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  • 1.
    Ernsth Bravell, Marie
    et al.
    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).
    Finkel, Deborah
    Indiana University Southeast, 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). Karolinska Institutet, Sweden.
    Reynolds, Chandra A.
    University of California, USA.
    Hallgren, Jenny
    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 Institutet, Sweden and University of Southern California, USA.
    Motor functioning differentially predicts mortality in men and women2017In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 72, p. 6-11Article in journal (Refereed)
    Abstract [en]

    Introduction

    Research indicates gender differences in functional performance at advanced ages, but little is known about their impact on longevity for men and women.

    Objective

    To derive a set of motor function factors from a battery of functional performance measures and examine their associations with mortality, incorporating possible gender interactions.

    Method

    Analyses were performed on the longitudinal Swedish Adoption/Twin Study of Aging (SATSA) including twenty-four assessments of motor function up to six times over a 19-year period. Three motor factors were derived from several factor analyses; fine motor, balance/upper strength, and flexibility. A latent growth curve model was used to capture longitudinal age changes in the motor factors and generated estimates of intercept at age 70 (I), rates of change before (S1) and after age 70 (S2) for each factor. Cox regression models were used to determine how gender in interaction with the motor factors was related to mortality.

    Results

    Females demonstrated lower functional performance in all motor functions relative to men. Cox regression survival analyses demonstrated that both balance/upper strength, and fine motor function were significantly related to mortality. Gender specific analyses revealed that this was true for women only. For men, none of the motor factors were related to mortality.

    Conclusion

    Women demonstrated more difficulties in all functioning facets, and only among women were motor functioning (balance/upper strength and fine motor function) associated with mortality. These results provide evidence for the importance of considering motor functioning, and foremost observed gender differences when planning for individualized treatment and rehabilitation.

  • 2.
    Hallgren, Jenny
    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).
    Mobile integrated care – Healthcare professionals experiences2019Conference paper (Refereed)
  • 3.
    Hallgren, Jenny
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Risk factors for hospital readmission among Swedish older adults2018In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 9, no 5, p. 603-611Article in journal (Refereed)
    Abstract [en]

    Introduction 

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

    Methods

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

    Results

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

    Conclusions

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

  • 4.
    Hallgren, Jenny
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Should I stay or should I go – Factors associated with hospitalization risk among older persons in Sweden2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    An increasingly older population will most likely lead to greater demands on the health care system, as older age is associated with an increased risk of having acute and chronic conditions. The number of diseases or disabilities is not the only marker of the amount of health care utilized, as persons may seek hospitalization without a disease and/or illness that requires hospital healthcare. Hospitalization may pose a severe risk to older persons, as exposure to the hospital environment may lead to increased risks of iatrogenic disorders, confusion, falls and nosocomial infections, i.e., disorders that may involve unnecessary suffering and lead to serious consequences.

    Aims: The overall aim of this thesis was to describe and explore individual trajectories of cognitive development in relation to hospitalization and risk factors for hospitalization among older persons living in different accommodations in Sweden and to explore older persons' reasons for being transferred to a hospital.

    Methods: The study designs were longitudinal, prospective and descriptive, and both quantitative and qualitative methods were used. Specifically, latent growth curve modelling was used to assess the association of cognitive development with hospitalization. The Cox proportional hazards regression model was used to analyse factors associated with hospitalization risk overtime. In addition, an explorative descriptive design was used to explore how home health care patients experienced and perceived their decision to seek hospital care.

