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  • 251. Chen, Tuo-Yu
    et al.
    Chan, Angelique
    Andersen-Ranberg, Karen
    Herr, Marie
    Fors, Stefan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Jeune, Bernard
    Herrmann, Francois R.
    Robine, Jean-Marie
    Gondo, Yasuyuki
    Saito, Yasuhiko
    Prevalence and Correlates of Falls Among Centenarians: Results from the Five-Country Oldest Old Project (5-COOP)2020Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 75, nr 5, s. 974-979Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Many studies have been conducted to investigate risk factors of falls in older people, but little is known about falls among centenarians. We analyzed the cross-sectional data from the Five-Country Oldest Old Project (5-COOP) to investigate the prevalence and correlates of falls among centenarians. Methods: Data collection was carried out in 2011-2014 in Japan, France, Switzerland, Sweden, and Denmark. The sample consisted of 1,165 centenarians who were at least 100 years old in 2011. The outcome variable was falls in the past 6 months. Demographics, chronic conditions, pain, visual impairment, global cognitive function, dizziness and syncope, number of medications, functional limitation (ie, dressing, bathing, toileting, transferring, incontinence, and feeding), mobility difficulty, poor strength, and assistive device usage were included in the analysis. Results: The prevalence of falls within the last 6 months was 33.7%, ranging from 21.6% (Japan) to 40.9% (France). Being male, experiencing dizziness, syncope, incontinence, and using assistive devices indoors were associated with an increased risk of falls among centenarians. Significant cross-country differences in the relationships between some risk factors (ie, gender, difficulty with bathing, toileting, transferring, and feeding, and using assistive devices for walking indoors and outdoors) and falls were observed. Subsample analysis using data from each country also showed that factors related to falls were different. Conclusions: The prevalence of falls among centenarians is high and fall-related factors may be different than those for their younger counterparts. Given that centenarians is an emerging population, more studies investigating risk factors are needed to better understand falls among centenarians.

  • 252. Cheng, Yingzhe
    et al.
    Li, Yuanjing
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Liang, Xiaoyan
    Wang, Pin
    Fa, Wenxin
    Liu, Cuicui
    Wang, Yongxiang
    Liu, Keke
    Wang, Nan
    Du, Yifeng
    Genetic Effects of NDUFAF6 rs6982393 and APOE on Alzheimer’s Disease in Chinese Rural Elderly: A Cross-Sectional Population-Based Study2022Ingår i: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 17, s. 185-194Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate the associations of genotypes of NDUFAF6 rs6982393 and APOE and their combined genotypes with the risk of Alzheimer’s disease (AD) and mild cognitive impairment (MCI) in Chinese rural elderly.

    Methods: This cross-sectional population-based study included 5096 older adults (age ≥ 60 years, 57.1% female). Genotypes of NDUFAF6 rs6982393 and APOE were detected using the multiple-polymerase chain reaction amplification. We diagnosed AD following the criteria of Diagnostic and Statistical Manual of Mental Disorders, the fourth edition and diagnosed MCI following the Petersen’s criteria MCI. Data were analyzed using the logistic regression model.

    Results: The overall prevalence of AD and MCI was 3.57% (95% confidence interval [CI]: 0.040, 0.053) and 22.65% (95% CI: 0.223, 0.247), separately. The TT versus CC/CT genotype of NDUFAF6 rs6982393 was related to a higher risk of AD with the multi-adjusted odds ratio (95% CI) being 1.61 (1.02, 2.54) in the total sample, 3.36 (1.48, 7.60) in those aged 60– 69, and 1.24 (0.71, 2.17) in those aged 70 years and above. The interaction between genotype of NDUFAF6 rs6982393 with age groups (60– 69 versus ≥ 70 years) was significant on the risk of AD. The presence of APOE ϵ4 was not significantly associated with the risk of AD. Carrying both NDUFAF6 TT and APOE ϵ4 was related to a higher risk of AD with the multi-adjusted odds ratio (95% CI) being 2.69 (1.10, 2.56). In addition, there was no significant association between the above genotypes and MCI.

    Conclusion: In Chinese rural elderly, the TT versus CT/CC genotype of NDUFAF6 rs6982393 was associated with an increased likelihood of AD; such an association only existed among young-old adults. Carrying both NDUFAF6 rs6982393-TT and APOE ϵ4 was related to a higher risk of AD. This finding highlights the importance of considering age and combined genotype in studying the genetic profiles of AD.

  • 253. Chereches, Flavia S.
    et al.
    Brehmer, Yvonne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Tilburg University, Tilburg, Netherlands.
    Olaru, Gabriel
    Personality and limitations in instrumental activities of daily living in old age: Reciprocal associations across 12 years2023Ingår i: European Journal of Personality, ISSN 0890-2070, E-ISSN 1099-0984, Vol. 37, nr 5, s. 543-559Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Personality traits have been reported to predict difficulties in performing instrumental activities of daily living (IADL) in old age, such as preparing meals or shopping. However, little is known about the reciprocal effects on personality. In this study, we examined bidirectional relationships between personality traits and the capacity to perform IADL using four waves of longitudinal data from 3540 older adults (aged 65 years and older) from the Health and Retirement Study. We applied a random-intercept cross-lagged panel model to separate between- and within-person effects across time and compared it to a traditional cross-lagged panel model. At the between-person level, higher neuroticism and lower conscientiousness were associated with more IADL limitations. Within individuals across time, increases in neuroticism and decreases in conscientiousness and extraversion were associated with increases in IADL limitations 4 years later. In contrast, increases in IADL limitations only predicted increases in neuroticism and decreases in extraversion. These results indicate that some personality traits affect and are affected by limitations in functional capacities in old age. Results of the within-person model build a strong foundation for future personality interventions as a pathway to maintain high functioning in old age.

  • 254.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Martin-Matthews, Anne
    University of British Columbia, Canada.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Svensson, Torbjörn
    Lund University.
    ISSA 2012: The medium-term impact of the first ISSA in the eyes of its participants2015Ingår i: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, nr 1, s. 44-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: This contribution aims at illustrating the perspective of students attending the first International Summer School on Ageing (ISSA), highlighting the midterm impact exerted by this initiative on their own educational career.

    Methods: The reported findings are based on a follow-up assessment questionnaire sent out to and filled-in by ISSA participants (n= 20) six months after the Summer School’s conclusion, with the aim of identifying whether participation in the ISSA had brought any advantage to each participant's professional and educational life.

    Results: Among the ISSA-related aspects identified as “important” for their future research activity, the main ones were “interacting with established researchers” (100%) and “being part of a research network” (85%), followed by “use of different approaches” and “training environment”. As for the aspects “influenced” by the ISSA, the “development of a professional network” was the most frequently mentioned (100%), followed by “research training” (84%), “research interest” (79%) and “career” (71%). The majority of participants reported that, since their ISSA attendance, had remained in contact with each other for study-related (65%) or work-related (60%) purposes. This networking activity has led to joint scientific collaborations with both mentors (one joint conference presentation and two peer-review publications) and fellow students (preparation of a project proposal in response toa research call and organisation of a scientific event).

    Conclusions: The reported findings show that the ISSA has been useful in creating a collaborative multidisciplinary network of younger and older researchers on ageing-related issues, which is likely to bear more fruitin the long-term.

