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Accidental falls, health-related quality of life and life satisfaction: a prospective study of the general elderly population.

https://arctichealth.org/en/permalink/ahliterature107598
Source
Arch Gerontol Geriatr. 2014 Jan-Feb;58(1):95-100
Publication Type
Article
Author
Magnus Stenhagen
Henrik Ekström
Eva Nordell
Sölve Elmståhl
Author Affiliation
Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden. Electronic address: magnus.stenhagen@med.lu.se.
Source
Arch Gerontol Geriatr. 2014 Jan-Feb;58(1):95-100
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Aged
Aged, 80 and over
Aging
Female
Follow-Up Studies
Health status
Humans
Male
Middle Aged
Personal Satisfaction
Population Surveillance - methods
Prospective Studies
Quality of Life
Risk factors
Sweden - epidemiology
Abstract
As the physical consequences of accidental falls in the elderly are well-researched, the long-term associations between falls and quality of life and related concepts are less known. The aim of this study was to prospectively examine the long-term relations between falls and health-related quality of life (HRQoL) and life satisfaction (LS) over six years in the general elderly population. One thousand three hundred and twenty-one subjects (aged 60-93 years), from the general population in the south of Sweden, were included in a baseline assessment and a follow-up after six years. HRQoL was measured with the SF-12 and LS with the life satisfaction index A (LSI-A). The differences in mean scores between fallers at baseline (n=113) and non-fallers were statistical analyzed. Furthermore, the prediction of falls on the outcomes was analyzed using a multivariate linear regression model adjusted for multiple confounding factors. Fallers scored significant lower in HRQoL and LS at baseline and after six years, compared to non-fallers, especially in the SF-12 physical component (p=
PubMed ID
23993268 View in PubMed
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The association between medical diagnosis and caregiver burden: a cross-sectional study of recipients of informal support and caregivers from the general population study 'Good Aging in Skåne', Sweden.

https://arctichealth.org/en/permalink/ahliterature295626
Source
Aging Clin Exp Res. 2018 Sep; 30(9):1023-1032
Publication Type
Journal Article
Date
Sep-2018
Author
Sölve Elmståhl
Beth Dahlrup
Henrik Ekström
Eva Nordell
Author Affiliation
Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, CRC, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, Build. 28 Fl.13, 205 02, Malmo, Sweden. solve.elmstahl@med.lu.se.
Source
Aging Clin Exp Res. 2018 Sep; 30(9):1023-1032
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Adaptation, Psychological
Aged
Aged, 80 and over
Caregivers - psychology
Cost of Illness
Cross-Sectional Studies
Dementia - psychology
Depression - epidemiology
Female
Humans
Male
Middle Aged
Stroke - epidemiology
Sweden - epidemiology
Abstract
Different kinds of chronic diseases might imply different dimensions of caregiver burden, not previously described among the caregivers to recipients from the general elder population.
The main objective was to examine differences in burden between the 343 caregivers to persons with different diagnoses.
A group of elderly recipients of informal care (n?=?343) from the general population study 'Good Aging in Skåne' (GÅS) Sweden, were divided into five diagnostic groups: dementia (n?=?90), heart and lung diseases (n?=?48), stroke (n?=?62), fractures (n?=?66), depression (n?=?40) and the group "other", consisting of different diagnoses (n?=?37) according to ICD-10. Differences in burden were analyzed using the Caregiver Burden Scale (CBS), a 22-item scale consisting of five dimensions: general strain, isolation, disappointment, emotional involvement and environmental burden. A total burden index comprises the mean of all the 22 items and a higher score indicates a higher burden.
The most common diagnosis associated to caregiving was dementia and fracture and the median hours weekly for informal support with instrumental ADL for the five diagnostic groups ranged from 7 to 45 h for spouses and from 4 to 7 h for parents. The highest proportion of caregivers scoring high total burden was seen among recipients with dementia (50%) and depression (38%); the OR for high total burden for the dementia group was 4.26 (2.29-7.92) and depression group 2.38 (1.08-5.24) adjusted for covariates like age, gender and ADL and these two groups had higher self-perception of burden in all the dimensions, especially the dimension's emotional burden and strain.
Informal support constitutes a substantial time for instrumental ADL for the diseased elders. Caregivers to persons with dementia and depression experience high burden.
Notes
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PubMed ID
29236217 View in PubMed
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Associations between functional ability and life satisfaction in the oldest old: results from the longitudinal population study Good Aging in Skåne.

