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  • 1. Arfwidson, Samuel
    et al.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Nordqvist, Persy
    Vårdbehov, sjukdomsdiagnoser och medicinkonsumtion bland äldre på ålderdomshem i Jönköpings län: en 7-årsuppföljning1976Report (Other (popular science, discussion, etc.))
  • 2.
    Bengnér, Malin
    et al.
    Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
    Béziat, Vivien
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ernerudh, Jan
    Division of Clinical Immunology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Nilsson, Bengt-Olof
    Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Department of Laboratory Medicine, Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Wikby, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Malmberg, Karl Johan
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Strindhall, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Independent skewing of the T cell and NK cell compartments associated with cytomegalovirus infection suggests division of labor between innate and adaptive immunity.2014In: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, Vol. 36, no 2, p. 571-582Article in journal (Refereed)
    Abstract [en]

    Cytomegalovirus (CMV) infection induces profound changes in different subsets of the cellular immune system. We have previously identified an immune risk profile (IRP) where CMV-associated changes in the T cell compartment, defined as a CD4/CD8 ratio < 1, are associated with increased mortality in elderly people. Since natural killer (NK) cells have an important role in the defense against viral infections, we examined whether the expansion of CD8 + T cells seen in individuals with CD4/CD8 ratio < 1 is coupled to a parallel skewing of the NK cell compartment. A number of 151 subjects were examined with CMV serology and a flow cytometry panel for assessment of T cell and NK cell subsets. CMV-seropositive individuals had higher frequencies of CD57 + and NKG2C + NK cells and lower frequencies of NKG2A + NK cells, in line with a more differentiated NK cell compartment. Intriguingly, however, there was no correlation between CD4/CD8 ratio and NK cell repertoires among CMV-seropositive donors, despite the profound skewing of the T cell compartment in the group with CD4/CD8 ratio < 1. Conversely, donors with profound expansion of NK cells, defined as NKG2C + NK cells with high expression of CD57 and ILT-2, did not display more common changes in their T cell repertoire, suggesting that NK cell expansion is independent of the T cell-defined IRP. Altogether, these results indicate that the effect of CMV on CD8 T cells and NK cells is largely nonoverlapping and independent.

  • 3.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Gerontologi: en introduktion1986Book (Other academic)
  • 4.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Psykologi1983In: Geriatrik och långvårdsmedicin: lärobok för universitets- och högskoleutbildningar, Stockholm: Natur & Kultur , 1983, p. 73-78Chapter in book (Other academic)
  • 5.
    Berg, Stig
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Jeppson, Lena
    Val av fel vårdnivå tvingar dementa till onödiga omflyttningar1991In: Läkartidningen, Vol. 88, p. 33-36Article in journal (Refereed)
  • 6.
    Berg, Stig
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Landahl, Sten
    Steen, Bertil
    Steen, Gunilla
    SCAG-S: beteendeskattningsskala för geriatriska och psykogeriatriska patienter : en svensk version1980Report (Other (popular science, discussion, etc.))
  • 7.
    Berg, Stig
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Norlin, Eva
    Olsson, Agneta
    Psykoterapi och andra metoder vid psykologisk behandling av äldre1974Report (Other academic)
  • 8.
    Bouillon, Kim
    et al.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, UK.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, UK.
    Sabia, Severine
    Department of Epidemiology and Public Health, University College London, London, UK.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, UK.
    Gale, Catharine R.
    MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, UK.
    Measures of frailty in population-based studies: An overview2013In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 13, no 64Article in journal (Refereed)
    Abstract [en]

    Background: Although research productivity in the field of frailty has risen exponentially in recent years, there remains a lack of consensus regarding the measurement of this syndrome. This overview offers three services: first, we provide a comprehensive catalogue of current frailty measures; second, we evaluate their reliability and validity; third, we report on their popularity of use.

    Methods: In order to identify relevant publications, we searched MEDLINE (from its inception in 1948 to May 2011); scrutinized the reference sections of the retrieved articles; and consulted our own files. An indicator of the frequency of use of each frailty instrument was based on the number of times it had been utilized by investigators other than the originators.

    Results: Of the initially retrieved 2,166 papers, 27 original articles described separate frailty scales. The number (range: 1 to 38) and type of items (range of domains: physical functioning, disability, disease, sensory impairment, cognition, nutrition, mood, and social support) included in the frailty instruments varied widely. Reliability and validity had been examined in only 26% (7/27) of the instruments. The predictive validity of these scales for mortality varied: for instance, hazard ratios/odds ratios (95% confidence interval) for mortality risk for frail relative to non-frail people ranged from 1.21 (0.78; 1.87) to 6.03 (3.00; 12.08) for the Phenotype of Frailty and 1.57 (1.41; 1.74) to 10.53 (7.06; 15.70) for the Frailty Index. Among the 150 papers which we found to have used at least one of the 27 frailty instruments, 69% (n = 104) reported on the Phenotype of Frailty, 12% (n = 18) on the Frailty Index, and 19% (n = 28) on one of the remaining 25 instruments.

    Conclusions: Although there are numerous frailty scales currently in use, reliability and validity have rarely been examined. The most evaluated and frequently used measure is the Phenotype of Frailty.

  • 9.
    Broström, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Wahlin, Åke
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Alehagen, Urban
    Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Sweden.
    Ulander, Martin
    Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden.
    Johansson, Peter
    Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Sweden.
    Sex-Specific Associations Between Self-reported Sleep Duration, Cardiovascular Disease, Hypertension, and Mortality in an Elderly Population2018In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 5, p. 422-428Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Both short and long sleep durations have been associated to increased mortality. Knowledge about sex-specific differences among elderly regarding associations between sleep duration, cardiovascular health, and mortality is sparse.

    OBJECTIVE: The aims of this study are to examine the association between self-reported sleep duration and mortality and to investigate whether this association is sex specific and/or moderated by cardiovascular morbidity, and also to explore potential mediators of sleep duration effects on mortality.

    METHODS: A population-based, observational, cross-sectional design with 6-year follow-up with mortality as primary outcome was conducted. Self-rated sleep duration, clinical examinations, echocardiography, and blood samples (N-terminal fragment of proBNP) were collected. A total of 675 persons (50% women; mean age, 78 years) were divided into short sleepers (≤6 hours; n = 231), normal sleepers (7-8 hours; n = 338), and long sleepers (≥9 hours; n = 61). Data were subjected to principal component analyses. Cardiovascular disease (CVD) and hypertension factors were extracted and used as moderators and as mediators in the regression analyses.

    RESULTS: During follow-up, 55 short sleepers (24%), 68 normal sleepers (20%), and 21 long sleepers (34%) died. Mediator analyses showed that long sleep was associated with mortality in men (hazard ratio [HR], 1.8; P = .049), independently of CVD and hypertension. In men with short sleep, CVD acted as a moderator of the association with mortality (HR, 4.1; P = .025). However, when using N-terminal fragment of proBNP, this effect became nonsignificant (HR, 3.1; P = .06). In woman, a trend to moderation involving the hypertension factor and short sleep was found (HR, 4.6; P = .09).

    CONCLUSION: Short and long sleep duration may be seen as risk markers, particularly among older men with cardiovascular morbidity.