    Results: The most common reasons for hospitalization were cardiovascular diseases, which caused more than one-quarter of first hospitalizations among the persons living in ordinary housing and nursing home residents (NHRs). The persons who had been hospitalized had a lower mean level of cognitive performance in general cognition, verbal, spatial/fluid, memory and processing speed abilities compared to those who had not been hospitalized. Significantly steeper declines in general cognition, spatial/fluid and processing speed abilities were observed among the persons who had been hospitalized. Cox proportional hazards regression analysis showed that the number of diseases, number of drugs used, having experienced a fall and being assessed as malnourished according to the Mini Nutritional Assessment scale were related to an increased hospitalization risk among the NHRs. Among the older persons living in ordinary housing, the risk factors for hospitalization were related to marital status, i.e., unmarried persons and widows/widowers had a decreased hospitalization risk. In addition, among social factors, receipt of support from relatives was related to an increased hospitalization risk, while receipt of support from friends was related to a decreased risk. The number of illnesses was not associated with the hospitalization risk for older persons in any age group or for those of either sex, when controlling for other variables. The older persons who received home health care described different reasons for their decisions to seek hospital care. The underlying theme of the home health care patients’ perceptions of their transfer to a hospital involved trust in hospitals. This trust was shared by the home health care patients, their relatives and the home health care staff, according to the patients.

    Conclusions: This thesis revealed that middle-aged and older persons who had been hospitalized exhibited a steeper decline in cognition. Specifically, spatial/fluid, processing speed, and general cognitive abilities were affected. The steeper decline in cognition among those who had been hospitalized remained even after controlling for comorbidities. The most common causes of hospitalization among the older persons living in ordinary housing and in nursing homes were cardiovascular diseases, tumours and falls. Not only health-related factors, such as the number of diseases, number of drugs used, and being assessed as malnourished, but also social factors and marital status were related to the hospitalization risk among the older persons living in ordinary housing and in nursing homes. Some risk factors associated with hospitalization differed not only between the men and women but also among the different age groups. The information provided in this thesis could be applied in care settings by professionals who interact with older persons before they decide to seek hospital care. To meet the needs of an older population, health care systems need to offer the proper health care at the most appropriate level, and they need to increase integration and coordination among health care delivered by different care services.

  • 5.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Dahl, Anna
    Ernsth Bravell, Marie
    Mölstad, Sigvard
    Midlöv, Patrik
    Östgren, Carl Johan
    Malmberg, Bo
    Josephson, Iréne
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Factors associated with a greater risk of hospitalization among nursing home residents2013Conference paper (Refereed)
    Abstract [en]

    Background: Nursing home residents are at a higher risk of hospital care as they represent the oldest and most frail segment of the population. At the same time, hospitalization is associated with a greater risk of various diseases, such as iatrogenic disorders, physical impairments and other adverse outcomes. Knowledge about factors associated with greater risk of hospitalization among nursing home residents is scarce. The aim of this study was to identify predictors of hospitalization among nursing home residents. Methods: Four hundred twenty-nine Swedish nursing home residents (mean age 84.9 years, ± 7.27, 71% females) were followed during three years in the longitudinal SHADES study. Participants were examined on physical, psychological, and social functioning, and information about hospitalization was recorded across the study period. Results: Of the 429 participants, 196 (45.7%) had at least one hospital admission during the three year follow-up period. The most common cause of admission was cardiovascular diseases (CVD) and complications due to falls.  Cox proportional hazard regression model controlling for dependency within nursing homes and municipalities showed that nursing home residents with previous falls (HR=1.59, p=.000), cognitive impairment (HR=1.28, p=.008) and malnutrition (HR=1.51, p=.018) were at a greater risk of hospitalization. Discussion: The results suggest that nursing home residents are at high risk of hospitalization, especially due to CVD and falls. Several modifiable factors associated with an increased risk of hospitalization were identified, including nutritional status and falls. Hospital admissions for older people could potentially be reduced by preventive measures aiming at fall reduction and malnutrition. 

  • 6.
    Hallgren, Jenny
    et al.
    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).
    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).
    Risk of hospitalization and readmission2019Conference paper (Refereed)
  • 7.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    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).
    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).
    Josephson, Iréne
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Older persons´ arguments for seeking hospital care while receiving home health care2014Conference paper (Other academic)
    Abstract [en]

    Background: Hospitalization among older persons is not unusual and can lead to serious consequences such as iatrogenic conditions. Although the majority of the hospitalizations are necessary, there are probably a substantial number of hospitalizations that could be avoided. Many of those persons that are hospitalized are living at home, and are entitled for home health care, meaning that they can receive basic as well as advanced medical care in their own home. Little is known about older persons’ perceptions about seeking hospital care despite having home health care.

