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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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Improved Housing Accessibility for Older People in Sweden and Germany: Short Term Costs and Long-Term Gains.

https://arctichealth.org/en/permalink/ahliterature289909
Source
Int J Environ Res Public Health. 2017 08 26; 14(9):
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-26-2017
Author
Björn Slaug
Carlos Chiatti
Frank Oswald
Roman Kaspar
Steven M Schmidt
Author Affiliation
Department of Health Sciences & Centre for Ageing and Supportive Environments (CASE), Lund University, SE-221 00 Lund, Sweden. bjorn.slaug@med.lu.se.
Source
Int J Environ Res Public Health. 2017 08 26; 14(9):
Date
08-26-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Activities of Daily Living
Aged, 80 and over
Architectural Accessibility - legislation & jurisprudence
Female
Germany
Housing - economics - statistics & numerical data
Humans
Male
Models, Theoretical
Public Policy - legislation & jurisprudence
Sweden
Abstract
The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.
Notes
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PubMed ID
28846592 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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The TECH@HOME study, a technological intervention to reduce caregiver burden for informal caregivers of people with dementia: study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature290259
Source
Trials. 2017 02 09; 18(1):63
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
02-09-2017
Author
Agneta Malmgren Fänge
Steven M Schmidt
Maria H Nilsson
Gunilla Carlsson
Anna Liwander
Caroline Dahlgren Bergström
Paolo Olivetti
Per Johansson
Carlos Chiatti
Author Affiliation
Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden. agneta.malmgren_fange@med.lu.se.
Source
Trials. 2017 02 09; 18(1):63
Date
02-09-2017
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Activities of Daily Living
Adaptation, Psychological
Caregivers - psychology
Cognition
Cost of Illness
Cost-Benefit Analysis
Dementia - diagnosis - economics - psychology - therapy
Equipment Design
Health Care Costs
Humans
Medical Informatics - economics - instrumentation
Protective Devices - economics
Quality of Life
Remote Sensing Technology - economics
Research Design
Surveys and Questionnaires
Sweden
Telemedicine - economics - instrumentation
Text Messaging
Time Factors
Transducers, Pressure - economics
Abstract
It is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality. The aim of this trial is to evaluate the effects of information and communication technology (ICT) on caregiver burden among informal caregivers of people with dementia by reducing the need for supervision.
This randomized controlled trial aims to recruit 320 dyads composed of people with dementia living in community settings and their primary informal caregivers. In the intervention group, people with dementia will have a home monitoring kit installed in their home while dyads in the control group will receive usual care. The ICT kit includes home-leaving sensors, smoke and water leak sensors, bed sensors, and automatic lights that monitor the individual's behavior. Alerts (text message and/or phone call) will be sent to the caregiver if anything unusual occurs. All study dyads will receive three home visits by project administrators who have received project-specific training in order to harmonize data collection. Home visits will take place at enrollment and 3 and 12 months following installation of the ICT kit. At every home visit, a standardized questionnaire will be administered to all dyads to assess their health, quality of life and resource utilization. The primary outcome of this trial is the amount of informal care support provided by primary informal caregivers to people with dementia.
This is the first randomized controlled trial exploring the implementation of ICT for people with dementia in a large sample in Sweden and one of the first at the international level. Results hold the potential to inform regional and national policy-makers in Sweden and beyond about the cost-effectiveness of ICT and its impact on caregiver burden.
ClinicalTrials.gov, NCT02733939 . Registered on 10 March 2016.
Notes
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PubMed ID
28183323 View in PubMed
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