  • 10.
    Dahl, Anna
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Hassing, Linda
    Göteborgs Universitet, Psykologiska institutionen.
    Fransson, Eleonor
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Gatz, Margaret
    University of Southern California.
    Reynolds, Chandra
    University of California Riverside.
    Pedersen, Nancy
    Karolinska Institutet.
    Midlife body mass index and late life cognitive functioning: findings from the Swedish Adoption/Twin Study of Aging2008In: Conference of Life History Research Society, 2008Conference paper (Refereed)
  • 11.
    Dahl, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Löppönen, Minna
    Åbo University.
    Isoaho, Raimo
    Åbo University.
    Berg, Stig
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Kivelä, Sirkka-Lisa
    Åbo University.
    Overweight and obesity in old age are not associated with greater dementia risk2008In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 56, no 12, p. 2261-2266Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

  • 12.
    Derwinger, Anna
    et al.
    Section of Psychology, Stockholm Gerontology Research Center and Department of Geriatric Epidemiology, Neurotec, Karolinska Institute.
    Stigsdotter Neely, Anna
    Section of Psychology, Stockholm Gerontology Research Center and Department of Geriatric Epidemiology, Neurotec, Karolinska Institute.
    Persson, Marie
    Section of Psychology, Stockholm Gerontology Research Center and Department of Geriatric Epidemiology, Neurotec, Karolinska Institute.
    Hill, Robert D.
    Department of Educational Psychology, University of Utah.
    Bäckman, Lars
    Section of Psychology, Stockholm Gerontology Research Center and Department of Geriatric Epidemiology, Neurotec, Karolinska Institute.
    Remembering Numbers in Old Age: Mnemonic Training Versus Self-Generated Strategy Training2003In: Aging, Neuropsychology and Cognition, ISSN 1382-5585, E-ISSN 1744-4128, Vol. 10, no 3, p. 202-214Article in journal (Refereed)
    Abstract [en]

    The effectiveness of two memory training programs designed to enhance four-digit number recall was examined in 90 healthy older adults. One group received instruction and training in the number-consonant mnemonic, whereas another group was instructed to adopt their own encoding and retrieval strategies to enhance number recall. Also, a control group receiving no training between testing occasions was included. The criterion task was administered according to the Buschke selective reminding procedure. Posttest performance was evaluated with and without cognitive support for remembering (i.e., verbal cues). Under unsupported conditions, the mnemonic group improved number recall following training and the selfgenerated strategy group showed a tendency in the same direction. When support was provided, group differences in favor of the two training groups increased. In addition, no training-related gains were observed in two verbal transfer tasks. The relatively similar patterns of gains in the two intervention groups were discussed in terms of advantages and disadvantages in the two training regimens balancing each other.

  • 13.
    Ek, Kristina
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Skövde, Institutionen för hälsa och lärande.
    Eriksson, Monika
    Skaraborg Hospital, Skövde, Sweden.
    Eriksson, Irene
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Healthcare providers’ experiences of assessing and performing oral care in older adults2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12189Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    The purpose of this study was to describe healthcare providers’ experiences, knowledge and attitudes in relation to the assessment of oral health in older adults.

    Background

    Oral health is an important element in the care of older adults. An increasing proportion of older people need the help and support of community‐based healthcare services, which are responsible for providing oral health assessment for this group. Although oral care is an important part of nursing care, studies show that it is often an overlooked area in the care of older people.

    Design

    An inductive qualitative description design was used.

    Methods

    The participating healthcare providers were selected from a municipality in western Sweden. Purposeful sampling was employed and data were collected through focus‐group interviews and were analysed with content analysis.

    Results

    The analysis resulted in four categories: healthcare providers’ knowledge and attitudes to oral health; routines affect flexibility; challenges in assessing and performing oral care and ethical dilemmas. The results showed that oral health was neglected because of several factors. Lack of knowledge, inadequate procedures and time constraints were most prominent. The healthcare providers’ own attitudes affected the performing of oral health assessments. Ethical dilemmas related to the attitudes of those people in receipt of care and their relatives, and their integrity and autonomy, could be seen as complicating factors.

    Conclusions

    The healthcare providers expressed that they did not have the necessary knowledge of oral health that was required in their area of responsibility. In addition, they described their own attitudes as being important when attending to the patients’ oral health.

    Implications for practice

    The healthcare providers themselves identified lack of knowledge and their own attitudes as being especially important factors in the oral care of older adults, and further research in this area is needed.

  • 14.
    Enache, D.
    et al.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Fereshtehnejad, S.-M.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Cermakova, P.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Garcia-Ptacek, S.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Johnell, K.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Religa, D.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Jelic, V.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Winblad, B.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Ballard, C.
    Wolfson Centre for Age-Related Diseases, King's College London, London, United Kingdom.
    Aarsland, D.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Fastbom, J.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksdotter, M.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Antidepressants and mortality risk in a dementia cohort: data from SveDem, the Swedish Dementia Registry2016In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 134, no 5, p. 430-440Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The association between mortality risk and use of antidepressants in people with dementia is unknown.

    OBJECTIVE: To describe the use of antidepressants in people with different dementia diagnoses and to explore mortality risk associated with use of antidepressants 3 years before a dementia diagnosis.

    METHODS: Study population included 20 050 memory clinic patients from the Swedish Dementia Registry (SveDem) diagnosed with incident dementia. Data on antidepressants dispensed at the time of dementia diagnosis and during 3-year period before dementia diagnosis were obtained from the Swedish Prescribed Drug Register. Cox regression models were used.

    RESULTS: During a median follow-up of 2 years from dementia diagnosis, 25.8% of dementia patients died. A quarter (25.0%) of patients were on antidepressants at the time of dementia diagnosis, while 21.6% used antidepressants at some point during a 3-year period before a dementia diagnosis. Use of antidepressant treatment for 3 consecutive years before a dementia diagnosis was associated with a lower mortality risk for all dementia disorders and in Alzheimer's disease.

    CONCLUSION: Antidepressant treatment is common among patients with dementia. Use of antidepressants during prodromal stages may reduce mortality in dementia and specifically in Alzheimer's disease.

  • 15.
    Enache, Daniela
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
    Solomon, Alina
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden, and Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
    Cavallin, Lena
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Kramberger, Milica Gregoric
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden, and Department of Neurology, University Medical Centre, Ljubljana, Slovenia.
    Aarsland, Dag
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden, and Center for Age-Related Diseases, Psychiatric Clinic, Stavanger University Hospital, Stavanger, Norway.
    Kivipelto, Miia
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden, and Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
    Eriksdotter, Maria
    Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
    Winblad, Bengt
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
    Jelic, Vesna
    Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
    CAIDE Dementia Risk Score and biomarkers of neurodegeneration in memory clinic patients without dementia2016In: Neurobiology of Aging, ISSN 0197-4580, E-ISSN 1558-1497, Vol. 42, p. 124-131Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore cross-sectional associations between Cardiovascular Risk Factors, Aging and Dementia Study (CAIDE) Dementia Risk Score and dementia-related cerebrospinal fluid and neuroimaging biomarkers in 724 patients without dementia from the Memory Clinic at Karolinska University Hospital, Huddinge, Sweden. We additionally evaluated the score's capacity to predict dementia. Two risk score versions were calculated: one including age, gender, obesity, hyperlipidemia, and hypertension; and one additionally including apolipoprotein E (APOE) ε4 carrier status. Cerebrospinal fluid was analyzed for amyloid β (Aβ), total tau, and phosphorylated tau. Visual assessments of medial temporal lobe atrophy (MTA), global cortical atrophy-frontal subscale, and Fazekas scale for white matter changes (WMC) were performed. Higher CAIDE Dementia Risk Score (version without APOE) was significantly associated with higher total tau, more severe MTA, WMC, and global cortical atrophy-frontal subscale. Higher CAIDE Dementia Risk Score (version with APOE) was associated with reduced Aβ, more severe MTA, and WMC. CAIDE Dementia Risk Score version with APOE seemed to predict dementia better in this memory clinic population with short follow-up than the version without APOE.

