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Distribution and evaluation of sense of coherence among older immigrants before and after a health promotion intervention - results from the RCT study promoting aging migrants' capability.

https://arctichealth.org/en/permalink/ahliterature297835
Source
Clin Interv Aging. 2018; 13:2317-2328
Publication Type
Journal Article
Randomized Controlled Trial
Date
2018
Author
L A Arola
E Barenfeld
S Dahlin-Ivanoff
G Häggblom-Kronlöf
Author Affiliation
Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Sweden, annikki.arola@arcada.fi.
Source
Clin Interv Aging. 2018; 13:2317-2328
Date
2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Adaptation, Psychological
Aged
Aged, 80 and over
Balkan Peninsula - ethnology
Emigrants and Immigrants - psychology
Female
Finland - ethnology
Follow-Up Studies
Health Promotion - methods
Humans
Independent living
Male
Outcome Assessment (Health Care)
Sense of Coherence
Sweden
Abstract
The migration process can be a threat to a person's sense of coherence (SOC) and to their ability to experience life as comprehensible, manageable, and meaningful. Seen from a salutogenic perspective, this may have a negative impact on the experience of health.
We describe the distribution of SOC and its components among older persons with an immigrant background now aging in Sweden. In addition, we evaluated whether a group-based health promotion program with a person-centered approach could support the SOC among older persons in this group.
A randomized controlled trial with postintervention follow-ups at 6 and 12 months was conducted with 131 independently living persons aged =70 years from Finland and the Balkan Peninsula. Participants were randomly allocated to an intervention group (4 weeks of group intervention and one follow-up home visit) and a control group (no intervention but access to ordinary health care services). The outcome measure was the SOC measured by SOC-13. Chi-square and ORs were calculated.
There was a significant improvement in total SOC scores for the intervention group at 6-month follow-up. Also, the ORs for the SOC components were higher in the person-centered intervention group. However, we found no significant between-group differences nor did the effect last until the 12-month follow-up.
Persons who have lived a long time in a host country after migration seem to have a SOC similar to native-born persons. Interventions with a person-centered approach could support the SOC by capturing individual life situations. Such interventions could support older persons by making everyday life more comprehensible and manageable and helping them to cope with challenges in daily life caused by aging.
PubMed ID
30532522 View in PubMed
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Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture - protocol of a randomized controlled trial (HIPFRA study).

https://arctichealth.org/en/permalink/ahliterature301757
Source
BMC Geriatr. 2018 10 01; 18(1):232
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
10-01-2018
Author
Paula Soukkio
Sara Suikkanen
Sanna Kääriä
Hannu Kautiainen
Sarianna Sipilä
Katriina Kukkonen-Harjula
Markku Hupli
Author Affiliation
Rehabilitation, South Karelia Social and Health Care District, Valto Käkelän katu 3, FI-53130, Lappeenranta, Finland. paula.soukkio@eksote.fi.
Source
BMC Geriatr. 2018 10 01; 18(1):232
Date
10-01-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Female
Finland - epidemiology
Frail Elderly - psychology
Hip Fractures - epidemiology - psychology - rehabilitation
Home Care Services - trends
Humans
Independent Living - psychology - trends
Male
Nutrition Assessment
Physical Therapy Modalities - psychology - trends
Quality of Life - psychology
Surveys and Questionnaires
Time Factors
Treatment Outcome
Abstract
Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture.
This is a non-blinded, parallel group, randomized controlled trial performed in South Karelia Social and Health Care District, Finland (population 131,000). Three hundred community-dwelling older persons with signs of frailty (age?=?65) and 300 persons with a recent hip fracture (age?=?60) will be recruited. Frailty is screened by FRAIL questionnaire and verified by modified Fried's frailty criteria. Both patient groups will be randomized separately to a physiotherapy and a usual care arm. Individualized, structured and progressive physiotherapy will be carried out for 60 min, twice a week for 12 months at the participant's home. The primary outcome at 24 months is duration of living at home. Our hypothesis is that persons assigned to the physiotherapy arm will live at home for six months longer than those in the usual care arm. Secondary outcomes are functional capacity, frailty status, health-related quality-of-life, falls, use and costs of social and health care services, and mortality. Assessments, among others Short Physical Performance Battery, Functional Independence Measure, Mini Nutritional Assessment, and Mini-Mental State Examination will be performed at the participant's home at baseline, 3, 6, and 12 months. Register data on the use and costs of social and health care services, and mortality will be monitored for 24 months.
Our trial will provide new knowledge on the potential of intensive, long-term home-based physiotherapy among older persons at risk for disabilities, to enhance functional capacity and thereby to postpone the need for institutional care, and diminish the use of social and health care services.
ClinicalTrials.gov Identifier: NCT02305433 , Registered Nov 28, 2014.
PubMed ID
30285645 View in PubMed
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Effects of Cognitive Training on Cognition and Quality of Life of Older Persons with Dementia.

