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  • 301.
    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.
    Lennartsson, Carin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutet för social forskning (SOFI).
    Rehnberg, Johan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    A social exclusion perspective on loneliness in older adults in the Nordic countries2022Ingår i: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 19, nr 2, s. 175-188Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.

  • 302.
    Dahlin Almevall, Albin
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Healthy Ageing and Well-Being in Old Age2023Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    In the decades to come, Sweden will be facing an unprecedented increase in the proportion of inhabitants aged 80 years or older. This age group is characterised by large heterogeneity; however ageing also poses challenges for health and well-being. These challenges apply not only to the individual, but also to the health care systems. Care of this older age group employs much of the nursing resources, affecting society as a whole. Healthy ageing can and should, therefore, be promoted in the decades prior to reaching old age, and once having reached old age, well-being should be a continued focus of health care and society. In this way older adults can continue perceiving good health and well-being. The overall aim of this thesis was to explore and describe areas of importance to healthy ageing and well-being in old age. 

    Predictors of healthy ageing were prospectively studied as part of the northern Sweden Silver-MONICA project, from baseline in 1999 (n=1595) to follow-up 20 years later (n=541). For the healthy ageing outcome, a composite outcome comprised of measures of cognition (MMSE), 2.4 metre walking speed, personal independence in everyday life (Katz P-ADL) and depression (GDS15) was constructed. To study perceptions of general well-being in old age, a subsample (n=52) age > 80 was analysed as a cross-section using mixed method with open-ended interviews and the PGCMS well-being measure. A similar approach was used (n=50) to investigate specific aspects of well-being in relation to home. To study the relationship between well-being and objectively measure everyday physical activity, an accelerometer was worn 24 hours per day for at least 5 consecutive days (n=77) and analysed for associations with the PGCMS and its subscales.  

    The five top ranking predictors determined by the healthy ageing index, comprising the total baseline cohort including those who passed away before possible follow-up were smoking status, NT-proBNP, waist circumference, leisure time physical activity level and HbA1c. For those who participated in the Silver-MONICA follow-up, the top five ranking predictors as determined by the healthy ageing index were leisure time physical activity, HbA1c, BMI, waist circumference and high sensitivity Troponin I. In interviews of general well-being, six areas were described that related to social context, health, physical activity, home, engagement and freedom. In regression analysis independence in activities of everyday living along with age were significantly associated with well-being. Acceptance was key for handling consequences of ageing that impacted well-being. Home was perceived as a central aspect of well-being; however, participants described being in the margins of home. Morale was higher among persons living in single-dwelling housing compared to those living in apartments. In activity measures, well-being was associated with the number of steps, time spent stepping and time spent stepping at >75 steps/minute.

    In conclusion, the combination of qualitative, quantitative and mixed methodology utilised in this thesis to study healthy ageing allowed for the possibility to nuance conclusions and to describe the subject from different points of view. Based on the findings, this thesis suggests that physical ability in old age is the basis for being able to engage in and experience the important factors of well-being described above. However, support from others, often family, can compensate for the lack of physical ability. The support is positive to well-being as long as it does not create feelings of being a burden. As consequences of ageing affect the areas most crucial to well-being, it seems that the extent and way these changed conditions are accepted has an important role in the maintaining of well-being in old age.

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  • 303.
    Dahlkvist, Eva
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Residents’ use and perceptions of residential care facility gardens: a behavior mapping and conversation study2020Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 15, nr 1, artikel-id e12283Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To describe the gardens and their use by individuals living at residential care facilities (RCFs) with high ratings on restorative values.

    Background

    Being outdoors has been described as important to older people's well‐being. Use of outdoor gardens may increase residents’ well‐being through experiences of restorative qualities such as being away and fascination. Thus far, there has been little research on restorative experiences of gardens in the care of older people.

    Design

    A descriptive design using behaviour mapping observations integrated with qualitative field notes and recorded conversations.

    Methods

    A criterion sampling of two gardens (out of a total of 87) was made based on residents’ ratings of restorative values; the two with the highest values were chosen. Eleven residents at the two RCFs took part. Data were collected through behaviour mapping observations, field notes and conversations on five occasions in the respective facilities during residents’ visits to the garden.

    Results

    The observations revealed that the main uses of the gardens were to socialise and relax. The conversations also showed that the garden stimulated residents’ senses and evoked memories from the past. These restorative values were interpreted as a sense of being away and fascination. Not having opportunities for outdoor visits was reported to result in disappointment and reduced well‐being.

    Conclusions

    The findings showed that two basic gardens with different characteristics and views could stimulate residents’ senses and evoke memories from the past; this supports the call for residents to be able to spend time in gardens to promote their well‐being.

    Implications for practice

    First‐line managers, nurses and healthcare staff in the care of older people should consider that regular opportunities to spend time outdoors may promote older people's well‐being through feelings of being away and fascination.

  • 304. Damiano, Cecilia
    et al.
    Onder, Graziano
    Zazzara, Maria Beatrice
    Carfì, Angelo
    Zucchelli, Alberto
    Marengoni, Alberto
    Vetrano, Davide L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Frailty, multimorbidity patterns and mortality in institutionalized older adults in Italy2022Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 34, nr 12, s. 3123-3130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Little is known on how frailty influences clinical outcomes in persons with specific multimorbidity patterns.

    Aims To investigate the interplay between multimorbidity and frailty in the association with mortality in older individuals living in nursing homes (NH).

    Methods We considered 4,131 NH residents aged 60 years and over, assessed through the interRAI LTCF instrument between 2014 and 2018. Follow-up was until 2019. Considering four multimorbidity patterns identified via principal component analysis, subjects were stratified in tertiles (T) with respect to their loading values. Frailty Index (FI) considered 23 variables and a cut-off of 0.24 distinguished between high and low frailty levels. For each pattern, all possible combinations of tertiles and FI were evaluated. Their association (Hazard Ratio [HR] and 95% confidence interval) with mortality was tested in Cox regression models.

    Results In the heart diseases and dementia and sensory impairments patterns, the hazard of death increases progressively with patterns expression and frailty severity (being HR T3 vs. T1 = 2.36 [2.01–2.78]; HR T3 vs. T1 = 2.12 [1.83–2.47], respectively). In heart, respiratory and psychiatric diseases and diabetes, musculoskeletal and vascular diseases patterns, frailty seems to have a stronger impact on mortality than patterns’ expression.

    Discussion Frailty increases mortality risk in all the patterns and provides additional prognostic information in NH residents with different multimorbidity patterns.

    Conclusions These findings support the need to routinely assess frailty. Older people affected by specific groups of chronic diseases need a specific care approach and have high risk of negative health outcomes.

  • 305.
    Danielsson, Henrik
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköping University, Linnaeus Centre HEAD.
    Kathleen, Pichora-Fuller
    University of Toronto, Department of Psychology.
    Dupuis, Kate
    Baycrest Health Sciences, Rotman Research Institute.
    Rönnberg, Jerker
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköping University, Linnaeus Centre HEAD.
    Modeling the effect of early ageing and hearing loss on cognition and participation in social leisure activities2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    There are well-known age-related declines in hearing, cognition and social participation. Furthermore, previous studies have shown that hearing loss is associated with both cognitive decline and increased risk for social isolation and that engagement in social leisure activities is related to cognitive decline. However, it is unclear how the three concepts and age relate to each other. In the current study, behavioral measures of hearing and memory were examined in relation to self-reported participation in social leisure activities. Data from two different samples were analyzed with structural equation modeling. The first consisted of 297 adults from Umeå, Sweden, who participated in the Betula longitudinal study. The second consisted of 273 older adults who volunteered for lab-based research on aging in Toronto, Canada. Structural equation modeling yielded two models with similar statistical properties for both samples. The first model suggests that age contributes to both hearing and memory performance, hearing contributes to memory performance, and memory (but not hearing) contributes to participation in social leisure activities. The second model also suggests that age contributes to hearing and memory performance and that hearing contributes to memory performance, but that age also contributes to participation in social leisure activities, which in turn contributes to memory performance. The models were confirmed in both samples, indicating robustness in the findings, especially since the samples differed on background variables such as years of education and marital status. Few participants in both samples were candidates for hearing aids, but most of those who were candidates used them. This suggests that even early stages of hearing loss can increase demands on cognitive processing that may deter participation in social leisure activities.