  • 255.
    Chiatti, Carlos
    et al.
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    Università degli Studi di Macerata, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy ; European Centre for Social Welfare Policy and Research, Austria.
    Gori, Cristiano
    Università Cattolica del Sacro Cuore, Italy ; Istituto per la ricerca sociale, Italy ; London School of Economics, UK.
    La "bussola" di NNA: lo stato dell'arte basato sui dati2010Ingår i: L'assistenza agli anziani non autosufficienti in Italia: 2° Rapporto, Rapporto promosso dall’IRCCS-INRCA per il Network nazionale per l’invecchiamento / [ed] N.N.A., Rimini: Maggioli Editore, 2010, s. 13-39Kapitel i bok, del av antologi (Refereegranskat)
  • 256.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy ; University of Newcastle upon Tyne, UK.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA) ; European Centre for Social Welfare Policy and Research of Vienna, Austria.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA) ; European Centre for Social Welfare Policy and Research of Vienna, Austria.
    Gori, Cristiano
    London School of Economics, UK.
    La "bussola" di N.N.A.: lo stato dell'arte basato sui dati2011Ingår i: L'assistenza agli anziani non autosufficienti in Italia: 3° Rapporto, Il monitoraggio degli interventie il punto sulla residenzialità / [ed] N.N.A., Rimini: Maggioli Editore, 2011, s. 13-34Kapitel i bok, del av antologi (Refereegranskat)
  • 257.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy Marche Polytechnic University, Italy ; Lund University.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Masera, Filippo
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Gli standard ed i requisiti di qualità nei servizi di assistenza residenziale2013Ingår i: L'assistenza agli anziani non autosufficienti in Italia: 4° Rapporto, Tra crisi e ripartenza / [ed] N.N.A., Rimini: Maggioli Editore, 2013, s. 71-91Kapitel i bok, del av antologi (Refereegranskat)
  • 258.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy ; Lund University.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Greco, Cosetta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Principi, Andrea
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Santini, Sara
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    Migrant care work for elderly households in Italy2013Ingår i: Ageing in the Mediterranean / [ed] Joseph Troisi, Hans-Joachim von Kondratowitz, Bristol: Policy Press, 2013, s. 235-256Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    This paper aims at pointing out the need for a more equitable, internationally driven approach to solve elder care staff shortages, on the background of the implications deriving from the widespread phenomenon of employing migrant care workers in the Italian elder care sector. The paper describes at first how this form of care provision has become so popular in this country to face the long term care needs characterising its ageing population. Main reasons are identified, on the one hand, in the decreasing availability of informal care, due to the increasing female participation in the labor market, a longer working life and a reduction in the support provided by social networks. On the “formal” side, a major role has been played also by the lack of appropriate long term care services, such as residential and public home care, as well as by a chronic shortage of nursing staff and a shorter length of hospital stays. The traditionally “cash-oriented” profile of the Italian welfare system – more based on cash-for-care measures rather than in-kind services – has ended up with perpetuating familistic tendencies stimulating the employment of foreign migrant care workers, often on a live-in, undeclared basis. The paper’s conclusions focus on the analysis of the main opportunities and challenges raised by this phenomenon, trying to catch all involved parties’ perspectives: the older care recipients’ families; the migrant care workers; the receiving and the sending societies. This approach allows to identify core advantages of this solution in the possibility to increase ageing in place opportunities (thus reducing institutionalisation rates) and to provide a more personalised home care at reasonable costs. On the other hand, drawbacks can occur in terms of low quality of care, risk of widespread undeclared labour conditions, possible exploitation of foreign migrants and abuse of older people, as well as “brain and care drain” effects in sending countries. A more neutral, internationally driven governance is therefore suggested in order to minimize these risks and promote equitable solutions to solve care provision shortages in some countries without “plundering the future” of other nations.

  • 259.
    Chimamiwa, Gibson
    et al.
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Giaretta, Alberto
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Alirezaie, Marjan
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Pecora, Federico
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Loutfi, Amy
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Are Smart Homes Adequate for Older Adults with Dementia?2022Ingår i: Sensors, E-ISSN 1424-8220, Vol. 22, nr 11, artikel-id 4254Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Smart home technologies can enable older adults, including those with dementia, to live more independently in their homes for a longer time. Activity recognition, in combination with anomaly detection, has shown the potential to recognise users' daily activities and detect deviations. However, activity recognition and anomaly detection are not sufficient, as they lack the capacity to capture the progression of patients' habits across the different stages of dementia. To achieve this, smart homes should be enabled to recognise patients' habits and changes in habits, including the loss of some habits. In this study, we first present an overview of the stages that characterise dementia, alongside real-world personas that depict users' behaviours at each stage. Then, we survey the state of the art on activity recognition in smart homes for older adults with dementia, including the literature that combines activity recognition and anomaly detection. We categorise the literature based on goals, stages of dementia, and targeted users. Finally, we justify the necessity for habit recognition in smart homes for older adults with dementia, and we discuss the research challenges related to its implementation.

  • 260. Choudhary, Anita
    et al.
    Pathak, Ashish
    Manickam, Ponnaiah
    Purohit, Manju
    Rajasekhar, Thomas Daniel
    Dhoble, Parag
    Sharma, Ashish
    Suliya, Juhi
    Apsingekar, Dhanashree
    Patil, Vandana
    Jaiswal, Ashish
    Gwarikar, Sudhir
    Östh, Josefine
    Jirwe, Maria
    Sophiahemmet Högskola.
    Diwan, Vinod Kumar
    Hallgren, Mats
    Mahadik, Vijay
    Diwan, Vishal
    Effect of yoga versus light exercise to improve well-being and promote healthy aging among older adults in central india: a study protocol for a randomized controlled trial2019Ingår i: Geriatrics (Basel, Switzerland), ISSN 2308-3417, Vol. 4, nr 4, artikel-id E64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga's effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60-80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied.

    DISCUSSION: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences.

    TRIAL REGISTRATION: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.

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  • 261.
    Christiansen, Line
    et al.
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Blekinge Institute of Technology, Karlskrona, Sweden.
    Cellek, Selim
    Anglia Ruskin University, Chelmsford, United Kingdom.
    Zhang, Jufen
    Anglia Ruskin University, Chelmsford, United Kingdom.
    Lemmens, Evi
    University Colleges Leuven-Limburg, Genk, Belgium.
    Garolera, Maite
    Brain, Cognition and Behavior—Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain.
    Mayoral-Cleries, Fermin
    Regional University Hospital of Málaga, Spain.
    Skär, Lisa
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Associations Between Mobile Health Technology use and Self-rated Quality of Life: A Cross-sectional Study on Older Adults with Cognitive Impairment2021Ingår i: Gerontology and geriatric medicine, E-ISSN 2333-7214, Vol. 7, s. 1-8, artikel-id 23337214211018924Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Quality of life (QoL) is affected even at early stages in older adults with cognitive impairment. The use of mobile health (mHealth) technology can offer support in daily life and improve the physical and mental health of older adults. However, a clarification of how mHealth technology can be used to support the QoL of older adults with cognitive impairment is needed. Objective: To investigate factors affecting mHealth technology use in relation to self-rated QoL among older adults with cognitive impairment. Methods: A cross-sectional research design was used to analyse mHealth technology use and QoL in 1,082 older participants. Baseline data were used from a multi-centered randomized controlled trial including QoL, measured by the Quality of Life in Alzheimer’s Disease (QoL-AD) Scale, as the outcome variable. Data were analyzed using logistic regression models. Results: Having moderately or high technical skills in using mHealth technology and using the internet via mHealth technology on a daily or weekly basis was associated with good to excellent QoL in older adults with cognitive impairment. Conclusions: The variation in technical skills and internet use among the participants can be interpreted as an obstacle for mHealth technology to support QoL. © The Author(s) 2021.

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  • 262.
    Christiansen, Line
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa. Blekinge Inst Technol, Karlskrona, Sweden..
    Sanmartin Berglund, Johan
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa. Blekinge Inst Technol, Karlskrona, Sweden..
    Anderberg, Peter
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa. Blekinge Inst Technol, Karlskrona, Sweden.;Univ Skovde, Skovde, Sweden..
    Cellek, Selim
    Anglia Ruskin Univ, GBR.
    Zhang, Jufen
    Anglia Ruskin Univ, GBR.
    Lemmens, Evi
    Univ Coll Leuven Limburg, BEL.
    Garolera, Maite
    Consorci Sanitari Terrassa, Brain Cognit & Behav Clin ReBarcelona, ESP.
    Mayoral-Cleries, Fermin
    Reg Univ Hosp Malaga, ESP.
    Skär, Lisa
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa. Blekinge Inst Technol, Karlskrona, Sweden..
    Associations Between Mobile Health Technology use and Self-rated Quality of Life: A Cross-sectional Study on Older Adults with Cognitive Impairment2021Ingår i: Gerontology and geriatric medicine, E-ISSN 2333-7214, Vol. 7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Quality of life (QoL) is affected even at early stages in older adults with cognitive impairment. The use of mobile health (mHealth) technology can offer support in daily life and improve the physical and mental health of older adults. However, a clarification of how mHealth technology can be used to support the QoL of older adults with cognitive impairment is needed. Objective: To investigate factors affecting mHealth technology use in relation to self-rated QoL among older adults with cognitive impairment. Methods: A cross-sectional research design was used to analyse mHealth technology use and QoL in 1,082 older participants. Baseline data were used from a multi-centered randomized controlled trial including QoL, measured by the Quality of Life in Alzheimer's Disease (QoL-AD) Scale, as the outcome variable. Data were analyzed using logistic regression models. Results: Having moderately or high technical skills in using mHealth technology and using the internet via mHealth technology on a daily or weekly basis was associated with good to excellent QoL in older adults with cognitive impairment. Conclusions: The variation in technical skills and internet use among the participants can be interpreted as an obstacle for mHealth technology to support QoL.

