Objective:

Weight changes may bean important indicator of an ongoing pathological process.Retrospective self-report might be the only possibility to capture prior weight. The objective of the study was to evaluate the accuracy of retrospective recallof body weight in old age and factors that might predict accuracy.

Design and Methods:

In 2007, 646 participants (mean age, 71.6 years) of the Swedish Adoption/Twin Study of Aging (SATSA)answered questions about their present weight and how much they weighed 20-years ago. Of these, 436 had self-reported their weighttwenty years earlier and among these 134 had also had their weight assessed at this time point.

Results:

Twenty yearretrospectively recalled weight underestimated the prior assessed weight by -1.89 ± 5.9 kg and underestimatedprior self-reported weight by -0.55 ±5.2 kg.Moreover, 82.4% of the sample were accurate within 10%, and 45.8% were accurate within 5% of their prior assessed weights;similarly, 84.2% and 58.0 %were accurate within 10% and 5% respectively, forprior self-reported weight. Current higher body mass index and preferences of reporting weights ending with zero or five was associated with an underestimation of prior weight, while greater weight change over 20 year, and low Mini-Mental State Scores (MMSE) (<25) led to an overestimation of prior weight.

Conclusions:

Recalled weight comes close to the assessed population mean, but at the individual level there is a large variation. The accuracy is affected by current BMI, changes in weight, end-digit preferences, and current cognitive ability. Recalled weight should be used with caution.

Background: Although the negative consequences on health of being obese are well known, most adults gain weight across the lifespan. The general increase in body mass index (BMI) is mainly considered to originate from behavioral and environmental changes; however, few studies have evaluated the influence of these factors on change in BMI in the presence of genetic risk. We aimed to study the influence of multifactorial causes of change in BMI, over 65 years.

Methods and Findings: Totally, 6130 participants from TwinGene, who had up to five assessments, and 536 from the Swedish Adoption/Twin Study of Aging, who had up to 12 assessments, ranging over 65 years were included. The influence of lifestyle factors, birth cohort, cardiometabolic diseases and an individual obesity genetic risk score (OGRS) based on 32 single nucleotide polymorphisms on change in BMI was evaluated with a growth model. For both sexes, BMI increased from early adulthood to age of 65 years, after which the increase leveled off; BMI declined after age of 80 years. A higher OGRS, birth after 1925 and cardiometabolic diseases were associated with higher average BMI and a steeper increase in BMI prior to 65 years of age. Among men, few factors were identified that influence BMI trajectories in late life, whereas for women type 2 diabetes mellitus and dementia were associated with a steeper decrease in BMI after the age of 65 years.

Conclusions: There are two turning points in BMI in late adulthood, one at the age of 65 years and one at the age 80 years. Factors associated with an increase in BMI in midlife were not associated with an increase in BMI after the age of 65 years. These findings indicate that the causes and consequences of change in BMI differ across the lifespan. Current health recommendations need to be adjusted accordingly.

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

Objectives: Older people in Spain and other Southern European countries are reported to feel lonelier than the older people in the North of Europe. Data from the 1970s and onwards consistently show this. The present study explores feelings of loneliness as a product of both cultural and situational determining factors, by comparing survey data for Spain and Sweden.

Material and method: Data derived from several national surveys of the older people in Spain and Sweden with questions about loneliness. For closer analysis we use the Spanish 2006 Encuesta de Condiciones de Vida (Living conditions Questionnaire), and the Swedish 2002–2003 Survey of Living Conditions.

Results: On average, 24% of older people in Spain and 10% of elderly Swedish people expressed sentiments of loneliness in the surveys used here (2006 and 2002-03 respectively). Living arrangements and perceived health are related with factors of loneliness in both countries, although levels differ. For example, people in good health who live alone are five times more likely to feel lonely in Spain (45%) than in Sweden (9%) and two-three times more likely when living alone in poor health (82% and 32% respectively). People in good health who live with their spouse/partner only are equally unlikely in both Spain and Sweden to express loneliness (4–5%). It often seems — when it occurs — to be due to caring for a spouse/partner, or problems in the relationship.

Conclusions: Results highlight the importance of contextual features — health and living arrangements — and cultural expectations in interpreting reported loneliness.