https://arctichealth.org/en/permalink/ahliterature120920
Source
Clin Interv Aging. 2012;7:313-20
Publication Type
Article
Date
2012
Author
Åsa Enkvist
Henrik Ekström
Sölve Elmståhl
Author Affiliation
Department of Health Sciences, Lund University, Malmö University Hospital, Malmö, Sweden. asa.enkvist@med.lu.se
Source
Clin Interv Aging. 2012;7:313-20
Date
2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Age Factors
Aged
Aged, 80 and over
Aging - physiology - psychology
Educational Status
Female
Humans
Longitudinal Studies
Male
Marital status
Personal Satisfaction
Quality of Life - psychology
Questionnaires
Sex Factors
Socioeconomic Factors
Sweden
Abstract
To describe change in functional ability in the oldest-old population during 3 years and examine its relation to life satisfaction (LS). A total of 681 individuals aged 78 and older from the population-based study Good Aging in Skåne took part.
Functional ability was assessed using Sonn and Åsberg's Activities of Daily Living (ADL) scale and related to LS assessed by Neugarten et al's Life Satisfaction Index A (LSI-A).
Fifty-one percent of 87-93-year-olds reported ADL decline during 3 years. Individuals reporting impaired ADL had a mean LSI-A value of 23.0 compared to 26.4 in those unchanged. ADL decline had a stronger negative effect on LS in the younger group (78-84 years), r = 0.207, P
Notes
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PubMed ID
22956866 View in PubMed
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Does informal support influence social participation of fractured elderly people?

https://arctichealth.org/en/permalink/ahliterature117656
Source
Arch Gerontol Geriatr. 2013 May-Jun;56(3):457-65
Publication Type
Article
Author
Henrik Ekström
Synneve Dahlin Ivanoff
Sölve Elmståhl
Author Affiliation
Department of Health Sciences, Division of Geriatric Medicine, Lund University, CRC, Entrance 72, Building 28, Floor 13, Malmö University Hospital, SE-205 02 Malmö, Sweden. henrik.ekstrom@med.lu.se
Source
Arch Gerontol Geriatr. 2013 May-Jun;56(3):457-65
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Leisure Activities - psychology
Male
Middle Aged
Osteoporotic Fractures - epidemiology - psychology
Patient Care - methods
Questionnaires
Retrospective Studies
Social Participation
Sweden - epidemiology
Abstract
This population-based cross-sectional study describes social participation expressed as the accomplishment of social, cultural, and leisure activities resulting from informal support given by relatives or friends, formal support given by the municipality or county, or a combination of the two, among 452 individuals aged 60-93 years suffering from osteoporosis-related fractures. A fourth group of individuals with fractures without any support was used as a reference group. Fractures included were humeral, wrist, vertebral, hip, pelvic and ankle fractures. Questionnaires were used to collect sociodemographic data and information on social participation, social support, and covariates. The results showed that a smaller proportion of those with only formal support took part in social, cultural, or leisure activities, compared to participants with informal support alone, both informal and formal support or those without any kind of support. The associations between categories of activity and kind of support were further tested in a logistic regression model adjusting for possible confounders. Odds ratios (ORs) for taking part in social, cultural, and leisure activities were significantly lower for participants with formal support and a combination of informal and formal support, while participants receiving informal support did not show a significantly reduced OR for taking part in any category of activity, compared to the reference group. In conclusion; informal support of older people with fractures is an important means of facilitating social participation and an active lifestyle. Attention should be paid to the vulnerable situation of those who rely solely on formal support.
PubMed ID
23276374 View in PubMed
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Effects of walking speed and results of timed get-up-and-go tests on quality of life and social participation in elderly individuals with a history of osteoporosis-related fractures.

https://arctichealth.org/en/permalink/ahliterature131860
Source
J Aging Health. 2011 Dec;23(8):1379-99
Publication Type
Article
Date
Dec-2011
Author
Henrik Ekström
Synneve Dahlin-Ivanoff
Sölve Elmståhl
Author Affiliation
Department of Health Sciences, Division of Geriatric Medicine, Malmö University Hospital, Malmö, Sweden. henrik.ekstrom@med.lu.se
Source
J Aging Health. 2011 Dec;23(8):1379-99
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Acceleration
Aged
Aged, 80 and over
Cross-Sectional Studies
Exercise Test - methods
Female
Health status
Humans
Male
Osteoporotic Fractures - physiopathology
Quality of Life
Social Environment
Sweden
Walking - physiology
Abstract
To investigate the relationships between physical performance, quality of life (QoL), and social participation among elderly men and women with a history of osteoporosis-related fractures.
The study was a population-based cross-sectional study including 155 participants aged 60 to 93 years from the Swedish longitudinal investigation, "Good Aging in Skåne." The participants had suffered fracture of the vertebrae, hip, pelvis, or ankle. Physical performance was expressed as walking speed (WS) and timed get-up-and-go (TUG). QoL was measured as using the Health Related Quality of Life (HRQoL) and Life Satisfaction (LS) scales. Social participation was defined as taking part in social, cultural, and leisure activities.
Lower WS and/or TUG were associated with lower HRQoL, lower LS, and a reduction in social participation, after adjustment for confounding factors.
Measurements of WS and TUG could be used to determine QoL and social participation in elderly people having sustained fractures.
PubMed ID
21868721 View in PubMed
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Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study 'Good ageing in Skane'.

