results: The cumulative design originally planned did not fit the internal logic of the municipality. Therefore, workflow and pace adjustments were made to proceed towards the joint ambition; the creation of fruitful conditions for the uptake of evidence-based knowledge. Long-term collaboration between academia and organizations outside academia demands a sensitive and flexible research approach, recognizing that collaboration implies mutuality and restricts the sovereignty of academia in designing research.
3.	Månsson Lexell, Eva, et al. (author) Occupational Adaptation in People With Multiple Sclerosis 2011 In: OTJR (Thorofare, N.J.). - : SAGE Publications. - 1539-4492 .- 1938-2383. ; 31:3, s. 127-134 Journal article (peer-reviewed)abstract The aim of this study was to gain an enhanced understanding of how people with multiple sclerosis experience their occupational adaptation. Ten people with multiple sclerosis were interviewed and the constant comparative method was used to analyze the data. Their occupational adaptation was experienced as a constant struggle and non-linear, and served as the means of achieving either a desired self or a desired family life. Adaptations of occupations differed according to the evolving goals of the participants. The findings showed that the participants often selected occupational adaptations to meet their family needs over their own. These findings can help professionals to establish where their clients with multiple sclerosis are in the adaptation process and offer appropriate client-centered interventions.
4.	Pettersson, Cecilia, 1963-, et al. (author) Housing accessibility for senior citizens in Sweden : Estimation of the effects of targeted elimination of environmental barriers. 2018 In: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 25:6, s. 407-418 Journal article (peer-reviewed)abstract AIM: To estimate the effects of targeted elimination of environmental barriers (EB) in the ordinary housing stock in Sweden, and to explore the estimated effects on accessibility at a population level in relation to (a) residents with different functional profiles, (b) different housing types and (c) building periods.METHOD: Data on dwellings from existing Swedish research databases were utilized. EB and accessibility were assessed by means of the Housing Enabler instrument. In simulations of EB removal, five items that correspond to the most common housing adaptations were selected. The simulations were applied to four functional profiles of different complexity.RESULT: EB known to be commonly removed by housing adaptations exist in large proportions of the existing ordinary housing stock. Estimated targeted elimination of selected barriers would have the largest accessibility effects for the more complex functional profiles. The effects would be consistently larger for one-family houses, and for all types of dwellings built before 1960.CONCLUSIONS: The elimination of the EB most commonly addressed by housing adaptations could result in a reduction of the housing accessibility problems that community-living older people are facing. For society to solve the housing situation for the ageing population well-informed and efficient upgrading of ordinary housing is imperative.
5.	Månsson Lexell, Eva, et al. (author) Constantly Changing Lives: Experiences of People With Multiple Sclerosis 2009 In: American Journal of Occupational Therapy. - : AOTA Press. - 0272-9490 .- 1943-7676. ; 63:6, s. 772-781 Journal article (peer-reviewed)abstract The purpose of this study was to gain an enhanced understanding of how people with multiple sclerosis (MS) experience their engagement in occupations. We interviewed 10 people and then analyzed the data gathered using the constant comparative method of grounded theory, The findings encompassed the core category "essentials of a constantly changing life," showing that along a continuum of change, the participants experienced a decreasing engagement in occupations that forced them to continuously struggle to maintain engagement. This struggle changed them and required them to construct a different life than before. Our findings suggest that professionals working in MS rehabilitation need to broaden their repertoire of interventions relevant to conditions in clients' social environment, with the intention of influencing those occupations that are individually most meaningful. Occupational therapists should focus on the client's engagement in occupations and its consequences for the client's life and self-identity.
6.	Löfqvist, Charlotte, et al. (author) Doctoral students’ experiences of being affiliated with an interdisciplinary graduate school in aging and health 2024 In: Teaching in Higher Education. - : Taylor & Francis. - 1356-2517 .- 1470-1294. ; 29:2, s. 502-517 Journal article (peer-reviewed)abstract The aim is to describe the development of a novel interdisciplinary graduate school, using the Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH) as a case example. We explore doctoral students’ perceptions of being part of SWEAH and provide implications for practice. Written self-reports reflecting 78 students’ experiences and perceptions were analyzed using thematic analysis. The findings reveal that affiliation with SWEAH is highly valued. The students emphasized the tailored courses and learning activities and reported that it was instrumental in deepening their knowledge and broadening their research perspectives. The findings demonstrate how students navigate between disciplinary and interdisciplinary contexts and become enculturated with intellectual mindset and understanding of the importance of network building. The graduate school adds an interdisciplinary layer of learning, influenced by peers and researchers, and demonstrates the importance of community building within interdisciplinary environments and how it can be achieved.
7.	Jonasson, Stina B., et al. (author) Prediction of Life Satisfaction in People with Parkinson's Disease 2020 In: Parkinson's Disease. - : Hindawi Limited. - 2042-0080 .- 2090-8083. ; 2020 Journal article (peer-reviewed)abstract Introduction. People with Parkinson's disease (PD) have lower life satisfaction (LS) than healthy peers. No study has yet identified predictors of LS in people with PD. Such information would be valuable for health care and future interventions that aim to maintain or increase LS. Aim. To examine how LS evolved in people with PD over a 3-year period, as well as to identify predictive factors of LS. Methods. We used data from baseline assessments and a 3-year follow-up of 163 people with PD (baseline, mean age 68 years; median PD duration 8 years, 35% women). LS was assessed with item 1 of the Life Satisfaction Questionnaire (LiSat-11). Dichotomized LS data from the 3-year follow-up were used as the dependent variable in multivariable logistic regression analyses. In the first step, independent variables included baseline information on sex, education, general self-efficacy, motor symptoms, perceived walking difficulties, fall-related activity avoidance, and difficulties with/need help in activities of daily living. At the second step, depressive symptoms were added as an independent variable. Results. The proportion of those who reported being satisfied with their lives reduced from 63.2% at baseline to 49.7% 3 years later (p=0.003). When depressive symptoms were not included in the analysis, general self-efficacy (odds ratio, OR = 1.081; 95% CI = 1.019-1.147) and perceived walking difficulties (OR = 0.962; 95% CI = 0.929-0.997) were significant (p<0.05) predictors of LS 3 years later. With depressive symptoms included, the influence of walking difficulties diminished, and depressive symptoms (OR = 0.730; 95% CI = 0.607-0.877) and general self-efficacy (OR = 1.074; 95% CI = 1.010-1.142) were the only significant predictors of LS 3 years later. Conclusions. LS is reduced over a 3-year period. The study suggests that perceived walking difficulties, general self-efficacy, and depressive symptoms are important predictors of LS in people with PD.