    Aim: To explore older persons’ reasoning for seeking hospital care.

    Method: Twenty-two older persons (age 66-93, 73 % females) living in southern Sweden, receiving home health care and having experiences of hospitalization, were interviewed about their health care experiences. The data was analyzed using qualitative content analysis.

    Results: Preliminary results indicate that the older persons’ emotions, past experiences and perceptions of health care resources influenced transitions to hospital. The results are illustrated by three categories: Home health care design; Specific medical condition; and Superior care at hospital. Conclusion: Understanding about older persons’ arguments for seeking care at hospital may have implication for how the homecare staff encounters individual’s perceived needs. Further, fulfillment of perceived health needs may reduce avoidable hospitalization and consequently improve quality of life.

  • 8.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Ernsth Bravell, Marie
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Dahl, Anna
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Östgren, Carl-Johan
    Midlöv, Patrik
    Mölstad, Sigvard
    Elderly living in institutions and their visits to acute care - Patterns; needs och habits?.2012Conference paper (Other academic)
    Abstract [en]

    Background: Every year 1.4 million visits are made to acute care or hospital in Sweden. Elderly makes about one third of these visits and many of them are considered to be unnecessary. Little is known about the patterns of hospitalization and visits to acute care among elderly living in institutions.

    Objective: The aim of this study is to longitudinally describe patterns of hospitalization and visits to the acute care among elderly living in institutions.

    Method: SHADES is a longitudinal study including 423 elderly (mean age of 84.8 years, ± 7.27, 71% females) living in institutions in Sweden. Participants were examined every six months during three years. One-hundred thirty individuals participated in all the six in-person testings.

    Results: At baseline 16 % of the respondents had visited the acute care at least once and around a fourth had been hospitalized the last six months. The most common reasons for visits to acute care were falls and infections. The reasons for hospitalization were mostly complications after falls (n=25) and circulatory diseases (n=24). About one third (n=48) of those who participated at all six IPTs visited the acute care in the hospital at least once during the study and nearly half (n=60) was hospitalized at least once during the study period.

    Discussion and Conclusion: Hospitalization and visits to acute care are common among persons living in institutions. The next step is to analyze the longitudinal trajectories of visits to the acute care and hospitalization in this group of elderly living in institutions. For the presentation analyzes will also be performed with the aim to examine which factors (e.g. diseases, drugs, function in daily life, social network factors) that relate to visits to the acute care and hospitalization. The results will provide important knowledge that can be used to prevent unnecessary hospitalization in order to provide continuity in the institutional care for the elderly and to save costs.

  • 9.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Ernsth Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Josephson, Iréne
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    In hospital we trust: Experiences of older peoples' decision to seek hospital care2015In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 36, no 4, p. 306-311Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People’s Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples’ arguments for seeking hospital care may have implications for how home care staff address individuals’ perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.

  • 10.
    Hallgren, Jenny
    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.
    Ernsth Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Mölstad, Sigvard
    Department of Clinical Sciences, Lund University, Sweden.
    Östgren, Carl Johan
    Department of Medical and Health Sciences, Linköping University, Sweden.
    Midlöv, Patrik
    Department of Clinical Sciences, Lund University, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Factors associated with increased hospitalisation risk among nursing home residents in Sweden: a prospective study with a three-year follow-up2016In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 11, no 2, p. 130-139Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Hospitalisation of nursing home residents might lead to deteriorating health.

    AIM: To evaluate physical and psychological factors associated with hospitalisation risk among nursing home residents.

    DESIGN: Prospective study with three years of follow-up.

    METHODS: Four hundred and twenty-nine Swedish nursing home residents, ages 65-101 years, from 11 nursing homes in three municipalities were followed during three years. The participants' physical and psychological status was assessed at baseline. A Cox proportional hazards model was used to evaluate factors associated with hospitalisation risk using STATA.

