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  • 1.
    Abbas, Päivi Maria
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Stockholms stad.
    Kommunala riktlinjer för anhöriganställningar: En kvalitativ innehållsanalys med feministisk teoriansats2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The overall aim was to investigate municipal guidelines for paid dependent care which were available online, i.e. documents regarding situations where a relative is hired to care for a next-to-kin. The overall aim has been built on the following three research questions regarding how municipalities describe: 1) which situations qualify for paid dependent care, 2) how the elderly person’s needs are met in case of paid dependent care and 3) how the dependent caregivers’ rights and well-being are ensured?

    There is no legal basis for demanding cash-for-care setting, and the local self-government determines whether the municipality offers this form of care. Recently, paid dependent care has been restricted and banned in several Swedish municipalities, and according to some statistics paid dependent care is allowed in 55–65 % of the Swedish municipalities. It is mostly women of foreign origin who are dependent caregivers nowadays, and feminist care research and the media lift up cash-for-care settings as a trap for women and for migrant integration.

    The study included guidelines from a total of 21 municipalities, which were analyzed using qualitative content analysis according to Elo & Kyngäs (2007). The guidelines analysed were found from the websites of Sweden's 121 medium and large municipalities (more than 20 000 inhabitants). The results were processed using feminist theory (Hirdman 2012).

    The results show that overall there are few guidelines available in Sweden's municipalities and that the regulations differ in the different municipalities’ guidelines. The guidelines that are available often contain general or vague descriptions. One conclusion is therefore that many municipalities ensure their own discretion and prevail through vague and general rules in their guidelines. From a feminist perspective, these different municipal policies create unfair structures and differences in conditions and terms for the elderly and their family caregivers regarding cash-for-care settings. Finally, the result shows that the few detailed descriptions prioritize elder people's rights over their caregivers'. Ensuring the paid dependent caregivers’ rights is mainly described to be done by checking and controlling them. In other words, the paid dependent caregivers are often invisible in the guidelines, are often regarded as pseudo-employees and therefore fall between the cracks in terms of their need for support (Sand 2010).

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    Abbas, P.M. (2016)
  • 2.
    Abellan, Antonio
    et al.
    Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain.
    Perez, Julio
    Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain.
    Pujol, Rogelio
    Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain.
    Sundström, Gerdt
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Jegermalm, Magnus
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Malmberg, Bo
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Partner care, gender equality, and ageing in Spain and Sweden2017In: International Journal of Ageing and Later Life, E-ISSN 1652-8670, Vol. 11, no 1, p. 69-89Article in journal (Refereed)
    Abstract [en]

    We used national surveys to study how older persons’ changing household patterns influence the gender balance of caregiving in two countries with distinct household structures and cultures, Spain and Sweden. In both countries, men and women provide care equally often for their partner in couple-only households. This has become the most common household type among older persons in Spain and prevails altogether in Sweden. This challenges the traditional dominance of young or middle-aged women as primary caregivers in Spain. In Sweden, many caregivers are old themselves. We focus attention to partners as caregivers and the consequences of changing household structures for caregiving, which may be on the way to gender equality in both countries, with implications for families and for the public services.

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  • 3. Abellán, Antonio
    et al.
    Ayala, Alba
    Pérez, Julio
    Pujol, Rogelio
    Sundström, Gerdt
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ramos, María
    The new carers2018In: Ageing and care: How will we live and care for ourselves when we get old?, Palma: Observatorio Sociale de "la caxia" , 2018, p. 25-31Chapter in book (Other academic)
    Abstract [en]

    Usually it is women who take care of family members in the home, but with age, gender differences become less pronounced and, from 80 years onwards, there are more men caring for a family member – generally their partner – than women. Social and demographic changes are presenting new challenges for public services. In particular, in two-person households with elderly inhabitants, one of whom is dependent, it is necessary to tackle not only the needs of the dependent partner but also those of the carer partner. For this reason, carer support programmes are needed.

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  • 4.
    Agahi, Neda
    et al.
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kelfve, Susanne
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden; Department of Sociology, Stockholm University, Stockholm, Sweden.
    Lennartsson, Carin
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Alcohol consumption in very old age and its association with survival: a matter of health and physical function2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 159, p. 240-245Article in journal (Refereed)
    Abstract [en]

    Background

    Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old.

    Methods

    Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n = 863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5–30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed.

    Results

    Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant.

    Conclusions

    The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.

    Graphical abstract

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  • 5.
    Agahi, Neda
    et al.
    Karolinska Institutet.
    Lennartsson, Carin
    Karolinska Institutet.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet.
    Shaw, Benjamin A.
    School of Public Health, University at Albany, Rensselaer, NY, USA.
    Trajectories of social activities from middle age to old age and late-life disability: a 36-year follow-up2013In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 42, no 6, p. 790-793Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to examine the association between 34-year trajectories of social activity, from middle age to old age and late-life disability.

    METHODS: data from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were used. LNU data from 1968, 1981, 1991 and 2000 were merged with SWEOLD data from 1992, 2002 and 2004 to create a longitudinal data set with five observation periods. Trajectories of social activities covered 1968-2002, and late-life disability was measured in 2004. The sample consisted of 729 individuals aged 33-61 at baseline (1968), who participated in at least four observation periods and who were free from mobility limitations at baseline. Four trajectories of social activity were identified and used as predictors of late-life disability.

    RESULTS: reporting low/medium levels of social activity from mid-life to old age was the most common trajectory group. Persons reporting continuously low/medium or decreasing levels of social activity had higher odds ratios for late-life disability (OR = 2.33 and OR = 2.15, respectively) compared with those having continuously high levels of activity, even when adjusting for age, sex and mobility limitations, and excluding persons with baseline mobility limitations.

    CONCLUSIONS: results suggest that the disability risk associated with social activities is related to recent levels of activity, but also that risk may accumulate over time, as indicated by the higher disability risk associated with the continuously low/medium level social activity trajectory.

  • 6.
    Alm Mårtensson, Anna
    et al.
    Länsstyrelsen i Jönköping.
    Boström, Anita
    Institutionen för hälsovetenskaper, Karlstads universitet.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lundgren, Charlie
    Länsstyrelsen Västerbotten.
    Ludvigsson, Mikael
    Linköpings universitet.
    Simmons, Johanna
    Medicinska och geriatriska akutkliniken, Universitetssjukhuset i Linköping.
    Att möta våldsutsatta äldre personer2022In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 183-220Chapter in book (Other academic)
  • 7.
    Alm Mårtensson, Anna
    et al.
    Länsstyrelsen i Jönköping.
    Boström, Anita
    Institutionen för hälsovetenskaper, Karlstads universitet.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lundgren, Charlie
    Länsstyrelsen Västerbotten.
    Östlund, Lena
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ansvarsområden för olika samhällsfunktioner2022In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 91-112Chapter in book (Other academic)
  • 8.
    Almborg, Ann-Helene
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Perceived Participation in Discharge Planning and Health Related Quality of Life after Stroke2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate the patients’ and their relatives’ perceived participation in discharge planning after stroke and the patients’ health-related quality of life, depressive symptoms, performance of personal daily activities and social activities in connection with discharge. Another aim was to evaluate the psychometric assumptions of the SF-36 for Swedish stroke patients.