8.	Nilsson, Maria H, et al. (author) Walking ability is a major contributor to fear of falling in people with Parkinson's disease: implications for rehabilitation. 2012 In: Parkinson's Disease. - : Hindawi Limited. - 2042-0080 .- 2090-8083. ; 2012:Sep 19 Journal article (peer-reviewed)abstract Although fear of falling (FOF) is common in people with Parkinson's disease (PD), there is a lack of research investigating potential predictors of FOF. This study explored the impact of motor, nonmotor, and demographic factors as well as complications of drug therapy on FOF among people with PD. Postal survey data (including the Falls Efficacy Scale, FES) from 154 nondemented people with PD were analyzed using multiple regression analyses. Five significant independent variables were identified explaining 74% of the variance in FES scores. The strongest contributing factor to FOF was walking difficulties (explaining 68%), followed by fatigue, turning hesitations, need for help in daily activities, and motor fluctuations. Exploring specific aspects of walking identified three significant variables explaining 59% of FOF: balance problems, limited ability to climb stairs, and turning hesitations. These results have implications for rehabilitation clinicians and suggest that walking ability is the primary target in order to reduce FOF. Specifically, balance, climbing stairs, and turning seem to be of particular importance.
9.	Fristedt, Sofi, 1969-, et al. (author) "Am I representative (of my age)? No, I'm not"-Attitudes to technologies and technology development differ but unite individuals across rather than within generations 2021 In: PLOS ONE. - : Public Library of Science (PLOS). - 1932-6203. ; 16:4 Journal article (peer-reviewed)abstract While a broad spectrum of technologies is integrated in everyday life and routines, most research on ageing, health and technology has focused on attitudes toward and adoption of digital technologies including e-health, or home based monitoring systems. The aim of this study was to explore differences and similarities in attitudes and experiences with different types of technologies and development within and between three generations. We applied a qualitative, descriptive design and recruited a purposeful sample of participants from three generations (30-39, 50-59, 70-79 year old). The 25 participants took part in 3 x 2 focus groups. Forming four categories, the findings show that technologies enable as well as complicate everyday life. Participants expressed trust as well as uncertainty about risks when using technology and stated that use of digital services is required while support is limited. They identified that technology development is inevitable but not always in the service of users. In conclusion, experiences of and attitudes towards technologies and technology development are not limited to generation; perspectives sometimes unite individuals across rather than within generations. Thus future technologies and technology development, as well as services and policies aiming to support the use of said technologies should consider individual user perspectives including needs, desires, beliefs or goals neglected in the existing technology models, and involve users beyond generations defined by chronological age. Such strategies are likely to be more successful in supporting development of technologies usable for all.
10.	Granbom, Marianne, et al. (author) A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing 2016 In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 16:1 Journal article (peer-reviewed)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.
11.	Hultqvist, Sara, 1977-, et al. (author) Collaboration in Grant Proposals and Assessments in Ageing Research – Justification or a Quest for a Collaborology? 2021 In: Social Epistemology. - : Taylor & Francis. - 0269-1728 .- 1464-5297. ; 35:5, s. 427-440 Journal article (peer-reviewed)abstract Orientation towards application, transdisciplinarity and social distribution are prominent ideas when policy prescribes how to conduct research on complex, real-world issues. Issues dealt with in ageing research are both epistemologically complex and politically contentious. By using the metaphor of ‘travelling ideas,' we have followed these ideas on their journey into 17 approved grant proposals on ageing and their assessments in Sweden in 2016. We considered collaboration as the modus operandi of the implementation of the three ideas. Thus, we analyzed how plans for collaboration were described in the data. The result shows that although the ideas were clearly present in the policy documents, they were almost eviscerated in the majority of proposals and assessments. Only three out of 17 proposals reflected the ideas. Thus, collaboration as an aspect of research was not codified. As long as there is no established way of describing collaboration, researchers struggle to invent their own tentative versions, that is, a collaborology.
12.	Hultqvist, Sara, et al. (author) “Why involve older people in research?” Revisiting Alan Walker’s earlier editorial based on recent experiences from the UserAge research programme 2023 In: Research Involvement and Engagement. - : BioMed Central (BMC). - 2056-7529. ; 9:1 Journal article (peer-reviewed)abstract Posed 16 years ago in a much-cited editorial by gerontologist, Alan Walker, “Why involve older people in research?” is a question that has since inspired researchers in many countries and from diverse disciplines. In Sweden, researchers and older people have been collaborating in the 6-year UserAge research programme, focusing on user involvement in research on ageing and health, UserAge aims at contributing to an in-depth understanding of the challenges and benefts of user involvement in diferent phases of the research process. Approaching programme completion, the authors take the opportunity to dwell upon current reasons for and modes of user involvement in ageing research in light of the argument originally put forward by Alan Walker back in 2007.
13.	Jonasson, Stina B., et al. (author) Psychometric evaluation of the Parkinson’s disease Activities of Daily Living Scale 2017 In: Parkinson's Disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. Journal article (peer-reviewed)abstract Objective: To evaluate a set of psychometric properties (i.e., data completeness, targeting andexternal construct validity) of the Parkinson’s disease Activities of Daily Living Scale (PADLS) in people with Parkinson’s disease (PD). Specific attention was paid to the association between PADLS and PD severity, according to the Hoehn & Yahr (H&Y) staging. Methods: The sample included 251 persons with PD (mean age 70 [SD 9] years). The data collection comprised a self-administered postal survey, structured interviews and clinical assessments at home visits. Results: Data completeness was 99.6% and the mean PADLS score was 2.1. Floor and ceiling effects were 22% and 2%, respectively. PADLS scores were more strongly associated (rs>0.5) with perceived functional independence, dependence in ADL, walking difficulties and self- rated PD severity than with variables such as PD duration and cognitive function (rs<0.5).PADLS scores differed across H&Y stages (Kruskal-Wallis test, p<0.001). Those in H&Y stages IV-V had more ADL disability than those in stage III (Mann-Whitney U-test, p<0.001), whereas there were no significant differences between the other stages. Conclusion: The PADLS revealed excellent data completeness, acceptable targeting and external construct validity. It seems to be well suited as a rough estimate of ADL disability inpeople with PD.
14.	Jönson, Håkan, et al. (author) SAPO – en modell för samverkan mellan forskare och aktörer utanför akademin inom området äldre och åldrande 2021 In: Äldre i Centrum Vetenskapligt supplement. - : Stiftelsen Stockholms läns Äldrecentrum. - 2003-9050 .- 2003-9069. ; 1:1, s. 5-14 Journal article (peer-reviewed)abstract En åldrande befolkningen har identifierats som en samhällsutmaning. En tydlig utveckling inom forskning om sådana utmaningar är krav på medverkan från patientgrupper, brukarorganisationer och andra aktörer utanför akademin. Syftet med artikeln är att introducera en modell för utformning och värdering av samverkan mellan akademiska forskare och aktörer utanför akademin. Modellen bygger på en genomgång av internationellt etablerade traditioner och ramverk för sådan samverkan och ramas in av komponenterna syfte, aktör, process och omfattning (SAPO) eller enklare uttryckt genom frågorna: varför, med vem, när och hur mycket? Med hjälp av modellen kan både forskare och aktörer utanför akademin föra mer systematiska och kritiskt värderande resonemang om samverkan. Det kan i sin tur leda till effektivare arbetsformer och nyttiggörande av resultat från det mångfasetterade forskningsområde som rör den åldrande befolkningen.