    RESULTS: Of the 429 participants, 196 (45.7%) were hospitalised at least once during the three-year follow-up period, and 109 (25.4%) during the first six months of the study. The most common causes of hospitalisation were cardiovascular diseases or complications due to falls. A Cox regression model showed that residents who have had previous falls (P < 0.001), are malnourished (P < 0.001), use a greater number of drugs (P < 0.001) and have more diseases (P < 0.001), are at an increased risk of hospitalisation.

    CONCLUSION: Nursing home residents are frequently hospitalised, often due to falls or cardiovascular diseases. Study results underscore the relationships between malnutrition, previous falls, greater numbers of drugs and diseases and higher risk of hospitalisation.

    IMPLICATIONS FOR PRACTICE: Preventive interventions aimed at malnutrition and falls at the nursing home could potentially reduce the number of hospitalisations. With improved education and support to nurses concerning risk assessment at the nursing homes, it may be possible to reduce the numbers of avoidable hospitalisation among nursing home residents and in the long run improve quality of life and reduce suffering.

  • 11.
    Hallgren, Jenny
    et al.
    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).
    Fransson, EIeonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Reynolds, Chandra A.
    Department of Psychology, University of California, Riverside, 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). School of Social Sciences, Indiana University Southeast, New Albany, United States.
    Pedersen, Nancy L.
    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.
    Cognitive trajectories in relation to hospitalization among older Swedish adults2018In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 74, p. 9-14Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    Research indicate that cognitive impairment might be related to hospitalization, but little is known about these effects over time.

    OBJECTIVE:

    To assess cognitive change before and after hospitalization among older adults in a population-based longitudinal study with up to 25 years of follow-up.

    METHOD:

    A longitudinal study on 828 community living men and women aged 50-86 from the Swedish Adoption/Twin Study of Ageing (SATSA) were linked to The Swedish National Inpatient Register. Up to 8 assessments of cognitive performance (general cognitive ability, verbal, spatial/fluid, memory, and processing speed) from 1986 to 2010 were available. Latent growth curve modelling was used to assess the association between cognitive performance and hospitalization including spline models to analyse cognitive trajectories pre- and post-hospitalization.

    RESULTS:

    A total of 735 persons (89%) had at least one hospital admission during the follow-up. Mean age at first hospitalization was 70.2 (±9.3)years. Persons who were hospitalized exhibited a lower mean level of cognitive performance in general ability, processing speed and spatial/fluid ability compared with those who were not hospitalized. The two-slope models revealed steeper cognitive decline before hospitalization than after among those with at least one hospitalization event, as compared to non-hospitalized persons who showed steeper cognitive decline after the centering age of 70 years.

    CONCLUSIONS:

    Persons being hospitalized in late life have lower cognitive performance across all assessed domains. The results indicate that the main decline occurs before the hospitalization, and not after. This might indicate that when you get treatment you also benefit cognitively.

  • 12.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Fransson, Eleonor I.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Finkel, Deborah G.
    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).
    Trajectories of motor function and cognition in relation to hospitalization2017Conference paper (Refereed)
    Abstract [en]

    Background: Hospitalization among older people is common and associated with adverse outcomes. However, knowledge about long-term effects on motor functions and cognitive abilities in relation to hospitalization is scarce. In order to explore development of motor functions and cognition after hospitalization, a longitudinal study among middle-aged and older adults with up to 25 years of follow-up was conducted.

    Methods: Overall, 828 participants from the Swedish Adoption/Twin Study of Ageing (SATSA) were linked to the Swedish National Inpatient Register, which contains information on participants’ hospital admissions. Up to 8 assessments of cognitive performance and 7 assessments of motor functions i.e. fine motor, balance/upper strength, and flexibility, from 1986 to 2010 were available. Latent growth curve modelling was used to assess the association between hospitalization and subsequent motor function and cognitive performance.

    Results: A total of 735 (89 %) persons had at least one hospital admission during the follow-up. The mean age at first hospitalization was 70.2 (± 9.3) years. Persons who were hospitalized exhibited a lower mean level of cognitive performance in all domains and in motor functions compared with those who were not hospitalized. A significantly steeper decline was observed in motor function abilities as well as in processing speed, spatial/fluid, and general cognitive ability performance of hospitalized participants. These patterns remained even after comorbidities and dementia prevalence were controlled for.