  • 16.
    Ericsson, Iréne
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Malmberg, Bo
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Läkemedelsgenomgång på boendet Blomstervägen i Gislaved 2008 och 2009.2010Other (Other (popular science, discussion, etc.))
  • 17.
    Ericsson, Iréne
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Persson, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Hanson, Elizabeth
    Linnéuniversitetet.
    Anhöriga till äldre personer med psykisk ohälsa: Kunskapsöversikt2016Report (Other academic)
    Abstract [sv]

    Efter slutfört arbete med denna kunskapsöversikt kan vi som så många före oss konstatera att området psykisk ohälsa hos äldre fortfarande är ett eftersatt område inom vård och omsorg och också vad gäller forskning. I kunskapsöversikten var syftet att fokusera på situationen att vara anhörig till en äldre person med psykisk ohälsa. Psykisk ohälsa hos äldre skiljer sig från psykisk ohälsa hos yngre vuxna. Därför kan det finnas anledning att tro att behovet av stöd hos anhöriga till äldre personer med psykisk ohälsa kan se annorlunda ut än stöd till anhöriga till personer med psykisk ohälsa i andra åldersgrupper. I studier som gjorts med fokus på anhöriga till personer med psykisk ohälsa, både nationellt och internationellt, utgör anhöriga till äldre personer med psykisk ohälsa oftast bara en liten del av materialet. Resultatet visar att olika typer av stöd till anhöriga från den formella vårdens sida behövs vid olika skeden av psykisk ohälsa och att de anhöriga ibland kan ha ett livslångt ansvar. Rollen som anhörig påverkas också av att personen med psykisk ohälsa åldras, och att psykisk och fysiska hälsa samt funktionsförmåga i vardagen förändras i och med åldrandet. Detta understryker vikten av ett personcentrerat synsätt för denna grupp äldre och deras anhöriga. För att kunna stödja anhöriga till äldre personer med psykiska hälsa krävs enligt kunskapsöversiktens resultat mer utbildning, information och utveckling av andra stödåtgärder för alla inblandade parter.

  • 18.
    Ernsth Bravell, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Malmberg, Bo
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Berg, Stig
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    End of life care in the oldest old2010In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 8, p. 335-344Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to describe the last year of life of a sample of the oldest old, focusing on care trajectories, health, social networks, and function in daily life activities.

    METHOD: Data originated from the NONA study, a longitudinal study of 193 individuals among the oldest old living in a Swedish municipality. During this longitudinal study, 109 participants died. Approximately one month after their death, a relative was asked to participate in a telephone interview concerning their relative's last year of life. One hundred two relatives agreed to participate.

    RESULTS: Most of the elderly in this sample of the oldest old (74.5%) died at an institution and the relatives were mostly satisfied with the end-of-life care. The oldest old relatives estimated that the health steadily declined during the last year of life, and that there was a decline in performing of daily life activities. They also estimated that those dying in institutions had fewer social contacts than those dying in a hospital or at home.

    SIGNIFICANCE OF RESULTS: Care at end of life for the oldest old is challenged by problems with progressive declines in ability to perform activities of daily living and health. The findings also highlight the need to support social networks at eldercare institutions.

  • 19.
    Fransson, Eleonor
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Normalt åldrande2008In: Den äldre parkinsonpatienten: Utredning, diagnostik och åtgärder för individuellt omhändertagande, Stockholm: Svensk Geriatrisk Förening , 2008, p. 7-9Chapter in book (Other (popular science, discussion, etc.))
  • 20.
    Garcia-Ptacek, Sara
    et al.
    Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden.
    Contreras Escamez, Beatriz
    Department of Geriatrics, Hospital Universitario de Getafe, Madrid, Spain.
    Zupanic, Eva
    Department of Neurology, University Medical Center, Ljubljana, Slovenia.
    Religa, Dorota
    Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
    von Koch, Lena
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Johnell, Kristina
    Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    von Euler, Mia
    Department of Clinical Science and Education, Södersjukhuset and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Eriksdotter, Maria
    Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden.
    Prestroke Mobility and Dementia as Predictors of Stroke Outcomes in Patients Over 65 Years of Age: A Cohort Study From The Swedish Dementia and Stroke Registries2018In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 19, no 2, p. 154-161Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore the association between prestroke mobility dependency and dementia on functioning and mortality outcomes after stroke in patients>65 years of age.

    Design: Longitudinal cohort study based on SveDem, the Swedish Dementia Registry and Riksstroke, the Swedish Stroke Registry.

    Participants: A total of 1689 patients with dementia >65 years of age registered in SveDem and suffering a first stroke between 2007 and 2014 were matched with 7973 controls without dementia with stroke.

    Measurements: Odds ratios (ORs) and 95% confidence intervals (CIs) for intrahospital mortality, and functioning and mortality outcomes at 3 months were calculated. Functioning included level of residential assistance (living at home without help, at home with help, or nursing home) and mobility dependency (independent, needing help to move outdoors, or needing help indoors and outdoors).

    Results: Prestroke dependency in activities of daily living and mobility were worse in patients with dementia than controls without dementia. In unadjusted analyses, patients with dementia were more often discharged to nursing homes (51% vs 20%; P < .001). Mortality at 3 months was higher in patients with dementia (31% vs 23% P < .001) and fewer were living at home without help (21% vs 55%; P < .001). In adjusted analyses, prestroke dementia was associated with higher risk of 3-month mortality (OR 1.34; 95% CI 1.18-1.52), requiring a higher level of residential assistance (OR 4.07; 3.49-.75) and suffering from more dependency in relation to mobility (OR 2.57; 2.20-3.02). Patients with dementia who were independent for mobility prestroke were more likely to be discharged to a nursing home compared with patients without dementia with the same prestroke mobility (37% vs 16%; P < .001), but there were no differences in discharge to geriatric rehabilitation (19% for both; P = .976). Patients, who moved independently before stroke, were more often discharged home (60% vs 28%) and had lower mortality. In adjusted analyses, prestroke mobility limitations were associated with higher odds for poorer mobility, needing more residential assistance, and death.

    Conclusions: Patients with mobility impairments and/or dementia present a high burden of disability after a stroke. There is a need for research on stroke interventions among these populations.

  • 21.
    Garcia-Ptacek, Sara
    et al.
    Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Cermakova, Pavla
    Division of Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Rizzuto, Debora
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Religa, Dorota
    Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
    Eriksdotter, Maria
    Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Causes of Death According to Death Certificates in Individuals with Dementia: A Cohort from the Swedish Dementia Registry.2016In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 64, no 11, p. e137-e142Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The causes of death in dementia are not established, particularly in rarer dementias. The aim of this study is to calculate risk of death from specific causes for a broader spectrum of dementia diagnoses.

    DESIGN: Cohort study.

    SETTING: Swedish Dementia Registry (SveDem), 2007-2012.

    PARTICIPANTS: Individuals with incident dementia registered in SveDem (N = 28,609); median follow-up 741 days. Observed deaths were 5,368 (19%).