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    Associations Between Mobile Health Technology use and Self-rated Quality of Life
  • 263.
    Christiansen, Mats
    Karolinska Institutet.
    ”Plötsligen är jag ett spöke!”: hiv i äldre bögars liv2013Ingår i: LHBTQ-personer och åldrande: nordiska perspektiv / [ed] Bromseth, Janne & Siverskog, Anna, Lund: Studentlitteratur AB, 2013, s. 203-222Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 264.
    Christiansen, Mats
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Åbo Akademi; Folkhälsomyndigheten.
    Handelsman Nielsen, Mika
    Folkhälsomyndigheten.
    Mehdiyar, Manijeh
    Folkhälsomyndigheten.
    The Graying Rainbow: Tracing LGBTQI Aging in Scandinavian Literature2023Ingår i: Innovation in Aging: Supplement 1, Folkhälsomyndigheten; Åbo Akademi , 2023, Vol. 7, s. 766-766Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: There have been several international reviews about aging LGBTQI health and living conditions, but where policy, social insurance, and services differ. The Public Health Agency of Sweden was given a government assignment to review the literature on LGBTI, emphasizing Scandinavian literature.

    Method: This scoping review includes peer-reviewed literature published in English or Scandinavian languages from January 1, 2012, to May 2022. Literature was searched in PsycINFO, PubMed, Web of Science, CINAHL, International Bibliography of the Social Sciences (IBSS), Social Science Database, Applied Social Sciences Index & Abstracts (ASSIA), and Sociological Abstracts, Sociology Database. Initially, 11,428 articles were found. After removing duplicates using Rayyan and reviewing titles and abstracts, 54 articles were read in full. After the final review, 16 articles remained. Thematic analysis was used to produce themes from the reviewed literature.

    Findings: The following two themes were identified: Aspects of health and Living conditions. Studies were primarily interpretive. There is a lack of studies about some subgroups of older LGBTQ people in this context; for instance, there are insufficient studies on older lesbian women and gay men. Furthermore, there is a lack of studies on somatic health for older LGBTQ people, generally. Comparatively, albeit in small samples, we better understand trans descriptions of aging than lesbian women and gay men. There were no studies found on intersex individuals.

    Implications: There remains a paucity of literature regarding the life and living conditions for LGBTQI older adults in Nordic countries.

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  • 265.
    Classon, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Fällman, Katarina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Wressle, Ewa
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Marcusson, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Relations between Concurrent Longitudinal Changes in Cognition, Depressive Symptoms, Self-Rated Health and Everyday Function in Normally Aging Octogenarians2016Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 11, nr 8, s. e0160742-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Ability to predict and prevent incipient functional decline in older adults may help prolong independence. Cognition is related to everyday function and easily administered, sensitive cognitive tests may help identify at-risk individuals. Factors like depressive symptoms and self-rated health are also associated with functional ability and may be as important as cognition. The purpose of this study was to investigate the relationship between concurrent longitudinal changes in cognition, depression, self-rated health and everyday function in a well-defined cohort of healthy 85 year olds that were followed-up at the age of 90 in the Elderly in Linkoping Screening Assessment 85 study. Regression analyses were used to determine if cognitive decline as assessed by global (the Mini-Mental State Examination) and domain specific (the Cognitive Assessment Battery, CAB) cognitive tests predicted functional decline in the context of changes in depressive symptoms and self-rated health. Results showed deterioration in most variables and as many as 83% of these community-dwelling elders experienced functional difficulties at the age of 90. Slowing-down of processing speed as assessed by the Symbol Digits Modality Test (included in the CAB) accounted for 14% of the variance in functional decline. Worsening self-rated health accounted for an additional 6%, but no other variables reached significance. These results are discussed with an eye to possible preventive interventions that may prolong independence for the steadily growing number of normally aging old-old citizens.

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  • 266.
    Classon, Elisabet
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    van den Hurk, Wobbie
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Mindmore AB, Sweden.
    Lyth, Johan
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Johansson, Maria
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Montreal Cognitive Assessment: Normative Data for Cognitively Healthy Swedish 80-to 94-Year-Olds2022Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 87, nr 3, s. 1335-1344Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The Montreal Cognitive Assessment (MoCA) is sensitive to cognitive impairment; however, it is also sensitive to demographic and socio-cultural factors. This necessitates reliable sub-population norms, but these are often lacking for older adults. Objective: To present demographically adjusted regression-based MoCA norms for cognitively healthy Swedish older adults. Methods: A pseudo-random sample of community-dwelling 80- to 94-year-olds, stratified by age and gender, was invited to the study. Initial telephone interviews and medical records searches (n = 218) were conducted to screen for cognitive impairment. N= 181 eligible participants were administered a protocol including the Swedish version of the MoCA and assessments of global cognition (Mini-Mental State Examination, MMSE) and depression (Patient Health Questionnaire-9, PHQ-9). Individuals scoring in the range of possible cognitive impairment on the MMSE or more than mild depression on the PHQ-9 were excluded (n = 23); three discontinued the test-session. Results: Norms were derived from the remaining n = 158. They were evenly distributed by gender, on average 85 years old, and with a mean education of 11 years. MoCA scores were independently influenced by age and education, together explaining 17.2% of the total variance. Higher age and lower education were associated with lower performance and 46% performed below the original cut-off (< 26/30). Conclusion: The negative impact of increasing age on MoCA performance continues linearly into the nineties in normal aging. Demographic factors should be considered when interpreting MoCA performance and a tool for computing demographically corrected standard scores is provided.

  • 267.
    Classon, Elisabet
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    van den Hurk, Wobbie
    Mindmore AB, Sweden.
    Wressle, Ewa
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Rehn, Inger
    Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Johansson, Maria
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    A quick test of cognitive speed (AQT): regression-based norms for cognitively healthy 80 to 94-year olds2022Ingår i: Aging, Neuropsychology and Cognition, ISSN 1382-5585, E-ISSN 1744-4128, Vol. 29, nr 5, s. 820-839Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Slowed processing speed is part of normal aging but also a symptom of many diseases, including dementia. A Quick Test of Cognitive Speed (AQT) consists of three conditions: color naming (AQT1), form naming (AQT2) and dual color-form naming (AQT3) and offers a user-friendly assessment of processing speed that is used internationally to identify cognitive impairment in elderly patients. Appropriate age-norms have however been lacking. This study provides regression-based norms derived from a Swedish sample of 158 cognitively healthy 80 to 94-year olds. The results show age effects in all three conditions, a non-linear education effect in AQT1, and age by gender interactions in AQT2 and AQT3: men performed worse with increasing age, but women remained on a par. However, irrespective of age and gender, AQT2 and AQT3 mean raw and predicted scores were slower than the hitherto recommended cutoff criteria for suspected cognitive impairment.

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  • 268.
    Cleeve, Helena
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    (In)visible materialities in the context of dementia care2020Ingår i: Sociology of Health and Illness, ISSN 0141-9889, E-ISSN 1467-9566, Vol. 42, nr 1, s. 126-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Seemingly mundane materialities are intertwined with important, but often neglected, care interactions. It has been argued that if healthcare professionals paid more attention to the roles materialities can have, everyday routines could become important occasions for care. In response to such proposals, we argue that it is relevant to examine how materialities are currently understood. In this article, we explore materialities as part of work in a dementia unit. Using abstracted illustrations of everyday materialities to elicit reflections, we conducted 11 individual interviews with certified nursing assistants. Through phenomenographic analysis we explain our findings as three different categories conceptualising understandings of materialities as: ‘tools for care’, ‘a set of principles for care’ and ‘caring relationships’. Our analysis indicates that understanding materialities as instruments was reinforced and made visible through the healthcare organisation while understanding materialities as part of specific relationships with residents appeared informal and less visible. How materialities were understood seemed to have several implications for residents. While care practices could benefit from nursing assistants’ abilities to alternate between ways of understanding materialitites, such competence seemed dependent on how professional care was organised, structured and materialised.