  • 306.
    Danielsson, Henrik
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköping University, Linnaeus Centre HEAD.
    Pichora-Fuller, Kathleen
    University of Toronto, Department of Psychology .
    Dupuis, Kate
    Baycrest Health Sciences, Rotman Research Institute.
    Rönnberg, Jerker
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköping University, Linnaeus Centre HEAD.
    Modeling the effect of early age-related hearing loss on cognition and participation in social leisure activities2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    There are well-known age-related declines in hearing, cognition and social participation. Furthermore, previous studies have shown that hearing loss is associated with both cognitive decline and increased risk for social isolation and that engagement in social leisure activities is related to cognitive decline. However, it is unclear how the three concepts and age relate to each other. In the current study, behavioral measures of hearing and memory were examined in relation to self-reported participation in social leisure activities. Data from two different samples were analyzed with structural equation modeling. The first consisted of 297 adults from Umeå, Sweden, who participated in the Betula longitudinal study. The second consisted of 273 older adults who volunteered for lab-based research on aging in Toronto, Canada. Structural equation modeling yielded two models with similar statistical properties for both samples. The first model suggests that age contributes to both hearing and memory performance, hearing contributes to memory performance, and memory (but not hearing) contributes to participation in social leisure activities. The second model also suggests that age contributes to hearing and memory performance and that hearing contributes to memory performance, but that age also contributes to participation in social leisure activities, which in turn contributes to memory performance. The models were confirmed in both samples, indicating robustness in the findings, especially since the samples differed on background variables such as years of education and marital status. Few participants in both samples were candidates for hearing aids, but most of those who were candidates used them. This suggests that even early stages of hearing loss can increase demands on cognitive processing that may deter participation in social leisure activities.

  • 307. Darin-Mattsson, A.
    et al.
    Andel, R.
    Keller-Celeste, R.
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Linking financial hardship and psychological distress from childhood to old age: testing the sensitive period, chain of risks, and accumulation of risks hypotheses2018Konferensbidrag (Refereegranskat)
  • 308. Darin-Mattsson, A.
    et al.
    Fors, S.
    Nilsen, Charlotta
    Fritzell, J.
    Andel, R.
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Occupational complexity in relation to late life physical functioning in Sweden2018Konferensbidrag (Refereegranskat)
  • 309.
    Darin-Mattsson, Alexander
    et al.
    Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Sweden.
    Andel, Ross
    University of South Florida and International Clinical Research Center, Tampa, USA.
    Celeste, Roger Keller
    Federal University of Rio Grande do Sul, Faculdade de Odontologia, Department Preventive and Social Dentistry, Porto Alegre, Brazil.
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Sweden.
    Linking financial hardship throughout the life-course with psychological distress in old age: Sensitive period, accumulation of risks, and chain of risks hypotheses.2018Ingår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 201, s. 111-119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model.

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  • 310.
    Darin-Mattsson, Alexander
    et al.
    Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden .
    Andel, Ross
    School af Aging Studies, University of South Florida, Tampa, USA; International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic .
    Fors, Stefan
    Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden.
    Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later?2015Ingår i: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 27, nr 7, s. 1266-1285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position.

    Method: Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study ofLiving Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions.

    Results: Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress.

    Discussion: With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psychological distress later in life.

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  • 311.
    Darin-Mattsson, Alexander
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Andel, Ross
    Fors, Stefan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Kåreholt, Ingemar
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Jönköping University, Sweden.
    Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later?2015Ingår i: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 27, nr 7, s. 1266-1285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position. Method: Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study of Living Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions. Results: Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress. Discussion: With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psychological distress later in life.

  • 312.
    Darin-Mattsson, Alexander
    et al.
    Aging Research Centre (ARC), Karolinska Institutet, Stockholm University, Sweden.
    Fors, Stefan
    Aging Research Centre (ARC), Karolinska Institutet, Stockholm University, Sweden.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Centre (ARC), Karolinska Institutet, Stockholm University, Sweden.
    Different indicators of socioeconomic status and their relative importance as determinants of health in old age2017Ingår i: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 16, nr 1, artikel-id 173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Socioeconomic status has been operationalised in a variety of ways, most commonly as education, social class, or income. In this study, we also use occupational complexity and a SES-index as alternative measures of socioeconomic status. Studies show that in analyses of health inequalities in the general population, the choice of indicators influence the magnitude of the observed inequalities. Less is known about the influence of indicator choice in studies of older adults. The aim of this study is twofold: i) to analyse the impact of the choice of socioeconomic status indicator on the observed health inequalities among older adults, ii) to explore whether different indicators of socioeconomic status are independently associated with health in old age.

    Methods: We combined data from two nationally representative Swedish surveys, providing more than 20 years of follow-up. Average marginal effects were estimated to compare the association between the five indicators of SES, and three late-life health outcomes: mobility limitations, limitations in activities of daily living (ADL), and psychological distress.

    Results: All socioeconomic status indicators were associated with late-life health; there were only minor differences in the effect sizes. Income was most strongly associated to all indicators of late-life health, the associations remained statistically significant when adjusting for the other indicators. In the fully adjusted models, education contributed to the model fits with 0-3% (depending on the outcome), social class with 0-1%, occupational complexity with 1-8%, and income with 3-18%.

    Conclusions: Our results indicate overlapping properties between socioeconomic status indicators in relation to late-life health. However, income is associated to late-life health independently of all other variables. Moreover, income did not perform substantially worse than the composite SES-index in capturing health variation. Thus, if the primary objective of including an indicator of socioeconomic status is to adjust the model for socioeconomic differences in late-life health rather than to analyse these inequalities per se, income may be the preferable indicator. If, on the other hand, the primary objective of a study is to analyse specific aspects of health inequalities, or the mechanisms that drive health inequalities, then the choice of indicator should be theoretically guided. 

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  • 313.
    Darin-Mattsson, Alexander
    et al.
    Karolinska Institutet, Sweden.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Karolinska Institutet, Sweden.
    Andel, Ross
    University of South Florida, Tampa, USA.
    Economic hardship and income before retirement in relation to anxiety and depression in older adulthood. (2015) Work-related stress in midlife and all-cause mortality: the role of sense of coherence.2015Ingår i: Life Courses in Cross-­National Comparison: Similarities and Differences: Abstract book, 2015, s. 69-Konferensbidrag (Refereegranskat)
  • 314. Dauber, Hanna
    et al.
    Pogarell, Oliver
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. IFT Institut für Therapieforschung, Germany; ELTE Eötvös-Loránd-University, Hungary.
    Braun, Barbara
    Older adults in treatment for alcohol use disorders: service utilisation, patient characteristics and treatment outcomes2018Ingår i: Substance Abuse Treatment, Prevention, and Policy, E-ISSN 1747-597X, Vol. 13, artikel-id 40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background In western countries demographic changes are leading to an ageing society. Consequently, the number of older adults with alcohol use disorders (AUDs) will rise and the demand of treatment is likely to increase. However, thus far not many older adults with an AUD are seeking treatment and little is known about the efficacy of treatment for older adults. The present study aimed at determining the proportion of older adults with an AUD in addiction treatment, particular characteristics and treatment outcomes of this clientele.

    Methods Using data of 10,860 patients with an AUD aged 60 and over that are documented within the national German addiction care system we conducted exploratory analyses with regard to prevalence, sociodemographic, disorder- and treatment-related variables.

