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  • 1.
    Ahorsu, Daniel Kwasi
    et al.
    Hong Kong Polytech Univ, Hung Hom, Hong Kong, Peoples R China..
    Lin, Chung-Ying
    Hong Kong Polytech Univ, Hung Hom, Hong Kong, Peoples R China.;Natl Cheng Kung Univ, Tainan, Taiwan..
    Pakpour, Amir H.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Qazvin Univ Med Sci, Qazvin, Iran.;Jonkoping Univ, Jonkoping, Sweden..
    The Association Between Health Status and Insomnia, Mental Health, and Preventive Behaviors: The Mediating Role of Fear of COVID-192020Ingår i: Gerontology and geriatric medicine, E-ISSN 2333-7214, Vol. 6, artikel-id 2333721420966081Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: This study examined the mediation role of fear of COVID-19 in the association between perceived health status of older adults and their insomnia, mental health, and COVID-19 preventive behaviors so as to have better understanding of the factors associated with COVID-19 and its preventive measures. Methods: A total of 413 older adults with a mean age of 57.72 (SD = 7.31) were recruited for this study. They responded to the measures on fear of COVID-19, insomnia, mental health, and COVID-19 preventive behaviors. Results: There were small-large significant interrelationships between insomnia, mental health, fear of COVID-19, and preventive behaviors. Fear of COVID-19 significantly mediated the associations between perceived health status and insomnia, mental health, and COVID-19 preventive behaviors. It was also observed that perceived health status directly influenced insomnia and mental health of older adults but not their COVID-19 preventive behaviors. Conclusion: Fear of COVID-19 has an important role to play in the management of the health and preventive behaviors of older adults. Health experts and communicators may capitalize on these findings to educate people on COVID-19. Future studies are needed to perfectly ascertain the extent of fear needed to stimulate or initiate better preventive behaviors and healthcare practices.

  • 2. Arfwidson, Samuel
    et al.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Nordqvist, Persy
    Vårdbehov, sjukdomsdiagnoser och medicinkonsumtion bland äldre på ålderdomshem i Jönköpings län: en 7-årsuppföljning1976Rapport (Övrig (populärvetenskap, debatt, mm))
  • 3.
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Malmberg, Karl Johan
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Strindhall, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Biomedicinsk plattform.
    Independent skewing of the T cell and NK cell compartments associated with cytomegalovirus infection suggests division of labor between innate and adaptive immunity.2014Ingår i: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, Vol. 36, nr 2, s. 571-582Artikel i tidskrift (Refereegranskat)
    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.

  • 4.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Gerontologi: en introduktion1986Bok (Övrigt vetenskapligt)
  • 5.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Psykologi1983Ingår i: Geriatrik och långvårdsmedicin: lärobok för universitets- och högskoleutbildningar, Stockholm: Natur & Kultur , 1983, s. 73-78Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 6.
    Berg, Stig
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Jeppson, Lena
    Val av fel vårdnivå tvingar dementa till onödiga omflyttningar1991Ingår i: Läkartidningen, Vol. 88, s. 33-36Artikel i tidskrift (Refereegranskat)
  • 7.
    Berg, Stig
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Landahl, Sten
    Steen, Bertil
    Steen, Gunilla
    SCAG-S: beteendeskattningsskala för geriatriska och psykogeriatriska patienter : en svensk version1980Rapport (Övrig (populärvetenskap, debatt, mm))
  • 8.
    Berg, Stig
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Norlin, Eva
    Olsson, Agneta
    Psykoterapi och andra metoder vid psykologisk behandling av äldre1974Rapport (Övrigt vetenskapligt)
  • 9.
    Blomstrand, Peter
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för naturvetenskap och biomedicin. Jönköping University, Hälsohögskolan, HHJ. Biomedicinsk plattform. Linkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden..
    Tesan, Dario
    Futurum Acad Hlth & Care, Reg Jonkoping Cty, Jonkoping, Sweden..
    Nylander, Elisabeth
    Jönköping University, Högskolebiblioteket.
    Ramstrand, Nerrolyn
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för rehabilitering. Jönköping University, Hälsohögskolan, HHJ. CHILD.
    Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older: an umbrella review2023Ingår i: European Review of Aging and Physical Activity, ISSN 1813-7253, E-ISSN 1861-6909, Vol. 20, nr 1, artikel-id 15Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acute exercise. Variation across studies due to heterogeneity was considered very high.Conclusions Mind-body exercise has moderate positive effects on the cognitive function of people aged 55 or older. To promote healthy aging, mind-body exercise should be used over a prolonged period to complement other types of exercise. Results of this review should be used to inform the development of guidelines to promote healthy aging.