  • 269. Cohen, Joachim
    et al.
    Beernaert, Kim
    Van den Block, Lieve
    Morin, Lucas
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). National Observatory of End of Life Care, France.
    Hunt, Katherine
    Miccinesi, Guido
    Cardenas-Turanzas, Marylou
    Onwuteaka-Philipsen, Bregje
    MacLeod, Rod
    Ruiz-Ramos, Miguel
    Wilson, Donna M.
    Loucka, Martin
    Csikos, Agnes
    Rhee, Yong-Joo
    Teno, Joan
    Ko, Winne
    Deliens, Luc
    Houttekier, Dirk
    Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data2017Ingår i: npj Primary Care Respiratory Medicine, E-ISSN 2055-1010, Vol. 27, artikel-id 14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease.

  • 270.
    Colomer, Laia
    et al.
    Linnéuniversitetet, Fakulteten för konst och humaniora (FKH), Institutionen för design (DE).
    Erlingsson, Christen
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Use of cultural heritage to enhance older people’s wellbeing2018Ingår i: Encyclopaedia of Global Archaeology / [ed] C. Smith, Cham: Springer, 2018, Living editionKapitel i bok, del av antologi (Refereegranskat)
  • 271.
    Condelius, Anna
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Andersson, Magdalena
    City of Malmö, Malmö, Sweden.
    Exploring Shared Care Plans for Older People Regarding their Fulfilment of Policy Requirements and Shared Decision Making2021Ingår i: Research on Ageing and Social Policy, E-ISSN 2014-671X, Vol. 9, nr 2, s. 154-183Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to explore the documentation in shared care plans regarding the fulfilment of policy requirements and shared decision-making. The sample consists of 15 shared care plans established for older people in Sweden. The analysis was performed using directed content analysis. The requirements in the Swedish law and the 15 indicators of shared decision making (SDM) in the Multifocal Approach to the Sharing in SDM inventory was used to define the main categories. The policy requirements were fulfilled to a varied extent. All the care plans were established in collaboration between the municipality and the county council, but social services were not represented in six of them. The older person and next of kin were present at 14 of the care planning meetings. The individual’s agreement to the establishment was documented in ten of the plans but how and what the person had agreed to was not specified further. The headings focused at the policy requirements and did not support a care planning process, or a documentation based on SDM. Six out of 15 indicators of SDM were reflected. The decision-making process needs to be acknowledged more in the process of establishing shared care plans for older people.

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  • 272. Cong, Lin
    et al.
    Ren, Yifei
    Hou, Tingting
    Han, Xiaolei
    Dong, Yi
    Wang, Yongxiang
    Zhang, Qinghua
    Liu, Rui
    Xu, Shan
    Wang, Lidan
    Du, Yifeng
    Qiu, Chengxuan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Shandong First Medical University, China.
    Use of Cardiovascular Drugs for Primary and Secondary Prevention of Cardiovascular Disease Among Rural-Dwelling Older Chinese Adults2020Ingår i: Frontiers in Pharmacology, E-ISSN 1663-9812, Vol. 11, artikel-id 608136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cardiovascular risk factors and related disorders are common among older adults, and use of various classes of cardiovascular (CV) drugs could reduce the risk of cardiovascular disease (CVD). However, data are sparse with regard to the use of CV drugs among rural-dwelling older adults in China. Therefore, this population-based study aimed to describe use of CV drugs among older adults living in the rural communities in China, while taking into account the use of CV drugs for primary and secondary prevention of CVDs. This study included 5,246 participants (age >= 65 years; 57.17% women; 40.68% illiteracy) in the baseline examination of the MIND-China study. In March-September 2018, data on health-related factors, CVDs (ischemic heart disease, atrial fibrillation, heart failure, and stroke), and CV drug use were collected via face-to-face survey, clinical examination, and laboratory tests. We classified CV drugs according to the Anatomical Therapeutic Chemical classification system for western medications and specific cardiovascular effects for the products of traditional Chinese medicine (TCM). We conducted descriptive analysis. The overall prevalence of major cardiovascular risk factors ranged from 14.30% in diabetes and 23.81% in dyslipidemia to 66.70% in hypertension, and CVDs affected 35.07% of all participants (36.28% in women vs. 33.47% in men, p = 0.035). In the total sample, calcium channel blockers (C08) were most commonly used (10.39%), followed by TCM products (7.64%), hypoglycemic agents (A10, 4.73%), renin-angiotensin system (RAS)-acting agents (C09, 4.61%), and lipid-lowering agents (C10, 4.17%). The proportions of CV drugs for primary prevention (i.e., use of CV drugs among people without CVD) were 3.14% for antithrombotic agents (mainly aspirin), 1.38% for lipid-lowering agents, and 3.11% for RAS-acting agents; the corresponding figures for secondary prevention (i.e., use of CV drugs among people with CVD) were 13.97%, 9.35%, and 7.39%. In conclusion, despite highly prevalent cardiovascular risk factors and CVDs, a fairly low proportion of the rural-dwelling older adults take CV medications for primary and secondary prevention. Notably, TCM products are among the most commonly used CV drugs. These results call for additional efforts to promote implementation of the evidence-based recommendations for prevention of CVDs in the primary care settings.

  • 273.
    Conradsson, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Boström, Gustaf
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?2013Ingår i: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 8, s. 1561-1568Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Functional capacity and dependency in activities of daily living (ADL) could be important mediators for an association between physical exercise and mental health. The aim of this study was to investigate whether a change in functional capacity or dependency in ADL is associated with a change in depressive symptoms and psychological well-being among older people living in residential care facilities, and whether dementia can be a moderating factor for this association.

    Methods: A prospective cohort study was undertaken. Participants were 206 older people, dependent in ADL, living in residential care facilities, 115 (56%) of whom had diagnosed dementia. Multivariate linear regression, with comprehensive adjustment for potential confounders, was used to investigate associations between differences over 3 months in Berg Balance Scale (BBS) and Geriatric Depression Scale (GDS-15) scores, and in BBS and Philadelphia Geriatric Center Morale Scale (PGCMS) scores. Associations were also investigated between differences in Barthel ADL Index and GDS-15 scores, and in Barthel ADL Index and PGCMS scores.

    Results: There were no significant associations between changes in scores over 3 months; the unstandardized beta for associations between BBS and GDS-15 was 0.026 (P=0.31), BBS and PGCMS 0.045 (P=0.14), Barthel ADL Index and GDS-15 0.123 (P=0.06), and Barthel ADL Index and PGCMS -0.013 (P=0.86). There were no interaction effects for dementia.

    Conclusion: A change in functional capacity or dependency in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people living in residential care facilities. These results may offer one possible explanation as to why studies of physical exercise to influence these aspects of mental health have not shown effects in this group of older people.

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    Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?
  • 274. Corazzini, Kirsten N.
    et al.
    Anderson, Ruth A.
    Bowers, Barbara J.
    Chu, Charlene H.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe University, Melbourne, VIC, Australia.
    Fagertun, Anette
    Gordon, Adam L.
    Leung, Angela Y. M.
    McGilton, Katherine S.
    Meyer, Julienne E.
    Siegel, Elena O.
    Thompson, Roy
    Wang, Jing
    Wei, Sijia
    Wu, Bei
    Lepore, Michael J.
    Toward Common Data Elements for International Research in Long-term Care Homes: Advancing Person-Centered Care2019Ingår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, nr 5, s. 598-603Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically diverse countries have launched the WE-THRIVE consortium to develop a common data infrastructure. WE-THRIVE aims to identify measurement domains that are internationally relevant, including in low-, middle-, and high-income countries, prioritize concepts to operationalize domains, and specify a set of data elements to measure concepts that can be used across studies for data sharing and comparisons. This article reports findings from consortium meetings at the 2016 meeting of the Gerontological Society of America and the 2017 meeting of the International Association of Gerontology and Geriatrics, to identify domains and prioritize concepts, following best practices to identify common data elements (CDEs) that were developed through the US National Institutes of Health/National Institute of Nursing Research's CDEs initiative. Four domains were identified, including organizational context, workforce and staffing, person-centered care, and care outcomes. Using a nominal group process, WE-THRIVE prioritized 21 concepts across the 4 domains. Several concepts showed similarity to existing measurement structures, whereas others differed. Conceptual similarity (convergence; eg, concepts in the care outcomes domain of functional level and harm-free care) provides further support of the critical foundational work in LTC measurement endorsed and implemented by regulatory bodies. Different concepts (divergence; eg, concepts in the person-centered care domain of knowing the person and what matters most to the person) highlights current gaps in measurement efforts and is consistent with WE-THRIVE's focus on supporting resilience and thriving for residents, family, and staff. In alignment with the World Health Organization's call for comparative measurement work for health systems change, WE-THRIVE's work to date highlights the benefits of engaging with diverse LTC researchers, including those in low-, middle-, and high-income countries, to develop a measurement infrastructure that integrates the aspirations of person-centered LTC.

