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Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia.

https://arctichealth.org/en/permalink/ahliterature51955
Source
Health Qual Life Outcomes. 2004 Sep 21;2:52
Publication Type
Article
Date
Sep-21-2004
Author
Christian K Andersen
Kim U Wittrup-Jensen
Anette Lolk
Kjeld Andersen
Per Kragh-Sørensen
Author Affiliation
MUUSMANN Research & Consulting, Haderslevvej 36, 6000 Kolding, Denmark. journals@noos.fr
Source
Health Qual Life Outcomes. 2004 Sep 21;2:52
Date
Sep-21-2004
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Alzheimer Disease - physiopathology - psychology
Caregivers
Cluster analysis
Cross-Sectional Studies
Dementia - classification - physiopathology - psychology
Denmark
Dependency (Psychology)
Female
Geriatric Assessment - methods
Humans
Interviews
Male
Psychometrics - instrumentation
Quality of Life - psychology
Severity of Illness Index
Sickness Impact Profile
Socioeconomic Factors
Abstract
BACKGROUND: Dementia is a chronic illness associated with a progressive loss of cognitive and intellectual abilities, such as memory, judgment and abstract thinking.The objective of this study was to assess the health utilities of patients with dementia in Europe and identify the key factors influencing their Health-Related Quality of Life (HRQol). METHODS: This study used cross-sectional data from the Odense study; a Danish cohort of patients aged 65-84 living in Odense, Denmark. A total of 244 patients with mild to severe dementia were interviewed together with a caregiver about their health status and activities of daily living (ADL). Alzheimer's disease was diagnosed according to the NINCDS-ADRDA criteria for probable dementia. Vascular dementia and other types of dementia were diagnosed according to the DSM-IIIR criteria. Severity of dementia was defined by score intervals on the Mini Mental State Examination score: mild (MMSE 20-30), moderate (MMSE 10-19), and severe (MMSE 0-9). Based on the ADL information, the patients' dependency level was defined as either dependent or independent. Questions from the Odense Study were mapped into each of the five dimensions of the EQ-5D in order to assess patients' HRQol. Danish EQ-5D social tariffs were used to value patients' HRQol.A regression analysis of EQ-5D values was conducted with backward selection on gender, age, severity, ADL level and setting in order to determine the main factor influencing HRQoL. RESULTS: The EQ-5D weight in patients independent upon others in ADL was 0.641 (95% CI: [0.612-0.669]), and in those dependent upon others was 0.343 (95% CI: [0.251-0.436]). CONCLUSION: Dependency upon others to perform ADL was the main factor affecting HRQoL.
PubMed ID
15383148 View in PubMed
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Abuse and neglect experienced by aging chinese in Canada.

https://arctichealth.org/en/permalink/ahliterature130694
Source
J Elder Abuse Negl. 2011 Oct;23(4):326-47
Publication Type
Article
Date
Oct-2011
Author
Daniel W L Lai
Author Affiliation
Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada. dlai@ucalgary.ca
Source
J Elder Abuse Negl. 2011 Oct;23(4):326-47
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Aged
Asian Continental Ancestry Group
Canada - epidemiology
Cross-Sectional Studies
Elder Abuse - ethnology
Female
Geriatric Assessment - methods
Humans
Male
Middle Aged
Questionnaires
Retrospective Studies
Risk Assessment - methods
Risk factors
Social Environment
Vulnerable Populations - ethnology - statistics & numerical data
Abstract
The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.
PubMed ID
21978291 View in PubMed
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Adequacy of nutrient intake among elderly persons receiving home care.

https://arctichealth.org/en/permalink/ahliterature154657
Source
J Nutr Elder. 2008;27(1-2):65-82
Publication Type
Article
Date
2008
Author
C Shanthi Johnson
Monirun Nessa Begum
Author Affiliation
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada. shanthi.johnson@uregina.ca
Source
J Nutr Elder. 2008;27(1-2):65-82
Date
2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Diet - methods - statistics & numerical data
Eating
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Health status
Home Care Services - statistics & numerical data
Humans
Male
Nutrition Assessment
Nutritional Status
Ontario
Questionnaires
Risk assessment
Risk factors
Sex Distribution
Abstract
This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.
PubMed ID
18928191 View in PubMed
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Advancing the Big Five of user-oriented care and accounting for its variations.