  • 10.
    Bostrom, Anne-Marie
    et al.
    Division of Nursing, Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden; R&D unit, Stockholms Sjukhem, Stockholm, Sweden.
    Lundgren, Dan
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Department of Quality and Development, Division of Social Services, Värnamo Municipality, Värnamo, Sweden.
    Kabir, Zarina Nahar
    Division of Nursing, Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Factors in the psychosocial work environment of staff are associated with satisfaction with care among older persons receiving home care services2022Ingår i: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, nr 6, s. e6080-e6090Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Older persons in Sweden are increasingly encouraged to continue living at home and, if necessary, be supported by home care services (HCS). Studies have examined whether the work environment of staff has an impact on the experiences and well-being of older persons in residential care facilities, but few have examined such associations in HCS. This study examined associations between home care staff's perceptions of their psychosocial work environment and satisfaction with care among older people receiving HCS. The setting was 16 HCS work units. Two surveys were conducted, one on psychosocial working conditions of staff, one on satisfaction of older persons receiving HCS. For each work unit, data on individual satisfaction were matched to average values concerning psychosocial work conditions. Outcomes analysed with linear regressions were overall satisfaction and indices regarding assessment of performance of services, contact with staff and sense of security. The index for treatment by staff was analysed with ordered logistic regressions. Cluster correlated-standard error clustering on work units was used. Results showed that good working conditions were important for satisfaction with care, specifically overall satisfaction, treatment by staff and sense of security. The most important psychosocial work factors were work group climate, sense of mastery, job control, overall job strain, frustrated empathy, balancing competing needs, balancing emotional involvement and lack of recognition. Receiving more HCS hours was associated with stronger relationships between working conditions and satisfaction with care, especially with overall satisfaction and treatment by staff as outcomes. Managers and policymakers for home care need to acknowledge that the working conditions of home care staff are crucial for the satisfaction of older persons receiving HCS, particularly those receiving many HCS hours. Psychosocial work factors together with job strain factors are areas to focus on in order to improve working conditions for staff and outcomes for older persons.

  • 11.
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, 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 overview2013Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 13, nr 64Artikel i tidskrift (Refereegranskat)
    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.

  • 12.
    Broström, Anders
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Wahlin, Åke
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    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 Population2018Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, nr 5, s. 422-428Artikel i tidskrift (Refereegranskat)
    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.

  • 13.
    Bulow, Per
    et al.
    Jönköping University, Hälsohögskolan.
    Bülow, Pia H.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för socialt arbete. Jönköping University, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd).
    Finkel, Deborah
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Indiana Univ Southeast, New Albany, IN 47150 USA..
    DIFFERENCES AND SIMILARITIES OF ELDERLY PERSONS IN SWEDEN WITH A DIAGNOSIS OF PSYCHOSIS OR NON-PSYCHOSIS (SMI)2022Ingår i: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, nr Supplement 1, s. 794-794Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Psychiatric care in Sweden is jointly organized by psychiatric practice and municipal social services. To determine who is entitled to support from the municipalities, the concept of “psychiatric disability” was created in connection with psychiatric reform in 1995. Psychiatric disability is a poorly identified concept and in Sweden, a person has severe mental illness (SMI) if they have difficulties in carrying out activities in crucial areas of life, these difficulties are caused by a mental disorder, and they are prolonged. Internationally, SMI is often synonymous with psychosis, but in Sweden other severe psychiatric conditions are included, but not dementia. Both practically and ethically, the unclear definition of SMI is a problem because it determines whether a person is granted interventions and what forms the interventions take. We investigated similarities and differences in people defined as SMI, divided into two groups, psychosis (Nf222) and non-psychosis (Nf253). Adults with SMI aged 65 or over (in 2016) have been assessed using data from four surveys carried out between 1996 and 2011, as well data available from national registers. People with psychosis had worse functional levels on the Global Assessment of Functioning and more unmet needs, according to Camberwell Assessment of Needs. However, differences between psychosis and non-psychosis groups varied across measures (e.g., education, income, living situation) and results differed depending on age at onset, year of first admission to a mental hospital, and length of institutionalization. These variables had a greater impact on the similarities and differences between measures than the diagnosis itself.

  • 14.
    Cahill, Suzanne
    Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Trinity College Dublin.
    Dementia: A disability and a human rights concern2022Ingår i: Critical Gerontology for Social Workers / [ed] S. Torres and S. Donnelly, Policy Press , 2022, s. 146-160Kapitel i bok, del av antologi (Refereegranskat)
  • 15.
    Chen, Yu-Pin
    et al.
    Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
    Kuo, Yi-Jie
    Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
    Liu, Chieh-hsiu
    Department of Geriatrics and Gerontology, Research Center of Clinical Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
    Chien, Pei-Chun
    Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
    Chang, Wei-Chun
    Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
    Lin, Chung-Ying
    Institute of Allied Health Sciences and Departments of Occupational Therapy and Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701, Taiwan.
    Pakpour, Amir H.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Prognostic factors for 1-year functional outcome, quality of life, care demands, and mortality after surgery in Taiwanese geriatric patients with a hip fracture: a prospective cohort study2021Ingår i: Therapeutic Advances in Musculoskeletal Disease, ISSN 1759-7218, E-ISSN 1759-720X, Vol. 13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Hip fractures are a major public health concern among elderly individuals. This study aimed to investigate potential perioperative factors that predict 1-year functional outcome, quality of life (QoL), care demands, and mortality in geriatric patients with a hip fracture.

    Methods: We prospectively enrolled geriatric patients who had undergone hip fracture surgery in one medical center from December 2017 to December 2019. Basic demographic data, handgrip strength, and responses to questionnaires for QoL and activities of daily living (ADL) before the injury were collected at baseline. QoL, ADL, additional care demands other than family support, and mortality events were monitored at 1 year after the operation.

    Results: Among 281 patients with a hip fracture, 39 (13.9%) died within 1 year of the index operation. The mean follow-up interval for the survivors was 403.3 (range: 358–480) days. Among the 242 survivors, ADL and QoL considerably decreased at approximately 1 year following hip surgery. Up to 33.9% of the participants became severely dependent and needed additional care at 1-year follow up. Prefracture ADL status was the crucial predictor for functional outcome, QoL, and additional care demand at 1-year follow up. Cox regression models indicated that male sex, low preoperative serum creatinine, handgrip strength, long surgical delay after a falling accident, and high Charlson Comorbidity Index were considerably associated with a high 1-year mortality risk in the geriatric hip fracture population.