    Prospective, descriptive and cross-sectional designs were used to study all patients with stroke admitted to the stroke unit at a hospital in southern Sweden from October 1, 2003 to November 30, 2005 each with one close relative. The total sample consisted of 188 patients (mean age=74.0 years) and 152 relatives (mean age=60.1 years). Data were collected during interviews, 2-3 weeks after discharge.

    The results showed that less depressive symptoms, more outdoor activities and performance of interests are important variables that related to higher HRQoL. SF-36 functions well as a measure of health related quality of life in Swedish stroke patients, but the two summary scales have shortcomings. Compared to a Swedish normal population, scores on all scales/components of the SF-36 were lower among stroke patients especially in the middle-aged group. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal setting. The relatives perceived that they need more information and they perceived low participation in goal setting and needs assessment. The professionals seem to lack effective practices for involving patients and their relatives to perceive participation in discharge planning. It is essential to develop and to implement methods for discharge planning, including sharing information, needs assessment with goal setting that facilitate patients’ and relatives’ perceived participation. The results suggest that ICF can be used in goal setting and needs assessment in discharge planning after acute stroke.

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  • 9.
    Almborg, Ann-Helene
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Ulander, Kerstin
    Thulin, Anders
    Berg, Stig
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Discharged after stroke - important factors for health-related quality of life.2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 15-16, p. 2196-2206Article in journal (Refereed)
    Abstract [en]

    AIMS: This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke.

    BACKGROUND: HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge.

    DESIGN: Cross-sectional study.

    METHODS: The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL.

    RESULTS: Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL.

    CONCLUSIONS: Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests.

    RELEVANCE TO CLINICAL PRACTICE: These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.

  • 10. Andel, Ross
    et al.
    Kåreholt, Ingemar
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    The role of midlife ocupational complexity and leisure time activity in cognitive performance later in life.2013Conference paper (Other academic)
  • 11.
    Andel, Ross
    et al.
    School of Aging Studies, University of South Florida, Tampa, Florida.
    Silverstein, Merril
    Sociology Department and School of Social Work, Aging Studies Institute, Syracuse University, New York.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    The role of midlife occupational complexity and leisure activity in late-life cognition2015In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 70, no 2, p. 314-321Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age.

    METHODS:

    We used 810 eligible participants from Longitudinal Study of Living Conditions of the Oldest Old, a Swedish nationally representative study of individuals aged 77+ with cognitive assessments (an abridged version of the Mini-Mental State Exam) administered in 1992 and 2002 and linked to information about their midlife occupation and leisure activities collected in 1968 and 1981. A bootstrapping technique was applied to examine the direct and interactive associations of occupational complexity and leisure activity with late-life cognition.

    RESULTS:

    Controlling for demographic and health-related factors from childhood, midlife, and late life, we found that greater work complexity, both with people and with data, and greater participation in cognitive or social leisure activities independently related to better late-life cognitive scores. The complexity-cognition link was moderated by leisure activity such that the cognitive benefit related to the complexity of work-especially complexity of working with people-was rendered insignificant when participation in leisure activities-especially social activities-was above average.

    DISCUSSION:

    Results are discussed in terms of using work complexity to compensate for lack of leisure activity as well as in terms of promoting leisure engagement to compensate for long-term cognitive disadvantage imposed by working in less challenging occupations.

  • 12.
    Andersson, Lars
    et al.
    Linköpings universitet.
    Sundström, Gerdt
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    En återkommande diskussion2019In: Äldre i centrum, ISSN 1653-3585, no 4, p. 54-58Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ingress: En del saker återkommer i det allmänna medvetandet och forskas om, gång på gång. Dit hör bilden av de äldres isolering. Två emeritusprofessorer förhåller sig dock skeptiska till den hajpade Svenska Ensamheten.

  • 13.
    Antevik, Johanna
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    "För att patienten kan få leva lite mer som den vill": - En kvalitativ intervjustudie om fysioterapeuters erfarenheter av patienters delaktighet i sin rehabilitering i ordinärt boende2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of older people in Sweden and globally who need health care at home is increasing. In Sweden, care is being transformed into Good and close care (Directly translated from God och nära vård), of which the patient's participation is central. Physiotherapists who work with older patients in ordinary housing need to work person-centred and support the patient with their self-care to enable participation.

    Aim: The aim of the study was to describe physiotherapists 'experience of older patients' participation in their rehabilitation in their home.  

    Method: Qualitative method with an inductive approach. Eight interviews were conducted with physiotherapists in municipal health care. The study was analyzed with qualitative content analysis.

    Results: The results revealed three overarching categories: 1) Factors that enable participation, 2) Barriers to participation and 3) A more independent life.

    Conclusion: Increased patient participation can lead to better treatment results, improved health, patients that are more independent and autonomy. Physiotherapists working in a structured person-centred and activity-oriented way, by listening to and guiding the patient and providing sufficient support for self-care, can promote patients' independence. Physiotherapists’ professional experience and clear activity goals contribute to person-centred treatment. Relatives’ attitudes, the patient’s ability and willingness to participate, lack of time, resources and the staff’s work environment in the patient’s home proved to be barriers to participation. 

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  • 14.
    Ayalon, Liat
    et al.
    Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
    Dolberg, Pnina
    Ruppin Academic Center, Emek Hefer, Israel.
    Mikulionienė, Sarmitė
    Institute of Sociology, Lithuanian Social Research Centre, Vilnius, Lithuania.
    Perek-Białas, Jolanta
    Institute of Sociology and Center of Evaluation and Public Policy Analysis, Jagiellonian University in Cracow, Cracow, Poland.
    Rapolienė, Gražina
    Institute of Sociology, Lithuanian Social Research Centre, Vilnius, Lithuania.
    Stypinska, Justyna
    Free University Berlin, Institute for East European Studies, Department of Sociology, Berlin, Germany.
    Wilińska, Monika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    de la Fuente-Núñez, Vânia
    Department on Ageing and Life Course, World Health Organization, Geneva, Switzerland.
    A systematic review of existing ageism scales2019In: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 54, article id 100919Article, review/survey (Refereed)
    Abstract [en]

    Ageism has been shown to have a negative impact on older people's health and wellbeing. Though multiple scales are currently being used to measure this increasingly important issue, syntheses of the psychometric properties of these scales are unavailable. This means that existing estimates of ageism prevalence may not be accurate. We conducted a systematic review aimed at identifying available ageism scales and evaluating their scope and psychometric properties. A comprehensive search strategy was used across fourteen different databases, including PubMed and CINAHL. Independent reviewers extracted data and appraised risk of bias following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Of the 29,664 records identified, 106 studies, assessing 11 explicit scales of ageism, were eligible for inclusion. Only one scale, the 'Expectations Regarding Aging' met minimum requirements for psychometric validation (i.e., adequate content validity, structural validity and internal consistency). Still, this scale only assesses the 'stereotype' dimension of ageism, thus failing to evaluate the other two ageism dimensions (prejudice and discrimination). This paper highlights the need to develop and validate a scale that accounts for the multidimensional nature of ageism. Having a scale that can accurately measure ageism prevalence is key in a time of increasing and rapid population ageing, where the magnitude of this phenomenon may be increasing.