https://arctichealth.org/en/permalink/ahliterature108217
Source
BMC Geriatr. 2013;13:81
Publication Type
Article
Date
2013
Author
Magnus Stenhagen
Henrik Ekström
Eva Nordell
Sölve Elmståhl
Author Affiliation
Department of Health Sciences, Division of Geriatric Medicine, Lund University, Skåne University Hospital, Malmö SE-205 02, Sweden. magnus.stenhagen@med.lu.se
Source
BMC Geriatr. 2013;13:81
Date
2013
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Aging - physiology
Databases, Factual - trends
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Population Surveillance - methods
Prospective Studies
Risk factors
Sweden - epidemiology
Abstract
Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design.
The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60-93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls.
The use of neuroleptics (OR 3.30, 95% CI: 1.15-9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17-3.04) and low walking speed (OR 1.77, 95% CI: 1.28-2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54-2.91), heart dysfunction, OR 1.66 (95% CI 1.26-2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88).
Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the relation between heart failure and falls in the elderly, as the treatment for this condition is poorly documented in this demographic. The findings of this study may be valuable in the development of intervention programmes aimed at sustainable, long-term reduction of falls in the elderly.
Notes
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PubMed ID
23919320 View in PubMed
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Home and health among different sub-groups of the ageing population: a comparison of two cohorts living in ordinary housing in Sweden.

https://arctichealth.org/en/permalink/ahliterature277620
Source
BMC Geriatr. 2016 Apr 26;16:90
Publication Type
Article
Date
Apr-26-2016
Author
Henrik Ekström
Steven M Schmidt
Susanne Iwarsson
Source
BMC Geriatr. 2016 Apr 26;16:90
Date
Apr-26-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - psychology
Cohort Studies
Cross-Sectional Studies
Environment
Female
Health status
Housing - standards
Humans
Male
Perception
Personal Satisfaction
Population Surveillance - methods
Sweden - epidemiology
Abstract
At present a majority of older people remain in their ordinary homes. Research has generated knowledge about home and health dynamics and increased the awareness of the complexity of housing as related to ageing. As this knowledge is based mainly on research on very old, single-living people in ordinary housing there is a need to study other sub-groups of the ageing population. Thus, the aim of the present descriptive study was to compare a younger old cohort with a very old cohort living in ordinary housing in Sweden in order to shed new light on home and health dynamics in different sub-groups of the ageing population.
Cross-sectional study of two population-based cohorts: one aged 67-70 years (n = 371) and one aged 79-89 years (n = 397) drawn from existing Swedish databases. Structured interviews and observations were conducted to collect data about socio-demographics, aspects of home, and symptoms. Besides descriptive statistics we computed tests of differences using the Chi-squared test and Mann-Whitney U-test.
Accessibility was significantly lower in the very old cohort compared to the younger old cohort even though the former were objectively assessed to have fewer environmental barriers. Those in the very old cohort perceived aspects of their housing situation as worse and were more dependent on external influences managing their housing situation. Although a larger proportion of the very old cohort had more functional limitations 22% were independent in ADL. In the younger old cohort 17% were dependent in ADL.
Keeping in mind that there were cohort differences beyond that of age, despite fewer environmental barriers in their dwellings the very old community-living cohort lived in housing with more accessibility problems compared to those of the younger old cohort, caused by their higher prevalence of functional limitations. Those in the very old cohort perceived themselves in a less favourable situation, but still as satisfied with housing as those in the younger old cohort. This kind of knowledge is indicative for prevention and intervention in health care and social services as well as for housing provision and societal planning. Further studies based on truly comparable cohorts are warranted.
Notes
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PubMed ID
27117314 View in PubMed
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Home and health in the third age - methodological background and descriptive findings.