    MEASUREMENTS: Information on number of deaths and causes of mortality was obtained from death certificates. Odds ratios for the presence of dementia on death certificates were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox hazards regression for cause-specific mortality, using Alzheimer's dementia (AD) as reference. Hazard ratios for death for each specific cause of death were compared with hazard ratios of death from all causes (P-values from t-tests).

    RESULTS: The most frequent underlying cause of death in this cohort was cardiovascular (37%), followed by dementia (30%). Dementia and cardiovascular causes appeared as main or contributory causes on 63% of certificates, followed by respiratory (26%). Dementia was mentioned less in vascular dementia (VaD; 57%). Compared to AD, cardiovascular mortality was higher in individuals with VaD than in those with AD (HR = 1.82, 95% CI = 1.64-2.02). Respiratory death was higher in individuals with Lewy body dementia (LBD, including Parkinson's disease dementia and dementia with Lewy bodies, HR = 2.16, 95% CI = 1.71-2.71), and the risk of respiratory death was higher than expected from the risk for all-cause mortality. Participants with frontotemporal dementia were more likely to die from external causes of death than those with AD (HR = 2.86, 95% CI = 1.53-5.32).

    CONCLUSION: Dementia is underreported on death certificates as main and contributory causes. Individuals with LBD had a higher risk of respiratory death than those with AD.

  • 22.
    Garcia-Ptacek, Sara
    et al.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Modéer, Ingrid Nilsson
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Fereshtehnejad, Seyed-Mohammad
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Farahmand, Bahman
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Religa, Dorota
    Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
    Eriksdotter, Maria
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Differences in diagnostic process, treatment and social support for Alzheimer's dementia between primary and specialist care: results from the Swedish Dementia Registry2017In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 46, no 2, p. 314-319Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: the increasing prevalence of Alzheimer's dementia (AD) has shifted the burden of management towards primary care (PC). Our aim is to compare diagnostic process and management of AD in PC and specialist care (SC).

    DESIGN: cross-sectional study.

    SUBJECTS: a total of, 9,625 patients diagnosed with AD registered 2011-14 in SveDem, the Swedish Dementia Registry.

    METHODS: descriptive statistics are shown. Odds ratios are presented for test performance and treatment in PC compared to SC, adjusted for age, sex, Mini-Mental State Examination (MMSE) and number of medication.

    RESULTS: a total of, 5,734 (60%) AD patients from SC and 3,891 (40%) from PC. In both, 64% of patients were women. PC patients were older (mean age 81 vs. 76; P < 0.001), had lower MMSE (median 21 vs. 22; P < 0.001) and more likely to receive home care (31% vs. 20%; P < 0.001) or day care (5% vs. 3%; P < 0.001). Fewer diagnostic tests were performed in PC and diagnostic time was shorter. Basic testing was less likely to be complete in PC. The greatest differences were found for neuroimaging (82% in PC vs. 98% in SC) and clock tests (84% vs. 93%). These differences remained statistically significant after adjusting for MMSE and demographic characteristics. PC patients received less antipsychotic medication and more anxiolytics and hypnotics, but there were no significant differences in use of cholinesterase inhibitors between PC and SC.

    CONCLUSION: primary and specialist AD patients differ in background characteristics, and this can influence diagnostic work-up and treatment. PC excels in restriction of antipsychotic use. Use of head CT and clock test in PC are areas for improvement in Sweden.

  • 23.
    Gustafsson, Gunnel
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Ernsth, Marie
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Förekomst och behandling av trycksår1996Report (Other academic)
  • 24.
    Hallgren, Jenny
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Risk factors for hospital readmission among Swedish older adults2018In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 9, no 5, p. 603-611Article in journal (Refereed)
    Abstract [en]

    Introduction 

    Hospital readmissions of older persons are common and often associated with complex health problems. The objectives were to analyze risk factors for readmission within 30 days from hospital discharge.

    Methods

    A prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/ Twin Study of Aging (SATSA) was conducted. During 9 years of follow-up, information on hospitalizations, readmissions and associated diagnoses were obtained from national registers. Logistic regression models controlling for age and sex were conducted to analyze risk factors for readmissions.

    Results

    Of the 772 participants, [mean age 69.7 (±11.1), 84 (63%)] were hospitalized and among these 208 (43%) had one or several readmissions within 30 days during the follow-up period. Most of the readmissions (57%) occurred within the frst week; mean days from hospital discharge to readmission was 7.9 (±6.2). The most common causes of admission and readmission were cardiovascular diseases and tumors. Only 8% of the readmissions were regarded as avoidable admissions. In a multivariate logistic regression, falling within the last 12 months (OR 0.57, p=0.039) and being a male (OR 1.84, p=0.006) increased the risk of readmission.

    Conclusions

    Most older persons that are readmitted return to hospital within the frst week after discharge. Experiencing a fall was a particular risk factor of readmission. Preventive actions should preferably take place already at the hospital to reduce the numbers of readmission. Still, it should be remembered that most readmissions were considered to be necessary.

  • 25.
    Hamedi-Shahraki, Soudabeh
    et al.
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran.
    Eshraghian, Mohammad-Reza
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran.
    Yekaninejad, Mir-Saeed
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran.
    Rasekhi, Aliakbar
    Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
    Chen, Hui
    School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, Australia.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Health-related quality of life and medication adherence in elderly patients with epilepsy.2019In: Neurologia i Neurochirurgia Polska, ISSN 0028-3843, E-ISSN 1897-4260, Vol. 53, no 2, p. 123-130Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics.

    METHODS: In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up.

    RESULTS: Medication adherence was significantly correlated with both seizure severity (β = -0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test.

    CONCLUSION: This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.

  • 26. Hassing, Linda B.
    et al.
    Dahl, Anna
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Thorvaldsson, Valgeir
    Berg, Stig
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Gatz, Margaret
    Pedersen, Nancy L.
    Johansson, Boo
    Overweight in midlife and risk of dementia: a 40-year follow-up study2009In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 33, no 8, p. 893-898Article in journal (Refereed)
    Abstract [en]

    Objective:

    This study examines whether overweight in midlife increases dementia risk later in life.

    Methods:

    In 1963 body mass index was assessed in 1152 participants of The Swedish Twin Registry, at the age of 45–65 years. These participants were later screened for dementia in a prospective study with up to 40 years follow-up. A total of 312 participants were diagnosed with dementia.

    Results:

    Logistic regression analyses adjusted for demographic factors, smoking and alcohol habits, indicated that men and women categorized as overweight in their midlife had an elevated risk of dementia (OR=1.59; 95% CI: 1.21–2.07, P=0.002), Alzheimer's disease (OR=1.71; 95% CI: 1.24–2.35, P=0.003), and vascular dementia (OR=1.55; 95% CI: 0.98–2.47, P=0.059). Further adjustments for diabetes and vascular diseases did not substantially affect the associations, except for vascular dementia (OR=1.36; 95% CI: 0.82–2.56, P=0.116), reflecting the significance of diabetes and vascular diseases in the etiology of vascular dementia. There was no significant interaction between overweight and APOE ɛ4 status, indicating that having both risk factors does not have a multiplicative effect with regard to dementia risk.

    Conclusions:

    This study gives further support to the notion that overweight in midlife increases later risk of dementia. The risk is increased for both Alzheimer's disease and vascular dementia, and follows the same pattern for men and women.