    Results Overall, we found a low proportion of older patients in treatment due to AUDs, but highly positive treatment outcomes. With regard to sociodemographic and disorder-related characteristics, older females and late-onset patients in particular constitute a unique clientele.

    Conclusions The low service utilisation on the one hand but good treatment prognosis on the other emphasise the need to promote treatment seeking among older adults with AUDs. In this context, the special characteristics we found among older patients may contribute to better reach this population and to improve provisions of targeted treatment approaches.

  • 315.
    Davey, Adam
    et al.
    Department of Public Health, Temple University, Philadelphia, Pennsylvania.
    Malmberg, Bo
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Sundström, Gerdt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Aging in Sweden: Local variation, local control2014Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, nr 4, s. 525-532Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aging in Sweden has been uniquely shaped by its history—most notably the long tradition of locally controlled services for older adults. We considered how local variations and local control shape the experience of aging in Sweden and organized the paper into 3 sections. First, we examine aging in Sweden along demography, economy, and housing. Next, we trace the origins and development of the Swedish welfare state to consider formal supports (service provision) and informal supports (caregiving and receipt of care). Finally, we direct researchers to additional data resources for understanding aging in Sweden in greater depth. Sweden was one of the first countries to experience rapid population aging. Quality of life for a majority of older Swedes is high. Local control permits a flexible and adaptive set of services and programs, where emphasis is placed on improving the quality and targeting of services that have already reached a plateau as a function of population and expenditures.

  • 316. de Frias, Cindy M
    et al.
    Bunce, David
    Wahlin, Åke
    Adolfsson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Sleegers, Kristel
    Cruts, Marc
    Van Broeckhoven, Christine
    Nilsson, Lars-Göran
    Cholesterol and triglycerides moderate the effect of apolipoprotein E on memory functioning in older adults2007Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 62, nr 2, s. P112-P118Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We used data from the Betula Study to examine associations between total cholesterol, triglycerides, and apolipoprotein E on 10-year changes in cognitive performance. Tests assessing episodic memory (recall and recognition), semantic memory (knowledge and fluency), and visuospatial ability (block design) were administered to 524 nondemented adults (initial age of 55-80 years); multilevel modeling was applied to the data. Higher triglyceride levels were associated with a decline in verbal knowledge. Lipid levels moderated the influence of apolipoprotein E on episodic memory, such that among epsilon 4 allele carriers, decline in recognition was noted for individuals with higher cholesterol levels. Cholesterol and triglyceride levels are pharmacologically modifiable risk factors that account for variation In normal cognitive aging.

  • 317. De Vriendt, P.
    et al.
    Gorus, E.
    Mets, T.
    Petrovic, M.
    Nygard, L.
    Kottorp, A.
    Rosenberg, Lena
    Division Of Occupational Therapy, Department Of Neurobiology, Care Science And Society, Karolinska Insitutet, Huddinge, Sweden.
    Malinowsky, C.
    Öhman, A.
    Josephsson, S.
    Graff, M.
    Vernooij-Dassen, M.
    Olde-Rikkert, M.
    Mild cognitive impairment and early stage dementia: Assessment and treatment of everyday functioning2012Ingår i: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 3, nr Suppl. 1, s. S12-S13Artikel i tidskrift (Refereegranskat)
  • 318.
    Degerman Gunnarsson, Malin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Lannfelt, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Ingelsson, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Basun, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Kilander, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    High Tau Levels in Cerebrospinal Fluid Predict Rapid Decline and Increased Dementia Mortality in Alzheimer's Disease2014Ingår i: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 37, nr 3-4, s. 196-206Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Cerebrospinal fluid (CSF) amyloid beta(42) (A beta(42)), total tau (t-tau) and phosphorylated tau (p-tau) are useful as predictors of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia. However, results are contradictory as to whether these biomarkers reflect the future rate of clinical decline. Methods: This is a retrospective study on 196 patients with AD [mild/moderate AD (n = 72) or AD-MCI (n = 124) at baseline] with a follow-up period of 2-9 years' duration (median 6 years). Lumbar punctures were performed at baseline as a part of the diagnostic procedure. Results: We found an increased risk of rapid cognitive decline defined as a drop in the Mini-Mental State Examination score of = 4 points/year in patients with CSF t-tau concentrations above the median (OR 3.31, 95% CI 1.53-7.16) and CSF p-tau above the median (OR 2.53, 95% CI 1.21-5.26). Patients with CSF t-tau in the highest quartile had a higher risk of dying in severe dementia (HR 4.67, 95% CI 1.16-18.82). Conclusions: In this large AD cohort, we found an association between high levels of CSF t-tau and p-tau and a more aggressive course of the disease, measured as a rapid cognitive decline and a higher risk of dying in severe dementia.

  • 319.
    Dekhtyar, Serhiy
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Vetrano, Davide Liborio
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Università Cattolica del Sacro Cuore, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Policlinico “A. Gemelli”, Italy.
    Marengoni, Alessandra
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). University of Brescia, Brescia, Italy.
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Pan, Kuan-Yu
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Calderón-Larrañaga, Amaia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center.
    Association Between Speed of Multimorbidity Accumulation in Old Age and Life Experiences: A Cohort Study2019Ingår i: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 188, nr 9, s. 1627-1636Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rapidly accumulating multiple chronic conditions (multimorbidity) during aging are associated with many adverse outcomes. We explored the association between 4 experiences throughout life-childhood socioeconomic circumstances, early-adulthood education, midlife occupational stress, and late-life social network-and the speed of chronic disease accumulation. We followed 2,589 individuals aged >= 60 years from the Swedish National Study on Aging and Care in Kungsholmen for 9 years (2001-2013). Information on life experiences was collected from detailed life-history interviews. Speed of disease accumulation was operationalized as the change in the count of chronic conditions obtained from clinical examinations, medical histories, laboratory data, drug use, and register linkages over 9 years. Linear mixed models were used to analyze the data. Speed of disease accumulation was lower in individuals with more than elementary education (for secondary, beta x time = -0.065, 95% CI: -0.126, -0.004; for university, beta x time = -0.118, 95% CI: -0.185, -0.050); for active occupations compared with high-strain jobs (beta x time = -0.078, 95% CI: -0.138, -0.017); and for richer social networks (for moderate tertile, beta x time = -0.102, 95% CI: -0.149, -0.055; for highest tertile, beta x time = -0.135, 95% CI: -0.182, -0.088). The association between childhood circumstances and speed of disease accumulation was attenuated by later-life experiences. Diverse experiences throughout life might decelerate chronic disease accumulation during aging.

  • 320. Dekhtyar, Serhiy
    et al.
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Zhengzhou University, China.
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Herlitz, Agneta
    Childhood school performance, education and occupational complexity: a life-course study of dementia in the Kungsholmen Project2016Ingår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 45, nr 4, s. 1207-1215Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Cognitive reserve hypothesis predicts that intellectually demanding activities over the life course protect against dementia. We investigate if childhood school performance remains associated with dementia once education and occupational complexity are taken into account. Methods: A cohort of 440 individuals aged 75+ from the Kungsholmen Project was followed up for 9 years to detect dementia. To measure early-life contributors to reserve, we used grades at age 9-10 extracted from the school archives. Data on formal education and occupational complexity were collected at baseline and first follow-up. Dementia was ascertained through comprehensive clinical examination. Cox models estimated the relationship between life-course cognitive reserve measures and dementia. Results: Dementia risk was elevated [hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.03 to 2.29] in individuals with low early-life school grades after adjustment for formal educational attainment and occupational complexity. Secondary education was associated with a lower risk of dementia (HR: 0.72, 95% CI: 0.50 to 1.03), although the effects of post-secondary and university degrees were indistinguishable from baseline. Occupational complexity with data and things was not related to dementia. However, an association was found between high occupational complexity with people and dementia, albeit only in women (HR: 0.39, 95% CI: 0.14 to 0.99). The pattern of results remained unchanged after adjustment for genetic susceptibility, comorbidities and depressive symptoms. Conclusion: Low early-life school performance is associated with an elevated risk of dementia, independent of subsequent educational and occupational attainment.