  • 275. Corna, Laurie M.
    et al.
    Platts, Loretta G.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Worts, Diana
    Price, Debora
    McDonough, Peggy
    Sacker, Amanda
    Di Gessa, Giorgio
    Glaser, Karen
    A sequence analysis approach to modelling the work and family histories of older adults in the UK2016Rapport (Övrigt vetenskapligt)
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  • 276.
    Corsonello, Andrea
    et al.
    Italian Natl Res Ctr Aging IRCCS INRCA, Ancona, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Fermo, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Cosenza, Italy.;IRCCS INRCA, Lab Geriatr Pharmacoepidemiol & Biostat, Via S Margherita 5, I-60124 Ancona, Italy..
    Fabbietti, Paolo
    IRCCS INRCA, Lab Geriatr Pharmacoepidemiol & Biostat, Via S Margherita 5, I-60124 Ancona, Italy..
    Formiga, Francesc
    Bellvitge Univ Hosp, IDIBELL, Geriatr Unit, Dept Internal Med, Barcelona, Spain..
    Moreno-Gonzalez, Rafael
    Bellvitge Univ Hosp, IDIBELL, Geriatr Unit, Dept Internal Med, Barcelona, Spain..
    Tap, Lisanne
    Erasmus MC, Univ Med Ctr Rotterdam, Dept Internal Med, Sect Geriatr Med, Rotterdam, Netherlands..
    Mattace-Raso, Francesco
    Erasmus MC, Univ Med Ctr Rotterdam, Dept Internal Med, Sect Geriatr Med, Rotterdam, Netherlands..
    Roller-Wirnsberger, Regina
    Med Univ Graz, Dept Internal Med, Graz, Austria..
    Wirnsberger, Gerhard
    Med Univ Graz, Dept Internal Med, Graz, Austria..
    Ärnlöv, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden..
    Carlsson, Axel C
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Weingart, Christian
    Friedrich Alexander Univ Erlangen Nurnberg, Krankenhaus Barmherzige Bruder, Inst Biomed Aging, Dept Gen Internal Med & Geriatr, D-93049 Regensburg, Germany..
    Freiberger, Ellen
    Friedrich Alexander Univ Erlangen Nurnberg, Krankenhaus Barmherzige Bruder, Dept Internal Med Geriatr, Inst Biomed Aging, Koberger Str 60, D-90408 Nurnberg, Germany..
    Kostka, Tomasz
    Med Univ Lodz, Hlth Ageing Res Ctr, Dept Geriatr, Lodz, Poland..
    Guligowska, Agnieszka
    Med Univ Lodz, Hlth Ageing Res Ctr, Dept Geriatr, Lodz, Poland..
    Gil, Pedro
    Hosp Clin San Carlos, Dept Geriatr Med, Madrid, Spain..
    Martinez, Sara Lainez
    Hosp Clin San Carlos, Dept Geriatr Med, Madrid, Spain..
    Melzer, Itshak
    Ben Gurion Univ Negev, Recanati Sch Community Hlth Profess, Fac Hlth Sci, Beer Sheva, Israel..
    Yehoshua, Ilan
    Maccabi Hlth Org, Negev Dist, Israel..
    Lattanzio, Fabrizia
    Italian Natl Res Ctr Aging IRCCS INRCA, Ancona, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Fermo, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Cosenza, Italy..
    Chronic kidney disease in the context of multimorbidity patterns: the role of physical performance2020Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, artikel-id 350Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Chronic kidney disease (CKD) is known to be associated with several co-occurring conditions. We aimed at exploring multimorbidity patterns associated with CKD, as well as the impact of physical performance and CKD severity on them in a population of older outpatients. Methods: Our series consisted of 2252 patients enrolled in the Screening of CKD among Older People across Europe multicenter observational study. Hypertension, stroke, transient ischemic attack, cancer, hip fracture, osteoporosis, Parkinson's disease, asthma, chronic obstructive pulmonary disease, congestive heart failure, angina, myocardial infarction, atrial fibrillation, anemia, CKD (defined as GFR < 60, <45 or < 30 ml/min/1.73 m(2)), cognitive impairment, depression, hearing impairment and vision impairment were included in the analyses. Physical performance was assessed by the Short Physical Performance Battery (SPPB) and used as stratification variable. Pairs of co-occurring diseases were analyzed by logistic regression. Patterns of multimorbidity were investigated by hierarchical cluster analysis. Results: CKD was among the most frequently observed conditions and it was rarely observed without any other co-occurring disease. CKD was significantly associated with hypertension, anemia, heart failure, atrial fibrillation, myocardial infarction and hip fracture. When stratifying by SPPB, CKD was also significantly associated with vision impairment in SPPB = 5-8 group, and hearing impairment in SPPB = 0-4 group. Cluster analysis individuated two main clusters, one including CKD, hypertension and sensory impairments, and the second including all other conditions. Stratifying by SPPB, CKD contribute to a cluster including diabetes, anemia, osteoporosis, hypertension and sensory impairments in the SPPB = 0-4 group. When defining CKD as eGFR< 45 or 30 ml/min/1.73 m(2), the strength of the association of CKD with hypertension, sensory impairments, osteoporosis, anemia and CHF increased together with CKD severity in pairs analysis. Severe CKD (eGFR< 30 ml/min/1.73 m(2)) contributed to a wide cluster including cardiovascular, respiratory and neurologic diseases, as well as osteoporosis, hip fracture and cancer. Conclusions: CKD and its severity may contribute significantly to specific multimorbidity patterns, at least based on the cluster analysis. Physical performance as assessed by SPPB may be associated with not negligible changes in both co-occurring pairs and multimorbidity clusters.

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  • 277.
    Corsonello, Andrea
    et al.
    INRCA Ancona, Ancona, Fermo & Cosenza, Italy.
    Roller-Wirnsberger, Regina
    Med Univ Graz, Dept Internal Med, Graz, Austria.
    Di Rosa, Mirko
    INRCA Ancona, Ancona, Fermo & Cosenza, Italy.
    Fabbietti, Paolo
    INRCA Ancona, Ancona, Fermo & Cosenza, Italy.
    Wirnsberger, Gerhard
    Med Univ Graz, Dept Internal Med, Graz, Austria.
    Kostka, Tomasz
    Med Univ Lodz, Dept Geriatr, Hlth Ageing Res Ctr, Lodz, Poland.
    Guligowska, Agnieszka
    Med Univ Lodz, Dept Geriatr, Hlth Ageing Res Ctr, Lodz, Poland.
    Tap, Lisanne
    Erasmus Univ, Med Ctr Rotterdam, Dept Internal Med, Sect Geriatr Med, Rotterdam, Netherlands.
    Mattace-Raso, Francesco
    Erasmus Univ, Med Ctr Rotterdam, Dept Internal Med, Sect Geriatr Med, Rotterdam, Netherlands.
    Gil, Pedro
    Hosp Clin San Carlos, Dept Geriatr Med, Madrid, Spain.
    Guardado-Fuentes, Lara
    Hosp Clin San Carlos, Dept Geriatr Med, Madrid, Spain.
    Meltzer, Itshak
    Ben Gurion Univ Negev, Fac Hlth Sci, Recanati Sch Community Hlth Profess, Beer Sheva, Israel.
    Yehoshua, Ilan
    Maccabi Healthcare Serv Southern Reg, Tel Aviv, Israel.
    Artzi-Medevdik, Rada
    Ben Gurion Univ Negev, Fac Hlth Sci, Recanati Sch Community Hlth Profess, Beer Sheva, Israel;Maccabi Healthcare Serv Southern Reg, Tel Aviv, Israel.
    Formiga, Francesc
    Bellvitge Univ Hosp IDIBELL, Internal Med Dept, Geriatr Unit, Barcelona, Spain;Bellvitge Univ Hosp IDIBELL, Nephrol Dept, Barcelona, Spain.
    Moreno-Gonzalez, Rafael
    Bellvitge Univ Hosp IDIBELL, Internal Med Dept, Geriatr Unit, Barcelona, Spain;Bellvitge Univ Hosp IDIBELL, Nephrol Dept, Barcelona, Spain.
    Weingart, Christian
    Friedrich Alexander Univ Erlangen Nurnberg, Krankenhaus Barmherzige Bruder Regensburg, Dept Gen Internal Med & Geriatr, Erlangen, Germany;Friedrich Alexander Univ Erlangen Nurnberg, Inst Biomed Aging, Erlangen, Germany.
    Freiberger, Ellen
    Friedrich Alexander Univ Erlangen Nurnberg, Krankenhaus Barmherzige Bruder Regensburg, Dept Gen Internal Med & Geriatr, Erlangen, Germany;Friedrich Alexander Univ Erlangen Nurnberg, Inst Biomed Aging, Erlangen, Germany.
    Ärnlöv, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.
    Carlsson, Axel C
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Karolinska Inst, Care Sci & Soc, Dept Neurobiol, Div Family Med, Huddinge, Sweden.
    Lattanzio, Fabrizia
    INRCA Ancona, Ancona, Fermo & Cosenza, Italy.
    Estimated glomerular filtration rate and functional status among older people: A systematic review2018Ingår i: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 56, s. 39-48Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: The association between chronic kidney disease (CKD) and functional status may change as a function of the equation used to estimate glomerular filtration rate (eGFR). We reviewed the predictive value of different eGFR equations in regard to frailty and disability outcomes. Methods: We searched Pubmed from inception to March 2018 for studies investigating the association between eGFR and self-reported and/or objective measures of frailty or disability. Cross-sectional and longitudinal studies were separately analysed. Results: We included 16 studies, one of which reporting both cross-sectional and longitudinal data. Three out of 7 cross-sectional studies compared different eGFR equations in regard to their association with functional status: two studies showed that cystatin C-based, but not creatinine-based eGFR may be associated with hand-grip strength or frailty; another study showed that two different creatinine-based eGFR equations may be similarly associated with disability. Four out of 10 longitudinal studies provided comparative data: two studies reported similar association with disability for different creatinine-based eGFR equations; one study showed that creatinine-based eGFR was not associated with frailty, but a not significant trend for association was observed with cystatin C-based eGFR; one study showed that cystatin C-based but not creatinine-based eGFR may predict incident mobility disability, while both methods may predict gait speed decline. High heterogeneity was observed in regard to confounders included in reviewed studies. None of them included the most recently published equations. Conclusion: Available data do not support the superiority of one of the eGFR equations in terms of measuring or predicting functional decline.