  • 27.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Futurum, Region Jönköping County, Sweden.
    Anna K., Dahl Aslan
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Stockholm, Sweden.
    Changes in nutritional status and its association with death among older persons2016Conference paper (Refereed)
    Abstract [en]

    It is well known that malnutrition is common among older persons and has a negative impact on health. Even though there is a growing literature on nutrition and aging, few studies focus on longitudinal changes in later life. The aims of this study are to characterize general nutritional status development over time, to identify clusters of nutritional status trajectories, as well as to study the association between the nutritional status trajectories and death. The baseline sample is drawn from the Screening Across the Lifespan Twins (SALT) study. All participants of SALT that had at least 3 assessments according to Mini Nutritional Status Shortform (MNA-SF) documented in the Senior Alert quality register between 2008 and 2015 were included for analyses (N=1509). At the first registration, mean age was 82.4 ± 7.5. According to MNA-SF, 13.3% persons were malnourished, 44.9% were at risk of malnutrition, and 41.8 % were well nourished. Preliminary analysis indicate that despite a general decline in nutritional status in old age, there is a large variability in the sample, making the data suitable for latent class trajectory analyses. Initial analyses also indicate that decrease in nutritional status is associated with decreased survival. Consequently, deterioration in nutritional status seems to be associated with mortality. Detecting malnutrition in older age is important in order to avoid premature death.

  • 28.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Wijk, H.
    University of Gothenburg, Sweden.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Improving nutritional status among persons with dementia by performing individualized interventions2016Conference paper (Refereed)
    Abstract [en]

    Poor nutritional status is common among persons with dementia and negatively associated with subjective health, mobility and mortality. When malnutrition occurs it is challenging to improve the nutritional status. The aim of the study was to investigate if a structured preventive care process could increase body weight, among persons with dementia at risk of malnutrition or malnourished. The structured preventive care process includes four steps which have been registered in a national quality register: 1) Risk assessment by Mini nutritional assessment-Short Form. 2) Team-based analysis of underlying causes (19 evidence-based risk factors) performed by staff including professionals like nurses, nurse assistants, occupational therapists and physiotherapists. 3)  Planning and performing interventions based on the need and problems of the individual (28 evidence-based actions) and 4) evaluation of performed interventions (body weight). A prepost design was used with body weight measured during baseline (0) and follow-up (7–106 days later). In total 526 persons with dementia at risk of malnutrition 176 The Gerontological Society of America Copyedited by: OUP at :: on January 10, 2017 http://gerontologist.oxfordjournals.org/ Downloaded from or malnourished, 65 years and older and with a care contact, were included. Results: 109 persons was registered in all four steps i.e. a team-based analysis of underlying causes have been performed. An improvement in the nutritional status was observed in these individuals (baseline Md 60.0 kg; follow-up Md 62.0  kg; p-value 0.013). No improvement was detected among those missing an analysis of underlying causes. Accordingly, by planning care in a structured way and give individualized interventions based on underlying causes can help improve nutritional status among persons with dementia at risk of malnutrition or malnourished.

  • 29.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Wijk, Helle
    Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 3, p. 292-298Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the study was to investigate the outcome of change in body weight associated with use of a structured preventive care process among persons with dementia assessed as at risk of malnutrition or malnourished. The preventive care process is a pedagogical model used in the Senior Alert (SA) quality register, where nutrition is one of the prioritized areas and includes four steps: assessment, analysis of underlying causes, actions performed and outcome.

    DESIGN: An analysis of data from SA with a pre-post design was performed.

    SETTING: The participants were living in ordinary housing or special housing in Sweden.

    PARTICIPANTS: 1912 persons, 65 years and older, registered in both SA and the dementia quality register Svedem were included.

    INTERVENTION: A national preventive care program including individualized actions.

    MEASUREMENTS: The Mini Nutritional Assessment-Short Form was used to assess nutritional status at baseline. Body weight was measured during baseline and follow-up (7-106 days after baseline).

    RESULTS: 74.3% persons were malnourished or at risk of malnutrition. Those at risk of malnutrition or malnourished who were registered in all four steps of the preventive care process, increased in body weight from baseline (Md 60.0 kg) to follow-up (Md 62.0 kg) (p=0.013). In those with incomplete registration no increase in body weight was found.

    CONCLUSION: Using all steps in the structured preventive care process seems to improve nutritional status of persons with dementia assessed as at risk of malnutrition or malnourished. This study contributes to the development of evidence-based practice regarding malnutrition and persons with dementia.

  • 30.
    Johansson, Yvonne A
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Skaraborgs Sjukhus.
    Ericsson, Iréne
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Bergh, Ingrid
    University of Skövde. Institutionen för hälsa och lärande.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs Sjukhus. Centrum för Forskning och Utveckling.
    Delirium in older hospitalized patients—signs and actions: a retrospective patient record review2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, p. 1-11, article id 43Article in journal (Refereed)
    Abstract [en]

    Background: Delirium is common in older hospitalized patients, and is associated with negative consequences for the patients, next of kin, healthcare professionals and healthcare costs. It is important to understand its clinical features, as almost 40% of all cases in hospitals may be preventable. Yet, delirium in hospitalized patients is often unrecognized and untreated. Few studies describe thoroughly how delirium manifests itself in older hospitalized patients and what actions healthcare professionals take in relation to these signs. Therefore, the aim of this study was to describe signs of delirium in older hospitalized patients and action taken by healthcare professionals, as reported in patient records.

    Methods: Patient records from patients aged ≥65 (n = 286) were retrospectively reviewed for signs of delirium, which was found in 78 patient records (27%). Additionally, these records were reviewed for action taken by healthcare professionals in relation to the patients' signs of delirium. The identified text was analyzed with qualitative content analysis in two steps.

    Results: Healthcare professionals responded only in part to older hospitalized patients’ needs of care in relation to their signs of delirium. The patients displayed various signs of delirium that led to a reduced ability to participate in their own care and to keep themselves free from harm. Healthcare professionals met these signs with a variation of actions and the care was adapted, deficient and beyond the usual care. A systematic and holistic perspective in the care of older hospitalized patients with signs of delirium was missing.

    Conclusion: Improved knowledge about delirium in hospitals is needed in order to reduce human suffering, healthcare utilization and costs. It is important to enable older hospitalized patients with signs of delirium to participate in their own care and to protect them from harm. Delirium has to be seen as a preventable adverse event in all hospitals units. To improve the prevention and management of older hospitalized patients with signs of delirium, person-centered care and patient safety may be important issues.

    Keywords: Signs of delirium, Neurocognitive disorders, Older hospitalized patients, Person-centered care, Patient safety, Patient participation, Action by healthcare professionals, Qualitative content analysis.

  • 31.
    Johansson, Yvonne A.
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Skaraborgs Sjukhus.
    Tsevis, Theofanis
    Tema åldrande, Karolinska universitetssjukhuset, Karolinska Institutet Stockholm.
    Bogdanovic, Nenad
    Tema åldrande, Karolinska universitetssjukhuset Karolinska Institutet Stockholm.
    Kenne Sarenmalm, Elisabeth
    Sahlgrenska akademin Göteborgs Universitet. Skaraborgs Sjukhus, Centrum för Forskning och Utveckling.
    Assessment of cognitive function and delirium - Lack of clinical routines2018Conference paper (Refereed)
    Abstract [en]

    Introduction: Cognitive impairment and delirium are often unidentified in hospitalized patients. Despite the fact that 40 % of all cases of delirium might be prevented, national guidelines are missing in Sweden. Study aim was to examine the routines about assessing cognitive function and delirium in a university hospital and a county hospital in Sweden.