  • 321.
    Delahunty, Fionn
    et al.
    Univ Gothenburg, Sweden; Chalmers Univ Technol, Sweden; NUI Galway, Ireland.
    Johansson, Robert
    Linköpings universitet, Institutionen för datavetenskap, Interaktiva och kognitiva system. Linköpings universitet, Tekniska fakulteten. Stockholm Univ, Sweden.
    Arcan, Mihael
    NUI Galway, Ireland.
    Passive Diagnosis incorporating the PHQ-4 for Depression and Anxiety2019Ingår i: SOCIAL MEDIA MINING FOR HEALTH APPLICATIONS (#SMM4H) WORKSHOP & SHARED TASK, ASSOC COMPUTATIONAL LINGUISTICS-ACL , 2019, s. 40-46Konferensbidrag (Refereegranskat)
    Abstract [en]

    Depression and anxiety are the two most prevalent mental health disorders worldwide, impacting the lives of millions of people each year. In this work, we develop and evaluate a multilabel, multidimensional deep neural network designed to predict PHQ-4 scores based on individuals written text. Our system outperforms random baseline metrics and provides a novel approach to how we can predict psychometric scores from written text. Additionally, we explore how this architecture can be applied to analyse social media data.

  • 322.
    Demnitz, Naiara
    et al.
    Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
    Gates, Anne T.
    Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Mortensen, Erik L.
    Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Garde, Ellen
    Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Wimmelmann, Cathrine L.
    Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Siebner, Hartwig R.
    Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health sciences, Copenhagen University, Copenhagen, Denmark.
    Kjaer, Michael
    Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark; Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health sciences, Copenhagen University, Copenhagen, Denmark.
    Is it all in the baseline? Trajectories of chair stand performance over 4 years and their association with grey matter structure in older adults2023Ingår i: Human Brain Mapping, ISSN 1065-9471, E-ISSN 1097-0193, Vol. 44, nr 11, s. 4299-4309Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Understanding individual variability in response to physical activity is key to developing more effective and personalised interventions for healthy ageing. Here, we aimed to unpack individual differences by using longitudinal data from a randomised-controlled trial of a 12-month muscle strengthening intervention in older adults. Physical function of the lower extremities was collected from 247 participants (66.3 ± 2.5 years) at four time-points. At baseline and at year 4, participants underwent 3 T MRI brain scans. K-means longitudinal clustering was used to identify patterns of change in chair stand performance over 4 years, and voxel-based morphometry was applied to map structural grey matter volume at baseline and year 4. Results identified three groups showing trajectories of poor (33.6%), mid (40.1%), and high (26.3%) performance. Baseline physical function, sex, and depressive symptoms significantly differed between trajectory groups. High performers showed greater grey matter volume in the motor cerebellum compared to the poor performers. After accounting for baseline chair stand performance, participants were re-assigned to one of four trajectory-based groups: moderate improvers (38.9%), maintainers (38.5%), improvers (13%), and decliners (9.7%). Clusters of significant grey matter differences were observed between improvers and decliners in the right supplementary motor area. Trajectory-based group assignments were unrelated to the intervention arms of the study. In conclusion, patterns of change in chair stand performance were associated with greater grey matter volumes in cerebellar and cortical motor regions. Our findings emphasise that how you start matters, as baseline chair stand performance was associated with cerebellar volume 4 years later.

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  • 323. Dent, Elsa
    et al.
    Hanlon, Peter
    Sim, Marc
    Jylhävä, Juulia
    Liu, Zuyun
    Vetrano, Davide L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Stolz, Erwin
    Pérez-Zepeda, Mario Ulises
    Crabtree, Daniel R.
    Nicholson, Caroline
    Job, Jenny
    Ambagtsheer, Rachel C.
    Ward, Paul R.
    Shi, Sandra M.
    Huynh, Quan
    Hoogendijk, Emiel O.
    Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology2023Ingår i: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 91, artikel-id 102082Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Frailty is an age-related clinical condition characterised by an increased susceptibility to stressors and an elevated risk of adverse outcomes such as mortality. In the light of global population ageing, the prevalence of frailty is expected to soar in coming decades. This narrative review provides critical insights into recent developments and emerging practices in frailty research regarding identification, management, risk factors, and prevention. We searched journals in the top two quartiles of geriatrics and gerontology (from Clarivate Journal Citation Reports) for articles published between 01 January 2018 and 20 December 2022. Several recent developments were identified, including new biomarkers and biomarker panels for frailty screening and diagnosis, using artificial intelligence to identify frailty, and investigating the altered response to medications by older adults with frailty. Other areas with novel developments included exercise (including technology-based exercise), multidimensional interventions, person-centred and integrated care, assistive technologies, analysis of frailty transitions, risk-factors, clinical guidelines, COVID-19, and potential future treatments. This review identified a strong need for the implementation and evaluation of cost-effective, community-based interventions to manage and prevent frailty. Our findings highlight the need to better identify and support older adults with frailty and involve those with frailty in shared decision-making regarding their care.

  • 324.
    Derbring, Sandra
    et al.
    DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
    Nordström, Melissa Barbos
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Svenningsson, Jenny-Ann
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Laakso, Katja
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden,.
    Ekström, Anna
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för sinnesorgan och kommunikation. Linköpings universitet, Medicinska fakulteten.
    Ingebrand, Elias
    Linköpings universitet, Institutionen för kultur och samhälle, Avdelningen för åldrande och social förändring. Linköpings universitet, Filosofiska fakulteten.
    Samuelsson, Christina
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Buchholz, Margret
    DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Correction: Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives - CORRIGENDUM (Oct, 10.1017/S0144686X21001446, 2021)2023Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 43, s. 2748-2749Artikel i tidskrift (Övrigt vetenskapligt)
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  • 325.
    Di Rosa, Mirko
    et al.
    National Institute of Health and Science on Aging (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Aging (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Aging (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Aging (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Aging (INRCA), Italy.
    Private employment of home care workers and use of health services by disabled older people in Italy2013Ingår i: Euroregional Journal of Socio-Economic Analysis, ISSN 2344-6404, Vol. 1, nr 1, s. 33-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Home care workers privately employed by households have become today the “third rail” of longtermcare policies in several industrialised countries. In Italy, estimates suggested that they might be asmany as over 840,000, most of them being foreign-born migrants living with the cared for person. So far, littleattention has been paid to the integration and coordination of these workers within the formal care sector.We analysed a cross-sectional sample of 4,814 disabled older Italians living in the community to assess theassociation between the private employment of home care workers and the likelihood of using other formalservices. After controlling for possible confounding effects of predisposing characteristics and need factors,we found that using private assistance at home is strongly associated with the use of all services. Thesecorrelations suggests that a “crowding-in” effect exists between the use of private care and public formalservices, and a clear pattern of care tasks allocation can be identified in Italy, where family and privatecarers are responsible for assisting the older person with basic tasks of daily living, while the residualcompetences of public formal sector relate to specialised health care services.