https://arctichealth.org/en/permalink/ahliterature260797
Source
Int J Environ Res Public Health. 2014 Jul;11(7):7060-80
Publication Type
Article
Date
Jul-2014
Author
Maya Kylén
Henrik Ekström
Maria Haak
Sölve Elmståhl
Susanne Iwarsson
Source
Int J Environ Res Public Health. 2014 Jul;11(7):7060-80
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Accidental Falls
Activities of Daily Living
Aged
Attitude to Health
Depression
Environment Design
Female
Health status
Housing
Humans
Male
Personal Satisfaction
Sweden
Abstract
The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation.
The study sample included 371 people aged 67-70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health.
The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings.
This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens.
Notes
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PubMed ID
25019267 View in PubMed
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Relationships between perceived aspects of home and symptoms in a cohort aged 67-70.

https://arctichealth.org/en/permalink/ahliterature270198
Source
Arch Gerontol Geriatr. 2015 Nov-Dec;61(3):529-34
Publication Type
Article
Author
Maria Haak
Maya Kylén
Henrik Ekström
Steven M Schmidt
Vibeke Horstmann
Sölve Elmståhl
Susanne Iwarsson
Source
Arch Gerontol Geriatr. 2015 Nov-Dec;61(3):529-34
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aging - psychology
Depression
Female
Health status
Health Surveys
Housing for the Elderly
Humans
Independent Living - psychology
Interviews as Topic
Male
Perception
Personal Satisfaction
Sweden
Abstract
The importance of the home environment increases with age. Perceived aspects of home influence life satisfaction, perceived health, independence in daily activities and well-being among very old people. However, research on health and perceived aspects of home among senior citizens in earlier phases of the aging process is lacking. Therefore, the main aim was to explore whether perceived aspects of home are related to number of and specific domains of symptoms in a cohort of people aged 67-70. Interview and observation data on aspects of home and health, collected with 371 individuals living in ordinary housing in urban as well as rural areas in southern Sweden, were used. Descriptive statistics, correlations, multiple linear and logistic regression models were employed. The results showed that the median number of symptoms was 6.0. Reporting fewer reported symptoms was associated with a higher meaning of home (p=0.003) and lower external housing related control beliefs (p=0.001) but not with usability in the home. High external control beliefs were significantly associated with symptoms from head (p=0.014), gastrointestinal (p=0.014) and tension symptoms (p=0.001). Low meaning of home was significantly associated with heart-lung symptoms (p=0.007), and low usability was associated with depressive symptoms (p=0.003). In conclusion, showing that perceived aspects of home are important for health in terms of physical and mental symptoms, this study contributes to the knowledge on the complex interplay of health and home in the third age.
PubMed ID
26199206 View in PubMed
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Restriction in social participation and lower life satisfaction among fractured in pain: results from the population study "Good Aging in Skåne".

https://arctichealth.org/en/permalink/ahliterature162216
Source
Arch Gerontol Geriatr. 2008 May-Jun;46(3):409-24
Publication Type
Article
Author
Henrik Ekström
Synneve Dahlin Ivanoff
Sölve Elmståhl
Author Affiliation
Department of Health Sciences, Division of Geriatric Medicine, CRC, Ent. 72, Build. 28, Fl. 13, Malmö University Hospital, SE-205 02 Malmö, Sweden. henrik.ekstrom@med.lu.se
Source
Arch Gerontol Geriatr. 2008 May-Jun;46(3):409-24
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Case-Control Studies
Female
Fractures, Bone - etiology - physiopathology
Health status
Humans
Life Change Events
Male
Middle Aged
Osteoporosis - complications - physiopathology
Pain - physiopathology
Pain Management
Personal Satisfaction
Quality of Life
Questionnaires
Regression Analysis
Sickness Impact Profile
Social Support
Socioeconomic Factors
Sweden
Abstract
The aim of this study was to describe social participation expressed as accomplished ordinary activities, health-related quality of life (HRQoL) and life satisfaction (LS), among elderly men and women with osteoporosis-related fractures with and without pain, compared to non-fractured controls. The study was a population-based case-control study conducted at a university hospital, including 408 subjects from the Good Ageing in Skåne investigation. Fractured men and women of age 60-93 years were divided into two groups: one with pain (FP; n=87) and one without pain (FnP; n=82). Fractures included vertebrae, hip, pelvis or ankle according to International Classification of Diseases version 10 (ICD-10). A third group of non-fractured subjects without pain (n=239) was used as controls (CnP). Questionnaires were used to collect information about HRQoL, LS, social participation in ordinary activities such as social, cultural and leisure time activities, pain during past month, co-morbidity, alcohol and tobacco consumption, medication, exercise earlier in life, walking-aid, and socio-demographic variables. The results showed that FP scored significantly lower than CnP in HRQoL and LS. In general, fractured were more restricted in participation and in 12 out of 21 activities FP had a significant lower participation compared to CnP. In a regression model, participation in social and leisure activities as well as fracture predicted independently levels of HRQoL and LS.
PubMed ID
17662482 View in PubMed
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