15.	Jörgensen, Sophie, et al. (author) Secondary health conditions, activity limitations, and life satisfaction in older adults with long-term spinal cord injury 2017 In: PM&R. - : Elsevier. - 1934-1482 .- 1934-1563. ; 9:4, s. 356-366 Journal article (peer-reviewed)abstract BackgroundMany individuals with a spinal cord injury (SCI) have lived several decades with their injury, leading to a need for a deeper understanding of factors associated with healthy aging in people with long-term SCI.ObjectivesTo (1) describe secondary health conditions, activity limitations, and life satisfaction in older adults with long-term SCI, and to (2) investigate how sociodemographics, injury characteristics, and secondary health conditions are associated with their activity limitations and life satisfaction.DesignCross-sectional descriptive cohort study.SettingHome and community settings.ParticipantsA total of 123 individuals (71% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time since injury 24 years.MethodsBaseline data as part of the Swedish Aging with Spinal Cord Injury Study. Associations between variables were investigated with multivariable linear regression analyses.Main Outcome MeasurementsBowel and bladder function, nociceptive and neuropathic pain, spasticity, the Spinal Cord Independence Measure, third version, and the Satisfaction With Life Scale.ResultsBowel-related and bladder-related problems were reported by 32% and 44%, respectively, 66% reported moderate or severe nociceptive and/or neuropathic pain, and 44% reported spasticity. Activity limitations were moderate (mean Spinal Cord Independence Measure, third version, total score 65.2, range 8-100) where injury characteristics and spasticity explained 68% of the variance. Higher level and more severe SCI (based on the American Spinal Injury Association Impairment Scale) exhibited the strongest association with more activity limitations. Life satisfaction was rated just above the midpoint between satisfied and dissatisfied with life (mean Satisfaction With Life Scale total score 20.7, range 6-34). Marital status, vocational situation, bladder function and injury characteristics explained 38% of the variance, where having a partner showed the strongest association with greater life satisfaction. Activity limitations and life satisfaction were not associated with gender, age and time since injury.ConclusionOlder adults with long-term SCI can maintain a relatively high level of physical independence and generally are satisfied with their lives, regardless of gender, age or time since injury. The associations demonstrate the importance of injury characteristics for the performance of daily activities and the social context for life satisfaction in older adults with long-term SCI.Level of EvidenceIII
16.	Löfqvist, Charlotte, et al. (author) Mobility and mobility-related participation outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use 2012 In: Disability and Rehabilitation. - : Informa Healthcare. - 1748-3107 .- 1748-3115. ; 7:3, s. 211-218 Journal article (peer-reviewed)abstract PURPOSE: The aim was to investigate outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use regarding need for assistance when moving around, frequency of mobility-related participation, easiness/difficulty in mobility during participation, and number of participation aspects performed in everyday life.METHOD: The study was a prospective cohort study, using an instrument focusing on mobility-related participation outcomes of mobility device interventions (NOMO 1.0), at baseline, after 4-months and 1-year use.RESULTS: The results show that the outcomes in terms of participation frequency and easiness in mobility occur in a short time perspective, and that the effects remained stable at 1-year follow-up. The frequency of going for a walk increased most prominently (26%). Even though the majority of the participation aspects were not performed, more often they became easier to perform: 56-91% found that shopping, walking and visiting family/friends were easier. Moreover, independence outdoors and indoors increased.CONCLUSIONS: This small study provides knowledge about the outcomes of powered wheelchairs and scooters in terms of mobility and mobility-related participation in real-life situations. The study supports results from former studies, but even so, larger studies are required in order to provide evidence for the effectiveness of powered wheelchairs and scooters. [Box: see text].
17.	Nilsson, Maria H., et al. (author) Psychometric properties of the general self-efficacy scale in Parkinson's disease 2015 In: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404. ; 132:2, s. 89-96 Journal article (peer-reviewed)abstract OBJECTIVE: This study aimed to investigate the psychometric properties of the General Self-Efficacy Scale (GSE) in people with Parkinson's disease (PD). More specifically, we investigated data completeness, scaling assumptions, targeting, reliability, and construct validity.MATERIALS AND METHODS: This study involves data available from two different projects that included people diagnosed with PD for at least 1 year, yielding two samples (1 and 2). The combined total sample (N = 346; 60% men) had a mean (SD) age and PD duration of 71 (8.9) and 9 years (6.3), respectively. Both samples received a self-administered survey by mail, which was administered twice in sample 2. Additional data (e.g., clinical assessments) were available for Sample 1.RESULTS: Total GSE scores were computable for 336 participants (97%). Corrected item-total correlations exceeded 0.4. Principal component analyses identified one component (the eigenvalue of the first component extracted was 6.9), explaining 69% of the total variance. Floor and ceiling effects were < 6%. Internal consistency (coefficient alpha) was 0.95. Analyses of test-retest reliability yielded (ICC) values from 0.69 to 0.80. The highest value refers to those (n = 47) with identical self-ratings of mobility (in the on condition) at both tests; the standard error of measurement was 3.1 points. Construct validity was further supported by correlations in accordance with a priori expectations.CONCLUSIONS: This study provides support for the validity and reliability of GSE scores in people with PD; the GSE can thus serve as a valuable outcome measurement in clinical practice and research.
18.	Norin, Lizette, et al. (author) Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury 2020 In: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; , s. 1-10 Journal article (peer-reviewed)abstract Introduction: Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method: Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings: Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grabbars (hygiene area) generated the most accessibility problems. Conclusion: Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.
19.	Offerman, Jens, et al. (author) Self-reported changes in use of and attitudes toward ICT in three generations in Sweden during the early phase of the COVID-19 pandemic 2024 In: Gerontology and geriatric medicine. - : Sage Publications. - 2333-7214. ; 10 Journal article (peer-reviewed)abstract COVID-19 has affected the daily activities of people worldwide. Recommendations introduced to reduce the spread of the virus led to increased use of Information and Communication Technologies (ICT) to meet everyday needs. Such rapid digitalization had not been seen previously and not been possible to study before. Hence, this study aimed to identify and describe self-reported changes in usage of and attitudes toward ICT among three generations in Sweden during the early phase of the COVID-19 pandemic. Additionally, it aimed to identify whether and how belonging to a specific generation was related to these changes. A national cross-sectional survey was conducted in June 2020 with a final sample of N?=?3,000, stratified into three generations (30?39, 50?59, and 70?79-year-old persons). A majority reported using digital technology more often than before the pandemic. Compared to the youngest generation, the oldest and middle-aged generations reported that they used digital technology more often than before the pandemic. Our results show which technologies were considered essential for different generations during the early phase of the pandemic. This information can be used to guide policy makers based on knowledge concerning the needs and demands for digital technologies in everyday life among people of different ages.
20.	Pettersson, Cecilia, 1963-, et al. (author) Autonomy and Housing Accessibility Among Powered Mobility Device Users 2014 In: American Journal of Occupational Therapy. - : American Occupational Therapy Association, Inc.. - 0272-9490 .- 1943-7676. ; 69:5 Journal article (peer-reviewed)abstract OBJECTIVE: To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users' autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy.METHOD: This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used.RESULTS: More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors.CONCLUSION: To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems.
