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23 records – page 1 of 3.

Abdominal and gynoid adiposity and the risk of stroke.

https://arctichealth.org/en/permalink/ahliterature136783
Source
Int J Obes (Lond). 2011 Nov;35(11):1427-32
Publication Type
Article
Date
Nov-2011
Author
F. Toss
P. Wiklund
P W Franks
M. Eriksson
Y. Gustafson
G. Hallmans
P. Nordström
A. Nordström
Author Affiliation
Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
Source
Int J Obes (Lond). 2011 Nov;35(11):1427-32
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Abdominal Fat - pathology - radiography
Absorptiometry, Photon
Adult
Age Distribution
Aged
Body Fat Distribution
Body mass index
Cardiovascular Diseases - epidemiology - pathology
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension - epidemiology - pathology
Incidence
Male
Middle Aged
Obesity - complications - epidemiology - pathology - radiography
Proportional Hazards Models
Risk factors
Stroke - epidemiology - etiology - pathology
Sweden - epidemiology
Abstract
Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke.
A cohort of 2751 men and women aged =40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg?m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age.
During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR)=1.66, 95% confidence interval (CI)=1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR=0.72, 95% CI=0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR=1.49, 95% CI=1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR=1.80, 95% CI=1.06-3.07; HR=1.71, 95% CI=1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension.
Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors.
PubMed ID
21343905 View in PubMed
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Attention, frailty, and falls: the effect of a manual task on basic mobility.

https://arctichealth.org/en/permalink/ahliterature46336
Source
J Am Geriatr Soc. 1998 Jun;46(6):758-61
Publication Type
Article
Date
Jun-1998
Author
L. Lundin-Olsson
L. Nyberg
Y. Gustafson
Author Affiliation
Department of Geriatric Medicine, Umeå University, Sweden.
Source
J Am Geriatr Soc. 1998 Jun;46(6):758-61
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Activities of Daily Living - classification
Aged
Aged, 80 and over
Attention
Cross-Sectional Studies
Disability Evaluation
Female
Frail Elderly
Geriatric Assessment
Humans
Male
Mental Status Schedule
Motor Skills
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sweden
Abstract
OBJECTIVE: To investigate the effect of a second task on balance and gait maneuvers used in everyday life. Our hypothesis was that those who were more distracted by a familiar manual task performed concurrently with functional maneuvers were more frail and more prone to falls. DESIGN: A cross-sectional design with prospective follow-up for falls. SETTING: Sheltered accommodation in Umeå, Sweden. PARTICIPANTS: Forty-two residents (30 women, 12 men; mean age +/- SD = 79.7 +/- 6.1 years), ambulant with or without a walking aid, able to follow simple instructions and able to carry a tumbler. MEASUREMENTS: Timed Up & Go (TUG), i.e., the time taken to rise from an armchair, walk 3 meters, turn round, and sit down again. TUG was repeated with an added manual task (TUGmanual), which was to carry a glass of water while walking. The Montgomery-Asberg Depression Rating Scale, Barthel Index, Functional Reach, Mini-Mental State Examination, and Line Bisection test were used to assess for frailty. The subjects were followed-up prospectively regarding falls indoors for a period of 6-months. RESULTS: Subjects with a time difference (diffTUG) between TUGmanual and TUG of > or = 4.5 seconds were considered to be distracted by the second task. Ten subjects had a difference in time of > or = 4.5 seconds. These subjects were more frail, and seven of them fell indoors during the follow-up period (odds ratio 4.7, 95%Confidence Interval (CI) 1.5-14.2). CONCLUSION: The time difference between the TUGmanual and the TUG appears to be a valid marker of frailty and a useful tool for identifying older persons prone to falling.
PubMed ID
9625194 View in PubMed
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Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people.

https://arctichealth.org/en/permalink/ahliterature270671
Source
J Nutr Health Aging. 2015 Apr;19(4):461-7
Publication Type
Article
Date
Apr-2015
Author
M. Burman
S. Säätelä
M. Carlsson
B. Olofsson
Y. Gustafson
C. Hörnsten
Source
J Nutr Health Aging. 2015 Apr;19(4):461-7
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Body mass index
Cause of Death
Female
Finland - epidemiology
Humans
Male
Malnutrition - diagnosis - epidemiology - mortality
Nutrition Assessment
Nutritional Status - physiology
Prevalence
Prospective Studies
Residence Characteristics
Sex Characteristics
Sweden - epidemiology
Abstract
to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people.
A prospective cohort study.
A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community.
Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years).
Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed.
The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (P
PubMed ID
25809811 View in PubMed
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Clinical profile of delirium in older patients.