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  • 326.
    Di Rosa, Mirko
    et al.
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Poli, Arianna
    Linköping University ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Balducci, Francesco
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA).
    L’altra bussola: le strategie di sostegno familiare e privato2015Ingår i: L'assistenza agli anziani non autosufficienti in Italia: 5° Rapporto, Un futuro da ricostruire / [ed] N.N.A., Rimini: Maggioli Editore, 2015, s. 35-54Kapitel i bok, del av antologi (Refereegranskat)
  • 327. Diaconu, Viorela
    et al.
    van Raalte, Alyson
    Martikainen, Pekka
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för forskning om ojämlikhet i hälsa (CHESS). Max Planck Institute for Demographic Research, Germany; University of Helsinki, Finland.
    Why we should monitor disparities in old-age mortality with the modal age at death2022Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 17, nr 2, artikel-id e0263626Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Indicators based a fixed “old” age threshold have been widely used for assessing socioeconomic disparities in mortality at older ages. Interpretation of long-term trends and determinants of these indicators is challenging because mortality above a fixed age that in the past would have reflected old age deaths is today mixing premature and old-age mortality. We propose the modal (i.e., most frequent) age at death, M, an indicator increasingly recognized in aging research, but which has been infrequently used for monitoring mortality disparities at older ages. We use mortality and population exposure data by occupational class over the 1971-2017 period from Finnish register data. The modal age and life expectancy indicators are estimated from mortality rates smoothed with penalized B-splines. Over the 1971-2017 period, occupational class disparities in life expectancy at 65 and 75 widened while disparities in M remained relatively stable. The proportion of the group surviving to the modal age was constant across time and occupational class. In contrast, the proportion surviving to age 65 and 75 has roughly doubled since 1971 and showed strong occupational class differences. Increasing socioeconomic disparities in mortality based on fixed old age thresholds may be a feature of changing selection dynamics in a context of overall declining mortality. Unlike life expectancy at a selected fixed old age, M compares individuals with similar survival chances over time and across occupational classes. This property makes trends and differentials in M easier to interpret in countries where old-age survival has improved significantly. 

  • 328.
    Ding, Mozhu
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Johnell, Kristina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Fastbom, Johan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Ljungdahl, Maria
    Qiu, Chengxuan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Atrial fibrillation and use of antithrombotic medications in older people: A population-based study2017Ingår i: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 249, s. 173-178Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Trends in the use of antithrombotic drugs in elderly patients with atrial fibrillation (AF) are largely unknown. We estimated the prevalence of AF in an older population, and examined whether use of anticoagulant and antiplatelet drugs in older AF patients has changed over time. Methods: Data from the population-based Swedish National study on Aging and Care in Kungsholmen (n = 3363, age = 60 years, 64.9% women) were used (2001-2004 and 2007-2010). AF cases were identified through 12-lead electrocardiogram, physician examinations, and patient register records (ICD-10 code I48). We used the CHADS(2) and CHA(2)DS(2)-VASc scores to estimate stroke risk, and an incomplete HAS-BLED score to estimate bleeding risk. Results: At baseline (2001-2004), 328 persons (9.8%) were ascertained to have AF. The prevalence of AF increased significantly with age from 2.8% in people aged 60-66 years to 21.2% in those = 90 years, and was more common in men than in women (11.2% vs. 9.0%). Among AF patients with CHADS2 score = 2 at baseline, 25% were taking anticoagulant drugs and 54% were taking antiplatelet drugs. High bleeding risk was significantly associated with not using anticoagulant drugs in AF patients (multi-adjusted OR = 2.50, p = 0.015). Between 2001-2004 and 2007-2010, use of anticoagulant drugs increased significantly, especially in AF patients with CHA2DS2-VASc score >= 2 (23% vs. 33%, p = 0.008) and in those with HAS-BLED score <3 (32% vs. 53%, p = 0.004). Conclusion: AF is common among old people. The use of anticoagulant drugs increased over time in AF patients, yet still two-thirds of those with high stroke risk remained untreated.

  • 329.
    Ding, Mozhu
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Qiu, Chengxuan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Rizzuto, Debora
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Grande, Giulia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Tracing temporal trends in dementia incidence over 25 years in central Stockholm, Sweden2020Ingår i: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 16, nr 5, s. 770-778Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Recent reports from high-income countries have suggested a declining incidence of dementia.

    Methods: Trends in dementia incidence over 25 years among people >= 75 years of age were examined using two population-based cohort studies: the Kungsholmen Project (KP, n = 1473, 1987-1998) and the Swedish National study on Aging and Care in Kungsholmen (SNAC-K, n = 1746, 2001-2013).

    Results: We identified 440 (29.9%) and 388 (22.2%) incident dementia cases in the KP and SNAC-K cohorts, respectively. The incidence of dementia declined by 30% (hazard ratio [HR] = 0.70; 95% confidence interval [CI] 0.61-0.80) during the second decade. Adjustment of education, psychosocial working conditions, lifestyle, and vascular diseases did not substantially change the results (HR = 0.77, 95% CI 0.65-0.90). This decline was observed particularly in women and people with elementary education.

    Discussion: Our study provides direct evidence of a declining trend in dementia incidence. Improved cognitive reserve and cardiovascular health could partially explain the decline.

  • 330. Doheny, Megan
    et al.
    Agerholm, Janne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Orsini, Nicola
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Burström, Bo
    Socio-demographic differences in the frequent use of emergency department care by older persons: a population-based study in Stockholm County2019Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, artikel-id 202Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In Sweden, the number of older people using emergency department (ED) care is rising. Among older persons an ED visit is a stressful event, which potentially could have been prevented or treated at other levels of care. Frequent ED use (> 4 visits a year) by older persons might reflect issues in the organisation of health care system to address their needs. We aimed to explore socio-demographic differences among older people seeking ED care in terms age and gender, and to investigate the association between income and frequent ED use. Methods: A population-based study analysing the utilisation of ED care by (N = 356,375) individuals aged 65+ years. We linked register data on socio-demographic characteristics from 2013 to health care utilisation data in 2014. Multivariable logistic regression was used to estimate the income differences in the frequent use of ED care, adjusting for living situation, country of birth, residential area, age in years, multi-morbidity and the use of other health care services. Results: Those 65+ years accounted for (27%) of all ED visits in Stockholm County in 2014. In the study population (2.5%) were identified as frequent ED users, who were predominantly in the lower income groups, living alone or in an institution, had more multi-morbidity, and utilised more of other health care services. The lowest income groups had a three-fold greater odds of being a frequent ED user than those in the highest income group. In the adjusted models, the odds were reduced by 12-44% for those in the lowest income groups. However, age and gender differences were observed with men 65-79 years (OR 1.75 CI: 1.51-2.03) and women 80+ years (OR 150, CI 1.19-1.87) in the lowest income groups having a higher odds of frequent ED use. Conclusion: This study observed that ED visits by older persons are driven by a need of care, and those that frequently visit hospital-based EDs are a socially disadvantaged group, which suggests that the organisation of care for older people should be reviewed in order to better meet their needs in other levels of care.

  • 331.
    Doheny, Megan
    et al.
    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).
    Orsini, Nicola
    Walander, Anders
    Burström, Bo
    Agerholm, Janne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Socioeconomic differences in inpatient care expenditure in the last year of life among older people: a retrospective population-based study in Stockholm County2022Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 12, nr 7, artikel-id e060981Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To investigate the association between inpatient care expenditure (ICE) and income group and the effect of demographic factors, health status, healthcare and social care utilisation on ICE in the last year of life.

    Design Retrospective population-based study.

    Setting Stockholm County.

    Participants Decedents ≥65 years in 2015 (N=13 538).

    Outcome ICE was calculated individually for the month of, and 12 months preceding death using healthcare register data from 2014 and 2015. ICE included the costs of admission and treatment in inpatient care adjusted for the price level in 2018.

    Results There were difference between income groups and ICE incurred at the 75th percentile, while a social gradient was found at the 95th percentile where the highest income group incurred higher ICE (SEK45 307, 95% CI SEK12 055 to SEK79 559) compared with the lowest income groups. Incurring higher ICE at the 95th percentile was driven by greater morbidity (SEK20 333, 95% CI SEK12 673 to SEK29 993) and emergency department care visits (SEK77 995, 95% CI SEK64 442 to SEK79 549), while lower ICE across the distribution was associated with older age and residing in institutional care.

    Conclusion Gaining insight into patterns of healthcare expenditure in the last year of life has important implications for policy, particularly as socioeconomic differences were visible in ICE at a time of greater care need for all. Future policies should focus on engaging in advanced care planning and strengthening the coordination of care for older people.