    Conclusion: Hip fracture has long-lasting effects (e.g. functional loss, decline in QoL, increased care demands, and high postoperative mortality rate) on the geriatric population. A robust screening method must be developed for identifying potential prognostic factors, and a stratified care approach must be used that accounts for personalized risks to improve functional outcomes and reduce mortality after hip fracture in geriatric patients, especially in Taiwan.

  • 16.
    Dahl, Anna
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Hassing, Linda
    Göteborgs Universitet, Psykologiska institutionen.
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    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 Aging2008Ingår i: Conference of Life History Research Society, 2008Konferensbidrag (Refereegranskat)
  • 17.
    Dahl, Anna K.
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Löppönen, Minna
    Åbo University.
    Isoaho, Raimo
    Åbo University.
    Berg, Stig
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Kivelä, Sirkka-Liisa
    Åbo University.
    Overweight and obesity in old age are not associated with greater dementia risk2008Ingår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 56, nr 12, s. 2261-2266Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

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

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

  • 18.
    Dahlin, Evelina
    et al.
    Jönköping University, Hälsohögskolan.
    Gunnarsson, Emma
    Jönköping University, Hälsohögskolan.
    Sjuksköterskors erfarenheter av att förebygga polyfarmakologisk behandling hos äldre patienter: En kvalitativ litteraturöversikt2022Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Polyfarmaci hos äldre är ett av vårdens stora problemområden. Många äldre patienter är missnöjda med det höga antalet tabletter de konsumerar. Polyfarmaci kan leda till negativa konsekvenser som exempelvis fall, konfusion och sjukhusinläggningar. Sjuksköterskan har en viktig roll i det förebyggande arbetet för konsekvenserna av polyfarmaci.Syfte: Syftet var att beskriva sjuksköterskans erfarenheter av att förebygga konsekvenser av polyfarmaci hos äldre patienter.Metod: En litteraturöversikt genomfördes med induktiv ansats och kvalitativ design. Litteraturöversikten inkluderade tolv vetenskapliga artiklar publicerade mellan 2011–2021. Data inhämtades från databaserna CINAHL och MEDLINE. Innehållsanalysen genomfördes med Fribergs metod.Resultat: Första huvudkategorin blev läkemedelsgenomgångar med underkategorierna uppdaterad läkemedelslista och att ändra rutiner för förskrivning av läkemedel. Andra huvudkategorin blev multiprofessionellt arbete. Tredje huvudkategorin blev farmakologisk kunskap vars underkategorier blev vikten av att ha goda kliniska kunskaper och välinformerade patienter.Slutsats: Polyfarmaci är ett komplext problem som i många fall inte kan undvikas. Däremot kan det förebyggas med hjälp av läkemedelsgenomgångar, multiprofessionellt arbete och sjuksköterskans farmakologiska kunskap.

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  • 19.
    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 Training2003Ingår i: Aging, Neuropsychology and Cognition, ISSN 1382-5585, E-ISSN 1744-4128, Vol. 10, nr 3, s. 202-214Artikel i tidskrift (Refereegranskat)
    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.

  • 20.
    Dickson, Natalie C.
    et al.
    Federat Univ, Inst Hlth & Wellbeing, Gippsland Campus,POB 3191, Churchill, Vic 3841, Australia..
    Gohil, Apeksha R.
    Federat Univ, Inst Hlth & Wellbeing, Gippsland Campus,POB 3191, Churchill, Vic 3841, Australia.;James Cook Univ, Coll Healthcare Sci, Townsville, Qld, Australia..
    Unsworth, Carolyn
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för rehabilitering. Federat Univ, Inst Hlth & Wellbeing, Gippsland Campus,POB 3191, Churchill, Vic 3841, Australia.;James Cook Univ, Coll Healthcare Sci, Townsville, Qld, Australia.;Monash Univ, Dept Neurosci, Clayton, Vic, Australia..
    Powered mobility device use in residential aged care: a retrospective audit of incidents and injuries2023Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, nr 1, artikel-id 363Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundPowered wheelchairs and motorised mobility scooters, collectively called powered mobility devices (PMD), are highly valued by older Australians, including those living in residential care, to facilitate personal and community mobility. The number of PMDs in residential aged care is expected to grow proportionally with that of the wider community, however, there is very little literature on supporting residents to use PMDs safely. Prior to developing such supports, it is important to understand the frequency and nature of any incidents experienced by residents whilst using a PMD. The aim of this study was to determine the number and characteristics of PMD use related incidents occurring in a group of residential aged care facilities in a single year in one state in Australia including incident type, severity, assessment, or training received and outcomes on follow-up for PMD users living in residential aged care.MethodsAnalysis of secondary data, including documentation of PMD incidents and injuries for one aged care provider group over 12 months retrospectively. Follow-up data were gathered 9-12 months post incident to review and record the outcome for each PMD user.ResultsNo fatalities were recorded as a direct result of PMD use and 55 incidents, including collisions, tips, and falls, were attributed to 30 residents. Examination of demographics and incident characteristics found that 67% of residents who had incurred incidents were male, 67% were over 80 years of age, 97% had multiple diagnoses and 53% had not received training to use a PMD. Results from this study were extrapolated to project that 4,453 PMD use related incidents occur every year within Australian residential aged care facilities, with the potential for outcomes such as extended recovery, fatality, litigation, or loss of income.ConclusionThis is the first time that detailed incident data on PMD use in residential aged care has been reviewed in an Australian context. Illuminating both the benefits and the potential risks of PMD use emphasizes the need to develop and improve support structures to promote safe PMD use in residential aged care.