    Methods: A web based questionnaire was developed and distributed to 58 managers. The questionnaire addressed routines for identifying cognitive impairment and delirium in clinical practice, for instance which assessment tools, and which terms were used.

    Results: The response rate was 43 % (25/58) equally distributed for nurses and physicians managers (43 and 44 %). Study findings showed that structured assessment of cognitive function and delirium were missing. Twelve managers (48 %) had established routines for assessment of cognitive function and seven (28 %) for assessment of delirium. It was unclear how the assessments were performed. Most common was free descriptions based on varying questions. Assessment tools and the term delirium were rarely used.  

    Conclusion: Established routines of assessing cognitive function and delirium are missing. Validated rapid clinical assessment tools for cognitive function and delirium are needed as well as consensus to use the term “delirium”.

  • 32.
    Karlsson, Ida K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dementia and its comorbidities: genetic and epigenetic influences2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Dementia is a multifactorial disorder of late life, characterized by memory deficits, personality changes, and impaired reasoning abilities. There is considerable co-morbidity between dementia, cardiovascular disease (CVD), and late-life depression, but the nature of the associations remains elusive. We therefore seek to investigate how genetic and epigenetic factors act, independently and in concert, to contribute to dementia as well as to its association with CVD and depression. The first two studies focused on what role specific genes play in the association between dementia, depression, and CVD. In study I, we investigated how apolipoprotein E (APOE) genotype affects the association between depression and dementia, and whether the timing of depression onset is of importance. Utilizing a nested case-control design with 804 dementia cases and 1,600 matched controls, we found that depression within ten years of dementia onset was associated with disease regardless of APOE genotype, while depression more distal to dementia was a risk factor only in carriers of the ε4 risk allele. Study II focused on the shared genetic architecture between dementia and CVD, and entailed two parts. In the first part we used data from 13,231 Swedish twins, and found that genetically predisposed CVD was a stronger risk factor for dementia compared to CVD with a lower genetic risk. In the second part of the study we utilized summary statistics from previously published genome-wide association studies to investigate the genetic overlap between Alzheimer´s disease (AD), the most common form of dementia, and coronary artery disease. We found no evidence of genetic overlap between the disorders, but that both diseases have a significant number of genes in common with lipid levels. The last two studies focused on epigenetic factors and investigated how gene specific methylation is associated with dementia. Study III focused on the APOE gene, and how methylation levels in leukocytes relate to the risk of dementia, AD, and CVD. Using data from 447 Swedish twins, we demonstrated that hypermethylation in the promoter region of the gene was associated with dementia and AD, but not with CVD. Results were similar within discordant twin pairs, and did not differ as a function of APOE genotype. In study IV, we focused on five other AD related genes that are differentially methylated in post-mortem brain samples from AD patients compared to controls. The aim was to investigate whether these differences could also be detected in blood samples collected pre-mortem. There was a significant difference in methylation of SORL1 in leukocytes from dementia patients and of BIN1 in leukocytes from AD patients. Findings were stronger in discordant twin pairs, indicating that the association cannot be attributed to genetic factors. In conclusion, the studies included in this thesis highlight the complexity of late-life comorbidities, and the importance of taking both genetic factors and the timing of disease into account when studying these associations. Furthermore, methylation of genes related to AD is of importance for dementia, and has the potential to serve both as a biomarker and identify mechanisms of disease development.

  • 33.
    Karlsson, Ida K.
    et al.
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Hagg, Sara
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Pedersen, Nancy L.
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Apolipoprotein E DNA Methylation in Dementia and Cardiovascular Disease2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55Article in journal (Refereed)
  • 34.
    Lin, Chung-Ying
    et al.
    Faculty of Health and Social Sciences, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ou, Huang-Tz
    Department of Pharmacy, National Cheng Kung University, Tainan, Taiwan.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Iran.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Sweden.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Validation of the 5-Item Medication Adherence Report Scale in Older Stroke Patients in Iran.2018In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 6, p. 536-543Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of feasible and validated measures to self-assess medication adherence for older patients with stroke. In addition, the potential determinants of medication adherence for older patients with stroke remain unclear.

    OBJECTIVES: The aims of this study were to (1) examine the psychometric properties of a 5-item questionnaire on medication adherence, specifically the 5-item Medication Adherence Report Scale (MARS-5), and (2) explore the determinants of medication adherence.

    METHODS: Stroke patients older than 65 years (N = 523) filled out the MARS-5 and the Hospital Anxiety and Depression Scale. The medication possession rate (MPR) was calculated to measure the objective medication adherence. Several clinical characteristics (stroke types, blood pressure, comorbidity, HbA1c, quantity of prescribed drugs, fasting blood glucose, and total cholesterol) and background information were collected. We used Rasch analysis with a differential item functioning test to examine psychometric properties.

    RESULTS: All 5 items in the MARS-5 fit in the same construct (ie, medication adherence), no differential item functioning items were displayed in the MARS-5 across gender, and the MARS-5 total score was strongly correlated with the MPR (r = 0.7). Multiple regression models showed that the MARS-5 and the MPR shared several similar determinants. In addition, the variance of the MARS-5 (R = 0.567) was more than that of the MPR (R = 0.300).

    CONCLUSIONS: The MARS-5 is a feasible and valid self-assessed medication adherence for older patients with stroke. In addition, several determinants were found to be related to medication adherence for older patients with stroke. Healthcare providers may want to take heed of these determinants to improve medication adherence for this population.

  • 35.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Periodontology, Centre of Oral Health Sciences, Malmö University, Malmö, Sweden.
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Ryhov, Jönköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Oral health matters for the nutritional status of older persons: A population-based study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1143-1152Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the association between oral health and nutritional status in the context of daily care for older people.

    BACKGROUND: Oral problems often increase with age and affect a person's ability to chew and swallow. They might also influence the ability to maintain a satisfactory nutritional status. Oral health awareness is therefore of great importance in nursing care for older people.

    DESIGN: A retrospective cross-sectional study.

    METHODS: Data from the Swedish quality register, Senior Alert, were used, including structured assessments of both oral and nutritional status using the Revised Oral Assessment Guide-Jönköping and the Mini Nutritional Assessment. In total, 1,156 persons (mean age: 82.8 ± 7.9) had both oral and nutritional assessments registered by the nursing staff in daily care.

    RESULTS: Approximately 29% of participants had moderate oral health problems. Another 12% had severe problems. Over 60% of the persons were considered at risk of malnutrition or were malnourished. There was a weak correlation between poor nutritional status and poor oral health, and approximately one-third of the persons who were at risk or malnourished had simultaneous oral problems. A multivariate logistic regression revealed that when problems involving voice and swallowing were present, there was also a greater possibility of being assessed as at risk of malnourishment or being malnourished.

    CONCLUSION: There is a relationship between oral health problems and nutritional status, indicating the importance of evaluating oral health status in older persons with nutritional problems.

    RELEVANCE TO CLINICAL PRACTICE: Nursing staff involved in care for older people should be aware of the importance of including regular oral health check-ups in their work. There is also a need for nursing staff members and oral health professionals to exchange knowledge.

