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A population-based study on well-being in the very old: the role of cardiovascular diseases and drugs.

https://arctichealth.org/en/permalink/ahliterature70738
Source
Arch Gerontol Geriatr. 2005 May-Jun;40(3):287-97
Publication Type
Article
Author
Margareta Westerbotn
Hedda Agüero-Torres
Johan Fastbom
Pernilla Hillerås
Author Affiliation
Sophiahemmet University College, Box 5605, SE-114 86 Stockholm, Sweden. margareta.westerbotn@sophiahemmethogskola.se
Source
Arch Gerontol Geriatr. 2005 May-Jun;40(3):287-97
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Agents - adverse effects - therapeutic use
Cardiovascular Diseases - drug therapy - epidemiology
Cross-Sectional Studies
Emotions - drug effects
Female
Geriatrics
Humans
Male
Population Surveillance - methods
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
Cardiovascular diseases constitute the most common health problems in very old people. Consequently, cardiovascular drugs are the medicines that are most frequently used by elderly subjects. Although many studies have examined the physiological effect and adverse reactions of these drugs, knowledge on their effect on emotional well-being is missing. The present study aims to examine the association between cardiovascular diseases and their medical treatment on the emotional well-being of very old people. We investigated a representative group of elderly subjects gathered from a population-based study (n=235). Participants were 84 years or older and cognitively intact (mini-mental state examination (MMSE) > or =24 points). Well-being was assessed with the positive and negative affect schedule (PANAS), measuring different mood categories. Cardiovascular diseases were diagnosed following the International Classification of Diseases. In this population the prevalence of cardiovascular diseases was high (62%). Multivariate regression analysis showed that while being affected by a cardiovascular disease did not affect the emotional well-being of the subjects (PANAS-PA, p=0.171; PANAS-NA, p=0.209), the use of some cardiovascular drugs showed an association. Cardiac glycosides (p=0.006) and nitrates (p=0.008) were associated with increased negative feelings. Due to high prevalence of cardiovascular diseases and use of cardiovascular medicines, this finding has relevance on the quality of life of elderly people. However, due to the nature of this study we cannot assess cause-effect relationship of this positive association. Therefore, the present findings suggest that there is a need for clinical studies in this increasing and limited studied age group.
PubMed ID
15814162 View in PubMed
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How do older people experience their management of medicines?

https://arctichealth.org/en/permalink/ahliterature272419
Source
J Clin Nurs. 2008 Mar;17(5A):106-15
Publication Type
Article
Date
Mar-2008
Author
Margareta Westerbotn
Elin Fahlström
Johan Fastbom
Hedda Agüero-Torres
Pernilla Hillerås
Source
J Clin Nurs. 2008 Mar;17(5A):106-15
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Humans
Qualitative Research
Sweden
Abstract
The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective.
Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes.
This qualitative study involved audiotaped interviews with 25 very old persons.
aged >or=85 years, mini-mental state examination >or=24, living at home, taking medicines regularly. Data collected May-June 2005, analysed using content analysis.
Descriptive study.
Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up.
Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes.
Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health-care resource use.
PubMed ID
18298761 View in PubMed
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Rate of cognitive decline in preclinical Alzheimer's disease: the role of comorbidity.

https://arctichealth.org/en/permalink/ahliterature71286
Source
J Gerontol B Psychol Sci Soc Sci. 2003 Jul;58(4):P228-36
Publication Type
Article
Date
Jul-2003
Author
Lars Bäckman
Sari Jones
Brent J Small
Hedda Agüero-Torres
Laura Fratiglioni
Author Affiliation
Aging Research Center at the Karolinska Institute and Stockholm Gerontology Research Center, Stockholm, Sweden. lars.backman@neurotec.ki.se
Source
J Gerontol B Psychol Sci Soc Sci. 2003 Jul;58(4):P228-36
Date
Jul-2003
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis - epidemiology - genetics - psychology
Comorbidity
Disease Progression
Female
Follow-Up Studies
Humans
Individuality
Male
Mental Status Schedule
Patient Admission - statistics & numerical data
Research Support, Non-U.S. Gov't
Risk factors
Sweden
Abstract
We investigated the influence of individual-difference variables implicated as risk factors for Alzheimer's disease (AD) or known to be related to cognitive performance in normal aging (e.g., age, sex, years of education, previous and recent diseases, apolipoprotein E status, social network, and substance use) on rate of cognitive change from preclinical to clinical AD. With the use of data from a population-based study, 230 persons who were nondemented at baseline and diagnosed with AD at a 3-year follow-up were examined with the Mini-Mental State Examination (MMSE). Of all predictor variables examined, only number of diseases resulting in hospital admission during the follow-up period made an independent contribution to rate of MMSE change. These results suggest that many variables affecting the onset of the degenerative process as well as cognitive functioning in normal aging exert little influence on rate of cognitive change in preclinical AD. This may reflect the fact that the emerging dementia disease overshadows the role of these variables for cognitive functioning. A possible exception to this pattern is that an increasing number of concomitant health conditions may exacerbate the rate of cognitive decline during the final portion of the preclinical phase in AD.
PubMed ID
12878651 View in PubMed
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Women are more disabled in basic activities of daily living than men only in very advanced ages: a study on disability, morbidity, and mortality from the Kungsholmen Project.

https://arctichealth.org/en/permalink/ahliterature52116
Source
J Clin Epidemiol. 2003 Jul;56(7):669-77
Publication Type
Article
Date
Jul-2003
Author
Eva von Strauss
Hedda Agüero-Torres
Ingemar Kåreholt
Bengt Winblad
Laura Fratiglioni
Author Affiliation
Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm, Sweden. eva.von.strauss@neurotec.ki.se
Source
J Clin Epidemiol. 2003 Jul;56(7):669-77
Date
Jul-2003
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Cohort Studies
Disabled persons - statistics & numerical data
Female
Geriatric Assessment
Health status
Humans
Male
Morbidity
Research Support, Non-U.S. Gov't
Sex Factors
Survival Analysis
Sweden - epidemiology
Abstract
OBJECTIVE: We explored the effect of morbidity, mortality, and occurrence of new disability on gender differences in activities of daily living (ADL) functioning in different age groups in the elderly population. METHODS: All 77+-year-old members of a community-based cohort were clinically examined by physicians, assessed by psychologists, and interviewed by nurses at baseline and after a 3-year interval. Diseases were diagnosed according to ICD-9 and the DSM-III-R criteria for dementia. The Katz index of ADL was used to measure basic functional status. RESULTS: After adjustment for socio-demographic characteristics, the oldest women (90+ years) had higher disability prevalence and a tendency for higher long-term disability incidence. Women aged 85+ years also had higher morbidity prevalence. Mortality among disabled subjects was similar for both genders, whereas higher mortality was found in younger nondisabled men (77-84 years). CONCLUSION: We conclude that gender differences in disability, morbidity, and mortality vary with age in the elderly population. Gender differences in morbidity and basic functional dependence were evident only in the oldest old. Based on current and previous findings, we speculate that more women may be at higher risk of developing severe disability than men in the advanced ages due to longer survival with slight disability earlier in adult life.
PubMed ID
12921936 View in PubMed
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