  • 21.
    Ek, Kristina
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Browall, Maria
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, 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 adults2018Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, nr 2, artikel-id e12189Artikel i tidskrift (Refereegranskat)
    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.

  • 22.
    Ekdahl, A. W.
    et al.
    Karolinska Institute, Sweden.
    Odzakovic, Elzana
    Linköpings universitet, Avdelningen för omvårdnad.
    Hellström, Ingrid
    Linköpings universitet, Avdelningen för omvårdnad.
    Living Unnoticed: Cognitive Impairment In Older People With Multimorbidity2016Ingår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 20, nr 3, s. 275-279Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To investigate the correlation between MMSE ≤ 23 and the presence of a diagnosis of dementia in the medical record in a population with multimorbidity.

    Design, setting, and participants: This cross-sectional study was part of the Ambulatory Geriatric Assessment - a Frailty Intervention Trial (AGe-FIT; N = 382). Participants were community dwelling, aged ≥ 75 years, had received inpatient hospital care at least three times during the past 12 months, and had three or more concomitant diagnoses according to the International Classification of Diseases, 10th revision.

    Measurements: The Mini Mental State Examination (MMSE) was administered at baseline. Medical records of participants with MMSE scores < 24 were examined for the presence of dementia diagnoses and two years ahead.

    Results: Fifty-three (16%) of 337 participants with a measure of MMSE had a MMSE scores < 24. Six of these 53 (11%) participants had diagnoses of dementia (vascular dementia, n = 4; unspecified dementia, n = 1; Alzheimers disease, n = 1) according to medical records; 89% did not.

    Conclusions: A MMSE-score < 24 is not well correlated to a diagnosis of dementia in the medical record in a population of elderly with multimorbidity. This could imply that cognitive decline and the diagnosis of dementia remain undetected in older people with multimorbidity. Proactive care of older people with multimorbidity should focus on cognitive decline to detect cognitive impairment and to provide necessary help and support to this very vulnerable group.

  • 23.
    Ekezie, Promise E.
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Eriksson, Ulrika
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Shaw, Benjamin A.
    Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, USA.
    Agahi, Neda
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Nilsen, Charlotta
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress?: A linked lives perspective2023Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 27, nr 9, s. 1796-1802Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain.

    Methods

    Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334.

    Results

    After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799).

    Conclusion

    In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.

  • 24.
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. 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 Registry2016Ingår i: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 134, nr 5, s. 430-440Artikel i tidskrift (Refereegranskat)
    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.

  • 25.
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, 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 dementia2016Ingår i: Neurobiology of Aging, ISSN 0197-4580, E-ISSN 1558-1497, Vol. 42, s. 124-131Artikel i tidskrift (Refereegranskat)
    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.

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  • 26.
    Ericsson, Iréne
    et al.
    Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Ekdahl, Anne W.
    Lund Univ, Helsingborg Hosp, Dept Clin Sci Helsingborg, Svartbrodregranden 3-5,Fack 2, S-25223 Helsingborg, Sweden..
    Hellstrom, Ingrid
    Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, S-11628 Stockholm, Sweden..
    "To be seen" - older adults and their relatives' care experiences given by a geriatric mobile team (GerMoT)2021Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 21, nr 1, artikel-id 636Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The proportion of older people in the population has increased globally and has thus become a challenge in health and social care. There is good evidence that care based on comprehensive geriatric assessment (CGA) is superior to the usual care found in acute hospital settings; however, the evidence is scarcer in community-dwelling older people. This study is a secondary outcome of a randomized controlled trial of community-dwelling older people in which the intervention group (IG) received CGA-based care by a geriatric mobile geriatric team (GerMoT). The aim of this study is to obtain a better understanding, from the patients' perspective, the experience of being a part of the IG for both the participants and their relatives. Methods Qualitative semistructured interviews of twenty-two community dwelling participants and eleven of their relatives were conducted using content analysis for interpretation. Results The main finding expressed by the participants and their relatives was in the form of feelings related to safety and security and being recognized. The participants found the care easily accessible, and that contacts could be taken according to needs by health care professionals who knew them. This is in accordance with person-centred care as recommended by the World Health Organisation (WHO) for older people in need of integrated care. Other positive aspects were recurrent health examinations and being given the time needed when seeking health care. Not all participants were positive as some found the information about the intervention to be unclear especially regarding whom to contact when in different situations. Conclusions CGA-based care of community-dwelling older people shows promising results as the participants in GerMoT found the care was giving a feeling of security and safety. They found the care easily accessible and that it was provided by health care professionals who knew them as a person and knew their health care problems. They found this to be in contrast to the usual care provided, but GerMoT care did not fulfill some people's expectations.

  • 27.
    Ericsson, Iréne
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Malmberg, Bo
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Läkemedelsgenomgång på boendet Blomstervägen i Gislaved 2008 och 2009.2010Övrigt (Övrig (populärvetenskap, debatt, mm))
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  • 28.
    Ericsson, Iréne
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Persson, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Hanson, Elizabeth
    Linnéuniversitetet.
    Anhöriga till äldre personer med psykisk ohälsa: Kunskapsöversikt2016Rapport (Övrigt vetenskapligt)
    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.

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  • 29.
    Ernsth Bravell, Marie
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Malmberg, Bo
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    End of life care in the oldest old2010Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 8, s. 335-344Artikel i tidskrift (Refereegranskat)
    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.