  • 332.
    Dohrn, Ing-Mari
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Karolinska Institutet, Sweden.
    Gardiner, Paul A.
    Winkler, Elisabeth
    Welmer, Anna-Karin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden; Stockholm Gerontology Research Center, Sweden.
    Device-measured sedentary behavior and physical activity in older adults differ by demographic and health-related factors2020Ingår i: European Review of Aging and Physical Activity, ISSN 1813-7253, E-ISSN 1861-6909, Vol. 17, nr 1, artikel-id 8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Our aim was to describe and explore older adults' device-measured sedentary behavior and physical activity (PA) pattern by sex, age, education, marital status, body mass index, and physical function; and to assess agreement regarding fulfillment of PA recommendations, i.e. 150 min/week of moderate-to-vigorous intensity PA (MVPA), between device-measured and self-reported PA. Method We included 656 older adults (64% women), aged 66, 81-87 or >= 90 years from a Swedish population-based cohort study. The activPAL3 accelerometer provided information on sedentary behavior (sedentary time, sedentary bouts, sit-to-stand transitions) and PA. Stepping >= 100 steps/min was considered MVPA; standing and stepping < 100 steps/min were considered light-intensity PA (LPA). Self-reported PA was compared with min/week in MVPA and steps/day. Results On average, 60% of wear time was spent sedentary, 36% in LPA, and 4% in MVPA. Relative to men, women, had significantly (p < 0.05) more sit-to-stand transitions, spent 33 min/day less sedentary and 27 min/day more in LPA, and were more likely to report meeting PA recommendations, but showed no difference in steps/day, MVPA, or sedentary bout duration. Older age was associated with more sedentary time, lower MVPA and fewer steps/day. The prevalence of meeting PA recommendations was 59% device-measured and 88% by self-report with limited agreement between methods (Cohen's Kappa = 0.21, Spearman's rho = 0.28). Age differences were much more pronounced with objective measures than by self-report. Conclusions We found significant sex differences in sedentary behavior and time in LPA in older adults, but not in MVPA, in contrast to previous findings. Sedentary time increased with age, with small differences in accumulation pattern. MVPA time was lower with older age, obesity, and poor physical function. A majority of the participants > 80 years did not meet the PA recommendations. Given the strong relationships between sedentary behavior, PA and health in older adults, programs are needed to address these behaviors. Agreement between device-measured and self-reported fulfillment of PA recommendations was limited. Device-based measurement adds value to PA studies, providing richer and different data than self-report.

  • 333.
    Dohrn, Ing-Mari
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Papenberg, Goran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Winkler, Elisabeth
    Welmer, Anna-Karin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden; Stockholm Gerontology Research Center,, Sweden.
    Impact of dopamine-related genetic variants on physical activity in old age - a cohort study2020Ingår i: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 17, nr 1, artikel-id 68Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives The beneficial effects of a physically active lifestyle in aging are well documented. Understanding the factors of importance for physical activity in older adults are therefore essential. Informed by animal and human data linking the dopamine system to motivation and reward processes, we investigated the associations between variations in dopamine genes and objectively measured physical activity and sedentary behaviour. Further, we aimed to verify whether higher age may exacerbate the impact of dopamine genes on physical activity. Methods We analyzed data from 504 older adults, 66-87 years, from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Physical activity was measured with activPAL accelerometers and DNA was extracted from blood samples for genotyping. We assessed the effects of three dopamine relevant genetic variations (DRD1, DRD2, and DRD3) on daily time in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity using analyses of covariance, adjusting for sex, age and physical function. Results Higher dopamine receptor efficacy was related to moderate-to-vigorous physical activity, but not to light-intensity physical activity or sedentary time. DRD1 explained 2.7% of variance in moderate-to-vigorous physical activity, with more pronounced effect in people aged >= 80 years, about 10% of explained variance. Conclusion Stronger genetic effects in older adults are in line with the well-established nonlinear effects of dopamine signaling on performance, expected to be exacerbated with aging. Individuals over 80 years, genetically predisposed to lower dopamine receptor efficacy, engaged on average 100 min/week in moderate-to-high physical activity, below the recommended levels beneficial for healthy aging. Our findings highlight that some individuals might need extra support to maintain a physically active lifestyle.

  • 334.
    Dong, Huan-Ji
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Bernfort, Lars
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Levin, Lars-Åke
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Dragioti, Elena
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Pain Catastrophizing in Older Adults with Chronic Pain: The Mediator Effect of Mood Using a Path Analysis Approach2020Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, nr 7, artikel-id 2073Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cognitive models of pain propose that catastrophic thinking is negatively associated with chronic pain. However, pain catastrophizing is a complex phenomenon requiring a multivariate examination. This study estimates the effects of mood variables (anxiety and depression) on pain catastrophizing in older adults with chronic pain. A postal survey addressing pain aspects was sent to 6611 people &gt;= 65 years old living in south-eastern Sweden. Pain catastrophizing was measured using the pain catastrophizing scale. Anxiety and depression were assessed using two subscales of the general well-being schedule. Data were analysed using a path analysis approach. A total of 2790 respondents (76.2 +/- 7.4 years old) reported chronic pain (&gt;= three months). The mediation model accounted for 16.3% of anxiety, 17.1% of depression, and 30.9% of pain catastrophizing variances. Pain intensity, insomnia, number of comorbidities, and lifestyle factors (smoking, alcohol consumption, and weight) significantly affected both pain catastrophizing and mood. Anxiety (standardized path coefficient (b(std)) = 0.324,p&lt; 0.001) in comparison to depression (b(std)= 0.125,p&lt; 0.001) had a greater effect on pain catastrophizing. Mood mediated the relationship between pain catastrophizing and pain-related factors accounting for lifestyle and sociodemographic factors.

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  • 335.
    Dove, Abigail
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Guo, Jie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Calderón-Larrañaga, Amaia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Vetrano, Davide Liborio
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Xu, Weili
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Association between social isolation and reduced mental well-being in Swedish older adults during the first wave of the COVID-19 pandemic: the role of cardiometabolic diseases2022Ingår i: Aging, ISSN 1945-4589, E-ISSN 1945-4589, Vol. 14, nr 6, s. 2462-2474Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Social isolation has been recommended as a strategy for reducing COVID-19 risk, but it may have unintended consequences for mental well-being. We explored the relationship between social isolation and symptoms of depression and anxiety in older adults during the first wave of the COVID-19 pandemic and assessed the role of cardiometabolic diseases (CMDs) in this association. Between May and September 2020, 1,190 older adults from the Swedish National Study on Aging and Care in Kungsholmen were surveyed about their behaviors and health consequences during the first wave of the COVID-19 pandemic. In total, 913 (76.7%) participants reported socially isolating at home to avoid infection during this period. Social isolation was associated with a greater likelihood of reduced mental well-being (i.e., feelings of depression or anxiety) (OR: 1.74, 95% CI: 1.15-2.65). In joint exposure analysis, there was a significant likelihood of reduced mental well-being only among people who were socially isolating and had CMDs (OR: 2.13, 95% CI: 1.22-3.71) (reference: not isolating, CMD-free). In conclusion, social isolation as a COVID-19 prevention strategy was related to reduced mental well-being in an urban sample of Swedish older adults, especially among individuals with CMDs.