https://arctichealth.org/en/permalink/ahliterature46221
Source
J Am Geriatr Soc. 1999 Nov;47(11):1300-6
Publication Type
Article
Date
Nov-1999
Author
O. Sandberg
Y. Gustafson
B. Brännström
G. Bucht
Author Affiliation
Department of Geriatric Medicine, University of Umeå, Sweden.
Source
J Am Geriatr Soc. 1999 Nov;47(11):1300-6
Date
Nov-1999
Language
English
Publication Type
Article
Keywords
Affective Symptoms - psychology
Aged
Aged, 80 and over
Anxiety - psychology
Circadian Rhythm
Cross-Sectional Studies
Delirium - diagnosis - physiopathology - psychology
Dementia - psychology
Depression - psychology
Female
Humans
Irritable Mood - physiology
Male
Prevalence
Psychomotor Disorders - psychology
Psychotic Disorders - psychology
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: To examine the prevalence, psychiatric and behavior symptoms, differing symptom profiles, and diurnal variations of delirium in older patients. DESIGN: A descriptive, point prevalence study with a cross-sectional design. SETTING: One ordinary county hospital (n = 148), three nursing homes (n = 202), five old people's homes (n = 196), and home medical care patients (n = 171) in parts of a hospital catchment area in Mid-Sweden. PARTICIPANTS: A total of 717 patients 75 years of age and older were observed and assessed for the prevalence of delirium. Women accounted for 66.4% of the studied population, and the mean age for both sexes was 83.7 years. MEASUREMENTS: All patients were examined using the OBS (Organic Brain Syndrome) scale, and delirium was diagnosed according to DSM-III-R. RESULTS: Delirium was diagnosed in 315 of 717 (43.9%) patients, and 135 of 315 (42.9%) of the delirious patients had dementia. Thirty-seven percent of the patients with delirium were delirious in the afternoon, evening, or at night, and 47% of the delirious patients had morning delirium. The delirious patients presented a wide variety of psychiatric symptoms. More than half the patients exhibiting anxiety, psychomotor slowing, depressed mood, and irritability. Nearly 26% were classified as having hypoactive, 22% as having hyperactive, and 42% as having mixed delirium, whereas 11% had neither hypo- nor hyperactive delirium. Seventy-seven percent were classified as having delirium with pronounced emotional and 43% with pronounced psychotic symptoms. CONCLUSIONS: This study shows that patients with delirium have very different clinical profiles. This might indicate a need for different treatment strategies for patients with different types of delirium.
Notes
Comment In: J Am Geriatr Soc. 1999 Nov;47(11):138210573453
PubMed ID
10573437 View in PubMed
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Clinical profile of delirium in patients treated for femoral neck fractures.

https://arctichealth.org/en/permalink/ahliterature200975
Source
Dement Geriatr Cogn Disord. 1999 Sep-Oct;10(5):325-9
Publication Type
Article
Author
A. Edlund
M. Lundström
G. Lundström
B. Hedqvist
Y. Gustafson
Author Affiliation
Department of Rehabilitation, Piteâ River Valley Hospital, Piteâ, Sweden.
Source
Dement Geriatr Cogn Disord. 1999 Sep-Oct;10(5):325-9
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Behavioral Symptoms
Chi-Square Distribution
Delirium - epidemiology - etiology - physiopathology
Disease Susceptibility
Female
Femoral Neck Fractures - epidemiology - surgery
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Postoperative Complications
Risk factors
Sweden - epidemiology
Treatment Outcome
Abstract
The incidence of delirium, its predisposing factors, clinical profile, associated symptoms and consequences were investigated in 54 consecutive patients, 19 men and 35 women, mean age 77.1 years, admitted to an 'ortho-geriatric unit' with femoral neck fractures. The incidence of postoperative delirium was 15/54 (27.8%) and a logistic regression model found that dementia and a prolonged waiting time for the operation increased the risk of postoperative delirium. Delirium during the night was most common but in 5 patients the delirium was worst in the morning. Patients with delirium suffered more anxiety, depressed mood, emotionalism, delusions and hallucinations. A larger proportion of patients with delirium could not return to their previous dwelling, and a larger proportion of delirious patients were either dead, wheelchair-bound or bedridden at the 6-month follow-up (p
PubMed ID
10473932 View in PubMed
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Delirium before and after operation for femoral neck fracture.