  • 30.
    Fauth, Elizabeth Braungart
    et al.
    Utah State Univ, Logan, UT 84322 USA..
    Hooyman, Andrew
    Arizona State Univ, Tempe, AZ USA..
    Schaefer, Sydney
    Arizona State Univ, Tempe, AZ USA..
    Hall, Anna
    Utah State Univ, Logan, UT 84322 USA..
    Ernsth-Bravell, Marie
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    DISCREPANCIES IN OBJECTIVE AND SUBJECTIVE FINE MOTOR ABILITIES IN OCTOGENARIANS2021Ingår i: Innovation in Aging, E-ISSN 2399-5300, Vol. 5, nr Supplement 1, s. 839-840Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Older individuals may have discrepancies between self-reported and performance-based abilities on activities of daily living (ADL). We examined objective and self-reported fine motor abilities (FMA). FMA are required for many ADLs, but are examined less frequently than gross-motor tasks in this population. We used two waves of the population-based OCTO-Twin study including mono-/dizygotic Swedish twins, aged 80+. One twin was randomly selected for analyses (baseline N=262; wave 2 N=198; Meanage =83.27; SDage=2.90; 66.4% female). Participants self-reported their ability to manipulate things with hands (cannot do, some problem, no problem) and completed a timed FMA assessment including five everyday tasks (e.g. inserting a key in a lock). Slow performance was coded as 1+ SD from the mean (=80+ seconds). At baseline, 65.8% of slow performers reported ‘no problems’ with hand manipulation. Over two waves (two years), a two-factor ANOVA (including slowness-by-perception interaction) supported a significant difference in total motor task performance between slow performers reporting ‘no problems’ and fast performers reporting ‘no problems’, for both rate of change (diff = -26 seconds, p<.0001) and wave 2 level (diff = 50 seconds, p < .0001). 82% of slow performers at wave 2 reported ‘no problems’, which is surprising given that they had become even slower over the past two years. Findings suggest that objective FMA measures are needed, as self-report is inaccurate and not prognostic. Future work will examine if discrepancies in performance/perceived FMA predict poorer outcomes, and/or if reporting ‘no problems’ despite slower performance is protective against cognitive adaptation to slowing.

  • 31.
    Finkel, Deborah
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Indiana Univ Southeast, New Albany, IN 47150 USA..
    Johansson, Linda
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Westerlind, Bjorn
    Linkoping Univ, Linkoping, Ostergotlands L, Sweden..
    Lindmark, Ulrika
    Karlstad Univ, Karlstad, Varmlands Lan, Sweden..
    Ernsth-Bravell, Marie
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    AGE AND SITE DIFFERENCES IN PLANNED AND PERFORMED ACTIONS IN RESPONSE TO IDENTIFIED RISKS IN OLDER ADULTS2022Ingår i: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, nr Supplement 1, s. 840-840Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    The Swedish health care system focuses on allowing older adults to “age in place”; however, that approach assumes that home health services are adequate to support health and prevent unnecessary decline. Data from the Senior Alert national quality register in Sweden were examined to compare the quality of care across care locations. First registration in Senior Alert was available for 2914 adults aged 57–109 (median age = 81): 3.6% dementia unit, 7.8% home health care, 4.4% rehabilitation unit, 62.8% hospital, 21.4% care home. There were significant differences across units in the number of identified risks in 4 categories: falls, malnutrition, oral health, and pressure ulcer. Individuals in rehabilitation units averaged 2.4 risks, individuals in dementia and care homes averaged 2.0 risks, and individuals in home health care and hospitals averaged 1.4 risks. For individuals with identified risks, the differences between planned and performed actions for each risk independently were greatest for those in home health care. Moreover, the correlation between total planned and performed actions in home health care was .79 for adults aged 65–80 years and .39 for adults aged 81 and over. The correlation did not differ across age for the other care units. Results suggest that individuals most in need of actions to address health risks (older adults in home health care) are least likely to have the actions performed. Training and support of workers responsible for home health care need to be improved if the “age in place” policy is to continue.

  • 32.
    Finkel, Deborah
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Indiana Univ Southeast, New Albany, IN 47150 USA..
    Nilsen, Charlotta
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Sindi, Shireen
    Karolinska Inst, Solna, Stockholms Lan, Sweden..
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Impact of Objective and Subjective Sep on Aging Trajectories of Functional Capacity2022Ingår i: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, nr Supplement 1, s. 220-220Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Long-term stress is associated with adverse health outcomes in aging. It is important to identify not only factors that influence functioning in late adulthood, such as accumulated stress, but also the timing of such factors. The aim of the current analysis was to examine how socioeconomic stressors throughout the life course are associated with aging in functional capacity. Data were available from 740 adults ranging in age from 40 to 83 at intake (mean = 62.4, SD = 8.2) who participated in up to 8 waves of data collection (mean = 3.9, SD = 2.4). A Functional Aging Index (FAI) was created by combining measures of sensory, pulmonary, gait, and grip functioning. Both childhood and adulthood measures of objective socioeconomic position (SEP) and perceived SEP (financial strain) were available. Latent growth curve models (corrected for twinness) were used to estimate the trajectory of change in FAI over age and the impact of child and adult SEP measures on the trajectories. Results indicated that both childhood and adult objective SEP independently influenced rates of change in FAI in adulthood: higher SEP was associated with higher mean functioning and slower rates of decline. In combination, model fitting indicated that if SEP is above the median in adulthood, then childhood SEP has no impact on FAI trajectories; however, if SEP is below the median in adulthood, then childhood SEP can play a role. In addition, results indicated possible long-term effects of childhood financial strain on rates of change in FAI in adulthood.