  • 15.
    Bai, Ge
    et al.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Szwajda, Agnieszka
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Wang, Yunzhang
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Li, Xia
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Bower, Hannah
    Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden..
    Karlsson, Ida K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
    Johansson, Boo
    Univ Gothenburg, Ctr Ageing & Hlth AgeCap, Dept Psychol, Gothenburg, Sweden..
    Aslan, Anna K. Dahl
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.;Univ Skovde, Sch Hlth Sci, Skovde, Sweden..
    Pedersen, Nancy L.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Hagg, Sara
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Jylhava, Juulia
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Frailty trajectories in three longitudinal studies of aging: Is the level or the rate of change more predictive of mortality?2021In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 50, no 6, p. 2174-2182Article in journal (Refereed)
    Abstract [en]

    Background: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality. Objectives: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality. Methods: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis. Results: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age similar to 75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement. Conclusions: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.

  • 16.
    Bai, Ge
    et al.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden..
    Wang, Yunzhang
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden..
    Kuja-Halkola, Ralf
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden..
    Li, Xia
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden..
    Tomata, Yasutake
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden.;Kanagawa Univ Human Serv, Fac Hlth & Social Serv, Sch Nutr & Dietet, Yokosuka, Kanagawa, Japan..
    Karlsson, Ida K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden.;Jonkoping Univ, Sch Hlth & Welf, Inst Gerontol & Aging Res Network Jonkoping ARN J, Jonkoping, Sweden..
    Pedersen, Nancy L.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden..
    Hagg, Sara
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden..
    Jylhava, Juulia
    Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A, S-17165 Stockholm, Sweden.;Univ Tampere, Fac Social Sci Hlth Sci, Tampere, Finland.;Univ Tampere, Gerontol Res Ctr GEREC, Tampere, Finland..
    Frailty and the risk of dementia: is the association explained by shared environmental and genetic factors?2021In: BMC Medicine, E-ISSN 1741-7015, Vol. 19, no 1, article id 248Article in journal (Refereed)
    Abstract [en]

    Background Frailty has been identified as a risk factor for cognitive impairment and dementia. However, it is not known whether familial factors, such as genetics and shared environmental factors, underlie this association. We analyzed the association between frailty and the risk of dementia in a large twin cohort and examined the role of familial factors in the association. Methods The Rockwood frailty index (FI) based on 44 health deficits was used to assess frailty. The population-level association between FI and the risk of all-cause dementia was analyzed in 41,550 participants of the Screening Across the Lifespan Twin (SALT) study (full sample, aged 41-97 years at baseline), using Cox and competing risk models. A subsample of 10,487 SALT participants aged 65 and older who received a cognitive assessment (cognitive sample) was used in a sensitivity analysis to assess the effect of baseline cognitive level on the FI-dementia association. To analyze the influence of familial effects on the FI-dementia association, a within-pair analysis was performed. The within-pair model was also used to assess whether the risk conferred by frailty varies by age at FI assessment. Results A total of 3183 individuals were diagnosed with dementia during the 19-year follow-up. A 10% increase in FI was associated with an increased risk of dementia (hazard ratio [HR] 1.17 (95% confidence interval [CI] 1.07, 1.18)) in the full sample adjusted for age, sex, education, and tobacco use. A significant association was likewise found in the cognitive sample, with an HR of 1.13 (95% CI 1.09, 1.20), adjusted for age, sex, and cognitive level at baseline. The associations were not attenuated when adjusted for APOE e4 carrier status or considering the competing risk of death. After adjusting for familial effects, we found no evidence for statistically significant attenuation of the effect. The risk conferred by higher FI on dementia was constant after age 50 until very old age. Conclusions A higher level of frailty predicts the risk of dementia and the association appears independent of familial factors. Targeting frailty might thus contribute to preventing or delaying dementia.

  • 17.
    Bannon, Brittany L.
    et al.
    Univ Utah, Salt Lake City, USA.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Pedersen, Nancy L.
    Karolinska Inst, Stockholm, Sweden.
    Reynolds, Chandra A.
    Univ Calif Riverside, USA.
    Illness behaviors mediate the link between social support and functional decline in the Swedish Adoption Twin Study of Aging2018In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 52, no Suppl. 1, p. S314-S314Article in journal (Refereed)
  • 18.
    Baumann, I.
    et al.
    Center for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland.
    Eyjólfsdóttir, H. S.
    Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
    Fritzell, J.
    Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
    Lennartsson, C.
    Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
    Darin-Mattsson, A.
    Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Andel, R.
    School of Aging Studies, University of South Florida, Tampa, FL, United States.
    Dratva, J.
    Center for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland.
    Agahi, N.
    Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
    Do cognitively stimulating activities affect the association between retirement timing and cognitive functioning in old age?2022In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 42, no 2, p. 306-330Article in journal (Refereed)
    Abstract [en]

    In response to the rising financial pressure on old-age pension systems in industrialised economies, many European countries plan to increase the eligibility age for retirement pensions. We used data from Sweden to examine whether (and if so, how) retirement after age 65 - the eligibility age for basic pension - compared to retiring earlier affects older adults' (between ages 70 and 85) cognitive functioning. Using a propensity score matching (PSM) approach, we addressed the selection bias potentially introduced by non-random selection into either early or late retirement. We also examined average and heterogeneous treatment effects (HTEs). HTEs were evaluated for different levels of cognitive stimulation from occupational activities before retirement and from leisure activities after retirement. We drew from a rich longitudinal data-set linking two nationally representative Swedish surveys with a register data-set and found that, on average, individuals who retire after age 65 do not have a higher level of cognitive functioning than those who retire earlier. Similarly, we did not observe HTEs from occupational activities. With respect to leisure activities, we found no systematic effects on cognitive functioning among those working beyond age 65. We conclude that, in general, retirement age does not seem to affect cognitive functioning in old age. Yet, the rising retirement age may put substantial pressure on individuals who suffer from poor health at the end of their occupational career, potentially exacerbating social- and health-related inequalities among older people.