  • 336.
    Dragioti, Elena
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Bernfort, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Larsson, Britt
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Levin, Lars-Åke
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Association of insomnia severity with well-being, quality of life and health care costs: A cross-sectional study in older adults with chronic pain (PainS65+)2018Ingår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 22, nr 2, s. 414-425Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundInsomnia is one of the most common complaints in chronic pain. This study aimed to evaluate the association of insomnia with well-being, quality of life and health care costs. MethodsThe sample included 2790 older individuals (median age=76; interquartile range [IQR]=70-82) with chronic pain. The participants completed a postal survey assessing basic demographic data, pain intensity and frequency, height, weight, comorbidities, general well-being, quality of life and the insomnia severity index (ISI). Data on health care costs were calculated as costs per year (Euro prices) and measured in terms of outpatient and inpatient care, pain drugs, total drugs and total health care costs. ResultsThe overall fraction of clinical insomnia was 24.6% (moderate clinical insomnia: 21.9% [95% CI: 18.8-23.3]; severe clinical insomnia: 2.7% [95% CI: 1.6-3.2]). Persons who reported clinical insomnia were more likely to experience pain more frequently with higher pain intensity compared to those reported no clinically significant insomnia. Mean total health care costs were Euro 8469 (95% CI: Euro4029-Euro14,271) for persons with severe insomnia compared with Euro 4345 (95% CI: Euro4033-Euro4694) for persons with no clinically significant insomnia. An association between severe insomnia, well-being, quality of life, outpatient care, total drugs costs and total health care costs remained after controlling for age, sex, pain intensity, frequency, body mass index and comorbidities using linear regression models. ConclusionsOur results determine an independent association of insomnia with low health-related quality of life and increased health care costs in older adults with chronic pain. SignificanceThe concurrence and the severity of insomnia among older adults with chronic pain were associated with decreased well-being and quality of life, and increased health care costs to society.

  • 337.
    Du Toit, Sanetta
    et al.
    University of Sydney.
    Rosenberg, Lena
    Karolinska Institutet, Stockholm, Sweden.
    Mondaca, Margarita
    Karolinska Institutet, Stockholm, Sweden.
    Lovarini, Meryl
    University of Sydney.
    Unpacking the concept of person-centred care within OT in dementia care2018Konferensbidrag (Refereegranskat)
    Abstract [en]

    Person-centred care (PCC), especially for frail and vulnerable elders with advanced dementia, remains in many ways an elusive concept. There appears to be a persistent strain between the medical and social models of care in institutionalised environments that strives to provide the last homely comforts to the people living there. A scoping review was conducted to determine how PCC is reflected by occupational therapy (OT) practice.

    The scoping review methodology followed guidelines by Arksey and O’Malley (2005). Eligibility criteria include peer-reviewed studies published between 1995 and 2015 focusing on OT within aged residential care with people who have moderate to severe cognitive impairment associated with dementia. Studies retrieved from the searches were first independently screened for relevance and then assessed for inclusion. Relevant data were extracted and summarised using a critical interpretive synthesis developed for this study.

    Key characteristics of each study will be presented to demonstrate how the advancement of PCC is supported or inhibited.

    PCC that is reflective of occupational engagement and supports natural scenarios of everyday life is paramount when providing services in someone’s last home. The diverse nature and holistic approach of OT; a history evident of pressure to conform to the medical model; and expanding into new areas of practice delivery continue to impact the day-to-day business of OT. In our efforts to contribute as professionals within institutional dementia care settings for older persons, we need to consider how we can better support and expand our services to reflect the essence of PCC.

  • 338. Duggan, Emily C.
    et al.
    Piccinin, Andrea M.
    Clouston, Sean
    Koval, Andriy V.
    Robitaille, Annie
    Zammit, Andrea R.
    Wu, Chenkai
    Brown, Cassandra L.
    Lee, Lewina O.
    Finkel, Deborah
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Psychology, Indiana University Southeast, New Albany, IN, USA.
    Beasley, William H.
    Kaye, Jeffrey
    Muniz-Terrera, Graciela
    Katz, Mindy
    Lipton, Richard B.
    Deeg, Dorly
    Bennett, David A.
    Björk, Marcus Praetorius
    Johansson, Boo
    Spiro, Avron
    Weuve, Jennifer
    Hofer, Scott M.
    A multi-study coordinated meta-analysis of pulmonary function and cognition in aging2019Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 74, nr 11, s. 1793-1804Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Substantial research is dedicated to understanding the aging-related dynamics among individual differences in level, change, and variation across physical and cognitive abilities. Evaluating replicability and synthesizing these findings has been limited by differences in measurements and samples, and by study design and statistical analyses confounding between-person differences with within-person changes. In this paper, we conducted a coordinated analysis and summary meta-analysis of new results on the aging-related dynamics linking pulmonary function and cognitive performance.

    METHODS: We performed coordinated analysis of bivariate growth models in data from 20,586 participants across eight longitudinal studies to examine individual differences in baseline level, rate of change, and occasion-specific variability in pulmonary and cognitive functioning. Results were summarized using meta-analysis.

    RESULTS: We found consistent but weak baseline and longitudinal associations in levels of pulmonary and cognitive functioning, but no associations in occasion-specific variability.

    CONCLUSIONS: Results provide limited evidence for a consistent link between simultaneous changes in pulmonary and cognitive function in a normal aging population. Further research is required to understand patterns of onset of decline and differences in rates of change within and across physical and cognitive functioning domains, both within-individuals and across countries and birth cohorts. Coordinated analysis provides an efficient and rigorous approach for replicating and comparing results across independent longitudinal studies.

  • 339.
    Dunér, Anna
    et al.
    Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    Bångsbo, Angela
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. Department of Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Olsson, Tina M.
    Jönköping University, HHJ, Avdelningen för socialt arbete.
    TalkingMats as a decision aid to promote involvement in choice and decision-making around home care services for older people with mild to moderate dementia - study protocol for a randomized controlled trial2023Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, nr 1, artikel-id 244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In Sweden, 72% of people with dementia live in ordinary housing. Of these, 50% receive home care services. Older people with dementia may benefit from developments in decision-making support which aim to facilitate their ability to communicate their personal needs and preferences with care managers and staff in home care services. In this study, we will test and evaluate the use of TalkingMats in Swedish municipal home care services for older people with mild to moderate dementia. TalkingMats is a low-technology communication tool, to help people with communication difficulties express their views. It uses a simple system of picture symbols which are placed on a textured mat. This study will provide insight into the extent to which TalkingMats benefits older people with dementia to feel more involved in decisions related to home care services. In addition, this study will assess the extent to which the use of TalkingMats promotes service providers' efforts to involve service recipients in decision making. The implementation of TalkingMats in home care services will also be studied.

    METHODS: A parallel group, two-armed randomized controlled trial design in which TalkingMats and Usual Conversation Method will be compared. Two specific situations where older people with dementia must make decisions about home care services will be studied. First, a follow-up needs-assessment conversation between study participants and care managers will be studied. Second, a conversation between participants and home care staff regarding the delivery of the decided home care services will be studied. In addition, a qualitative approach will be used to gain an understanding of study participant and service provider experiences of the impact and implementation of TalkingMats.

    DISCUSSION: The combined exploratory, descriptive, and experimental study design is considered an important strength which will facilitate multi-facetted knowledge production concerning the involvement and communication needs of older people with dementia generally and within the context of home care services specifically. Combining qualitative and quantitative methods will maximize our ability to assess the effects of TalkingMats.

    TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05561998 . Registered in September 28, 2022.

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  • 340.
    Dunér, Anna
    et al.
    Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    Bångsbo, Angela
    Department of Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Olsson, Tina M.
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för socialt arbete. Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    TalkingMats as a decision aid to promote involvement in choice and decision-making around home care services for older people with mild to moderate dementia - study protocol for a randomized controlled trial [protocol]2023Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, nr 1, artikel-id 244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In Sweden, 72% of people with dementia live in ordinary housing. Of these, 50% receive home care services. Older people with dementia may benefit from developments in decision-making support which aim to facilitate their ability to communicate their personal needs and preferences with care managers and staff in home care services. In this study, we will test and evaluate the use of TalkingMats in Swedish municipal home care services for older people with mild to moderate dementia. TalkingMats is a low-technology communication tool, to help people with communication difficulties express their views. It uses a simple system of picture symbols which are placed on a textured mat. This study will provide insight into the extent to which TalkingMats benefits older people with dementia to feel more involved in decisions related to home care services. In addition, this study will assess the extent to which the use of TalkingMats promotes service providers' efforts to involve service recipients in decision making. The implementation of TalkingMats in home care services will also be studied.