    Discussion: We are the first to show that hospitalization is associated with steeper decline in both motor function and cognitive abilities across more than two decades of post-hospitalization follow-up.

  • 13.
    Hallgren, Jenny
    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.
    Fransson, Eleonor I.
    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.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Reynolds, Chandra A.
    Department of Psychology, University of Southern California, Riverside, USA.
    Pedersen, Nancy L.
    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. Ageing - living conditions and health.
    Factors associated with hospitalization risk among community living middle aged and older persons: results from the Swedish Adoption/TwinStudy of Aging (SATSA)2016In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 66, p. 102-108Article in journal (Refereed)
    Abstract [en]

    The aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46–103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR = 1.02, p < 0.001) and more support from relatives (HR = 1.09, p = 0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR = 0.75, p = 0.033) and widow/widower (HR = 0.69, p < 0.001)) and support from friends (HR = 0.93, p = 0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization.

  • 14.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Reynolds, C. A.
    University of California, USA.
    Pedersen, Nancy L.
    Karolinska Institutet.
    Dahl, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jonkoping Univ, Sch Hlth Sci, Inst Gerontol, Jonkoping, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Factors associated with hospitalization among older people in Sweden: Results from the Satsa Study2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, p. 678-679Article in journal (Refereed)
    Abstract [en]

    Background: Hospitalization among older people is common and associated with risk of adverse outcomes such as iatrogenic disorders and physical impairments. Knowledge about personal characteristics and social factors related to hospitalization is scarce. In order to understand which factors that are related to hospitalization risk, a prospective study with a multifactorial approach was conducted.

    Methods: In 2003, 794 Swedish persons (mean age 70.1 years, 60.7% females) answered a postal questionnaire as a part of the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). Participants were asked about physiological and psychological health, personality and socio economic factors. During seven years of follow-up, information on hospitalizations and the associated diagnoses were obtained from the Swedish National Inpatient Register.

    Results: Preliminary results show that 484 persons (61.0%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases and tumors. Cox proportional hazard regression model controlling for age, sex and dependency within twin pairs, showed that higher locus of control (HR=0.89, 95% CI=0.83-0.96), marital status (widow/widower (HR=0.64, 95 % CI=0.50-0.81) and unmarried (HR=0.67, 95% CI=0.50-0.90)), and support from friends (HR=0.93, 95% CI=0.87-0.99) were associated with lower risk of hospitalization, while greater numbers of diseases (HR=1.11, 95% CI=1.03-1.20) and negative life events (HR=1.16, 95%  CI=1.00-1.34) were associated with increased risk of hospitalization.

    Discussion: Our results show that both personal and social factors were important for the risk of hospitalization. This might be used in future interventions for understanding health care utilization.

  • 15.
    Karlsson, Ida K.
    et al.
    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).
    Hallgren, Jenny
    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.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Reynolds, C. A.
    Department of Psychology, University of California, Riverside, 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).
    Genetic influences on body mass index across Adulthood and late-life2018In: Innovation in Aging, ISSN 1556-343X, Vol. 2, no suppl_1, p. 620-620Article in journal (Refereed)
    Abstract [en]

    Although genetic factors significantly contribute to variation in body-mass index (BMI), the effects appear to differ with age. To investigate this, we applied polygenic methods to longitudinal data from the Swedish Twin Registry where BMI was available for age categories ranging from 20–35 to above 80. Using GCTA, a polygenic method to estimate heritability, we showed that heritability explains around 20% of the variability in BMI across age categories. However, a polygenic risk score based on the largest GWAS of BMI (PRSBMI) explained 4–6% of the variation in BMI before 65, but less than 0.5% after age 65. This indicates that while there is substantial heritability of BMI across adulthood and late-life, the genetic variants identified in GWAS mainly predict BMI before age 65. Hence, more work is warranted studying the genetics of BMI in late-life, to better understand its biology and what distinguishes it from BMI earlier in adulthood.

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