21.	Pettersson, Cecilia, 1963-, et al. (author) Men's and women's perspectives on using a powered mobility device : benefits and societal challenges 2014 In: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 21:6, s. 438-446 Journal article (peer-reviewed)abstract OBJECTIVE: To describe how men and women experience their use of powered wheelchairs (PW) and powered scooters (PS) in everyday occupations, in the home and in society at large.METHODS: A qualitative research approach with focus-group methodology was used. Four focus groups were created, with men and women as well as PW and PS users in different groups. Applying a descriptive approach, data were analysed according to the principles described by Krueger.FINDINGS: Three categories emerged and revealed that even though use of PW and PS increased independence and enabled everyday occupations, participants struggled to be independent powered mobility device (PMD) users. They experienced many accessibility problems in dwellings and in society, described similarly by users of PW and PS. Men and women experienced their use of (PMD) differently, especially in relation to the service delivery process.CONCLUSIONS: The study contributes with new knowledge on accessibility for PW and PS users and related service delivery processes, stating that gender differences regarding provision and training must be taken into account. Occupational therapists can contribute to an enhanced understanding of PMD users' challenges in person-environment-occupation transactions in the home and society, and thereby promote occupational justice for PMD users.
22.	Slaug, Björn, et al. (author) Meaning of home attenuates the relationship between functional limitations and active aging 2024 In: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 36:1 Journal article (peer-reviewed)abstract Background and aims: Active aging is the process through which people strive to maintain wellbeing when growing old. Addressing the lack of research on active aging in the context of housing, the aim was to describe active aging among people aged 55 and older considering relocation and investigate whether perceived housing moderates the relationship between functional limitations and active aging.Methods: We utilized cross-sectional data from a sub-sample (N = 820; mean age = 69.7; 54% women) of the Prospective RELOC-AGE. Functional limitations were reported using 10 dichotomous questions. Active aging was assessed with the University of Jyvaskyla Active Aging Scale (UJACAS; 17 items, self-rated for four perspectives). Perceived housing was self-rated with four usability questions and meaning of home (MOH; 28 items). Cross-sectional associations and interactions were analysed using linear regression models, adjusting for gender and educational level.Results: Each functional limitation decreased the active aging score by almost five points (p < 0.001). Usability did not moderate that relationship while MOH significantly attenuated the association between functional limitations and active aging (p = 0.039). Those with high MOH had two points less decrease in active aging score compared to those with low MOH.Discussion and conclusions: Having a home with more personal meaning attached to it seems to provide more ability and opportunity for meaningful activities, thus supporting active aging despite functional limitations. This sheds new light on the known association between MOH and different aspects of wellbeing in old age and has relevance for theory development, housing policies and housing counselling targeting younger older adults.
23.	Timpka, Jonathan, et al. (author) Objective Observer vs. Patient Motor State Assessments Using the PD Home Diary in Advanced Parkinsons Disease 2022 In: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 13 Journal article (peer-reviewed)abstract Background: The Parkinson Disease (PD) Home Diary (HD) is a commonly used clinical outcome measure, but it has not been extensively compared to direct assessments by experienced observers. Objective: Validation of patient-reported HD by investigating the agreement between motor state assessments by patients and observers. Methods: This observational study included patients with PD and motor fluctuations. Observers were physicians or research nurses. Patients completed a screening visit, one day of diary ratings at home, and then two days of ratings on-site during which patients and observers simultaneously judged the participants motor state. Results: Observers and 40 patients completed 1,288 pairs of half-hourly blinded motor state assessments. There were significant differences between observer and patient ratings (P < 0.001) and the temporal agreement was poor (Cohens kappa = 0.358). The agreement between patient and observer ratings was 71.1% for observed "On without dyskinesia", 57.3% for observed "Off", and 49.4% for observed "On with dyskinesia". Daily times spent in the three motor states as aggregated diary data showed fair to excellent reliability with intraclass coefficient values ranging from 0.45 to 0.52 for "On" and 0.77 for "Off". Conclusion: There were significant differences between observer and patient ratings. Patients and observers generally agreed on when the patients was in the "On" state (with or without dyskinesia). Patient ratings on the hour level seem to be influenced by other aspects of the patients experience than the observed motor state, but assessment of daily time spent in the different motor state provides reasonable reliability.
24.	Timpka, Jonathan, et al. (author) Time to workforce exit after a Parkinsons disease diagnosis 2023 In: NPJ PARKINSONS DISEASE. - : NATURE PORTFOLIO. - 2373-8057. ; 9:1 Journal article (peer-reviewed)abstract The impact of Parkinsons disease (PD) on workforce participation has received little attention even though demographic, lifestyle, and political changes together will result in an increased burden of PD on the working-age population. In this study, we investigate workforce survival after a PD diagnosis, as well as what demographic factors that are associated with workforce survival. As an exploratory outcome, we investigate workforce survival in persons with and without device-aided treatment (DAT). This is a nested case-cohort study based on Swedish national data from 2001-2016. Controls were matched on year of birth, sex, and municipality of residence. The used registers contain data on demographics, social insurance, in- and outpatient visits, filled drug prescriptions, and cause of death on the person-level. A total of 4781 persons with PD and 23,905 controls were included. The median survival until all-cause workforce exit was 43 months among persons that were workforce-active at the time of PD diagnosis, compared to 66 months in non-PD controls. Being female, >= 50 years old at diagnosis, or having a lower education were contributing factors to health-related workforce exit. Persons receiving DAT during follow-up exhibited shorter workforce survival than controls. However, this needs further investigation, particularly as patients have generally already left the workforce at the time for start of DAT. It is evident that PD has grave negative effects on workforce participation. Thus, supportive measures need to start at an early stage after diagnosis, and the development of new interventions is urgently needed.
25.	Dahlin-Ivanoff, Synneve, 1950, et al. (author) The multiple meaning of home as experienced by very old Swedish people. 2007 In: Scandinavian journal of occupational therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:1, s. 25-32 Journal article (peer-reviewed)abstract The aim of this study was to explore aspects of the meaning of home as experienced by very old single-living people in Sweden. A grounded theory approach was used, and interviews were conducted with 40 men and women aged 80-89. The findings indicate that home has a central place in the lives of very old people because it is where they live and spend so much time. The significance of the home is based on the fact that it means so many different things to the participants. The theme comprises two key categories: home means security and home means freedom. Each of these has three sub-categories. In home means security, these are: living in a familiar neighborhood, everything functions, and having memories to live on. Home means freedom comprises a place for reflection, a social meeting-point, and leaving your own mark. Home is part of the environment and influences the meaning and selection of activities that very old people decide to engage in. When occupational therapists prescribe assistive devices or recommend changes in the home environment, they must be very well aware of and reflect on what home means to their clients and base their measures on that.