  • 19. Baumann, I.
    et al.
    Sif Eyjólfsdóttir, H.
    Fritzell, J.
    Lennartsson, C.
    Darin-Mattsson, A.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Andel, R.
    Dratva, J.
    Agahi, N.
    Retirement age and cognitive functioning in old age: the role of stimulating occupational activities. The role of occupational activity in explaining the association between retirement timing and cognitive functioning in old age2018Conference paper (Refereed)
  • 20. Baumann, I.
    et al.
    Sif Eyjólfsdóttir, H.
    Fritzell, J.
    Lennartsson, C.
    Darin-Mattsson, A.
    Nilsen, Charlotta
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Andel, R.
    Dratva, J.
    Agahi, N.
    Retirement age and cognitive functioning in old age: the role of stimulating occupational activities2018Conference paper (Refereed)
  • 21.
    Beam, Christopher R.
    et al.
    Univ Southern Calif, Dept Psychol, Los Angeles, CA 90007 USA.;Univ Southern Calif, Sch Gerontol, Los Angeles, CA 90007 USA..
    Finkel, Deborah
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Indiana Univ Southeast, Dept Psychol, New Albany, IN 47150 USA.;Jonkoping Univ, Inst Gerontol, Smaland, Sweden..
    Turkheimer, Eric
    Univ Virginia, Dept Psychol, Gilmer Hall, Charlottesville, VA 22903 USA..
    Guterbock, Thomas
    Univ Virginia, Survey Res Ctr, Charlottesville, VA USA..
    Johnson, Sean
    Univ Virginia, Survey Res Ctr, Charlottesville, VA USA..
    Giangrande, Evan J.
    Univ Virginia, Dept Psychol, Gilmer Hall, Charlottesville, VA 22903 USA..
    Pasquenza, Natalie
    Univ Louisville, Dept Pediat, Louisville, KY 40292 USA..
    Ryan, Lesa
    Univ Louisville, Dept Pediat, Louisville, KY 40292 USA..
    Davis, Deborah W.
    Univ Louisville, Dept Pediat, Louisville, KY 40292 USA..
    Preliminary Results of Cognitive Ability Trajectories from Infancy Through Middle-Age in the Louisville Twin Study2021In: Behavior Genetics, ISSN 0001-8244, E-ISSN 1573-3297, Vol. 51, no 6, p. 693-694Article in journal (Refereed)
  • 22.
    Beam, Christopher R.
    et al.
    Department of Psychology, University of Southern California, Los Angeles, CA, United States.
    Turkheimer, Eric
    Department of Psychology, University of Virginia, Charlottesville, VA, United States.
    Finkel, Deborah
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Psychology, Indiana University Southeast, New Albany, IN, United States.
    Levine, Morgan E.
    Department of Pathology, School of Medicine, Yale University, New Haven, CT, United States.
    Zandi, Ebrahim
    Norris Comprehensive Cancer Center & Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
    Guterbock, Thomas M.
    Center for Survey Research and Department of Sociology, University of Virginia, Charlottesville, VA, United States.
    Giangrande, Evan J.
    Department of Psychology, University of Virginia, Charlottesville, VA, United States.
    Ryan, Lesa
    Department of Pediatrics, University of Louisville, Louisville, KY, United States.
    Pasquenza, Natalie
    Department of Pediatrics, University of Louisville, Louisville, KY, United States.
    Davis, Deborah W.
    Department of Pediatrics, University of Louisville, Louisville, KY, United States.
    Midlife study of the Louisville Twins: Connecting cognitive development to biological and cognitive aging2020In: Behavior Genetics, ISSN 0001-8244, E-ISSN 1573-3297, Vol. 50, no 2, p. 73-83Article in journal (Refereed)
    Abstract [en]

    The Louisville Twin Study (LTS) began in 1958 and became a premier longitudinal twin study of cognitive development. The LTS continuously collected data from twins through 2000 after which the study closed indefinitely due to lack of funding. Now that the majority of the sample is age 40 or older (61.36%, N = 1770), the LTS childhood data can be linked to midlife cognitive functioning, among other physical, biological, social, and psychiatric outcomes. We report results from two pilot studies in anticipation of beginning the midlife phase of the LTS. The first pilot study was a participant tracking study, in which we showed that approximately 90% of the Louisville families randomly sampled (N = 203) for the study could be found. The second pilot study consisted of 40 in-person interviews in which twins completed cognitive, memory, biometric, and functional ability measures. The main purpose of the second study was to correlate midlife measures of cognitive functioning to a measure of biological age, which is an alternative index to chronological age that quantifies age as a function of the breakdown of structural and functional physiological systems, and then to relate both of these measures to twins’ cognitive developmental trajectories. Midlife IQ was uncorrelated with biological age (−.01) while better scores on episodic memory more strongly correlated with lower biological age (−.19 to −.31). As expected, midlife IQ positively correlated with IQ measures collected throughout childhood and adolescence. Additionally, positive linear rates of change in FSIQ scores in childhood significantly correlated with biological age (−.68), physical functioning (.71), and functional ability (−.55), suggesting that cognitive development predicts lower biological age, better physical functioning, and better functional ability. In sum, the Louisville twins can be relocated to investigate whether and how early and midlife cognitive and physical health factors contribute to cognitive aging. 

  • 23.
    Bengnér, Malin
    et al.
    Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
    Béziat, Vivien
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ernerudh, Jan
    Division of Clinical Immunology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Nilsson, Bengt-Olof
    Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Department of Laboratory Medicine, Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Wikby, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Malmberg, Karl Johan
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Strindhall, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Independent skewing of the T cell and NK cell compartments associated with cytomegalovirus infection suggests division of labor between innate and adaptive immunity.2014In: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, Vol. 36, no 2, p. 571-582Article in journal (Refereed)
    Abstract [en]

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

  • 24.
    Bjurbäck, Helena
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    I gränslandet mellan att bistå och bistånd: En kartläggning av biståndshandläggares hantering av sociala problem2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Socialt arbete med äldre har under lång tid behandlats synonymt med äldreomsorg. Detta trots att målgruppen är heterogen med skiftande och individuella behov precis som alla andra människor. Detta gör att äldreomsorgen inte sällan får agera sista instans även för äldre personer med sociala problem som kanske inte alltid har tydliga omsorgsbehov. Detta riskerar leda till att vissa sociala problem som äldre personer har faller mellan stolarna och därför behöver biståndshandläggarens uppgifter och arbete för äldre personer breddas. Äldreförvaltningen i Göteborgs stad har beslutat att bredda yrkesrollen till att bistå äldre personer som har behov utanför äldreomsorgen. I samverkan med forskare vid Institutionen för socialt arbete, Göteborgs universitet och Högskolan Väst delades en webbenkät ut till 205 biståndshandläggare i Göteborgs Stad inom avdelningen för myndighet äldre. Kartläggningen genomförs innan förändringen av yrkesrollen ägt rum med som en sorts temperaturtagning av utgångsläget och förutsättningar inför breddningen av yrkesrollen. Materialet från enkätundersökningen används och utgör material till aktuell magisteruppsats för att studera i vilken utsträckning som sociala problem hanteras inom äldreomsorgen inom den traditionella biståndshandläggarrollen. Syftet är att studera biståndshandläggares arbete med sociala problem inom äldreomsorgen och hur detta påverkas av utbildningsbakgrund och antal år i arbetet som biståndshandläggare. Resultaten visar att biståndshandläggare sällan möter sociala problem och att de hänvisar i låg uträckning till andra myndigheter och verksamheter. Det verkar som att antal år i arbetet har större betydelse än utbildningsbakgrund för hantering av sociala problem. Samtidigt säger studien för lite om biståndshandläggarens förutsättningar i arbetet och fler studier behövs. Biståndshandläggare vill arbeta mer förebyggande. Utifrån studiens resultat kan kunskap om relationen mellan olika sociala problem därför förstås som viktig för att de bättre ska kunna upptäcka och förebygga problemen. Breddningen av biståndshandläggarens uppdrag kan även kräva mer kunskap om hanteringen av sociala problem mellan myndigheter och verksamheter som kommer i kontakt med äldre personer och de sociala problemen.