  • 33.
    Finkel, Deborah
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Pedersen, N. L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Reynolds, C. A.
    Department of Psychology, University of California – Riverside, United States.
    Cognitive aging: the role of genes and environments in patterns of change2022Ingår i: Twin Research for Everyone: From Biology to Health, Epigenetics, and Psychology / [ed] A. Tarnoki, D. Tarnoki, J. Harris and N. Segal, Elsevier , 2022, s. 351-370Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Behavior genetic investigations of cognitive aging began in earnest in the 1980s. After an initial focus on general cognitive ability (GCA) in earlier lifespan periods, aging researchers turned their focus to investigations of age changes in GCA as well as specific cognitive abilities, finding different patterns of change with age and different compositions of genetic and environmental contributions to change. Mapping the human genome in the early 2000s provided researchers with tools to investigate multiple genes associated with cognitive function. Moreover, contexts in which cognitive aging occurs, as well as the role of gene and environment interplay, have become a focus.

  • 34.
    Fox, Siobhan
    et al.
    Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
    Foley, Tony
    Department of General Practice, University College Cork, Cork, Ireland.
    Cahill, Suzanne
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. School of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland; Centre for Economic and Social Research on Dementia, NUI Galway, Galway, Ireland.
    Kilty, Caroline
    Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.
    "Give me the knowledge, and I can do what I want with it, it's my right and my choice": Triangulated perspectives on the disclosure of young onset dementia2023Ingår i: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 22, nr 8, s. 1757-1775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction

    Receiving a diagnosis of young onset dementia is particularly distressing; the person under 65 years is often in employment, with financial commitments, young children, and an active social life. Some of the stress experienced by younger people experiencing cognitive changes can be reduced by an early and accurate diagnosis, but this is contingent on the timing of disclosure and a process which is sensitive and appropriate to the person. The study aim was to explore experiences of giving and receiving a diagnosis of young onset dementia, by triangulating the perspectives of the key parties involved.

    Methods

    A qualitative design was employed, using semi-structured interviews. Participants (N = 47) included people with young onset dementia (n = 10), family members (n = 12), and health and social care professionals (n = 25). Thematic analysis and triangulation enabled identification of overall themes across different participant groups.

    Results

    All participant groups agreed on key aspects of good disclosure practice, with two overarching themes: The optimal conditions for disclosure, and how best to disclose a diagnosis. Positive experiences of disclosure were prefaced on having the appropriate space and time; having a support person present; clearly labelling the diagnosis; providing appropriate information at the right pace. Other findings include recommendations for longer appointment times, offering additional support for young families, and for carers of people with atypical presentations (e.g. frontotemporal dementia).

    Conclusion

    Many people with young onset dementia had unsatisfactory disclosure experiences. Health and social care professionals should provide a 'pre-disclosure' appointment, elicit the amount of information the person may want at the point of disclosure of the diagnosis, balance truth and hope, provide contact details for follow-up, and overall be mindful of the individual in front of them. While young onset dementia may be a life-altering diagnosis, a disclosure meeting which is sensitively undertaken can increase the person's agency, coping ability, and ultimately empower them to live well with their diagnosis.

  • 35.
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Normalt åldrande2008Ingår i: Den äldre parkinsonpatienten: Utredning, diagnostik och åtgärder för individuellt omhändertagande, Stockholm: Svensk Geriatrisk Förening , 2008, s. 7-9Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 36.
    Gaber, Sophie N.
    et al.
    Faculty of Brain Sciences, Division of Psychiatry, University College London, London, UK; Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden; Department of Women's and Children's Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Guerrero, Manuel
    Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Department of Bioethics and Medical Humanities, Faculty of Medicine, University of Chile, Santiago, Chile.
    Rosenberg, Lena
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för rehabilitering. Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Characteristics and consequences of participatory research approaches in long-term care facilities for older adults: a meta-ethnography of qualitative studies2023Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 402, nr Suppl. 1, s. S43-S43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Participatory research approaches can potentially empower older adults and improve their quality of life and care. These include research designs, methods, and conceptual frameworks in collaboration with people directly involved and invested in the research and research outcomes. However, participatory research approaches have rarely been explored in long-term care facilities for older adults, such as nursing homes or residential care facilities. We aimed to provide increased understanding and recommendations about how participatory research approaches can be conceptualised and used in long-term care facilities for older adults.

    METHODS: Inspired by Noblit and Hare (1988) and the seven phases of the eMERGe guidelines (2019), we performed a meta-ethnography (synthesis of qualitative research). We searched MEDLINE, CINAHL, ERIC, Sociological Abstracts, and Web of science in July 2021 and June 2022 for studies published between Jan 1, 2001, and June 27, 2022 (see appendix for search terms). We included peer-reviewed qualitative publications on participatory research approaches with older adults or staff in long-term care facilities, written in English. To promote rigour, a protocol was used with two authors independently screening the articles, reaching consensus through critical discussions with a third author, and using the Critical Appraisal Skills Programme (CASP) checklist. We extracted data regarding types of participatory research approaches and themes. This study is registered with PROSPERO, CRD42021275187.

    FINDINGS: Ten of 1445 articles screened were included in the analysis. Using seven types of participatory research approaches, the included studies investigated experiences of approximately 153 residents and 99 staff from seven countries (Australia, Belgium, England, Guyana, Ireland, Sweden, and the Netherlands). We identified five themes, expressed as a conceptual model with recommendations: (1) participatory backdrop; (2) collaborative places; (3) seeking common ground and solidarity; (4) temporal considerations; and (5) empowerment, growth, and cultural change. We recommend researchers allow flexible time for the slow-paced progression and potentially unintended consequences of this emergent approach.