26.	Haak, Maria, et al. (author) Home as a signification of independence and autonomy: experiences among very old Swedish people. 2007 In: Scandinavian journal of occupational therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:1, s. 16-24 Journal article (peer-reviewed)abstract The aim of this study was to explore independence in the home as experienced by very old single-living people in Sweden. A grounded theory approach was used and interviews were conducted with 40 men and women aged 80-89. Data analysis revealed the core category "Home as a signification of independence" with two main categories: "Struggle for independence" and "Governing daily life". The findings showed that home is strongly linked to independence, and being independent is extremely valued. Explicit descriptions of the ageing process as an individual process of changing living conditions within the home emerged from the findings. Hence, the ageing process influences the participants' perception of themselves as independent persons. Along the ageing process the participants' view of independence changed from being independent in activity performance without help from others to experiencing independence in being able to make autonomous decisions concerning daily life at home. Consequently, there is a need to develop strategies to support very old people in staying as active and independent as possible in their own homes. In addition, since the findings highlight that independence is a complex construct, there is a need for conceptual differentiation between independence and a construct often used synonymously, namely autonomy.
27.	Haak, Maria, et al. (author) Home as the locus and origin for participation- experiences among very old Swedish people 2007 In: OTJR. - 1539-4492. ; 27:3, s. 95-103 Journal article (peer-reviewed)
28.	Haak, Maria, et al. (author) The importance of successful place integration for perceived health in very old age: a qualitative meta-synthesis 2011 In: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 56:6, s. 589-595 Journal article (peer-reviewed)abstract The aim of this study was to increase our understanding of the multifaceted phenomenon of home and health, by exploring processes underlying these dynamics when living at home in very old age. A qualitative meta-synthesis was used on four complementary qualitative studies, based on data from the Swedish ENABLE-AGE In-depth Study, focusing on very old, single-living people's experiences of home in relation to participation, independence and health (N = 40). Over time, very old people manage increased frailty by means of three intertwined processes concerning changes in everyday life: The turning points, The struggle and The negotiations. The findings show that these processes take place through the context of the Homelike functional home and a state of mind labelled, The awareness of frailty. The results can be useful in constructing and implementing guidelines for more holistic approaches to housing provision for senior citizens. Further, the study delivers a deeper understanding about how very old people live their lives, useful for practitioners as well as it contributes to theory development within the context of ageing and environments.
29.	Iwarsson, Susanne, et al. (author) Assessment of dependence in daily activities combined with a self-rating of difficulty. 2009 In: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 41:3, s. 150-6 Journal article (peer-reviewed)abstract OBJECTIVE: To study the information gained by extending a well-established instrument of dependence/independence in activities of daily living with a self-rating of difficulty, and to illustrate the relevance and usefulness of this combined approach with cross-national data. DESIGN AND SUBJECTS: Cross-sectional survey study data collected with 1918 very old persons in 5 European countries. METHODS: The "ADL staircase assessment" of dependence/independence, extended with a self-rating of difficulty, was administered at home visits. Data distribution in the 5 national samples and analyses with or without use of the self-rating data were carried out. RESULTS: High proportions of the subjects were independent in most of the activities assessed, while substantial proportions reported difficulties. Considerable differences were identified among the national samples. In personal activities of daily living, those assessed as independent varied from 87% to 100%, while the proportion of those who rated themselves as "independent without difficulty" ranged from 53% to 98%. In instrumental activities, 33-91% were assessed as independent, while the proportions of "independent without difficulty" ranged from 24% to 77%. Analysis results differed as to whether or not self-ratings of difficulty were used. CONCLUSION: The combined approach to data collection gave a diversified, information-rich picture. The assessment used is easy to administer and can be used in practice contexts in different countries.
30.	Ståhl, Agneta, et al. (author) Detection of warning surfaces in pedestrian environments: The importance for blind people of kerbs, depth, and structure of tactile surfaces 2010 In: DISABILITY AND REHABILITATION. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 32:6, s. 469-482 Journal article (peer-reviewed)abstract Purpose.The overall purpose was to study whether and how persons with blindness detect warning surfaces with a long white cane in a real pedestrian environment after following a natural guidance surface to the warning surfaces. Of particular interest was the importance of kerb, depth, and structure of the warning surfaces. Method.A concurrently mixed methods approach, with a combination of observation using a structured form together with ‘think aloud’ and a structured interview, was used. It was done with well-defined samples and study sites in an inter-disciplinary research context. Results.The results show that the most important design characteristic for detection of the warning surfaces with a white cane is the structure of the surface, while the depth of the surface and availability of a kerb do not have any impact on the detection. A precondition was that there is a distinct natural guidance surface leading up to the warning surface. Conclusions.The probability among pedestrians with blindness to detect a tactile surface is not higher if the design solution has a kerb. This study also confirms the complexity of being a blind pedestrian in the traffic environment. The results can be used for evidence-based physical planning. The study also has implications for development of more efficient vision rehabilitation.
31.	Oswald, Frank, et al. (author) Homeward bound: Introducing a four-domain model of perceived housing in very old age 2006 In: Journal of Environmental Psychology. - : Elsevier BV. - 1522-9610 .- 0272-4944. ; 26:3, s. 187-201, s. 168-168 Journal article (peer-reviewed)abstract The aim of this article is to introduce an integrative and more comprehensive approach to understanding and measuring perceived housing in old age. First, four conceptual domains of subjective housing were introduced, based on the assumption that each of the domains brings a unique perspective to the understanding of perceived housing: housing satisfaction, usability in the home, meaning of home and housing-related control beliefs. Second, relationships between the proposed domains were empirically examined using correlative analysis, factor analysis and structural equation modelling (SEM) techniques. Cross-cultural similarities and differences in the observed empirical relations were then analysed across three Western European countries. Data were drawn from a sub-sample of the participants in the European ENABLE-AGE Project amounting to 1223 old adults aged 80-89 years and living alone in their private homes in Swedish, British, and German urban regions. The ENABLE-AGE data set has the advantage of containing measures related to all four domains of perceived housing which are the focus of this paper. The results of exploratory and confirmatory factor analysis as well as of the SEM give empirical support for the usefulness of the theoretically proposed four component model of perceived housing. Furthermore, multi-group analysis supports the assumption of similarity of perceived housing among older people living in the different countries. (c) 2006 Elsevier Ltd. All rights reserved.
32.	Jörgensen, Sophie, et al. (author) Depressive symptoms among older adults with long-Term spinal cord injury : Associations with secondary health conditions, sense of coherence, coping strategies and physical activity 2017 In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 49:8, s. 644-651 Journal article (peer-reviewed)abstract Objectives: To assess the presence of depressive symptoms among older adults with long-Term spinal cord injury and investigate the association with sociodemographic and injury characteristics; and to determine how potentially modifiable factors, i.e. secondary health conditions, sense of coherence, coping strategies and leisure-Time physical activity, are associated with depressive symptoms. Design: Cross-sectional study. Subjects: A total of 122 individuals (70% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time since injury 24 years. Methods: Data from the Swedish Aging with Spinal Cord Injury Study, collected using the Geriatric Depression Scale-15, the 13-item Sense of Coherence Scale, the Spinal Cord Lesion-related Coping Strategies Questionnaire and the Physical Activity Recall Assessment for people with Spinal Cord Injury. Associations were analysed using multivariable linear regression. Results: A total of 29% reported clinically relevant depressive symptoms and 5% reported probable depression. Sense of coherence, the coping strategy Acceptance, neuropathic pain and leisure-Time physical activity explained 53% of the variance in depressive symptoms. Conclusion: Older adults with long-Term spinal cord injury report a low presence of probable depression. Mental health may be supported through rehabilitation that strengthens the ability to understand and confront life stressors, promotes acceptance of the injury, provides pain management and encourages participation in leisure-Time physical activity.