  • 36.
    Malmberg, Bo
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Var kunskap om äldre finns1982In: Når vi ut med vår information?: kunskapsspridning om, till och av äldre : symposium i Wenner-Gren center, Stockholm 2-3 februari 1982 / [ed] Carl Ström, Yngve Zotterman, Stockholm: Liber förlag/Allmänna förlaget , 1982Conference paper (Other academic)
  • 37.
    Marseglia, Anna
    et al.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Fratiglioni, Laura
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Sweden.
    Santoni, Giola
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Sweden.
    Pedersen, Nancy L
    Department of Psychology, University of Southern California, Los Angeles, CA, United States.
    Xu, Weili
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Sweden.
    Cognitive Trajectories of Older Adults With Prediabetes and Diabetes: A Population-Based Cohort Study2018In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 73, no 3, p. 400-406Article in journal (Refereed)
    Abstract [en]

    Background: Diabetes has been linked to dementia risk; however, the cognitive trajectories in older adults with diabetes remain unclear. We aimed to investigate the effect of prediabetes and diabetes on cognitive trajectories among cognitively intact older adults in a long-term follow-up study.

    Methods: Within the Swedish Adoption/Twin Study of Aging, 793 cognitively intact older adults aged ≥50 were identified at baseline and followed for up to 23 years. Based on standardized scores from 11 cognitive tests, administered at baseline and up to seven follow-ups, four cognitive domains (verbal abilities, spatial/fluid, memory, perceptual speed) were identified by principal-component analysis. Prediabetes was defined according to blood glucose levels in diabetes-free participants. Diabetes was ascertained based on self-report, hypoglycemic medication use and blood glucose levels. Data were analyzed with linear mixed-effect models adjusting for potential confounders.

    Results: At baseline, 68 participants (8.6%) had prediabetes and 45 (5.7%) had diabetes. Compared to diabetes-free individuals, people with diabetes had a steeper decline over time in perceptual speed and verbal abilities. The annual declines in these domains were greater than the annual decline in memory. Prediabetes was associated with lower performance in memory in middle-age, but also associated with a less steep memory decline over the follow-up.

    Conclusions: Diabetes is associated with a faster decline in perceptual speed and verbal abilities, while prediabetes is associated with lower memory performance in middle-age. However, the detrimental effects of hyperglycemia seem to not affect memory over time.

  • 38.
    Meinow, Bettina
    et al.
    Karolinska Institutet.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet.
    Thorslund, Mats
    Karolinska Institutet.
    Parker, Marti G.
    Karolinska Institutet.
    Complex health problems among the oldest old in Sweden: increased prevalence rates between 1992 and 2002 and stable rates thereafter2015In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 12, no 4, p. 285-297Article in journal (Refereed)
    Abstract [en]

    Studies of health trends in older populations usually focus on single health indicators. We include multiple medical and functional indicators, which together indicate the broader impact of health problems experienced by individuals and the need for integrated care from several providers of medical and long-term care. The study identified severe problems in three health domains (diseases/symptoms, mobility, and cognition/communication) in three nationally representative samples of the Swedish population aged 77+ in 1992, 2002, and 2011 (n a parts per thousand 1900; response rate > 85 %). Institutionalized people and proxy interviews were included. People with severe problems in two or three domains were considered to have complex health problems. Results showed a significant increase of older adults with complex health problems from 19 % in 1992 to 26 % in 2002 and no change thereafter. Changes over time remained when controlling for age and sex. When stratified by education, complex health problems increased significantly for people with lower education between 1992 and 2002 and did not change significantly between 2002 and 2011. For higher-educated people, there was no significant change over time. Among the people with severe problems in the symptoms/disease domain, about half had no severe problems in the other domains. People with severe mobility problems, on the other hand, were more likely to also have severe problems in other domains. Even stable rates may imply an increasing number of very old people with complex health problems, resulting in a need for improved coordination between providers of medical care and social services.

  • 39.
    Palmer, Kathy
    et al.
    Department of Psychology,Stockholm University,Stockholm,Sweden.
    Kabir, Zarina N.
    Department of Neurobiology,Care Sciences and Society,Karolinska Institutet,Stockholm,Sweden.
    Ahmed, Tanvir
    International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
    Hamadani, Jena D.
    International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
    Cornelius, Christel
    Aging Research Centre, NVS, Karolinska Institutet, Stockholm, Sweden.
    Kivipelto, Miia
    Aging Research Centre, NVS, Karolinska Institutet, Stockholm, Sweden.
    Wahlin, Åke
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Prevalence of dementia and factors associated with dementia in rural Bangladesh: data from a cross-sectional, population-based study2014In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 26, no 11, p. 1905-1915Article in journal (Refereed)
    Abstract [en]

    Background: There are currently no published reports of dementia prevalence or factors associated with dementia occurrence in Bangladesh. The aims are to report the prevalence of definite and questionable dementia in rural Bangladesh, and examine factors potentially associated with dementia occurrence, including sociodemographic, clinical, social, and nutritional factors.

    Methods: We used data from a population-based, cross-sectional study from Matlab, in rural Bangladesh, on 471 persons aged 60+ years. Participants underwent a clinical examination including diagnosis of somatic disorders, and a structured interview including questions about sociodemographic and social factors.  Nutritional status was measured with the Mini Nutritional Assessment, and blood tests were conducted to assess a range of nutritional and clinical aspects. Age- and sex-specific dementia prevalence was calculated.  Crude and adjusted logistic regression was used to examine associations between dementia and clinical,  social, and nutritional factors. Dementia was diagnosed using a two-step procedure by physicians according to DSM-IV criteria.

    Results: The prevalence of questionable dementia was 11.5% and definite dementia was 3.6%. Dementia prevalence increased with increasing years of age (adjusted OR: 1.04; 95% CI = 1.002–1.1) and decreased with more years of education (adjusted OR: 0.8; 95% CI = 0.6–0.99). Being malnourished increased the odds of dementia almost six-fold (adjusted OR: 5.9; 95% CI = 1.3–26.3), while frequent participation in social activities was associated with a decreased odds (adjusted OR: 0.5; 95% CI = 0.2–0.9).

    Conclusions: The prevalence of dementia in rural Bangladesh is similar to other countries in the South Asia region, but lower than reports from other world regions. Malnutrition is strongly associated with dementia occurrence, and is a relevant area for future research within low-income countries.

  • 40.
    Persson, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Family caregivers of elderly people with mental illness (not dementia) – who are they?2015Conference paper (Other academic)
    Abstract [en]

    In Sweden the context of care services to elderly with mental illness is complex and takes place in primary health care, psychiatric clinics, geriatric clinics and geriatric care. This creates a situation which is hard to overview and handle for the sole family. It is also known that there is a lack of knowledge concerning symptoms of mental illness and psychiatric disorders in old age, which means that elderly people don’t get appropriate assessment, treatment and care. Mental illness in old age differs from mental illness in younger ages; the symptoms may be more complex and are often combined with somatic disorders. Physiological and psychological changes in old age also reflect the mental health, and pharmacological treatment needs to be more careful due to physiological changes in the aged body.

    These facts have an impact on the family caregivers. Family caregivers regard well-functioning formal care as a good support for them too. When the formal care doesn’t work or work poorly, or the professionals don’t coordinate the care of the aged person with mental illness, the burden is more massive for the family caregiver. It is also a fact that family caregivers of people with mental illness, despite their wishes, often serve as a coordinator for the professional care of their kindred.