    INTERPRETATION: This meta-ethnography provides an international and systematic synthesis of a diverse group of small-scale qualitative studies, which are, however, limited by insufficient reporting of participants' age, gender, or ethnicity. FUNDING: The Strategic Research Area in Health Care Science (SFO-V) at Karolinska Institutet and the Swedish Research Council for Health, Working Life and Welfare (FORTE).

  • 37.
    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, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, 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 Registries2018Ingår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 19, nr 2, s. 154-161Artikel i tidskrift (Refereegranskat)
    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.

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  • 38.
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. 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.2016Ingår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 64, nr 11, s. e137-e142Artikel i tidskrift (Refereegranskat)
    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.

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  • 39.
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. 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 Registry2017Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 46, nr 2, s. 314-319Artikel i tidskrift (Refereegranskat)
    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.

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  • 40.
    Gustafsson, Gunnel
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ernsth, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Förekomst och behandling av trycksår1996Rapport (Övrigt vetenskapligt)
  • 41.
    Gustafsson, Susanne
    et al.
    Vårdalinstitutet, Swedish Institute for Health Sciences, Sweden; Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden; Hospital of Södra Älvsborg, Borås, Sweden.
    Wilhelmson, K.
    Eklund, K.
    Gosman-Hedström, G.
    Zidén, L.
    Kronlöf, G. H.
    Højgaard, B.
    Slinde, F.
    Rothenberg, E.
    Landahl, S.
    Dahlin-Ivanoff, S.
    Health-promoting interventions for persons aged 80 and older are successful in the short term-results from the randomized and three-armed elderly persons in the risk zone study2012Ingår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 60, nr 3, s. 447-454Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self-rated health, and activities of daily living (ADLs) at 3-month follow-up.

    Design

    Randomized, three-armed, single-blind, controlled trial performed between November 2007 and May 2011.

    Setting

    Two urban districts of Gothenburg, Sweden.

    Participants

    Four hundred fifty-nine community-living adults aged 80 and older not dependent on the municipal home help service.

    Intervention

    A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit.

    Measurements

    Change in frailty, self-rated health, and ADLs between baseline and 3-month follow-up.

    Results

    Both interventions delayed deterioration of self-rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12-3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated.

    Conclusion

    Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.

  • 42.
    Hallgren, Jenny
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Risk factors for hospital readmission among Swedish older adults2018Ingår i: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 9, nr 5, s. 603-611Artikel i tidskrift (Refereegranskat)
    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.

  • 43.
    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.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. 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.2019Ingår i: Neurologia i Neurochirurgia Polska, ISSN 0028-3843, E-ISSN 1897-4260, Vol. 53, nr 2, s. 123-130Artikel i tidskrift (Refereegranskat)
    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.

  • 44. Hammar, Isabelle Ottenvall
    et al.
    Berglund, Helene
    Dahlin-Ivanoff, Synneve
    Faronbi, Joel
    Gustafsson, Susanne
    The Frail Elderly Research Support Group, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; The Gothenburg University Centre for Ageing and Health, Gothenburg, Sweden.
    Risk for depression affects older people's possibilities to exercise self-determination in using time, social relationships and living life as one wants: A cross-sectional study with frail older people2018Ingår i: Health Psychology Research, ISSN 2420-8124, Vol. 6, nr 1, artikel-id 7577Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exercising self-determination in daily life is highly valued by older people. However, being in the hands of other people may challenge the older people's possibilities to exercise self-determination in their daily life. Among frail older people living in Sweden, risk for depression is highly predominant. There is a knowledge gap regarding if, and how having a risk of depression affects older people's self-determination. The objective was, therefore, to explore if, and in that case how, frail older people's self-determination is affected by the risk of depression. In this cross-sectional, secondary data analysis, with 161 communitydwelling frail older people, simple logistic regression models were performed to explore the association between self-determination, the risk of depression and demographic variables. The findings showed that risk for depression and reduced self-determination were significantly associated in the dimensions: use of time (P=0.020), social relationship (P=0.003), help and support others (P=0.033), and the overall self-determination item (P=0.000). Risk for depression significantly affected self-determination in use of time (OR=3.04, P=0.014), social relationship (OR=2.53, P=0.011), and overall self-determination (OR=6.17, P=0.000). This point out an increased need of strengthening healthcare professionals' perspectives, and attitudes towards a self-determined, friendly, and person-centred dialogue.

  • 45. Hassing, Linda B.
    et al.
    Dahl, Anna
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Thorvaldsson, Valgeir
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Gatz, Margaret
    Pedersen, Nancy L.
    Johansson, Boo
    Overweight in midlife and risk of dementia: a 40-year follow-up study2009Ingår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 33, nr 8, s. 893-898Artikel i tidskrift (Refereegranskat)
    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.

  • 46.
    Hoang, Minh Tuan
    et al.
    Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Schön, Pär
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    Von Koch, Lena
    Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Xu, Hong
    Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Tan, Edwin C. K.
    The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, NSW, Australia.
    Johnell, Kristina
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Eriksdotter, Maria
    Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Garcia-Ptacek, Sara
    Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    The Impact of Educational Attainment and Income on Long-Term Care for Persons with Alzheimer's Disease and Other Dementias: A Swedish Nationwide Study2023Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, nr 2, s. 789-800Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Long-term care improves independence and quality of life of persons with dementia (PWD). The influence of socioeconomic status on access to long-term care was understudied.

    Objective: To explore the socioeconomic disparity in long-term care for PWD.

    Methods: This registry-based study included 14,786 PWD, registered in the Swedish registry for cognitive and dementia disorders (2014-2016). Education and income, two traditional socioeconomic indicators, were the main exposure. Outcomes were any kind of long-term care, specific types of long-term care (home care, institutional care), and the monthly average hours of home care. The association between outcomes and socioeconomic status was examined with zero-inflated negative binomial regression and binary logistic regression.