33.	Malm, Camilla, et al. (author) What motivates informal carers to be actively involved in research, and what obstacles to involvement do they perceive? 2021 In: Research Involvement and Engagement. - : Springer Science and Business Media LLC. - 2056-7529. ; 7:1 Journal article (peer-reviewed)abstract Background: Due to demographic changes and a strained public sector operating in many countries globally, informal care is increasing. Currently, at least 1.3 million adults in Sweden regularly provide help, support and/or care to a family member/significant other. With no sign of an imminent decrease in their caring activities, it is important that informal carers are considered as a key stakeholder group within research that affects them, e.g., the co-design of carer and/or dyadic support interventions. The objective of this descriptive, quantitative study was to investigate informal carers’ perceived motivations and obstacles to become involved in research. Methods: A cross-sectional survey design was adopted, using first-wave data from a panel study. The data, collected in Sweden between September 2019 and March 2020, included survey responses from 147 informal carers who were either aged 60+ years themselves or were caring for someone who was aged 60+ years. Results: Our main results showed that informal carers are, in general, interested in research. Slightly fewer were interested in becoming actively involved themselves, but older age was the only characteristic significantly associated with less interest of being actively involved. Two latent motivational dimensions emerged from the factor analysis: ‘family motivation’ and ‘the greater good motivation’. These, according to our results, almost equally valued dimensions, described the differing reasons for informal carers to become involved in research. The most common perceived obstacle was lack of time and it was reported by more women than men. Conclusion: Our study contributes with new knowledge of informal carers’ perceived motivations and obstacles regarding carer involvement in research. Paying attention to the differing motivational dimensions held by informal carers could help researchers create conditions for more inclusive and systematic participation of informal carers within research. Thereby, increasing the opportunities for research that is deemed to be of higher societal impact. IRRID (International Registered Report Identifier): RR2-10.2196/17759.
34.	Månsson Lexell, Eva, et al. (author) The complexity of daily occupations in multiple sclerosis. 2006 In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 13:4, s. 8-241 Journal article (peer-reviewed)abstract The aims of this study were to describe which self-care, productivity, and leisure occupations individuals with multiple sclerosis (MS) perceive as difficult to perform on admission to rehabilitation and the individuals' own perception of the importance of, performance of, and satisfaction with these occupations. Whether the reported self-care, productivity, and leisure occupations were related to sex, age, disease severity, and living arrangements was also investigated. Forty-seven men and women (mean age 49.4 years) were assessed with the Canadian Occupational Performance Measure (COPM) on admission to rehabilitation. The individuals reported 366 occupations (median 8, range 3-15), which were categorized as self-care (51%), productivity (30%), and leisure (19%). Three COPM subcategories—household management (26%), personal care (21%), and functional mobility (20%)—accounted for two-thirds of the reported occupations. All prioritized occupations (n=238; (median 5, range 2-7) had high ratings for importance and the ratings for performance and satisfaction were generally low. Men reported significantly more occupations related to self-care than women, but no significant difference between the sexes could be found for productivity and leisure. No significant differences between the occupational areas were found when age, disease severity, or/and living arrangements were included in the analysis. In conclusion, individuals with MS perceive difficulties with occupations related to all aspects of daily life. This underscores the need to use assessment tools that capture the complexity of daily occupations.
35.	Persson, Dennis, et al. (author) Value Dimensions, Meaning, and Complexity in Human Occupation – A Tentative Structure for Analysis. 2001 In: Scandinavian Journal of Occupational Therapy. - London, UK : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 8:1, s. 7-18 Journal article (peer-reviewed)abstract In occupational therapy and occupational science, it is important to clarify the perspective from which the analysis of occupation is addressed. The purpose of this paper is to present a tentative structure for describing occupation, allowing for analysis in a lifelong panorama as well as for the immediate experience a person acquires from performing a single occupation. The concept of occupational value is introduced as a prerequisite for meaning, defining three different dimensions: concrete, symbolic, and self-reward value. A dynamic categorisation of single occupations is presented, considering each unique occupational performance viewed from a macro, meso, and a micro perspective, inspired by dynamic systems theory. It is proposed that all occupations are meaningful if they are integrated parts of a person's occupational continuity, and that it is the interaction between the mentioned three perspectives that determines their meaningfulness. With an explicit focus on value and meaning as perceived by the unique person, occupational therapists will become more skilled in designing meaningful occupational therapy interventions. This paper is a contribution to the development of occupational science as well as to occupational therapy, but the theoretical framework presented must be empirically tested in order to demonstrate its validity.
36.	Reuter, Arlind, et al. (author) Optimising conditions and environments for digital participation in later life: a macro-meso-micro framework of partnership-building 2023 In: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 14, s. 1-7 Journal article (peer-reviewed)abstract The ongoing digitalisation of societies, exacerbated by the COVID-19 pandemic, has led to increased efforts to ensure the digital inclusion of older adults. Digital inclusion strategies throughout the COVID-19 pandemic predominantly focused on increasing access and basic digital literacy of Information and Communication Technologies (ICTs) for all members of society. Older adults, who are more likely to experience digital exclusion, are amongst the target groups of digital inclusion strategies. We propose that beyond digital inclusion, there is a need to focus on digital participation and optimise opportunities for everyone to participate in communities and society in post-pandemic times. Creative digital skills are the foundation of digital participation and can lead to a variety of contributions. Digital participation offers conditions that support agency and active contributions in a digitalised society. Taking macro-, meso-, and micro-level enablers of digital participation in later life into account, we argue for the establishment and implementation of multi-layered and multisectoral partnerships that address environmental factors (including social and physical dimensions) of digital participation and create opportunities for diverse, meaningful and fulfilling engagement with ICTs in later life. The partnership approach can be used in designing and implementing digital participation programmes and should be further evaluated against the needs and lived experiences of older individuals. Foresighted research is needed to investigate key factors of effective partnerships for optimising environments for digital participation in later life.
37.	Timpka, Jonathan, et al. (author) Reduced workforce participation 5 years prior to first Parkinson’s disease sick-leave 2018 In: npj Parkinson's Disease. - : Springer Science and Business Media LLC. - 2373-8057. ; 4 Journal article (peer-reviewed)abstract The importance of understanding the prodromal phase of Parkinson’s disease (PD) by systematic recording of prediagnostic symptoms and reductions in body functions has been highlighted. The aim of this study was to investigate whether persons later diagnosed with PD exhibit increased physician-certified sickness absence 1, 2, and 5 years prior to a first sick-leave episode attributed to PD. A case-control study was performed to analyze data from all nontrivial (exceeding 14 days) sick-leave episodes in Sweden between 2008 and 2014. The 537 incident PD sick-leave episodes were identified as PD sick-leave cases and compared to 537 sick-leave controls identified by matching age, sex, and date of the first day of the sick-leave episode. The total sickness absence and sickness absence due to musculoskeletal diagnoses were found to be increased among the PD sick-leave cases from 5 years prior to the first sick-leave episode ascribed to PD when compared to the controls. No differences between PD sick-leave cases and sick-leave controls were found with regard to mental and behavioral diagnoses. We conclude that the capacity to participate in working life is reduced already at the early prediagnostic stages of PD. This finding can be used as a basis for further research into the process of identifying individuals at risk for developing PD, particularly in combination with further investigation into biochemical, genetic, and imaging biomarkers.