     

     

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  • 25.
    Bjursell, Cecilia
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Growth through education: the narratives of older adults2019In: Frontiers in Sociology, E-ISSN 2297-7775, Vol. 4, article id 11Article in journal (Refereed)
    Abstract [en]

    The focus of Narrative Gerontology is placed on stories about the aging process. In the present paper, the learning of older adults in a Senior University context is captured by means of stories written by the participants themselves. The examination of older adults' stories, as they look back on life or any narrative that connected to a specific area of life, can contribute to our understanding of growth later in life. The aim of the study is to examine how growth manifests itself later in life. Participants at Senior University were asked to share their experiences of education later in life. Participation was voluntary and the identity of each participant was kept anonymous for the purpose of the research project. Fifty-three stories written by Senior University participants (n = 38 women and 15 men) were analyzed according to: (i) an inductive analysis of the stories that resulted in a description of the main topics addressed in the stories, and (ii) a deductive analysis that invoked a theoretical framework concerning the existential aspects of older adults' learning, including “corporeality,” “relationality,” “spatiality,” “temporality,” and “materiality.” The two analyses were compared, and it was noted that “relationality” and “spatiality” corresponded to the educational experiences in the stories. “Relationality” was observed to be concerned with the social dimensions of life; but in the context of Senior University, “relationality” was strongly intertwined with the learning process. “Spatiality” addressed how older adults relate to physical- and mental space. Participation at Senior University entailed an expansion of both physical- and mental space for the participants. A number of tensions were identified in the stories. One the one hand, the stories can be interpreted as illustrations of moving forward and embracing continued growth and development. On the other hand, the stories can be interpreted as illustrations of resistance toward aging and decline. Since life is complex and contradictory, multiple, and even contradictory plots, co-exist in life stories.

  • 26.
    Bjursell, Cecilia
    et al.
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Nystedt, Paul
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sternäng, Ola
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Stockholm Centre for Health and Social Change (SCOHOS).
    Education level explains participation in work and education later in life2017In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 43, no 10, p. 511-521Article in journal (Refereed)
    Abstract [en]

    A prolonged working life is crucial for sustaining social welfare and fiscal stability for countries facing ageing populations. The group of older adults is not homogeneous; however, differences within the group may affect the propensity to continue working and to participate in continuing education. The aim of this paper is to explore how participation in work and education vary with gender, age, and education level in a sample of older adults. The study was performed in Sweden, a context characterized by high female labour-market-participation rates and a high average retirement age. The participants were 232 members of four of the major senior citizens? organizations. We found no differences in participation in work and education based on gender. People older than 75 years were found to be as active as people 65?75 years old in education, but the older group worked less. There were positive associations between education level and participation in both work and education. Hence, this study implies that socio-economic inequalities along these dimensions are widened later in life. This highlights the importance of engaging workers with lower education levels in educational efforts throughout life. It also emphasizes the need for true lifelong learning in society.

  • 27.
    Björklund Carlstedt, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Bridge employment - ett fortsatt arbetsliv2018In: Äldre i centrum, ISSN 1653-3585, no 2, p. 44-47Article in journal (Other (popular science, discussion, etc.))
  • 28.
    Blaakilde, Anne Leonora
    et al.
    Region Zealand.
    Wilinska, MonikaJönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).Mosberg Iversen, SaraUniversity of Southern Denmark.
    Special issue: Growing old with and via media. MedieKultur: Journal of media and communication research, 33(63)2017Collection (editor) (Other academic)
  • 29.
    Blane, A.
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, H. C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, M.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Parsons, R.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    The cognitive and socio-demographic influences on driving performance and driving cessation in post-stroke drivers2016In: Advances in Transportation Studies, ISSN 1824-5463, no 38, p. 75-90Article in journal (Refereed)
    Abstract [en]

    Background: Driving is a complex activity requiring highly integrated cognitive and perceptual functions that can be negatively affected following a stroke. The decision to continue or cease with driving after a stroke may not be exclusively dependent on deficits in cognitive and motor abilities. Instead, it is possible that social supports, alternative means of transportation, education level, income, self-regulation ability and the awareness of personal health problems may also influence the decision.

    Aim: The aim of this research was to explore the influence of personal and socioeconomic factors, in addition to existing cognitive impairment, on the decision of post-stroke adults to return to driving.

    Method: A case control design was employed to compare driving performance of 48 individuals who had experienced a stroke and 22 volunteer healthy control participants. Half of the post-stroke cohort (N=24) had continued driving and the other half had ceased driving. Socio-demographic and driving-related cognitive performance data were collected to characterise the comparison groups before driving performance was assessed in a driving simulator.

    Results: Overall, the post-stroke groups did not perform as well as the control participants in the cognitive and driving assessments. The perceived ability to drive after a stroke was not significantly correlated with participants'€™ actual driving ability. Post-stroke adults were more likely to continue driving if they reported having a tertiary level education and a greater income.

    Conclusion: The decision to return to driving after a stroke is a complicated, multifactorial process. This study confirms previous research, which found that cognition and driving performance are impaired poststroke. The findings also suggest that post-stroke drivers'€™ decision to return to driving was not linked to their ability to drive, but more to socio-demographic and environmental factors. Further screening tools and assessments to identify those at risk when returning to the road post-stroke are required. 

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  • 30.
    Blane, Alison
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Lee, Hoe C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Willstrand, Tania Dukic
    Swedish National Road and Transport Research Institute (VTI), Human Factors, Göteborg, Sweden.
    Assessing Cognitive Ability and Simulator-Based Driving Performance in Poststroke Adults2017In: Behavioural Neurology, ISSN 0953-4180, E-ISSN 1875-8584, article id 1378308Article in journal (Refereed)
    Abstract [en]

    Driving is an important activity of daily living, which is increasingly relied upon as the population ages. It has been well-established that cognitive processes decline following a stroke and these processes may influence driving performance. There is much debate on the use of off-road neurological assessments and driving simulators as tools to predict driving performance; however, the majority of research uses unlicensed poststroke drivers, making the comparability of poststroke adults to that of a control group difficult. It stands to reason that in order to determine whether simulators and cognitive assessments can accurately assess driving performance, the baseline should be set by licenced drivers. Therefore, the aim of this study was to assess differences in cognitive ability and driving simulator performance in licensed community-dwelling poststroke drivers and controls. Two groups of licensed drivers (37 poststroke and 43 controls) were assessed using several cognitive tasks and using a driving simulator. The poststroke adults exhibited poorer cognitive ability; however, there were no differences in simulator performance between groups except that the poststroke drivers demonstrated less variability in driver headway. The application of these results as a prescreening toolbox for poststroke drivers is discussed.