https://arctichealth.org/en/permalink/ahliterature302899
Source
J Am Geriatr Soc. 2018 04; 66(4):664-670
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
04-2018
Author
Eeva-Liisa Kallio
Hannareeta Öhman
Marja Hietanen
Helena Soini
Timo E Strandberg
Hannu Kautiainen
Kaisu H Pitkälä
Author Affiliation
Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
Source
J Am Geriatr Soc. 2018 04; 66(4):664-670
Date
04-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Aged, 80 and over
Cognition - physiology
Cognitive Behavioral Therapy - methods
Dementia - therapy
Female
Finland
Humans
Independent living
Male
Neuropsychological Tests - statistics & numerical data
Quality of Life - psychology
Single-Blind Method
Abstract
To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia.
Single-blind randomized controlled trial with 3- and 9-month follow-up.
Adult day care centers in Helsinki, Finland.
Older individuals with mild to moderate dementia living at home and attending adult day care twice a week (N = 147; mean age 83, 72% female, 63% at mild stage of dementia).
A systematic 12-week training program focused on subskills of executive function: attention, working memory, cognitive flexibility, and planning. The intervention group (n = 76) underwent cognitive training twice a week for 45 minutes, and the control group (n = 71) attended day care as usual.
Primary outcomes were the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) for global cognition and the 15-dimensional instrument (15D) for HRQoL. The outcomes were measured at baseline and 3 and 9 months.
Both groups deteriorated in global cognition and HRQoL during follow-up, and there were no differences between the two groups in change on the ADAS-Cog (P = .43) or 15D (P = .61) over time (adjusted for age and sex). At 3 months, changes were 0.8 (95% confidence interval (CI) = -0.2-1.8) for the intervention group and 1.7 (95% CI = 0.6-2.7) for the control group on the ADAS-Cog and -0.040 (95% CI = -0.058 to -0.021) for the intervention group and -0.037 (95% CI = -0.056 to -0.018) for the control group on the 15D.
Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.
Notes
CommentIn: J Am Geriatr Soc. 2018 Apr;66(4):645-647 PMID 29345742
PubMed ID
29345724 View in PubMed
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Effects of preventive home visits on health-related quality-of-life and mortality in home-dwelling older adults.

https://arctichealth.org/en/permalink/ahliterature300278
Source
Scand J Prim Health Care. 2019 Mar; 37(1):90-97
Publication Type
Journal Article
Randomized Controlled Trial
Date
Mar-2019
Author
Heini Liimatta
Pekka Lampela
Pirjo Laitinen-Parkkonen
Kaisu H Pitkala
Author Affiliation
a Hyvinkää City Health Centre , Hyvinkää , Finland.
Source
Scand J Prim Health Care. 2019 Mar; 37(1):90-97
Date
Mar-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Female
Finland - epidemiology
Geriatric Assessment
Home Care Services
House Calls
Humans
Independent living
Male
Mortality
Preventive Health Services
Quality of Life
Abstract
We explored the effectiveness of preventive home visits on the health-related quality-of-life (HRQoL) and mortality among independently community-dwelling older adults.
A randomised controlled trial.
Independently home-dwelling older adults 75 years and older, consisting of 211 in the intervention and 211 in the control group.
Hyvinkää town municipality, Finland.
We used the change in HRQoL measured by the 15D scale as our primary outcome. Mortality at two years was retrieved from central registers.
At the one-year time point, the HRQoL according to the 15D scores deteriorated in the control group, whereas we found no change in the intervention group. The difference between the 15D score changes between the groups was -0.015 (95% CI -0.029 to -0.0016; p?=?0.028, adjusted for age, sex, and baseline value). At the two-year time point as the visits ended, that difference diminished. There was no difference in mortality between the groups during the 24-month follow-up.
Preventive home visits implemented by a multidisciplinary team with CGA appear to help slow down the decline in HRQoL among older adults, although the effect diminishes when the visits end. Key points We are exploring preventive home visits as means to support the health-related quality-of-life (HRQoL) of home-dwelling older adults Multiprofessional preventive home visits in this intervention study helped to maintain the HRQoL when measured using 15D The effects on HRQoL diminished when the intervention ended, so could further benefits be attained with a longer intervention?The clinical trial registration number: ACTRN12616001411437.
PubMed ID
30810457 View in PubMed
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Serum 25-hydroxyvitamin D levels and incident falls in older women.