Personer som bor och vårdas på särskilt boende (säbo) har omfattande omvårdnadsbehov och ofta nedsatt kognitiv funktion, de är ofta multisjuka och har många olika läkemedel samtidigt.

Om en god vårdkvalitet ska kunna garanteras, måste kompetensen bland vårdpersonalen höjas, framför allt avseende specifik geriatrisk kompetens.

En betydande andel av de äldre som bor och vårdas på säbo avlider också där, trots att förutsättningarna för att ge en god palliativ vård vid livets slut är begränsade.

Background and aims: This study examines gender-specific behavioral correlates of depressive symptoms using a secondary data analysis of a cross-sectional, population-based sample of older unlike-sex twins.

Methods: Unlike-sex twins aged 69–88 were identified through a national Swedish registry and sent a survey about health, including depressive symptoms (CES-D) and the frequency of engaging in physical, social and mental activities. A total of 605 complete twin pairs responded.

Results: Depressive symptom scores were associated with frequency of engagement in physical and mental activities, but only in men. No statistically significant associations with depressive symptom scores for any of the three types of activities were found in women.

Conclusions: The results suggest that engaging in physical and mental activities may protect older men from developing depressive symptoms, but longitudinal data are needed to offer more conclusive findings on the role that physical, mental, and social activities play in the maintenance of psychological health in older men and women.

Personer som lever med demenssjukdom såväl som mentalt friska människor behöver uppleva välbefinnande. Ett viktigt mål i vården och omsorgen av personer med demens är därför att hitta vägar för att försöka främja välbefinnande hos personen. Avhandlingens övergripande syfte varatt utveckla kunskap om aspekter av betydelse för att äldre personer med måttlig till svår demens ska uppleva välbefinnande.

Avhandlingen baseras på empiriskt material från fyra delstudier. Den första delstudien, I(etnografi) genererade fältanteckningar från 31 observationstillfällen samt nio kvalitativa intervjuer med vårdgivare, så kallade kontaktmän till personen med demens. Delstudie II(testutveckling/tvärsnittsstudie) utgjordes av 336 testprotokoll som bearbetades statistiskt. Materialet i delstudie III (reformulerad grundad teori) innefattade 18 kvalitativa intervjuer med personer med demens samt 18 observationsprotokoll från observation av icke-verbalt språk. Den sista delstudien (IV) (konstruktivistisk grundad teori) bestod av fältanteckningar från 24 videoinspelningar av Egentids-situationer och 24 kvalitativa intervjuer med personer med demens samt åtta kvalitativa intervjuer med vårdgivare.

Resultatet från avhandlingens studier visar att de kognitivt friska personerna som finns i personens närhet har en avgörande betydelse för upplevelsen av välbefinnande hos personer med måttlig till svår demens. För att interaktion ska vara önskvärd och ge välbefinnande måste den mentalt friska parten ha kunskap och insikt om att det finns en större medvetenhet hos personen med måttlig till svår demens än vad det omedelbara intrycket av förmågor ger. Om denna insikt saknas finns risk att interaktionen kan leda till kränkning i stället för välbefinnande. Det är förmodligen av betydelse att ha kunskap om och försöka fånga personens kvarvarande förmågor istället för att fokusera på brister. Kunskap om kvarvarande förmågor och till exempel överinlärda förmågor som fångas i anpassade test kan bidra till en mer positiv syn på personen och innebära att kvarvarande förmågor bättre tas tillvara, vilket kan bidra till välbefinnande. Personen med måttlig till svår demens kan kommunicera ett välbefinnande men det kräver lyssnarens förmåga och förmåga att tolka. Det kan också kräva en del praktiska ansträngningar med hänsyn till personens kognitiva nedsättningar som till exempel hjälpmedel i form av bilder och ting. Förmodligen ger interaktion som leder till en relation alltid en upplevelse av välbefinnande. Tid är en avgörande faktor för att upprätta relationer som ger välbefinnande hos personer med måttlig till svår demens. Det är därför viktigt att i vården avsätta tillräcklig tid, som vid till exempel Egentid, för att upprätta relationer och därigenom främja välbefinnande.