https://arctichealth.org/en/permalink/ahliterature280692
Source
Int J Health Care Qual Assur. 2016;29(2):162-76
Publication Type
Article
Date
2016
Author
Petri Kajonius
Ali Kazemi
Source
Int J Health Care Qual Assur. 2016;29(2):162-76
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Classification
Female
Geriatric Assessment - methods
Humans
Interviews as Topic
Male
Models, organizational
Outcome Assessment (Health Care)
Patient-Centered Care - organization & administration
Precision Medicine
Quality of Health Care
Risk assessment
Sweden
Abstract
Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care.
Two municipalities were selected for in-depth field studies. First, in each municipality, the authors interviewed and observed care workers' interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, the authors conducted interviews with care workers and care unit managers (Study 2).
A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level).
The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.
PubMed ID
26959896 View in PubMed
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Adverse drug effects in elderly people -- a disparity between clinical examination and adverse effects self-reported by the patient.

https://arctichealth.org/en/permalink/ahliterature164731
Source
Eur J Clin Pharmacol. 2007 May;63(5):509-15
Publication Type
Article
Date
May-2007
Author
Pasi Lampela
Sirpa Hartikainen
Raimo Sulkava
Risto Huupponen
Author Affiliation
Department of Pharmacology and Toxicology, University of Kuopio, P.O. Box 1627, 70211, Kuopio, Finland. Pasi.Lampela@uku.fi
Source
Eur J Clin Pharmacol. 2007 May;63(5):509-15
Date
May-2007
Language
English
Publication Type
Article
Keywords
Adverse Drug Reaction Reporting Systems - statistics & numerical data
Aged
Aged, 80 and over
Data Collection - methods
Drug-Related Side Effects and Adverse Reactions
Female
Finland
Geriatric Assessment - methods
Humans
Male
Physicians - statistics & numerical data
Polypharmacy
Reproducibility of Results
Abstract
The trend towards polypharmacy is increasing among the elderly, and associated with this trend is an increased risk of adverse drug effects and drug-drug interactions. Our objective was to assess whether drug adverse effects reported by patients are in general agreement with those identified by a physician.
We evaluated the medication of 404 randomly selected individuals aged 75 years or older by means of interviews carried out by trained nurses and examinations conducted by a physician. The medication used by these patients was recorded prior to the physician's examination and modified thereafter if considered appropriate. Adverse effects noted by the physician were compared to those self-reported by the patients.
Almost all of the patients (98.8%) were using at least one drug, and the mean total number of drugs used was 6.5. Adverse effects were self-reported by 11.4% of the patients, whereas the physician observed apparent adverse drug effects in 24.0% of the patients. No adverse effects were reported in 53.2% of the patients. There were only seven patients that had adverse effects that were both self-reported and identified by the physician, and only four of these patients reported the same adverse effect that had been identified by the physician.
There was a great disparity between the adverse effects identified by the physician and those reported by the patients themselves. Based on our results, it would appear that elderly people tend to neglect adverse drug effects and may consider them to be an unavoidable part of normal ageing. Therefore, physicians should enquire about possible adverse effects even though elderly patients may not complain of any drug-related problems.
Notes
Comment In: Eur J Clin Pharmacol. 2007 Oct;63(10):979-80; author reply 98117618426
PubMed ID
17351768 View in PubMed
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[Analysis and management of comorbidity among the elderly must be coordinated. Treatment can be evaluated with the DBU method implemented at community centers for the aged].

https://arctichealth.org/en/permalink/ahliterature175189
Source
Lakartidningen. 2005 Mar 7-13;102(10):758-9, 762-3, 765
Publication Type
Article

Are segmental MF-BIA scales able to reliably assess fat mass and lean soft tissue in an elderly Swedish population?