38.	Zingmark, Magnus, et al. (author) Challenges related to self-assessment of active ageing during the Covid-19 pandemic in Sweden 2022 In: BMC Research Notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 15:1 Journal article (peer-reviewed)abstract Objective: The aim is to describe and reflect upon potentially pandemic-related impact on self-assessments of active ageing. As part of the baseline data collection in the Prospective RELOC-AGE (ClinicalTrials.gov NCT04765696) study, telephone interviews, including the University of Jyvaskyla Active Aging Scale (UJACAS) were conducted with 820 people 55 years or older listed with an interest of relocation at three housing companies in Sweden. Field notes alongside the interviews focused on two topics: (1) how respondents reasoned and replied to the questions included in the UJACAS; (2) whether there were specific items that seemed to be affected by the pandemic. Results: For four items (Participating in events, Exercising, Maintaining friendships, Getting to know new people), recurrent comments indicated that respondents had been affected by the pandemic situation regarding one or more of the facets in UJACAS: will to act, ability to act, opportunity to act, or frequency or extent of doing the activity. Opportunities to act was most frequently commented on as a factor affected by restricted participation in activities. As Prospective RELOC-AGE is a longitudinal study focused on associations between housing, relocation and active ageing, it is imperative to consider the potential pandemic-related impact on baseline data in future analyses. ¤¤¤¤¤
39.	Zingmark, Magnus, et al. (author) Exploring associations of housing, relocation, and active and healthy aging in sweden : Protocol for a prospective longitudinal mixed methods study 2021 In: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 10:9 Journal article (peer-reviewed)abstract Background: While housing and neighborhood features have the potential to impact opportunities for active aging, there is a lack of knowledge related to how older people reason regarding their housing situation and how housing and fulfillment of relocation are associated with active and healthy aging. Objective: The objectives of Prospective RELOC-AGE are to study housing choices and relocation and explore effects on active and healthy aging among men and women aged 55 years and older in Sweden considering relocation. Methods: The estimated sample (2800) will include people aged 55 years and older being listed for relocation at either of two housing companies: a local public housing company in Southern Sweden and a national condominium provider. Prospective RELOC-AGE has a 2-level longitudinal mixed methods design and includes quantitative surveys (implemented by a professional survey company) and a telephone interview for baseline data collection in 2021, with follow-ups with the same procedures in 2022 and 2023. The survey and interviews include questions related to present housing and neighborhood, relocation plans and expectations, a range of perspectives on active and healthy aging, and demographics. Linking to national registers will provide additional data on home help and health care use, objective housing, and neighborhood characteristics. To explore what housing attributes older adults considering relocation find important and to what extent when making their decisions on housing, we will develop a discrete choice experiment to be implemented with a subsample of participants. Further, a grounded theory approach will be applied to collect in-depth interview data from participants who have moved to another dwelling, within 6 months of the move. A follow-up interview 12 months later will focus on participants' deepened experience over time in terms of fulfilled expectations and relocation experiences. Results: As of submission of this protocol (June 2021), recruitment has commenced with approximately 960 respondents to the survey and ongoing telephone interviews. We anticipate recruitment and data collection based on surveys and interviews to continue during 2021. Conclusions: Prospective RELOC-AGE has the capacity to generate new policy-relevant knowledge on associations of housing, relocation, and active and healthy aging. Such knowledge is relevant for the development of proactive approaches to housing in old age on the individual, group, and societal levels.
40.	Kylén, Maya, et al. (author) Housing attribute preferences when considering relocation in older age 2023 In: Innovation in Aging. - : Oxford University Press. - 2399-5300. ; 7:Supplement_1, s. 223-223 Journal article (peer-reviewed)
41.	Nilsson, Maria, et al. (author) Walking ability is a major contributor to fear of falling in people with Parkinson’s disease : implications for rehabilitation 2012 In: Parkinson's Disease. - 2090-8083 .- 2042-0080. ; , s. 713236- Journal article (peer-reviewed)abstract Although fear of falling (FOF) is common in people with Parkinson's disease (PD), there is a lack of research investigating potential predictors of FOF. This study explored the impact of motor, nonmotor, and demographic factors as well as complications of drug therapy on FOF among people with PD. Postal survey data (including the Falls Efficacy Scale, FES) from 154 nondemented people with PD were analyzed using multiple regression analyses. Five significant independent variables were identified explaining 74% of the variance in FES scores. The strongest contributing factor to FOF was walking difficulties (explaining 68%), followed by fatigue, turning hesitations, need for help in daily activities, and motor fluctuations. Exploring specific aspects of walking identified three significant variables explaining 59% of FOF: balance problems, limited ability to climb stairs, and turning hesitations. These results have implications for rehabilitation clinicians and suggest that walking ability is the primary target in order to reduce FOF. Specifically, balance, climbing stairs, and turning seem to be of particular importance.
42.	Rosqvist, Kristina, et al. (author) Satisfaction with care in late stage Parkinson’s disease 2019 In: Parkinson's Disease. - 2090-8083 .- 2042-0080. ; 2019 Journal article (peer-reviewed)abstract In late stage Parkinson’s disease (PD) (i.e., Hoehn and Yahr (HY) stages IV-V), both motor and nonmotor symptoms (NMS) are pronounced, and the patients become increasingly dependent on help in their daily life. Consequently, there is an increasing demand on health-care and social care resources for these patients and support for their informal caregivers. The aim of this study was to assess satisfaction with care in late stage PD patients and to identify factors associated with satisfaction with care. Moreover, to assess their informal caregivers’ satisfaction with support and to identify factors associated with caregivers’ satisfaction with support. Factors potentially associated with satisfaction with care/support were assessed in 107 late stage PD patients and their informal caregivers () and entered into multivariable logistic regression analyses. Fifty-eight (59%) of the patients and 45 (59%) of the informal caregivers reported satisfaction with their overall care/support. Patients satisfied with their care reported higher independence in activities of daily living (ADL) (Katz ADL index; ), less depressive symptoms (Geriatric Depression Scale, GDS-30; ), and higher individual quality of life (QoL) (Schedule for the Evaluation of Individual Quality of Life Questionnaire, SEIQoL-Q; ). Multivariable logistic regression analyses identified depressive symptoms () and independence in ADL () as independently associated with satisfaction with care. For informal caregivers, the analyses identified patients’ HY stage () and caregivers’ QoL (Alzheimer’s Carers Quality of Life Inventory, ACQLI; ) as independently associated with satisfaction with caregiver support. The results indicate that an effective both pharmacological and nonpharmacological PD therapy is important, to adequately treat motor and NMS (e.g., depressive symptoms) in order to improve depressive symptoms and patient independence in ADL. This may benefit not only the patients, but also their informal caregivers.