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  • 31.
    Bogl, Leonie H.
    et al.
    Institute for Molecular Medicine FIMM, Finland and University of Helsinki, Finland.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Sweden.
    Kaprio, Jaakko
    Institute for Molecular Medicine FIMM, Finland and University of Helsinki, Finland.
    Does the sex of one’s co-twin affect height and BMI in adulthood?: A study of dizygotic adult twins from 31 cohorts2017In: Biology of Sex Differences, ISSN 2042-6410, Vol. 8, no 1, article id 14Article in journal (Refereed)
    Abstract [en]

    Background: The comparison of traits in twins from opposite-sex (OS) and same-sex (SS) dizygotic twin pairs is considered a proxy measure of prenatal hormone exposure. To examine possible prenatal hormonal influences on anthropometric traits, we compared mean height, body mass index (BMI) and the prevalence of being overweight or obese between men and women from OS and SS dizygotic twin pairs.

    Methods: The data were derived from COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) database, and included 68,494 SS and 53,808 OS dizygotic twin individuals above the age of 20 years from 31 twin cohorts representing 19 countries. Zygosity was determined by questionnaires or DNA genotyping depending on the study. Multiple regression and logistic regression models adjusted for cohort, age and birth year with the twin type as a predictor were carried out to compare height and BMI in twins from OS pairs with those from SS pairs and to calculate the adjusted odds ratios and 95% confidence intervals for being overweight or obese.

    Results: OS females were, on average, 0.31 cm (95% confidence interval (CI): 0.20, 0.41) taller than SS females. OS males were also, on average, taller than SS males, but this difference was only 0.14 cm (95% CI: 0.02, 0.27). Mean BMI and the prevalence of overweight or obesity did not differ between males and females from SS and OS twin pairs. The statistically significant differences between OS and SS twins for height were small and appeared to reflect our large sample size rather than meaningful differences of public health relevance.

    Conclusions: We found no evidence to support the hypothesis that prenatal hormonal exposure or postnatal socialization (i.e., having grown up with a twin of the opposite sex) has a major impact on height and BMI in adulthood.

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  • 32.
    Bokenberger, Kathleen
    et al.
    Karolinska Institutet.
    Pedersen, Nancy
    Karolinska Institutet.
    Gatz, Margaret
    University of Southern California.
    Dahl, Anna
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    The Type A behavior pattern and cardiovascular disease as predictors of dementia2014In: Health Psychology, ISSN 0278-6133, E-ISSN 1930-7810, Vol. 33, no 12, p. 1593-1601Article in journal (Refereed)
    Abstract [en]

    Objective: Research has suggested that greater psychophysiological reactivity to stress increases risk of dementia and that those with the Type A behavior pattern (TABP) are predisposed to elevated stress reactivity and cardiovascular disease (CVD), but no study has evaluated the associations among TABP, CVD, and dementia, prospectively. Hence, the present study aimed to investigate dementia risk in relation to TABP and CVD.

    Methods: A population-based cohort of 1,069 persons with a baseline mean age of 64.81 years from the Swedish Twin Registry was followed consecutively for up to 23 years. Based on self-reported items, TABP was measured using 6 scales: Ambition, Stress, Hard-driving, Neuroticism, Cynicism, and Paranoia. CVD was self-reported and dementia was diagnosed adhering to Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R) or Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria.

    Results: TABP was generally not associated with dementia risk. However, significant interaction effects of stress, paranoia, and cynicism with CVD on dementia risk were observed. That is, for those with CVD, high scores on stress, paranoia, and cynicism were associated with increased risk of dementia (hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 0.95-2.15; HR = 1.39, 95% CI = 0.83-2.33; HR = 1.25, 95% CI = 0.76-2.06, respectively), whereas for those who did not have CVD, high scores on these measures appeared to be protective (HR = 0.76, 95% CI = 0.50-1.14; HR = 0.55, 95% CI = 0.34-0.89; HR = 0.50, 95% CI = 0.29-0.84, respectively).

    Conclusion: Some features of TABP confer an increased risk for dementia in those with CVD, whereas those without CVD are protected. When evaluating the risk of dementia, CVD and personality traits should be taken into consideration.

  • 33.
    Bokenberger, Kathleen
    et al.
    Karolinska Institutet.
    Ström, Peter
    Karolinska Institutet.
    Aslan, Anna K. Dahl
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet.
    Johansson, Anna
    Karolinska Institutet.
    Åkerstedt, Torbjörn
    Stockholms universitet.
    Pedersen, Nancy L.
    Karolinska Institutet.
    The effect of shift work on cognitive aging across the late adult life course2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, article id 360Article in journal (Other academic)
  • 34.
    Bokenberger, Kathleen
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Ström, Peter
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Anna L. V.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Gatz, Margaret
    Department of Psychology, University of Southern California, Los Angeles CA, USA.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Åkerstedt, Torbjörn
    Stress Research Institute, Stockholm University, Sweden.
    Association between sleep characteristics and incident dementia accounting for baseline cognitive status: A prospective population-based study2017In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 72, no 1, p. 134-139Article in journal (Refereed)
    Abstract [en]

    Background: While research has shown that sleep disorders are prevalent among people with dementia, the temporal relationship is unclear. We investigated whether atypical sleep characteristics were associated with incident dementia while accounting for baseline cognitive functioning.

    Methods: Screening Across the Lifespan Twin Study (SALT) participants were 11,247 individuals from the Swedish Twin Registry who were at least 65 years at baseline (1998-2002). Sleep and baseline cognitive functioning were assessed via the SALT telephone screening interview. Data on dementia diagnoses came from national health registers. Cox regression was performed to estimate hazard ratios (HR) for dementia.

    Results: After 17 years of follow-up, 1,850 dementia cases were identified. Short (≤ 6 hours) and extended (> 9 hours) time-in-bed (TIB) compared to the middle reference group (HR=1.40, 95% CI=1.06-1.85, HR=1.11, 95% CI=1.00-1.24, respectively) and rising at 8:00AM or later compared to earlier rising (HR=1.12, 95% CI=1.01-1.24) were associated with higher dementia incidence. Bedtime, sleep quality, restorative sleep, and heavy snoring were not significant predictors. Findings stratified by baseline cognitive status indicated that the association between short TIB and dementia remained in those cognitively intact at the start.

    Conclusions: Short and extended TIB as well as delayed rising among older adults predicted increased dementia incidence in the following 17 years. The pattern of findings suggests that extended TIB and late rising represent prodromal features whereas short TIB appeared to be a risk factor for dementia.

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  • 35.
    Bokenberger, Kathleen
    et al.
    Karolinska Institutet, Sweden.
    Ström, Peter
    Karolinska Institutet, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Sweden.
    Åkerstedt, Torbjörn
    Karolinska Institutet, Sweden and Stockholm University, Sweden.
    Pedersen, Nancy L.
    Karolinska Institutet, Sweden and University of Southern California, USA.
    Shift work and cognitive aging: A longitudinal study2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, p. 485-493Article in journal (Refereed)
    Abstract [en]

    Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed.

    Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986–2012. Night work history (ever/never) from 1998–2002 was available from a subsample (N=320). Early adult cognitive test scores were available for 77 men.

    Results In latent growth curve modeling, there were no main effects of "any-type" or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand.

    Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.