https://arctichealth.org/en/permalink/ahliterature275943
Source
Exp Gerontol. 2015 Dec;72:239-43
Publication Type
Article
Date
Dec-2015
Author
Gianluca Tognon
Vibeke Malmros
Elisa Freyer
Ingvar Bosaeus
Kirsten Mehlig
Source
Exp Gerontol. 2015 Dec;72:239-43
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Adiposity
Aged, 80 and over
Body mass index
Body Weight
Electric Impedance
Female
Geriatric Assessment - methods
Healthy Volunteers
Humans
Linear Models
Male
Reproducibility of Results
Sweden
Abstract
The assessment of body composition is an important measure to monitor the process of healthy aging and detect early signs of disease. Dual X-ray absorptiometry (DXA) is considered a valid technique for the assessment of body composition but is confined to the clinical environment. Multi-frequency bio-electrical impedance analysis (MF-BIA) might be a versatile alternative to DXA. We aimed to assess whether a segmental MF-BIA scale can be an accurate and reliable tool for the monitoring of body composition in the elderly and whether the presence of metallic prostheses can influence the agreement between the two techniques.
Weight and height were measured in 92 healthy subjects (53 women) aged 80-81 years from the H70 Gerontological and Geriatric study in Gothenburg. Total and segmental fat mass (FM) and lean soft tissue (LST) were estimated by DXA (Lunar Prodigy, Scanex, Sweden) and segmental MF-BIA (MC-180MA, Tanita, Japan). Bland-Altman analyses were performed to assess the agreement between the two techniques. The prediction of DXA-FM by MF-BIA was compared to that of the body mass index (BMI).
MF-BIA showed a significant underestimation of FM and an overestimation of LST that was larger in men than in women. Smaller but significant deviations were found for appendicular LST and SMM. MF-BIA was not superior to BMI at predicting DXA-FM. The lack of agreement between MF-BIA and DXA was not due to the presence of metal prostheses or diagnoses such as hypertension and edema. The prediction equations applied by the device used in this study should be adapted to the elderly population and details about the reference population(s) should be disclosed.
PubMed ID
26456399 View in PubMed
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Are there any clinical characteristics of depression in elderly people that could be useful for case finding in general practice?

https://arctichealth.org/en/permalink/ahliterature45854
Source
Scand J Prim Health Care. 2003 Dec;21(4):214-8
Publication Type
Article
Date
Dec-2003
Author
Karin Fröjdh
Anders Håkansson
Staffan Janson
Author Affiliation
Research and Development Unit for Primary Health Care, Vårdcentralen Kronoparken, Karlstad, Sweden. karin.frojdh@liv.se
Source
Scand J Prim Health Care. 2003 Dec;21(4):214-8
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antidepressive Agents - therapeutic use
Cross-Sectional Studies
Depression - diagnosis - drug therapy
Family Practice - organization & administration
Female
Geriatric Assessment - methods
Health Services Research
Humans
Male
Medical Records
Office visits - statistics & numerical data
Questionnaires
Sweden
Abstract
OBJECTIVES: The aim of this study was to identify clinical characteristics of depression in elderly people that could be useful for case finding in general practice. DESIGN: A cross-sectional study of clinical characteristics through review of medical records. SETTING: Herrhagen health centre, Karlstad, Sweden. SUBJECTS: Seventy-one persons with a high depressive score in a screening of depressive symptoms and an age-matched and sex-matched control group of 138 persons with a low depressive score. RESULTS: The high depressive score group had an increased relative risk for "mental health problems" (RR 3.4; CI 95% 1.7-7.2), "many contacts with the health care centre" (> or = 14/3 years) (RR 2.9; CI 95% 1.4-6.1), and prescriptions of benzodiazepines (RR 1.7; CI 95% 1.0-2.9). Two-thirds of those in the high depressive score group had at least one of these characteristics. However, three-quarters of those with any of these characteristics had a low depressive score. In our population of elderly people with an estimated prevalence of 10.2% the positive predictive value would be 21% and the negative predictive value 95%. CONCLUSION: General practitioners should suspect a possible depressive disorder in elderly patients with mental health problems, with frequent contacts with the health centre or with prescriptions of benzodiazepines. Despite the high occurrences of these prominent clinical characteristics in the high-score group, they did not unfortunately have sufficient discriminatory power to be useful for case finding.
PubMed ID
14695071 View in PubMed
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Assessing capacity within a context of abuse or neglect.