43.	Zingmark, Magnus, et al. (author) Prospective RELOC-AGE: Baseline data from a longitudinal mixed-methods study exploring associations of housing, relocation and active ageing in Sweden 2022 In: 2673-9259. - : MDPI. ; 3:3, s. 388-389 Journal article (peer-reviewed)abstract Introduction: To inform the design of policies and societal support related to housing, knowledge is needed about how housing and relocation are associated with active ageing and health outcomes. The objectives of Prospective RELOC-AGE are to study housing choices and relocation and explore effects on active ageing among men and women aged 55+ in Sweden considering relocation. Material and Methods: Recruitment included people aged 55+ listed with an interest for relocation at either of three housing companies. A two-level longitudinal mixed-methods design included a survey and a telephone interview for the baseline data collection. The questions related to present housing and neighbourhood, relocation plans and expectations, a range of perspectives on active and healthy ageing, and demographics. Exploratory and inferential statistics are applied to investigate how personal and neighbourhood-level characteristics are associated with active ageing and health outcomes such as life-space mobility and self-rated health.Results: The sample (n = 1966) included 56% women, mean age 70 years. Preliminary analyses indicated that 83% rated their health has good or better, 53% lived in apartments. Several reasons for signing up with an interest for relocation were reported. Further analyses will broaden the scope of baseline sample characteristics, and associations with active ageing, life-space mobility and self-rated health will be explored.Conclusions: Prospective RELOC-AGE has the capacity to generate new policy-relevant knowledge on associations of housing, relocation and active ageing relevant for the development of proactive approaches to housing in old age on the individual, group as well as societal levels.
44.	Hedberg-Kristiansson, E, et al. (author) Patient experiences of participation in the prescription process of mobility devices 2006 In: British Journal of Occupational Therapy. ; 4, s. 169-76 Journal article (peer-reviewed)
45.	Brandt, Åse, et al. (author) Older people's use of powered wheelchairs for activity and participation 2004 In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 36:2, s. 70-77 Journal article (peer-reviewed)abstract Objective: The aims of this study were to investigate outcomes of older people's use of powered wheelchairs and risk factors for negative outcomes. Design: The study was a cross-sectional interview-study including 111 powered wheelchair users over 65 years of age. Results: All participants used their powered wheelchair in the summer; nearly all users regarded it as important and found that it gave them independence. The wheelchair made activity and participation possible for the users. The most frequent activity in the summer was going for a ride, and in the winter it was shopping. However, some could not use the wheelchair for visits, and supplementary travel modes are called for. Users who could not walk at all or who could not transfer without assistance were more likely not to be able to carry out prioritized activities. Furthermore, other risk factors for negative outcomes and need for further research were identified. Conclusion: The use of powered wheelchairs is a relevant societal intervention in relation to older people with limited walking ability in order to make activity and participation possible. It is likely that a larger proportion of older people could benefit from this intervention, in particular if current practices are improved taking activity and participation outcomes into consideration.
46.	Iwarsson, Susanne (author) A Long-Term Perspective on Person-Environment Fit and ADL Dependence Among Older Swedish Adults. 2005 In: The Gerontologist. - 1758-5341. ; 45:3, s. 327-336 Journal article (peer-reviewed)abstract Purpose: This study described person–environment (P–E) fit and activities of daily living (ADLs) among older adults, and it explored the relationship between P–E fit and ADL dependence, testing Lawton's docility hypothesis at two points in time. Design and Methods: From a random sample of individuals aged 75–84 living in a Swedish municipality, 72 persons were available for baseline and follow-up interviews over a 6-year period. Interviews and observations were used for data collection at home visits. Results: P–E fit problems as well as ADL dependence increased from baseline to follow-up. Functional limitations and dependence on mobility devices increased; few changes were found concerning environmental barriers. At follow-up, ADL dependence and P–E fit correlated significantly in the frailest subsample. Implications: In advanced age, P–E fit problems in housing are related to ADL dependence. The increase of P–E fit problems mostly results from functional decline, although to some extent it is from environmental changes as well. The methodology used demonstrates the potential to increase our understanding of how the main components of Lawton's model change and interact over time.
47.	Löfqvist, Charlotte, et al. (author) Use of mobility devices and changes over 12 months among very old people in five European countries. 2007 In: Aging clinical and experimental research. - 1720-8319. ; 19:6, s. 497-505 Journal article (peer-reviewed)abstract BACKGROUND AND AIMS: Mobility devices (MDs) such as walking sticks, rollators and wheelchairs, often play an important role for older people living at home, striving to remain independent in everyday activities. The aim of this study was to explore how the use of MDs changes over time among very old people in five European countries. METHODS: Empirical data from the ENABLE-AGE Survey Study, part of a major interdisciplinary research project carried out in Sweden (n=314), Germany (n=322), the United Kingdom (n=316), Hungary (n=179), and Latvia (n=225), were used. RESULTS: The use of MDs in the Swedish, German and UK samples showed a significant increase between the first occasion of data collection (T1) and the second (T2), 12 months later. A walking stick was the most common MD on both occasions, with the exception that the number of users of rollators outdoors exceeded the number of users of walking sticks in the Swedish sample at T2. Among non-users of MDs at T1, 12-21% became new users at T2. Continued use was seen between T1 and T2 (80-94%) in the various samples, but the type of MD used changed. In the Swedish, German and UK samples, significant changes were seen in the use of MDs with greater assistive potential over the year. CONCLUSIONS: This study shows that the pattern of MD use changes over a short period of time. More research is needed to determine outcomes of MD use in very old age, focusing on the extent to which MDs decrease disability during the aging process, not least in a European perspective.
48.	Haak, Maria, et al. (author) The influence of participation on mortality in very old age among community-living people in Sweden 2019 In: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 31:2, s. 265-271 Journal article (peer-reviewed)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.
49.	Jonsson, Oskar, et al. (author) Understanding the wicked problem of providing accessible housing for the ageing population in Sweden 2021 In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:3 Journal article (peer-reviewed)abstract While accessible housing is known as important to promote healthy ageing, the societal issue of providing accessible housing for the ageing population bears the characteristics of a “wicked problem”. The aim of this study was to gain a better understanding of crucial variables for decision-making about the provision of accessible housing for the ageing population in Sweden. Materials used for a deductive content analysis were elicited through a research circle involving three researchers and twelve non-academic representatives. Brown and colleagues’ conceptual five-dimension framework to address wicked problems was used for the understanding of crucial variables in decision-making about housing provision. The findings show that such reasoning is dominated by the socioeconomic dimension. Findings in the biophysical dimension reveal well-known challenges pertaining to the definition and interpretation of the concept of accessibility and its operationalization. The dimensions are intertwined in a complex manner, which is essential for effective and efficient decision-making. The findings could make decision-makers aware of the diversity of individual thinking involved when addressing this wicked problem. Acting upon the crucial variables identified in this study could contribute to progressive decision-making and more efficient ways to develop and provide accessible housing to promote health ageing.
50.	Norin, Lizette, et al. (author) Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury 2021 In: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; 84:12, s. 765-774 Journal article (peer-reviewed)abstract Introduction: Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method: Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings: Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion: Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.

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