https://arctichealth.org/en/permalink/ahliterature191082
Source
J Am Geriatr Soc. 2001 Oct;49(10):1335-40
Publication Type
Article
Date
Oct-2001
Author
A. Edlund
M. Lundström
B. Brännström
G. Bucht
Y. Gustafson
Author Affiliation
Department of Rehabilitation, Piteå River Valley Hospital, Sweden.
Source
J Am Geriatr Soc. 2001 Oct;49(10):1335-40
Date
Oct-2001
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chi-Square Distribution
Delirium - epidemiology - etiology - psychology
Female
Femoral Neck Fractures - surgery
Humans
Incidence
Logistic Models
Male
Prospective Studies
Risk factors
Abstract
The aim of this study was to investigate the differences between preoperative and postoperative delirium regarding predisposing, precipitating factors and outcome in older patients admitted to hospital with femoral neck fractures.
A prospective clinical assessment of patients treated for femoral neck fractures.
Department of orthopedic surgery at Umeå University Hospital, Sweden.
One hundred one patients, age 65 and older admitted to the hospital for treatment of femoral neck fractures.
The Organic Brain Syndrome (OBS) Scale.
Thirty patients (29.7%) were delirious before surgery and another 19 (18.8%) developed delirium postoperatively. Of those who were delirious preoperatively, all but one remained delirious postoperatively. The majority of those delirious before surgery were demented, had been treated with drugs with anticholinergic properties (mainly neuroleptics), had had previous episodes of delirium, and had fallen indoors. Patients who developed postoperative delirium had perioperative falls in blood pressure and had more postoperative complications such as infections. Male patients were more often delirious both preoperatively and postoperatively. Patients with preoperative delirium were more often discharged to institutional care and had poorer walking ability both on discharge and after 6 months than did patients with postoperative delirium only.
Because preoperative and postoperative delirium are associated with different risk factors it is necessary to devise different strategies for their prevention.
PubMed ID
11890492 View in PubMed
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Source
Osteoporos Int. 1998;8(1):92-5
Publication Type
Article
Date
1998
Author
A. Ramnemark
L. Nyberg
B. Borssén
T. Olsson
Y. Gustafson
Author Affiliation
Department of Geriatric Medicine, Umeå University, Sweden. anna.ramnemark@germed.umu.se
Source
Osteoporos Int. 1998;8(1):92-5
Date
1998
Language
English
Publication Type
Article
Keywords
Accidental Falls
Adult
Aged
Aged, 80 and over
Arm Injuries - complications - epidemiology
Cerebrovascular Disorders - complications
Female
Fractures, Bone - complications - epidemiology
Hip Fractures - complications - epidemiology
Humans
Incidence
Male
Middle Aged
Osteoporosis - complications - epidemiology
Retrospective Studies
Risk
Sweden - epidemiology
Time Factors
Wrist Injuries - complications - epidemiology
Abstract
Fractures are a serious complication after stroke. Among patients with femoral neck fractures, a large subgroup have had a previous stroke. This study aimed to investigate the incidence of fractures after stroke. Included in the study were 1139 patients consecutively admitted for acute stroke. Fractures occurring from stroke onset until the end of the study or death were registered retrospectively. Hip fracture incidence was compared with corresponding rates from the general population. Patients were followed up for a total of 4132 patient-years (median 2.9 years). There were 154 fractures in 120 patients and median time between the onset of stroke and the first fracture was 24 months. Women had significantly more fractures than men (chi 2 = 15.6; p
PubMed ID
9692083 View in PubMed
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Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment.