https://arctichealth.org/en/permalink/ahliterature151676
Source
J Elder Abuse Negl. 2009 Apr;21(2):156-69
Publication Type
Article
Date
Apr-2009
Author
Deborah O'Connor
Margaret Isabel Hall
Martha Donnelly
Author Affiliation
Centre for Research on Personhood in Dementia and School of Social Work, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada. deborah.oconnor@ubc.ca
Source
J Elder Abuse Negl. 2009 Apr;21(2):156-69
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
British Columbia
Elder Abuse - diagnosis - psychology
Female
Geriatric Assessment - methods
Humans
Interpersonal Relations
Male
Middle Aged
Self Care - methods
Spouse Abuse - psychology
Vulnerable Populations - statistics & numerical data
Abstract
In 2000, with the implementation of Part III of the Adult Guardianship Act: Support and Assistance for Abused and Neglected Adults, British Columbia formally recognized the need to examine issues of decisional capacity of older adults within a context of abuse or neglect. Interestingly, however, although the test of capacity was clearly laid out under this piece of legislation, the potential influence that living in a situation of abuse or neglect may have on how the person makes decisions is not explicitly addressed. Similarly, this is a missing link throughout the literature discussing decisional capacity in older adults. This gap exists despite the fact that determining the "protection" needs of someone who is being abused and/or neglected often hinges directly on that person's decisional capacity. The purpose of this article is to examine the unique aspects associated with assessing and determining capacity for older adults who are living in a situation of abuse or neglect. The specific objectives are to: (a) examine how living in a situation of abuse or neglect may influence the determination of capacity and (b) explore the implications of conducting an assessment within a potentially abusive context. The legal notion of undue influence and the psychological concept of relational connection are introduced as potentially important for considering decision making within this context.
PubMed ID
19347716 View in PubMed
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Assessing the relative and absolute reliability of the Falls Efficacy Scale-International questionnaire in elderly individuals with increased fall risk and the questionnaire's convergent validity in elderly women with osteoporosis.

https://arctichealth.org/en/permalink/ahliterature119212
Source
Osteoporos Int. 2013 Jun;24(6):1853-8
Publication Type
Article
Date
Jun-2013
Author
A. Halvarsson
E. Franzén
A. Ståhle
Author Affiliation
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, SE-141 83 Huddinge, Stockholm, Sweden. alexandra.halvarsson@ki.se
Source
Osteoporos Int. 2013 Jun;24(6):1853-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Aged - psychology
Aged, 80 and over
Fear - psychology
Female
Geriatric Assessment - methods
Humans
Male
Osteoporosis, Postmenopausal - psychology
Proprioception
Psychometrics
Quality of Life
Questionnaires - standards
Reproducibility of Results
Risk factors
Self Efficacy
Sweden
Abstract
The Falls Efficacy Scale-International (FES-I) is a highly reliable questionnaire for assessing fear of falling in elderly individuals with increased fall risk and has low or no convergent validity with balance performance tests and health-related quality of life (HRQL) among elderly women with osteoporosis, which indicates that both measurements should be included as they are measuring different components.
Fear of falling is increased in elderly individuals with osteoporosis and FES-I is a widely used questionnaire to assess fear of falling. There is limited evidence of the reliability and convergent validity in elderly with increased risk of falling and osteoporosis.
Reliability and validity study of the FES-I. Community-dwelling elderly with increased fall risk, 59 subjects, were recruited to the reliability assessment, and 81 women with osteoporosis, in the validity assessment. For the reliability assessment, two postal surveys were used. For the validity assessment, we used baseline data from an on-going study in women with osteoporosis. The FES-I was correlated to a single-item question regarding fear of falling, self-reported history of falls, balance performance tests and health-related quality of life.
The FES-I had very good relative reliability (intra-class correlation 0.88) and internal consistency reliability (Cronbach's alpha 0.94). The value for absolute reliability was a standard error of measure 2.9 (10.6 %), smallest real difference 7.9 (29 %). There was "little if any" to "low" correlation between the FES-I and the single-item question regarding fear of falling and self-reported history of falls, HRQL and balance performance tests.
The FES-I seems to be a highly reliable questionnaire for assessing fear of falling in elderly with increased fall risk but has low relation to/convergent validity with balance performance and HRQL among elderly women with osteoporosis.
PubMed ID
23124715 View in PubMed
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240 records – page 1 of 24.