    METHODS: A parallel group, two-armed randomized controlled trial design in which TalkingMats and Usual Conversation Method will be compared. Two specific situations where older people with dementia must make decisions about home care services will be studied. First, a follow-up needs-assessment conversation between study participants and care managers will be studied. Second, a conversation between participants and home care staff regarding the delivery of the decided home care services will be studied. In addition, a qualitative approach will be used to gain an understanding of study participant and service provider experiences of the impact and implementation of TalkingMats.

    DISCUSSION: The combined exploratory, descriptive, and experimental study design is considered an important strength which will facilitate multi-facetted knowledge production concerning the involvement and communication needs of older people with dementia generally and within the context of home care services specifically. Combining qualitative and quantitative methods will maximize our ability to assess the effects of TalkingMats.

    TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05561998 . Registered in September 28, 2022.

  • 341. Dybjer, E.
    et al.
    Dahl Aslan, Anna K.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Nilsson, P.
    Hassing, L.
    Trajectories of survival in men with type 1 diabetesfFollowed for 56 years after conscript testing at 18 years of age2019Konferensbidrag (Refereegranskat)
  • 342.
    Eckerblad, Jeanette
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Symptom burden among people with chronic disease2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction: Chronic diseases tend to increase with old age. Older people with chronic disease are commonly suffering from conditions which produce a multiplicity of symptoms and a decreased health-related quality of life. Nurses have a responsibility to prevent, ease or delay a negative outcome through symptom management, or assist in achieving an acceptable level of symptom relief.

    Aim: The overall aim of the thesis was to describe different aspects of symptom burden from the perspective of community-dwelling people with chronic disease.

    Methods: This thesis is based upon four papers that used both quantitative and qualitative data to describe different aspects of symptom burden, experienced by people with chronic diseases. Paper (I) is a cross-sectional study with 91 participants diagnosed with chronic obstructive pulmonary disease. Papers (II and IV) are based upon secondary outcome data from a randomized controlled trial with 382 community-dwelling older people with multimorbidity. Paper (II) is a cross-sectional study and Paper (IV) has a descriptive and an explorative design reporting on the trajectory of symptom prevalence and symptom burden. Paper (III) is a qualitative study with participants from the AGe-FIT.

    Results: Among people diagnosed with COPD the most prevalent symptoms with the highest symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy, with just a few differences between participants with moderate and severe airflow limitation (I). For older people with multimorbidity, pain was the symptom with the highest prevalence and burden. Other highly prevalent symptoms were lack of energy and a dry mouth. Poor vision, likelihood of depression, and diagnoses of the digestive system were independently related to the total symptom burden score (II). The symptoms experienced by the older people were persistent and the symptom burden remained high over time (IV). The experience of living with a high symptom burden was described as an endless struggle. The analysis revealed an overall theme, “To adjust and endure” and three sub-themes, “to feel inadequate and limited”, “to feel dependent”, and “to feel dejected” (III).

    Conclusions: The results of this thesis indicate the importance of early symptom identification. People with chronic diseases have an unmet need for optimized treatment that focuses on the total symptom burden, and not only disease specific symptoms. A large proportion of older people with multimorbidity suffer a high and persistent symptom burden, and the prevalence and trajectory of pain are high. Older people sometimes think their high age is the reason they experience a diversity of symptoms, and they do not always communicate these to their health-care provider.

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  • 343.
    Eckerblad, Jeanette
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Theander, Kersti
    Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, Karlstad, Sweden.
    Ekdahl, Anne
    Geriatric Medicine, Department of Research and Education, Helsingborg Hospital, Sweden; Division of Clinical Geriatrics, Departmentof Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm,Sweden .
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Symptom trajectory and symptom burden in older people with multimorbidity, secondary outcome from the RCT AGe-FIT study2016Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 11, s. 2773-2783Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    The aim of this study was to follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment.

    Background

    Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health-related quality of life. There is a need to move from a single-disease model and address the complexity of older people living with multimorbidity.

    Design

    Secondary outcome data from the randomized controlled Ambulatory Geriatric Assessment Frailty Intervention Trial (AGe-FIT).

    Methods

    Symptom trajectory of 31 symptoms was assessed with the Memorial Symptom Assessment Scale. Data from 247 participants were assessments at baseline, 12 and 24 months, 2011–2013. Participants in the intervention group received care from an ambulatory geriatric care unit based on comprehensive geriatric assessment in addition to usual care.

    Results

    Symptom prevalence and symptom burden were high and stayed high over time. Pain was the symptom with the highest prevalence and burden. Over the 2-year period 68–81% of the participants reported pain. Other highly prevalent and persistent symptoms were dry mouth, lack of energy and numbness/tingling in the hands/feet, affecting 38–59% of participants. No differences were found between the intervention and control group regarding prevalence, burden or trajectory of symptoms.

    Conclusions

    Older community-dwelling people with multimorbidity had a persistent high burden of symptoms. Receiving advanced interdisciplinary care at an ambulatory geriatric unit did not significantly reduce the prevalence or the burden of symptoms.

  • 344.
    Eckerblad, Jeanette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Theander, Kersti
    Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, Karlstad, Sweden.
    Ekdahl, Anne
    Region Östergötland, Närsjukvården i centrala Östergötland, Geriatriska kliniken. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Hellström, Iingrid
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Ersta Sköndal University College, Stockholm, Sweden.
    To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity2015Ingår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 28, nr 4, s. 322-327Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life. Objectives The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.

    Method A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden. The participants were 79-€“89 years old with a mean of 12 symptoms per person. Data were analyzed using content analyses.

    Results The experience of living with a high symptom burden revealed the overall theme, “To adjust and endure” and three sub-themes. The first sub-theme was "To feel inadequate and limited". Participants reported that they no longer had the capacity or the ability to manage, and they felt limited and isolated from friends or family. The second sub-theme was "To feel dependent". This was a new and inconvenient experience; the burden they put on others caused a feeling of guilt. The final sub-theme was "To feel dejected". The strength to manage and control their conditions was gone; the only thing left to do was to sit or lie down and wait for it all to pass.

    Conclusion This study highlights the importance of a holistic approach when taking care of older people with multi-morbidity. This approach should employ a broad symptom assessment to reveal diseases and conditions that are possible to treat or improve.

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  • 345.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Du kan själv ta hand om besvär med hälsan2009Ingår i: Livslots för äldre, Vårdalsinstitutet , 2009, s. 46-63Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 346.
    Edberg, Anna-Karin
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Landahl, Sten
    Hur du använder läkemedel2009Ingår i: Livslots för seniorer, Stockholm: Hjälpmedelsinstitutet , 2009, 1, s. 65-75Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 347.
    Edholm, Peter
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Strandberg, Emelie
    Örebro universitet, Institutionen för hälsovetenskaper.
    Kadi, Fawzi
    Örebro universitet, Institutionen för hälsovetenskaper.
    A healthy diet rich in N-3 PUFAS enhances the effects of resistance training in elderly women2017Konferensbidrag (Refereegranskat)
  • 348.
    Edholm, Peter
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Strandberg, Emelie
    Örebro universitet, Institutionen för hälsovetenskaper.
    Kadi, Fawzi
    Örebro universitet, Institutionen för hälsovetenskaper.
    A healthy diet rich in N-3 PUFAS enhances the effects of resistance training in elderly women2017Konferensbidrag (Refereegranskat)
  • 349.
    Edvardsson, Bo
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    ADL (activities of daily living) och inlärningsprinciper1976Övrigt (Övrig (populärvetenskap, debatt, mm))
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  • 350.
    Edvardsson, Bo
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. Högskolan i Örebro, Institutionen för psykologi och pedagogik.
    Försök med geriatrisk aktivering1976Övrigt (Övrigt vetenskapligt)
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