  • 278.
    Cortes, Diana S.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Laukka, Petri
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi.
    Ebner, Natalie C.
    Fischer, Håkan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Age-Related Differences in Evaluation of Social Attributes From Computer-Generated Faces of Varying Intensity2019Ingår i: Psychology and Aging, ISSN 0882-7974, E-ISSN 1939-1498, Vol. 34, nr 5, s. 686-697Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In everyday life throughout the life span, people frequently evaluate faces to obtain information crucial for social interactions. We investigated age-related differences in judgments of a wide range of social attributes based on facial appearance. Seventy-one younger and 60 older participants rated 196 computer-generated faces that systematically varied in facial features such as shape and reflectance to convey different intensity levels of seven social attributes (i.e., attractiveness, competence, dominance, extraversion, likeability, threat, and trustworthiness). Older compared to younger participants consistently gave higher attractiveness ratings to faces representing both high and low levels of attractiveness. Older participants were also less sensitive to the likeability of faces and tended to evaluate faces representing low likeability as more likable. The age groups did, however, not differ substantially in their evaluations of the other social attributes. Results are in line with previous research showing that aging is associated with preference toward positive and away from negative information and extend this positivity effect to social perception of faces.

  • 279. Crea, Simona
    et al.
    Edin, Benoni B.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Knaepen, Kristel
    Meeusen, Romain
    Vitiello, Nicola
    Time-Discrete Vibrotactile Feedback Contributes to Improved Gait Symmetry in Patients With Lower Limb Amputations: Case Series2017Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 97, nr 2, s. 198-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Reduced sensory feedback from lower leg prostheses results in harmful gait patterns and entails a significant cognitive burden because users have to visually monitor their locomotion. Objectives. The purpose of this study was to validate a sensory feedback device designed to help elderly patients with transfemoral amputation to improve their temporal gait symmetry after a training program aimed at associating the vibrotactile patterns with symmetrical walking. Design. This was a prospective quasi-experimental study including 3 elderly patients walking with lower leg prostheses. Methods. During training sessions, participants walked on a treadmill equipped with feedback device that controlled vibrotactile stimulators based on signals from a sensorized insole while provided with visual feedback about temporal gait symmetry. The vibrotactile stimulators delivered short-lasting, low-intensity vibrations synchronously with certain gait phase transitions. During pretraining and posttraining sessions, participants walked without visual feedback about gait symmetry under 4 conditions: with or without vibrotactile feedback while performing or not performing a secondary cognitive task. The primary outcome measure was temporal gait symmetry. Results. with <= 52 hours of training,the participants improved their temporal gait symmetry from 0.82 to 0.84 during the pretraining evaluation session to 0.98 to 1.02 during the follow-up session across all conditions. Following training, participants were able to maintain good temporal gait synmsetry, without any evidence of an increased cognitive burden. Limitations. The small sample size and short follow-up time do not allow straightforward extrapolations to larger populations or extended time periods. Conclusions. Low-cost, gait phase-specific vibrotactile feedback after training combined with visual feedback may improve the temporal gait synmsetry in patients with transfemoral amputation without representing an additional cognitive burden.

  • 280.
    Dahl, Anna
    Institute of Gerontology, School of Health Sciences, Jönköping University.
    Body mass index, cognitive ability, and dementia: prospective associations and methodological issues in late life2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Syftet med den här studien är att studera sambandet mellan övervikt, kognitiv funktion och demens, och att bedöma tillförlitligheten av självrapporterat body mass index (BMI) och olika datakällor som ofta används i epidemiologiska studier för att identifiera personer med demens. I avhandlingen används data från tre populationsbaserade studier: the Swedish Adoption/Twin Study of Aging (SATSA), Aging in Women and Men: A Longitudinal Study of Gender Differences in Health Behaviour and Health among Elderly (Gender studien) och den Finska Lieto studien. I studie I granskas överensstämmelsen mellan självrapporterad och uppmätt BMI bland 774 män och kvinnor i SATSA, 40 till 88 år (medelålder 63.9 år) vid det första mättillfället. Latent growth curve (LGC) modeller visade en liten men signifikant ökning i medelvärdesskillnaden mellan uppmätt och självrapporterat BMI (0.02 kg/m2/år) över tid, som förmodligen inte påverkar resultaten om BMI används som en kontinuerlig variabel i longitudinella studier. I studie II utvärderas överensstämmelsen mellan demensdiagnoser från en konsensuskonferens med demensdiagnoser från andra källor. Av 498 personer som var 70 till 81 år vid det första mättillfället (medelålder 74.5 år) i Gender studien diagnostiserades 87 personer med demens under de åtta år som studien pågick. De bästa datakällorna var de medicinska journalerna och sjuksköterskornas bedömningar, med både hög sensitivitet (0.83 och 0.80) och specificitet (0.98 och 0.96). Sensitiviteten för slutenvårdsregistret var låg (0.26) och underestimerade därmed prevalensen av demens. I studie III analyseras sambandet mellan övervikt i medelåldern och kognitiv förmåga i hög ålder. De 781 personer som deltog i SATSA var 25 till 63 år vid det första mättillfället (medelålder 41.6 år) 1963 eller 1973, då de självrapporterade längd och vikt. Med start 1986 testades dessa personers kognitiva förmåga fem gånger fram till och med 2002. LGC-modeller visade att personer som var överviktiga i medelåldern hade lägre kognitiv förmåga och att den förmågan försämrades snabbare i hög ålder, även när personer med demens uteslöts från analyserna, vilket tyder på att övervikt i medelåldern påverkar den kognitiva förmågan oberoende av demens. I studie IV studeras sambandet mellan BMI och demensrisk bland 605 personer som var 65 till 92 år vid första mättillfället (medelålder 70.8 år) i Lieto studien. Bland dessa diagnostiserades 86 personer med demens under en uppföljningsperiod på åtta år. Cox regressioner visade att för varje enhetsökning i BMI minskade risken att drabbas av demens med åtta procent (hazard ratio=0.92, 95% konfidensintervall=0.87–0.97). Sambandet kvarstod då personer som diagnostiserades med demens under de först fyra åren uteslöts från analyserna, vilket tyder på att personer som drabbas av demens har ett lågt BMI minst åtta år innan demens konstateras kliniskt.