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  • 36.
    Boman, I.-L.
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Lundberg, S.
    Royal Institute of Technology, School of Technology and Health, Handen, Sweden.
    Nygård, L.
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    First steps in designing a videophone for people with dementia: identification of users' potentials and the requirements of communication technology.2012In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 7, no 5, p. 356-63Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To identify, based on the literature, people with dementia's potentials to manage an easy-to-use videophone, and to develop a videophone requirement specification for people with dementia.

    METHOD: The study is based on the Inclusive Design method, utilising the first two of four phases. Content analyses of literature reviews were used to identify users' potentials for managing a videophone and to gather recommendations regarding communication technology design for the target group. Existing videophones in Sweden were examined regarding potential fit to users with dementia.

    FINDINGS: This led to detailed identification of cognitive, physical and psychosocial challenges that people with dementia will probably have when using an ordinary telephone or videophone. A requirement specification for videophone design to fit users with dementia was formulated, with the seven principles of Universal Design as a framework.

    CONCLUSIONS: The requirement specification presented here is aimed at designing a videophone but might also facilitate design of other products for people with dementia, particularly in the field of communication technology. Based on this, further work will focus on developing a design concept and a prototype to be empirically tested by people with dementia and their significant others, i.e. the final two design process phases.

  • 37.
    Boman, Inga-Lill
    et al.
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Department of Rehabilitation Medicine, Danderyds Hospital, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Rosenberg, Lena
    Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Users' and professionals' contributions in the process of designing an easy-to-use videophone for people with dementia2014In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 9, no 2, p. 164-172Article in journal (Refereed)
    Abstract [en]

    Purpose: To develop a design concept for an easy-to-use videophone for people with dementia and to evaluate the design and need of such a product.

    Method: In this project, we have used an inclusive design approach that includes the target users in the design process. In an earlier study, the need of a videophone was examined and a requirement specification was developed. In this study, a preliminary design concept was developed. Five focus groups of people with dementia, significant others and occupational therapists working with people with dementia were formed to capture their experiences, expectations and thoughts concerning the videophone and the design concept. Data were analysed using a grounded theory approach.

    Findings: The participants pointed out that the design of the videophone should be flexible in order to meet the needs of people with dementia, be easy-to-use and not look like assistive technology. In order to facilitate learning, the videophone should be introduced in an early stage of the disease.

    Conclusions: A videophone has potentials to enable videophone calls without assistance, add quality in communication and provide possibilities for monitoring. Further work will focus on developing a prototype to be empirically tested by people with dementia and significant others.

    Implications for Rehabilitation

    • An easy-to-use videophone was viewed as an important device that could support people with dementia in making videophone calls without assistance. It was also viewed as a product that significant others could use for monitoring the person with dementia, for example to judge the well-being of the person. But monitoring should be used with caution and not without the consent of the person with dementia.
    • It was viewed as important that the videophone be introduced in an early stage of the disease in order to facilitate learning, so that the person can get used to the new way of making telephone calls and incorporate the new habit in his/her routines.
    • In order to motivate people with dementia to start using a videophone, it was recommended that the videophone should be introduced as a product which is a pleasure to use, and not as a compensation for impairment or to solve a problem.
  • 38.
    Boström, Anita
    et al.
    Institutionen för hälsovetenskaper, Karlstads universitet.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ludvigsson, Mikael
    Linköpings universitet.
    Saveman, Britt-Inger
    Institutionen för omvårdnad, Umeå universitet.
    Simmons, Johanna
    Medicinska och geriatriska akutkliniken, Universitetssjukhuset i Linköping.
    Siverskog, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Åkerlund, Nina
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Förekomsten av våld i nära relationer bland äldre personer2022In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 31-64Chapter in book (Other academic)
  • 39.
    Boström, Martina
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Trygghet - på vems villkor? Uppfattningar om och erfarenheter av trygghet hos äldre personer med behov av omsorg2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to increase the knowledge and understanding of how older people with varying needs of care perceive and experience sense of security in ordinary homes and in nursing homes.

    This thesis comprised four studies, which are to be found at the end of this manuscript. The first two studies were based on the same data material, collected using focus group interviews with 45 elderly individuals living in senior housing with minimal care needs. The interviews were analyzed using qualitative content analysis (I, II). The third study was based on secondary analysis of a user survey of 350 older individuals in ordinary housing with some kind of elder care/service and 145 older individuals with around-the-clock care needs living in nursing homes. The material was processed using descriptive and analytical statistics (III). The fourth study followed three older individuals for 12-16 weeks, using four in-depth interviews and observations to examine the move from ordinary into nursing homes. This material was also analyzed using qualitative content analysis. The use of a personal emergency response system (PERS) was perceived as limiting the lives of elderly people, because the alarm only functions within a person’s apartment. The limited range of the PERS was perceived as reducing elders’ freedom and increasing insecurity, anxiety, and fear (I). Increased reliance on care interventions using monitoring technology, with which the individual and their position is monitored on a larger scale, was not considered a problem, as long as it led to increased security and allowed older individuals to maintain control and a sense of self (II). Perceived health, secure relationships, knowledge, and control were factors that were related to perceived sense of security in the daily lives of older individuals with care, both in ordinary homes and in nursing homes (III).

    Moving to a nursing home and gradually transferring the control of one’s belongings and daily routines to care staff led to a feeling of greater safety for the older person, but not necessarily a sense of security (IV). In summary, older individuals value, prioritize, and perceive sense of security as very important in their life, but do not always experience a sense of security in ordinary housing and nursing homes. Security is perceived as something so important in life that older people will consider sacrificing their privacy and integrity in lieu of security. Because the sense of security is not always perceived and experienced as good, older individuals search for strategies that contribute to their sense of security through material objects and through relationships with other people. These results indicate that it is essential to support older individuals’ everyday life, regardless of care type, to promote a sense of security on their terms.

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  • 40.
    Bouillon, Kim
    et al.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, UK.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, UK.
    Sabia, Severine
    Department of Epidemiology and Public Health, University College London, London, UK.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, UK.
    Gale, Catharine R.
    MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, UK.
    Measures of frailty in population-based studies: An overview2013In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 13, no 64Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 41.
    Brink, Satya
    Gerontology Research Centre, Simon Fraser University, Burnaby, Canada.
    Elder care: the nexus for family, work and health policy2004Report (Other academic)
  • 42.
    Brink, Satya
    Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada.
    International policy trends in housing the elderly in developed countries1990In: Ageing International, ISSN 0163-5158, E-ISSN 1936-606X, Vol. 17, no 2, p. 13-20Article in journal (Refereed)
    Abstract [en]

    The proportion of elderly persons in the population is rising in the developed countries. Housing and related social policies are undergoing change to respond to this socio-demographic change within the context of wider changes in policy thinking with respect to housing and aging. International trends in housing policy for elderly people may be discerned despite national variations. The governments of developed countries are beginning to be more engaged in multi-sectoral planning, in decentralization of responsibilities for housing, health and support services and in cost-sharing arrangements for housing and related policies. The quality of life for elderly persons has benefitted through increased opportunities for aging in place in their own homes and through better designed residential facilities. The nineties have been called"the age of age." The aging of the population presents immense challenges to the way human settlements are designed and organized. The responses to the challenge will be determined, nevertheless, more by societal choices than by socio-demographic changes. 