https://arctichealth.org/en/permalink/ahliterature211180
Source
Dan Med Bull. 1996 Sep;43(4):350-9
Publication Type
Article
Date
Sep-1996
Author
O. Sletvold
R. Tilvis
A. Jonsson
M. Schroll
J. Snaedal
K. Engedal
K. Schultz-Larsen
Y. Gustafson
Author Affiliation
Department of Geriatrics, Municipality Hospital, Copenhagen.
Source
Dan Med Bull. 1996 Sep;43(4):350-9
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Aged
Denmark
Finland
Geriatrics - methods - standards
Humans
Iceland
Norway
Sweden
Abstract
A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help for the clinician concerned with hospital based geriatric medicine. It may also be useful for quality control and teaching. Not least, it may be useful for health professionals other than geriatricians. To some extent, the position of geriatric medicine in the Nordic countries varies between the countries. However, the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have shown favourable outcomes. Results from controlled Nordic trials are compiled and summaries of meta-analyses are presented. The concept of Nordic geriatric work-up is based on a model defining health and disease in old age as dimensions of pathology, impairments, functional limitations, and disability, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors and barriers, stating important differences between multidisciplinary and interdisciplinary processes. Checklists and assessment scales may be very useful when performing a geriatric work-up, but they should be used with caution. Specific scales covering different functional areas of the geriatric patient are recommended for clinical practice. Such scales must be valid, reliable, acceptable to the patient, responsive to change, and should be in an appropriate format, as well as easy to administer. Prior to the use among geriatric teams in the Nordic countries the scales should be translated into all the Nordic languages, and the translated versions should ideally have been subjected to validity and reliability testing. However, so far no scale meets these demands regarding all the five Nordic languages.
PubMed ID
8884136 View in PubMed
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Higher morale is associated with lower risk of depressive disorders five years later among very old people.

https://arctichealth.org/en/permalink/ahliterature283857
Source
Arch Gerontol Geriatr. 2017 Mar - Apr;69:61-68
Publication Type
Article
Author
J. Niklasson
M. Näsman
F. Nyqvist
M. Conradsson
B. Olofsson
H. Lövheim
Y. Gustafson
Source
Arch Gerontol Geriatr. 2017 Mar - Apr;69:61-68
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged, 80 and over
Depressive Disorder - epidemiology - prevention & control - psychology
Female
Finland - epidemiology
Follow-Up Studies
Geriatric Assessment - methods
Health status
Humans
Incidence
Male
Morale
Optimism - psychology
Psychological Tests
Risk factors
Sweden - epidemiology
Abstract
The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and =95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, p
PubMed ID
27889589 View in PubMed
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Incidence of falls in three different types of geriatric care. A Swedish prospective study.

https://arctichealth.org/en/permalink/ahliterature209169
Source
Scand J Soc Med. 1997 Mar;25(1):8-13
Publication Type
Article
Date
Mar-1997
Author
L. Nyberg
Y. Gustafson
A. Janson
P O Sandman
S. Eriksson
Author Affiliation
Department of Geriatric Medicine, Umeå University, Sweden.
Source
Scand J Soc Med. 1997 Mar;25(1):8-13
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Aged
Aged, 80 and over
Female
Homes for the Aged - statistics & numerical data
Hospitals, Psychiatric - statistics & numerical data
Humans
Incidence
Male
Nursing Homes - statistics & numerical data
Odds Ratio
Prospective Studies
Rehabilitation Centers - statistics & numerical data
Risk factors
Sweden - epidemiology
Wounds and Injuries - epidemiology
Abstract
The incidence and consequences of falls were investigated in three different types of Swedish geriatric care clinics: a geriatric rehabilitation clinic, a psychogeriatric clinic and a nursing home. Falls were prospectively registered by the nursing staff. The incidence rate (and 95% confidence interval) of falls per 10,000 patient days of the psychogeriatric clinic was 171 (146-196), compared with 92 (72-112) at the geriatric rehabilitation clinic, and 31 (22-41) at the nursing home. Most falls (62%) did not result in injury, while major injuries occurred in 5%. We conclude that accidental falls are a major problem in geriatric care in Sweden, but there is a considerable difference in incidence rates between different types of institutions.
PubMed ID
9106939 View in PubMed
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23 records – page 1 of 3.