    Results: PWD with compulsory education had lower likelihood of receiving any kind of long-term care (OR 0.80, 95% CI 0.68-0.93), or home care (OR 0.83, 95% CI 0.70-0.97), compared to individuals with university degrees. Their monthly average hours of home care were 0.70 times (95% CI 0.59-0.82) lower than those of persons with university degrees. There was no significant association between education and the receipt of institutional care. Stratifying on persons with Alzheimer's disease showed significant association between lower education and any kind of long-term care, and between income and the hours of home care.

    Conclusions: Socioeconomic inequalities in long-term care existed in this study population. Lower-educated PWD were less likely to acquire general long-term care, home care and had lower hours of home care, compared to their higher-educated counterparts. Income was not significantly associated with the receipt of long-term care.

  • 47.
    Holleman, Jasper
    et al.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden.
    Kåreholt, Ingemar
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Aspö, Malin
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
    Hagman, Göran
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
    Udeh-Momoh, Chinedu T.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK; Global Brain Health Institute, University of California San Francisco, USA; Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
    Kivipelto, Miia
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
    Solomon, Alina
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK; Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.
    Sindi, Shireen
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK.
    Life-course stress, cognition, and diurnal cortisol in memory clinic patients without dementia2024Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 119, artikel-id 105316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To examine associations of life-course stress with cognition and diurnal cortisol patterns in older adulthood, as well as potential mediation effects of diurnal cortisol patterns and perceived stress on the association between life-course stress and cognition.

    METHODS: 127 participants without dementia were selected from a cohort of Swedish memory clinic patients. Cross-sectional associations between scores on two chronic stress questionnaires (perceived stress, stressful life events (SLEs)), five cognitive domains (overall cognition, memory, working memory, processing speed, perceptual reasoning), and two measures of diurnal cortisol patterns (total daily output, diurnal cortisol slope), as well as potential mediation effects of diurnal cortisol patterns and perceived stress on associations between life-course stress and cognition, were assessed using linear regressions.

    RESULTS: Greater lifetime exposure to SLEs was associated with worse memory, working memory, and processing speed performance, but not with diurnal cortisol patterns. A greater number of SLEs in late childhood was associated with worse working memory and processing speed, while a greater number of SLEs in non-recent adulthood were associated with better overall cognition and perceptual reasoning. Greater perceived stress was associated with a flattened diurnal cortisol slope, but not with cognition. No evidence for interplay between self-reported and physiological stress markers was found in relation to cognition, although there appeared to be a significant positive indirect association between economic/legal SLEs and the diurnal cortisol slope via perceived stress.

    CONCLUSIONS: The associations between SLEs and cognition depend on the period during which SLEs occur, but seem independent of late-life cortisol dysregulation.

  • 48. Hou, J.
    et al.
    Hess, J. L.
    Armstrong, N.
    Bis, J. C.
    Grenier-Boley, B.
    Karlsson, Ida K.
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Leonenko, G.
    Numbers, K.
    O’Brien, E. K.
    Shadrin, A.
    Thalamuthu, A.
    Yang, Q.
    Andreassen, O. A.
    Brodaty, H.
    Gatz, M.
    Kochan, N. A.
    Lambert, J. -C
    Laws, S. M.
    Masters, C. L.
    Mather, K. A.
    Pedersen, N. L.
    Posthuma, D.
    Sachdev, P. S.
    Williams, J.
    Fan, C. C.
    Faraone, S. V.
    Fennema-Notestine, C.
    Lin, S. -J
    Escott-Price, V.
    Holmans, P.
    Seshadri, S.
    Tsuang, M. T.
    Kremen, W. S.
    Glatt, S. J.
    Polygenic resilience scores capture protective genetic effects for Alzheimer’s disease2022Ingår i: Translational Psychiatry, E-ISSN 2158-3188, Vol. 12, nr 1, artikel-id 296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Polygenic risk scores (PRSs) can boost risk prediction in late-onset Alzheimer’s disease (LOAD) beyond apolipoprotein E (APOE) but have not been leveraged to identify genetic resilience factors. Here, we sought to identify resilience-conferring common genetic variants in (1) unaffected individuals having high PRSs for LOAD, and (2) unaffected APOE-ε4 carriers also having high PRSs for LOAD. We used genome-wide association study (GWAS) to contrast “resilient” unaffected individuals at the highest genetic risk for LOAD with LOAD cases at comparable risk. From GWAS results, we constructed polygenic resilience scores to aggregate the addictive contributions of risk-orthogonal common variants that promote resilience to LOAD. Replication of resilience scores was undertaken in eight independent studies. We successfully replicated two polygenic resilience scores that reduce genetic risk penetrance for LOAD. We also showed that polygenic resilience scores positively correlate with polygenic risk scores in unaffected individuals, perhaps aiding in staving off disease. Our findings align with the hypothesis that a combination of risk-independent common variants mediates resilience to LOAD by moderating genetic disease risk.

  • 49.
    Johansson, Linda
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Lannering, Christina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Futurum, Region Jönköping County, Sweden.
    Anna K., Dahl Aslan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Stockholm, Sweden.
    Changes in nutritional status and its association with death among older persons2016Konferensbidrag (Refereegranskat)
    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.

  • 50.
    Johansson, Linda
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Wijk, H.
    University of Gothenburg, Sweden.
    Christensson, Lennart
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Improving nutritional status among persons with dementia by performing individualized interventions2016Konferensbidrag (Refereegranskat)
    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.

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