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  • 281.
    Dahl, Anna
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Kan man undvika demens genom en sund och aktiv livsstil?2008Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 3, s. 22-26Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    En vanlig föreställning om åldrandet är att de flesta äldre för eller senare blir glömska. Även om hög ålder är en av de största riskfaktorerna för sämre minnesfunktioner, så har merparten av den åldrande befolkningen väl fungerande minne och andra intellektuella funktioner. Faktum kvarstår dock att det finns stora individuella skillnader, en del äldre har mycket gott minne, medan andra inte minns namnen på sina barn eller ens att de har barn. Hur kommer det sig? Beror det på gener, livsstil, eller är det slumpen som avgör vem som drabbas av glömska på ålderns höst?

  • 282.
    Dahl, Anna
    et al.
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Berg, Stig
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Nilsson, Sven E.
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Identification of dementia in epidemiological research: A study on the usefulness of various data sources2007Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 19, nr 5, s. 381-389Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims: Prevalence and incidence ratios of dementia in epidemiological studies vary according to the data source used. Medical records, cognitive tests, and registry information are sources frequently used to differentiate dementia from normal aging. The aim of the present study was to compare the identification of dementia from these different sources with that from consensus diagnosis. 

    Methods: 498 elderly people (age range 70–81 at baseline) enrolled in a Swedish population-based longitudinal twin study (Gender) were evaluated on physical and mental health and interviewed for their socio-demographic background three times during an eight-year period. Reviews of medical records and the Swedish Discharge Registry (DR) were conducted. The 10th percentile was used to differentiate between dementia and non-dementia in all cognitive tests. Scores of 24 or below on the Mini-Mental State Examination (MMSE) (range 1–30) indicated dementia. A consensus conference diagnosed dementia on the basis of total information. The consensus diagnosis was used as the gold standard. 

    Results: MMSE scores (sensitivity 64%, specificity 96%, kappa 0.65) and the review of medical records (sensitivity 57%, specificity 99%, kappa 0.65) were good sources for dementia identification. The precision of medical records increased when recordings of cognitive impairment were included (sensitivity 83%, specificity 98%, kappa 0.84). The discharge registry had low sensitivity (26%) and kappa coefficient (0.31). 

    Conclusions: The present study shows that both review of medical records and MMSE scores are good although not perfect identifiers of dementia. The discharge registry is an uncertain source of dementia identification.

  • 283.
    Dahl, Anna
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Hassing, Linda
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Obesity and cognitive aging2013Ingår i: Epidemiologic reviews, ISSN 0193-936X, E-ISSN 1478-6729, Vol. 35, nr 1, s. 22-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Obesity is a health problem that has reached epidemic proportions. Given the high prevalence of obesity, even a small adverse impact of obesity on cognitive aging might have a serious effect on public health. The purpose of this systematic review was to examine the relation between obesity and cognitive function in late life among persons not diagnosed with dementia and to evaluate the evidence for a causal association. Medline was used to search for the following terms: obesity, overweight, cognition, cognitive, age, and aged. To be included, studies must have had a population-based, dementia-free sample and a 5-year minimum interval between measurement of the predictor and the outcome. Only 11 studies met the criteria. Of these, 7 studies assessed obesity in midlife and cognitive function in later life, and 4 studies assessed obesity and cognitive function in late life. The reviewed studies showed clear evidence that midlife obesity was associated with cognitive aging, whereas this association was weaker in late life; thus, no firm conclusions could be drawn. The findings of this review suggest that, although there is evidence for an association between midlife obesity and low cognitive abilities in late life, the direction of the association and the causality remain to be clarified.

  • 284.
    Dahl, Anna
    et al.
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Hassing, Linda B.
    Department of Psychology, University of Gothenburg, Sweden.
    Fransson, Eleonor
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Berg, Stig
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Gatz, Margrete
    Department of Psychology, University of Southern California, Los Angeles, USA ; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Reynolds, Chandra A.
    Department of Psychology, University of California, Riverside, USA.
    Pedersen, Nancy L.
    Department of Psychology, University of Southern California, Los Angeles, USA ; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Being overweight in midlife is associated with lower cognitive ability and steeper cognitive decline in late life2010Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 65A, nr 1, s. 57-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although an increasing body of evidence links being overweight in midlife with an increased risk for dementia in late life, no studies have examined the association between being overweight in midlife and cognitive ability in late life. Our aim was to examine the association between being overweight in midlife as measured by body mass index (BMI) and cognitive ability assessed over time. METHODS: Participants in the Swedish Adoption/Twin Study Aging were derived from a population-based sample. The participants completed baseline surveys in 1963 or 1973 (mean age 41.6 years, range 25-63 years). The surveys included questions about height, weight, diseases, and lifestyle factors. Beginning in 1986, the same individuals were assessed on neuropsychological tests every 3 years (except in 1995) until 2002. During the study period, 781 individuals who were 50 years and older (60% women) had at least one complete neuropsychological assessment. A composite score of general cognitive ability was derived from the cognitive test battery for each measurement occasion. RESULTS: Latent growth curve models adjusted for twinness showed that persons with higher midlife BMI scores had significantly lower general cognitive ability and significantly steeper longitudinal decline than their thinner counterparts. The association did not change substantially when persons who developed dementia during the study period were excluded from the analysis. CONCLUSIONS: Higher midlife BMI scores precede lower general cognitive ability and steeper cognitive decline in both men and women. The association does not seem to be mediated by an increased risk for dementia

  • 285.
    Dahl, Anna
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Hassing, Linda
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Margaret, Gatz
    Reynolds, Chandra
    Pedersen, Nancy
    Body mass index across midlife and cognitive change in late life2013Ingår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 37, nr 2, s. 296-302Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: High midlife body mass index (BMI) has been linked to a greater risk of dementia in late life, but few have studied the effect of BMI across midlife on cognitive abilities and cognitive change in a dementia-free sample.

    Methods: We investigated the association between BMI, measured twice across midlife (mean age 40 and 61 years, respectively), and cognitive change in four domains across two decades in the Swedish Adoption/Twin Study of Aging.

    Results: Latent growth curve models fitted to data from 657 non-demented participants showed that persons who were overweight/obese in early midlife had significantly lower cognitive performance across domains in late life and significantly steeper decline in perceptual speed, adjusting for cardio-metabolic factors. Both underweight and overweight/obesity in late midlife were associated with lower cognitive abilities in late life. However, the association between underweight and low cognitive abilities did not remain significant when weight decline between early and late midlife was controlled for.

    Conclusion: There is a negative effect on cognitive abilities later in life related to being overweight/obese across midlife. Moreover, weight decline across midlife rather than low weight in late midlife per se was associated with low cognitive abilities. Weight patterns across midlife may be prodromal markers of late life cognitive health.

  • 286.
    Dahl, Anna
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Hassing, Linda
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Reynolds, Chandra
    Gatz, Margaret
    Pedersen, Nancy
    Body Mass Index across midlife and cognitive change in late life: delayed and cumulative effects2011Ingår i: 64th Annual Scientific Meeting of Gerontological Society of America, 2011Konferensbidrag (Refereegranskat)
  • 287.
    Dahl, Anna K.
    et al.
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Hassing, Linda B.
    Department of Psychology, University of Gothenburg, Sweden.
    Fransson, Eleonor I.
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Agreement between self-reported and measured height, weight and body mass index in old age: a longitudinal study with 20 years of follow-up2010Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 39, nr 4, s. 445-451Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: self-reported body mass index (BMI) based on self-reported height and weight is a widely used measure of adiposity in epidemiological research. Knowledge about the accuracy of these measures in late life is scarce.

    Objective: the study aimed to evaluate the accuracy and changes in accuracy of self-reported height, weight and BMI calculated from self-reported height and weight in late life.

    Design: a longitudinal population-based study with five times of follow-up was conducted.

    Participants: seven hundred seventy-four community-living men and women, aged 40–88 at baseline (mean age 63.9), included in The Swedish Adoption/Twin Study of Aging.

    Methods: participants self-reported their height and weight in a questionnaire, and height and weight were measured by experienced research nurses at an in-person testing five times during a 20-year period. BMI was calculated as weight (kilogramme)/height (metre)2.

    Results: latent growth curve modelling showed an increase in the mean difference between self-reported and measured values over time for height (0.038 cm/year) and BMI (0.016 kg/m2/year), but not for weight.

    Conclusions: there is a very small increase in the mean difference between self-reported and measured BMI with ageing, which probably would not affect the results when self-reported BMI is used as a continuous variable in longitudinal studies.