    Despite the unique context of the situation for older adults and their relatives, hardly any Swedish studies about family care giving for persons with mental illness focus on family caregivers of elderly. A common pattern is instead that family caregivers of elderly people with mental illness are included in studies concerning adults with mental illness and their relatives. Considering the fact that both symptoms of mental illness in old age and the way in which elderly are taking formal care of are different comparing to younger adults, this needs to be more explored.

    The mental illness of the old person and the context of care services are two factors that influences the caregivers’ situation. Another factor is the relationship to the old person with mental illness. In the Swedish studies concerning caregivers to adults with mental illness or psychiatric diseases there is a wide range of relationships, from old spouses and siblings, to middle-aged children and young grown-up grandchildren. The relation to the person with mental illness reflects how the situation is perceived, but there is not much information to find about this over a lifespan.

    The purpose is to describe the complex situation of the family caregivers to elderly with mental illness and to outline the fact that we don’t know much about them.

  • 41.
    Rantakari, Minna-Kristiina
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Sjuksköterskans smärtidentifiering hos äldre med demenssjukdom2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
  • 42.
    Rantzow, Veronica
    et al.
    Higher Vocational Education, Helsingborg.
    Andersson, Pia
    Kristianstad University.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Occurrence of oral health problems and planned measures in dependent older people in nursing care2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 23-24, p. 4381-4389Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVE:

    To describe oral health problems and planned measures in older people receiving nursing care.

    BACKGROUND:

    Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities.

    METHODS:

    Data were obtained from the web-based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014-June 2015 were included. The Revised Oral Assessment Guide-the Jönköping (ROAG-J) was used routinely by nursing staff in nursing care facilities to measure oral health status.

    RESULTS:

    Oral assessments were made on 2,567 individuals (65.7% women). The most common oral health problem was related to "Teeth" (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were "Moistening of the mouth" (16.6%), followed by "Brushing - assistance or complete help" (13.5%).

    CONCLUSION:

    Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care.

    RELEVANCE TO CLINICAL PRACTICE:

    The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes.

  • 43. Reynolds, CA
    et al.
    Hong, MG
    Eriksson, MG
    Blennow, K
    Johansson, Boo
    Malmberg, Bo
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Gatz, Margaret
    Pedersen, Nancy
    Bennet, AM
    Prince, JA
    Sequence variation in SORL1 and dementia risk in Swedes.2010In: Neurogenetics, ISSN 1364-6745, E-ISSN 1364-6753, Vol. 11, no 1, p. 139-142Article in journal (Refereed)
  • 44. Reynolds, CA
    et al.
    Hong, MG
    Eriksson, UK
    Blennow, K
    Bennet, AM
    Johansson, Boo
    Malmberg, Bo
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Wiklund, F
    Gatz, Margaret
    Pedersen, NL
    Prince, JA
    A survey of ABCA1 sequence variation confirms association with dementia.2009In: Human Mutation, ISSN 1059-7794, E-ISSN 1098-1004, Vol. 30, no 9, p. 1348-1354Article in journal (Refereed)
  • 45.
    Rizzuto, Debora
    et al.
    Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Feldman, Adina L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Ida K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Gatz, Margaret
    Department of Psychology, University of Southern California, Los Angeles, California.
    Pedersen, Nancy L.
    Department of Psychology, University of Southern California, Los Angeles, California.
    Detection of dementia cases in two Swedish health registers: A validation study2018In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 61, no 4, p. 1301-1310Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Population-based health registers are potential assets in epidemiological research; however, the quality of case ascertainment is crucial.

    OBJECTIVE: To compare the case ascertainment of dementia, from the National Patient Register (NPR) and the Cause of Death Register (CDR) with dementia diagnoses from six Swedish population based studies.

    METHODS: Sensitivity, specificity, and positive predictive value (PPV) of dementia identification in NPR and CDR were estimated by individual record linkage with six Swedish population based studies (n = 19,035). Time to detection in NPR was estimated using data on dementia incidence from longitudinal studies with more than two decades of follow-up.

    RESULTS: Barely half of the dementia cases were ever detected by NPR or CDR. Using data from longitudinal studies we estimated that a record with a dementia diagnosis appears in the NPR on average 5.5 years after first diagnosis. Although the ability of the registers to detect dementia cases was moderate, the ability to detect non-dementia cases was almost perfect (99%). When registers indicate that there is a dementia diagnosis, there are very few instances in which the clinicians determined the person was not demented. Indeed, PPVs were close to 90%. However, misclassification between dementia subtype diagnoses is quite common, especially in NPR.

    CONCLUSIONS: Although the overall sensitivity is low, the specificity and the positive predictive value are very high. This suggests that hospital and death registers can be used to identify dementia cases in the community, but at the cost of missing a large proportion of the cases.

  • 46.
    Roheger, Mandy
    et al.
    University Hospital Cologne, Germany.
    Zupanic, Eva
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Religa, Dorota
    Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
    Kalbe, Elke
    University Hospital Cologne, Germany.
    Eriksdotter, Maria
    Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
    Garcia-Ptacek, Sara
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Mortality and nursing home placement of dementia patients in rural and urban areas: a cohort study from the Swedish Dementia Registry.2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 4, p. 1308-1313Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Life in rural and urban areas differs in regard to social support and health care. Our aim was to examine the association between nursing home placement and survival of patients with dementia living in urban vs. rural areas.

    METHODS: We performed a longitudinal cohort study of patients with dementia at time of diagnosis (n = 58 154) and at first follow-up (n = 21 522) including patients registered from 2007 through 2014 in the Swedish Dementia Registry (SveDem). Descriptive statistics are shown. Odds ratios with 95% CI are presented for nursing home placement and hazard ratios for survival analysis.

    RESULTS: In age- and sex-adjusted analyses, patients living in urban areas were more likely to be in nursing homes at the time of dementia diagnosis than patients in rural areas (1.49, 95% CI: 1.29-1.73). However, there were no differences in rural vs urban areas in either survival after dementia diagnosis (urban: 0.99, 0.95-1.04, intermediate: 1.00, 0.96-1.04), or nursing home placement at first follow-up (urban: 1.00, 0.88-1.13; intermediate: 0.95, 0.85-1.06).

    CONCLUSION: Persons with dementia living in rural areas are less likely to live in a nursing home than their urban counterparts at the time of dementia diagnosis, but these differences disappear by the time of first follow-up. Differences in access to nursing homes between urban and rural settings could explain these findings. Results should be considered in the future healthcare decisions to ensure equality of health care across rural and urban areas.

  • 47.
    Sandberg, Jonas
    Linköping University, Department of Neuroscience and Locomotion, Geriatrics.
    Placing a spouse in a care home for older people: (Re)-Constructing Roles and Relationships2001Doctoral thesis, comprehensive summary (Other academic)
  • 48.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Etnologisk metod: en möjlighet för omvårdnadsforskningen1994In: Det sitter i väggarna: Kulturella föreställningar i vård och utbildning / [ed] Bo Carlsson, Åsa Lindberg-Sand, Kalmar: Kalmar läns vårdhögskola , 1994Chapter in book (Other (popular science, discussion, etc.))
  • 49.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Måltidsmiljö och rutiner2003In: Svårigheter att äta / [ed] Albert Westergren, Lund: Studentlitteratur , 2003, p. 119-127Chapter in book (Other (popular science, discussion, etc.))
  • 50.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Äldres måltidsvanor2003In: Svårigheter att äta / [ed] Albert Westergren, Lund: Studentlitteratur , 2003Chapter in book (Other academic)
12 1 - 50 of 56
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