https://arctichealth.org/en/permalink/ahliterature299865
Source
Osteoporos Int. 2019 Jan; 30(1):93-101
Publication Type
Journal Article
Randomized Controlled Trial
Date
Jan-2019
Author
K Uusi-Rasi
R Patil
S Karinkanta
K Tokola
P Kannus
C Lamberg-Allardt
H Sievänen
Author Affiliation
The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland. kirsti.uusi-rasi@uta.fi.
Source
Osteoporos Int. 2019 Jan; 30(1):93-101
Date
Jan-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Aged
Aged, 80 and over
Anthropometry - methods
Biomarkers - blood
Bone Density - drug effects - physiology
Cholecalciferol - therapeutic use
Dietary Supplements
Exercise Therapy - methods
Female
Finland - epidemiology
Humans
Incidence
Independent living
Physical Functional Performance
Vitamin D - analogs & derivatives - blood
Abstract
Three hundred eighty-seven home-dwelling older women were divided into quartiles based on mean serum 25-hydroxyvitamin D (S-25(OH)D) levels. The rates of falls and fallers were about 40% lower in the highest S-25(OH)D quartile compared to the lowest despite no differences in physical functioning, suggesting that S-25(OH)D levels may modulate individual fall risk.
Vitamin D supplementation of 800 IU did not reduce falls in our previous 2-year vitamin D and exercise RCT in 70-80 year old women. Given large individual variation in individual responses, we assessed here effects of S-25(OH)D levels on fall incidence.
Irrespective of original group allocation, data from 387 women were explored in quartiles by mean S-25(OH)D levels over 6-24 months; means (SD) were 59.3 (7.2), 74.5 (3.3), 85.7 (3.5), and 105.3 (10.9) nmol/L. Falls were recorded monthly with diaries. Physical functioning and bone density were assessed annually. Negative binomial regression was used to assess incidence rate ratios (IRRs) for falls and Cox-regression to assess hazard ratios (HR) for fallers. Generalized linear models were used to test between-quartile differences in physical functioning and bone density with the lowest quartile as reference.
There were 37% fewer falls in the highest quartile, while the two middle quartiles did not differ from reference. The respective IRRs (95% CI) for falls were 0.63 (0.44 to 0.90), 0.78 (0.55 to 1.10), and 0.87 (0.62 to 1.22), indicating lower falls incidence with increasing mean S-25(OH)D levels. There were 42% fewer fallers (HR 0.58; 040 to 0.83) in the highest quartile compared to reference. Physical functioning did not differ between quartiles.
Falls and faller rates were about 40% lower in the highest S-25(OH)D quartile despite similar physical functioning in all quartiles. Prevalent S-25(OH)D levels may influence individual fall risk. Individual responses to vitamin D treatment should be considered in falls prevention.
PubMed ID
30255229 View in PubMed
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The use of case management for community-dwelling older people: the effects on loneliness, symptoms of depression and life satisfaction in a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature302678
Source
Scand J Caring Sci. 2018 Jun; 32(2):889-901
Publication Type
Journal Article
Randomized Controlled Trial
Date
Jun-2018
Author
Elin Taube
Jimmie Kristensson
Patrik Midlöv
Ulf Jakobsson
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Source
Scand J Caring Sci. 2018 Jun; 32(2):889-901
Date
Jun-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Case Management
Community Health Nursing - methods
Depression - psychology
Female
Frail Elderly - psychology
Humans
Independent living
Loneliness - psychology
Male
Personal Satisfaction
Quality of Life - psychology
Sweden
Abstract
To investigate the effects of a case management intervention for community-dwelling frail older people, with functional dependency and repeated contacts with the healthcare services, focusing on loneliness, depressive symptoms and life satisfaction.
A two-armed, nonblinded, randomised control trial with repeated follow-ups, of N = 153 participants at baseline allocated to an intervention (n = 80) and control (n = 73) group.
Inclusion criteria were the following: =65 years of age, living in ordinary housing, in need of assistance in two or more self-reported activities of daily living, having at least two hospital admissions or at least four visits in outpatient care 12 months prior to enrolment. Case managers (nurses and physiotherapists) provided an intervention of general case management, general information, specific information and continuity and safety. The intervention ranged over 12 months with one or more home visit(s) being conducted per month. An intention-to-treat analysis was applied for the primary outcomes of loneliness, depressive symptoms and life satisfaction, along with complete case and sensitivity analyses.
During the trial period n = 12 died and n = 33 dropped out. No significant difference was found between the groups at baseline regarding sociodemographic characteristics, subjective health or primary outcomes. The intention-to-treat analysis did not result in any significant effects for the primary outcomes at any of the follow-ups (6 and 12 months). The complete case analysis resulted in a significant difference in favour of the intervention regarding loneliness (RR = 0.49, p = 0.028) and life satisfaction (ES = 0.41, p = 0.028) at 6 months and for depressive symptoms (ES = 0.47, p = 0.035) at 12 months.
The use of case management for frail older people did not result in clear favourable effects for the primary outcomes. However, the study indicates that case management may be beneficial in terms of these outcomes. Due to the complexity of the outcomes, an elaboration of the components and assessments is suggested.
PubMed ID
28895175 View in PubMed
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6 records – page 1 of 1.