  • 288.
    Dahl, Anna K.
    et al.
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Löppönen, Minna
    Department of Family Medicine, University of Turku, Finland ; Härkätie Health Centre, Finland.
    Isoaho, Raimo
    Department of Family Medicine, University of Turku, Finland ; Nordic School of Public Health, Gothenburg, Sweden.
    Berg, Stig
    Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
    Kivelä, Sirkka-Liisa
    Department of Family Medicine, University of Turku, Finland ; Satakunta Central Hospital, Satakunta, Finland ; Unit of Family Medicine, Turku University Hospital, Finland.
    Overweight and obesity in old age are not associated with greater dementia risk2008Ingår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 56, nr 12, s. 2261-2266Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To describe the association between body mass index (BMI) and dementia risk in older persons.

    DESIGN: Prospective population‐based study, with 8 years of follow‐up.

    SETTING: The municipality of Lieto, Finland, 1990/91 and 1998/99.

    PARTICIPANTS: Six hundred five men and women without dementia aged 65 to 92 at baseline (mean age 70.8).

    MEASUREMENTS: Weight and height were measured at baseline and at the 8‐year follow‐up. Dementia was clinically assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria.

    RESULTS: Eighty‐six persons were diagnosed with dementia. Cox regression analyses, adjusted for age, sex, education, cardiovascular diseases, smoking, and alcohol use, indicated that, for each unit increase in BMI score, the risk of dementia decreased 8% (hazard ratio (HR)=0.92, 95% confidence interval (CI)=0.87–0.97). This association remained significant when individuals who developed dementia early during the first 4 years of follow‐up were excluded from the analyses (HR=0.93, 95% CI=0.86–0.99). Women with high BMI scores had a lower dementia risk (HR=0.90, 95% CI=0.84–0.96). Men with high BMI scores also tended to have a lower dementia risk, although the association did not reach significance (HR=0.95, 95% CI=0.84–1.07).

    CONCLUSION: Older persons with higher BMI scores have less dementia risk than their counterparts with lower BMI scores. High BMI scores in late life should not necessarily be considered to be a risk factor for dementia.

  • 289.
    Dahl, Anna K.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Karolinska Institutet.
    Starr, J. M.
    University of Edinburgh, Scotland.
    Allerhand, M.
    University of Edinburgh, Scotland.
    Deary, I. J.
    University of Edinburgh, Scotland.
    Acceptance of bodily appearance in young-old and old age - Prevalence and predictors2015Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, s. 355-355Artikel i tidskrift (Övrigt vetenskapligt)
  • 290.
    Dahl Aslan, Anna
    Hälsohögskolan i Jönköping.
    Psykologiskt åldrande2020Ingår i: Äldre och åldrande: grundbok i gerontologi / [ed] Marie Ernsth Bravell; Lena Östlund, Malmö: Gleerups Utbildning AB, 2020, 3, s. 209-236Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 291.
    Dahl Aslan, Anna K.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Psykologiskt åldrande2020Ingår i: Äldre och åldrande: grundbok i gerontologi / [ed] Marie Ernsth Bravell & Lena Östlund, Malmö: Gleerups Utbildning AB, 2020, 3, s. 209-236Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 292.
    Dahl Aslan, Anna K.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Starr, John M.
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.
    Pattie, Alison
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.
    Deary, Ian
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.
    Cognitive consequences of overweight and obesity in the ninth decade of life?2015Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 44, nr 1, s. 59-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/OBJECTIVES: the association between late-life obesity and late-life cognitive abilities is poorly understood. We studied the association between body mass index (BMI) and cognitive change in longitudinal population-based study spanning over the ninth decade of life.

    SUBJECTS/METHODS: in total, 475 participants free of dementia at baseline from the Lothian Birth Cohort 1921 (mean age: 79.1 years, SD: 0.6) were included. Height and weight were assessed at baseline. BMI was calculated as kg/m(2). Cognitive abilities were assessed at age ∼11 years and at age ∼79, ∼83, ∼87 and ∼90 years.

    RESULTS: latent growth models showed that men being overweight and obese had a 0.65 (SD: 0.3) and 1.10 (SD: 0.5) points less steep decline in general cognitive ability (as measured by the Moray House Test) for each year than people of normal weight. These associations were to some extent confounded by childhood intelligence. No other association between BMI and cognition was significant, either for men or women. People who were obese in old age had significantly lower childhood intelligence (m = 43.6, SD: 1.3) than people who were normal in weight (m = 47.0, SD: 0.8) and persons being overweight (m = 47.5, SD: 0.8), F (472, 3) = 3.2, P = 0.043.

    CONCLUSIONS: the current study shows weak or no evidence for an association between BMI in old age and cognitive function, especially not when childhood intelligence is controlled for. Lower intelligence at the age of 11 years predicted obesity at the age of 79 years.

  • 293.
    Dahl Aslan, Anna K.
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Institute of Gerontology, School of Health Sciences, Jönköping, Sweden.
    Starr, John M.
    Geriatric Medicine, University of Edinburgh, Royal Victoria Hospital, Edinburgh, UK ; Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK.
    Pattie, Alison
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK.
    Deary, Ian
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK.
    Cognitive consequences of overweight and obesity in the ninth decade of life?2015Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 44, nr 1, s. 59-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/OBJECTIVES: the association between late-life obesity and late-life cognitive abilities is poorly understood. We studied the association between body mass index (BMI) and cognitive change in longitudinal population-based study spanning over the ninth decade of life.

    SUBJECTS/METHODS: in total, 475 participants free of dementia at baseline from the Lothian Birth Cohort 1921 (mean age: 79.1 years, SD: 0.6) were included. Height and weight were assessed at baseline. BMI was calculated as kg/m(2). Cognitive abilities were assessed at age ∼11 years and at age ∼79, ∼83, ∼87 and ∼90 years.

    RESULTS: latent growth models showed that men being overweight and obese had a 0.65 (SD: 0.3) and 1.10 (SD: 0.5) points less steep decline in general cognitive ability (as measured by the Moray House Test) for each year than people of normal weight. These associations were to some extent confounded by childhood intelligence. No other association between BMI and cognition was significant, either for men or women. People who were obese in old age had significantly lower childhood intelligence (m = 43.6, SD: 1.3) than people who were normal in weight (m = 47.0, SD: 0.8) and persons being overweight (m = 47.5, SD: 0.8), F (472, 3) = 3.2, P = 0.043.

    CONCLUSIONS: the current study shows weak or no evidence for an association between BMI in old age and cognitive function, especially not when childhood intelligence is controlled for. Lower intelligence at the age of 11 years predicted obesity at the age of 79 years.

  • 294.
    Dahlberg, Lena
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Ageing in a changing place: a qualitative study of neighbourhood exclusion2020Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 40, nr 10, s. 2238-2256Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 295.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete. Karolinska Institutet; Stockholm University.
    Ageing in a changing place: a qualitative study of neighbourhood exclusion2019Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 40, nr 10, s. 2238-2256, artikel-id PII S0144686X1900045XArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    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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  • 296.
    Dahlberg, Lena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Agahi, Neda
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Lennartsson, Carin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Lonelier than ever? Loneliness of older people over two decades2018Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 75, s. 96-103Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 297.
    Dahlberg, Lena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Agahi, Neda
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Lennartsson, Carin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Planned and Unplanned Hospital Admissions and Their Relationship with Social Factors: Findings from a National, Prospective Study of People Aged 76 Years or Older2018Ingår i: Health Services Research, ISSN 0017-9124, E-ISSN 1475-6773, Vol. 53, nr 6, s. 4248-4267Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 298.
    Dahlberg, Lena
    et al.
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Andersson, Lars
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen Åldrande och social förändring. Linköpings universitet, Filosofiska fakulteten.
    Lennartsson, Carin
    Aging Research Center, Karolinska Institutet, Solna, Sweden; Stockholm University, Stockholm, Sweden.
    Long-term predictors of loneliness in old age: results of a 20-year national study2018Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, nr 2, s. 190-196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 299.
    Dahlberg, Lena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Andersson, Lars
    Lennartsson, Carin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Long-term predictors of loneliness in old age: results of a 20-year national study2018Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, nr 2, s. 190-196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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 20years 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 62.2years at baseline and 82.4years at follow-up.

    Results: Each form of social engagement in old age was significantly associated with the same form of social engagement 20years 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 20years 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.

  • 300.
    Dahlberg, Lena
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    McKee, Kevin J.
    Social exclusion and well-being among older adults in rural and urban areas2018Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 79, s. 176-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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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