  • 43.
    Brink, Satya
    International Consultant in Education and Human Capital, Chelsea, Canada.
    Learning in later years in the lifelong learning trajectory2017In: Journal of Intergenerational Relationships, ISSN 1535-0770, E-ISSN 1535-0932, Vol. 15, no 1, p. 14-25Article in journal (Refereed)
    Abstract [en]

    An examination of learning in later life in the context of lifelong learning shows that it is a phase on its own and not simply an extension of adult learning, particularly in the 21st century. It exhibits characteristics unlike earlier phases and has benefits that are more aligned with later life. The changes to the growing share of this demographic in the population has implications for the provision of learning opportunities. The life stage changes that are evolving are shown compared to previous generations. The needs and benefits of late life learning are described in contrast to adult learning and the adaptations for successful lifelong learning are listed based on life span theories and current research. 

  • 44.
    Brink, Satya
    Canada Mortgage and Housing Corporation, Government of Canada, Ottawa, Canada, and Gerontology Research Centre, Simon Fraser University, British Columbia, Burnaby, BC, Canada.
    Social equity or distributive justice? The reliance on mainstream and targeted housing policies to serve the elderly in Canada, the United States, Sweden and France1989In: Scandinavian Housing and Planning Research, ISSN 0281-5737, Vol. 6, no 2, p. 103-113Article in journal (Refereed)
    Abstract [en]

    This paper examines the application of the principles of social equity and distributive justice in practice by governments under economic and demographic pressures. The housing policies that benefit the elderly are identified in Canada, the United States, Sweden and France and a policy analysis of the mainstream and targeted policies is carried out. The objectives of this paper are to observe the use of mainstream and targeted policies to house the elderly, to examine how elements benefiting the elderly are incorporated into mainstream policies and to identify the object! ves of targeted elements of policies benefiting the elderly. Governments tend to use mainstream policies and also to use various strategies for adding targeted elements to them. Targeted policies for the elderly are used sparingly. In practice, government actions for social equity and distributive justice are limited to ensuring access to a minimum level of welfare and reducing inequalities.

  • 45.
    Bülow, Pia H.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Bülow, Per
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.
    Wilińska, Monika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Torgé, Cristina Joy
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Jegermalm, Magnus
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    The meaning of illness, times and spaces: Stories about severe mental illness from a life course perspective2019Conference paper (Refereed)
  • 46.
    Cahill, Suzanne
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. School of Social Work and Social Policy, Trinity College Dublin, Ireland; Centre for Economic and Social Research on Dementia, National University of Ireland, Galway, Ireland.
    Personhood, dementia literacy, and the causes and consequences of Alzheimer's disease fear2021In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 33, no 10, p. 997-999Article in journal (Other academic)
  • 47.
    Cahill, Suzanne
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Trinity College Dublin, Ireland.
    Perspectives on the person with dementia and family caregiving in Ireland2021Book (Refereed)
    Abstract [en]

    This book is all about dementia in Ireland and what has and has not been happening in a country where dementia has been a taboo topic for so long. In particular it examines the dementia landscape since late 2014, following the launch of Ireland's first National Dementia Strategy. A lot has happened in Ireland since that time but a lot more needs to happen for people to live well with dementia and have their human rights upheld. There are an estimated 55,000 Irish people living with dementia and these figures are set to triple by 2050. Although topics explored in the book,such as obtaining a diagnosis, accessing home care services and moving from home into a nursing home relate to Ireland, they are discussed against the backdrop of policy, practice and research developments in dementia in other parts of the world. In this way the book provides the reader with a wealth of information including research evidence, best practice guidelines and international expertise. The book has been dedicated to Mnánah 'éireann, in recognition of the hard physical and emotional work, caregivers,mostly women do behind closed doors. Throughout the book, an appeal is made for more state support to be given to these formal and informal caregivers. 

  • 48.
    Cahill, Suzanne
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Centre for Economic and Social Research, NUI Galway, Ireland.
    Using technology in dementia care2021In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 20, no 8, p. 3055-3056, article id 14713012211011265Article, book review (Other (popular science, discussion, etc.))
  • 49.
    Cahill, Suzanne
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Social Work and Social Policy, Dementia Care NUI Galway, Trinity College Dublin, Dublin, Ireland.
    Bielsten, Therese
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Zarit, Steven H.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Department of Human Development and Family Studies, Penn State University, University Park, PA, USA.
    Developing a Framework for the Support of Informal Caregivers: Experiences from Sweden, Ireland, and the United States2023In: Research on Aging, ISSN 0164-0275, E-ISSN 1552-7573, Vol. 45, no 3-4, p. 385-395Article in journal (Refereed)
    Abstract [en]

    Policies and services to support informal caregivers vary considerably across countries. This paper examines the role of caregivers and how perspectives on that role may influence the availability of benefits and services in three countries that differ considerably in their care systems - Sweden, Ireland and the United States. We developed a nine-dimensional framework for examining differences, including policies and how the role of caregiver is conceptualized. We found differences in the three countries in how services are organized, which reflected assumptions about the caregiver role. There were also similarities in the three countries. Caregivers held an ambiguous position within each social system and there was little concern for equity in the delivery of support services. Increased clarity about the role of caregivers may facilitate development of policies that more effectively meet their varied needs.

  • 50.
    Campbell, Sarah
    et al.
    Manchester Metropolitan University, Manchester, UK.
    Clark, Andrew
    University of Salford, Salford, UK.
    Keady, John
    University of Manchester, Manchester, UK.
    Manji, Kainde
    Age Scotland, Scotland, UK.
    Odzakovic, Elzana
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Rummery, Kirstein
    University of Stirling, Stirling, UK.
    Ward, Richard
    University of Stirling, Stirling, UK.
    'I can see what's going on without being nosey…': What matters to people living with dementia about home as revealed through visual home tours.2023In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 38, no 9, article id e5999Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This paper considers home from the perspective of people living with dementia supporting ongoing discourse around ageing in place and the significance of creating more inclusive communities.

    METHODS: Forty-six home tour interviews led by people living with dementia were conducted in England and Scotland to better understand the connectivity between home and neighbourhood for people living with dementia. These interviews used a range of participatory and creative approaches including video, photographic images and in situ interviews. Data were analysed via reflexive thematic analysis.

    RESULTS: Three themes were identified in data analysis. 1. Connected home and neighbourhood, where participants revealed the dynamic relationship between home and neighbourhood; 2. Practices of home, where participants discussed the everyday nature of their homes and routines; and 3. Displaying home and family, which reflected participant's biographical homes in the context of living with dementia.

    DISCUSSION: The findings show that home holds multiple meanings for people living with dementia. For example, home is understood as a part of the neighbourhood and an extension of the home space into gardens and backyards, thus extending existing discourses that solely focus on the inside of people's homes. For people living with dementia, homes are also sites of negotiation and renegotiation where new meanings are created to reflect the changing nature and context of the home. There is not one fixed solution to these issues. Support and understanding for people living with dementia will need to evolve to adapt to the shifting dynamics and multiple meanings of home.

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