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- Elmståhl, Sölve, et al.
(författare)
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Body composition and dietary habits in 80-year-old smoking men without cardiovascular disease
- 1991
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Ingår i: Aging (Milan, Italy). - 0394-9532. ; 3:3, s. 77-269
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Tidskriftsartikel (refereegranskat)abstract
- Eighty-year-old male residents in the community of Malmö were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). Of 1,280 subjects, 122 were selected for further studies and allocated into 4 groups: 1) no CVD, non-smokers; 2) no CVD, smokers; 3) CVD, smokers; and 4) CVD, non-smokers. The smokers had consumed on the average 13 g of tobacco daily for 59 years. Lean body mass (LBM), body fat (BF), % body fat (%BF), and total body water (TBW) were estimated by means of bioelectrical impedance analysis. The mean body weight (BW), LBM, and %BF for all subjects were 74.1 +/- 10.2 kg, 58.0 +/- 6.8 kg, and 21.3 +/- 5.9 kg, respectively. There were no significant differences between all subjects with and without CVD. A lower BW among smokers than in non-smokers was explained by lower BF and %BF in the former. Smokers who had lived predominantly in rural areas had lower BW (6.9 kg) and LBM (5.2 kg) than those from an urban area. A positive correlation was noted between the degree of physical activity and LBM and TBW. Seventeen percent of the smokers exercised regularly. The CVD group had higher plasma cholesterol concentrations than the non-CVD group. Plasma triglycerides showed a positive correlation with BF, %BF and BW, whereas HDL cholesterol was negatively correlated with BF, %BF and BW. It is concluded that smoking is one of several important factors related to body composition, and the penetrance of this factor is still apparent in elderly men.
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- Gustafson, Yngve, 1949-
(författare)
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Acute confusional state (delirium) : clinical studies in hip-fracture and stroke patients
- 1991
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Acute confusional state (ACS) or delirium according to DSM-III-R holds a central position in the medicine of old age. ACS is a common and sometimes the only symptom of diseases and medical complications in the elderly patient.The aim of this study was to elucidate ACS in patients with femoral neck fractures and patients with acute stroke with regard to frequency, predictors, possible pathogenetic mechanisms, associated complications, assessment and documentary routines and the clinical outcome for the patients. An intervention program to prevent postoperative ACS based on our results was developed and evaluated.The main findings of the study were high frequencies of ACS in elderly patients with femoral neck fractures (61 %) and in patients with acute stroke (48 %). The main risk factors for ACS in patients with femoral neck fractures were old age, diseases and drug treatment interfering with cerebral cholinergic metabolism. There was no link between anaesthetic technique and ACS but the connection between peroperative hypotension, early postoperative hypoxia and ACS was close.In stroke patients the degree of extremity paresis and old age were independent ACS risk factors. ACS was commonly associated with post stroke complications such as myocardial infarction, pneumonia, urinary infection and urinary retention. In stroke patients there was a close connection between high hypothalamic-pituitary-adrenal axis (HPA-axis) activity and ACS. High HPA-axis activity and disturbances in the cerebral cholinergic system may be two important ACS mechanisms.A correct diagnosis is a prerequisite for proper treatment of ACS and its underlying causes. In the orthopaedic wards both physicians and nurses diagnosed and documented ACS poorly and therefore associated complications were insufficiently treated.The intervention program for postoperative ACS, aimed mainly at protecting the cerebral oxidative metabolism and thereby the cerebral cholinergic metabolism which is especially sensitive to hypoxia. Postoperative complications associated with ACS were also treated. The intervention resulted in reduced frequency, duration and severity of postoperative ACS and in shorter orthopedic ward stay for patients with femoral neck fractures.Key words: Acute confusional state, delirium, elderly
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- Herlitz, Agneta, 1962-
(författare)
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Remembering in Alzheimer's disease : utilization of cognitive support
- 1991
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present doctoral thesis was to investigate the ability of patients with Alzheimer's disease (AD) to utilize cognitive support in order to improve episodic remembering. A review of previous research indicated that most studies have failed to find beneficial effects of encoding support on memory in AD patients. The ability to utilize cognitive support (i.e., motoric activities, semantic organization, and semantic knowledge) for episodic remembering was investigated in five studies (Bäckman & Herlitz, 1990; Herlitz, Adolfsson, Bäckman, & Nilsson, in press; Herlitz & Bäckman, 1990; Herlitz & Viitanen, in press; Karlsson et al., 1989). Patients with mild, moderate, or severe AD, and normal older adults participated in the studies. On the basis of the results from these studies and the review of the literature, it was concluded that (a) AD patients, irrespective of dementia severity, perform at a lower level than normal older adults in episodic memory tasks; (b) provided that support is supplied at retrieval, AD patients may be sensitive to manipulations at encoding; (c) the strength of the encoding manipulation determines the size of the memory improvement in AD patients; and (d) depending on dementia severity, the type of encoding support also determines the magnitude of memory improvement obtained.
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