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A 10-Year Follow-Up of Adiposity and Dementia in Swedish Adults Aged 70 Years and Older.

https://arctichealth.org/en/permalink/ahliterature300956
Source
J Alzheimers Dis. 2018; 63(4):1325-1335
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Ilse A C Arnoldussen
Valter Sundh
Kristoffer Bäckman
Silke Kern
Svante Östling
Kaj Blennow
Henrik Zetterberg
Ingmar Skoog
Amanda J Kiliaan
Deborah R Gustafson
Author Affiliation
Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.
Source
J Alzheimers Dis. 2018; 63(4):1325-1335
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adiponectin - blood
Adiposity
Aged
Aged, 80 and over
Anthropometry
Body mass index
Dementia - blood - epidemiology - pathology
Fasting
Female
Humans
Independent living
Leptin - blood
Longitudinal Studies
Male
Psychiatric Status Rating Scales
Sex Factors
Sweden - epidemiology
Waist-Hip Ratio
Abstract
Adiposity measured in mid- or late-life and estimated using anthropometric measures such as body mass index (BMI) and waist-to-hip ratio (WHR), or metabolic markers such as blood leptin and adiponectin levels, is associated with late-onset dementia risk. However, during later life, this association may reverse and aging- and dementia-related processes may differentially affect adiposity measures.
We explored associations of concurrent BMI, WHR, and blood leptin and high molecular weight adiponectin levels with dementia occurrence.
924 Swedish community-dwelling elderly without dementia, aged 70 years and older, systematically-sampled by birth day and birth year population-based in the Gothenburg city region of Sweden. The Gothenburg Birth Cohort Studies are designed for evaluating risk and protective factors for dementia. All dementias diagnosed after age 70 for 10 years were identified. Multivariable logistic regression models were used to predict dementia occurrence between 2000-2005, 2005-2010, and 2000-2010 after excluding prevalent baseline (year 2000) dementias. Baseline levels of BMI, WHR, leptin, and adiponectin were used.
Within 5 years of baseline, low BMI (
PubMed ID
29758945 View in PubMed
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The AGES-Reykjavik Study suggests that change in kidney measures is associated with subclinical brain pathology in older community-dwelling persons.

https://arctichealth.org/en/permalink/ahliterature300494
Source
Kidney Int. 2018 09; 94(3):608-615
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Sanaz Sedaghat
Jie Ding
Gudny Eiriksdottir
Mark A van Buchem
Sigurdur Sigurdsson
M Arfan Ikram
Osorio Meirelles
Vilmundur Gudnason
Andrew S Levey
Lenore J Launer
Author Affiliation
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Source
Kidney Int. 2018 09; 94(3):608-615
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Keywords
Aged
Albuminuria - physiopathology - urine
Cerebral Small Vessel Diseases - diagnosis - epidemiology
Creatinine - urine
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate - physiology
Humans
Incidence
Independent living
Kidney - physiopathology
Magnetic Resonance Imaging
Male
Prospective Studies
Renal Insufficiency, Chronic - physiopathology - urine
Risk factors
Serum Albumin
White Matter - diagnostic imaging - pathology
Abstract
Decreased glomerular filtration rate (GFR) and albuminuria may be accompanied by brain pathology. Here we investigated whether changes in these kidney measures are linked to development of new MRI-detected infarcts and microbleeds, and progression of white matter hyperintensity volume. The study included 2671 participants from the population-based AGES-Reykjavik Study (mean age 75, 58.7% women). GFR was estimated from serum creatinine, and albuminuria was assessed by urinary albumin-to-creatinine ratio. Brain MRI was acquired at baseline (2002-2006) and 5 years later (2007-2011). New MRI-detected infarcts and microbleeds were counted on the follow-up scans. White matter hyperintensity progression was estimated as percent change in white matter hyperintensity volumes between the two exams. Participants with a large eGFR decline (over 3 ml/min/1.73m2 per year) had more incident subcortical infarcts (odds ratio 1.53; 95% confidence interval 1.05, 2.22), and more marked progression of white matter hyperintensity volume (difference: 8%; 95% confidence interval: 4%, 12%), compared to participants without a large decline. Participants with incident albuminuria (over 30 mg/g) had 21% more white matter hyperintensity volume progression (95% confidence interval: 14%, 29%) and 1.86 higher odds of developing new deep microbleeds (95% confidence interval 1.16, 2.98), compared to participants without incident albuminuria. The findings were independent of cardiovascular risk factors. Changes in kidney measures were not associated with occurrence of cortical infarcts. Thus, larger changes in eGFR and albuminuria are associated with increased risk for developing manifestations of cerebral small vessel disease. Individuals with larger changes in these kidney measures should be considered as a high risk population for accelerated brain pathology.
PubMed ID
29960746 View in PubMed
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The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study.

https://arctichealth.org/en/permalink/ahliterature293028
Source
BMC Geriatr. 2017 12 27; 17(1):292
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-27-2017
Author
Laila Arnesdatter Hopstock
Elisabeth Bøe Utne
Alexander Horsch
Tove Skjelbakken
Author Affiliation
Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. laila.hopstock@uit.no.
Source
BMC Geriatr. 2017 12 27; 17(1):292
Date
12-27-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Aged
Aged, 80 and over
Anemia - complications - diagnosis - epidemiology - physiopathology
Cohort Studies
Female
Frailty - diagnosis - epidemiology - physiopathology
Geriatric Assessment - methods
Hemoglobins - analysis
Humans
Independent Living - statistics & numerical data
Male
Norway - epidemiology
Risk Assessment - methods
Risk factors
Self Report
Statistics as Topic
Abstract
Falls are common among elderly people, and the risk increase with age. Falls are associated with both health and social consequences for the patient, and major societal costs. Identification of risk factors should be investigated to prevent falls. Previous studies have shown anemia to be associated with increased risk of falling, but the results are inconsistent. The aim of this study was to investigate the association between anemia and self-reported falls among community-living elderly people. The study is a replication of the study by Thaler-Kall and colleagues from 2014, who studied the association between anemia and self-reported falls among 967 women and men 65 years and older in the KORA-Age study from 2009.
We included 2441 participants (54% women) 65 years and older from the population-based Tromsø 5 Study 2001-2002. Logistic regression models were used to investigate the association between anemia (hemoglobin
Notes
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PubMed ID
29282000 View in PubMed
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Cardiovascular biomarkers predict fragility fractures in older adults.

https://arctichealth.org/en/permalink/ahliterature299736
Source
Heart. 2019 03; 105(6):449-454
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2019
Author
Madeleine Johansson
Fabrizio Ricci
Giuseppe Di Martino
Cecilia Rogmark
Richard Sutton
Viktor Hamrefors
Olle Melander
Artur Fedorowski
Author Affiliation
Department of Clinical Sciences, Faculty of Medicine, Clinical Research Center, Lund University, Malmö, Sweden.
Source
Heart. 2019 03; 105(6):449-454
Date
03-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adrenomedullin - blood
Aged
Atrial Natriuretic Factor - blood
Biomarkers - blood
Body mass index
Cardiovascular System - metabolism
Cohort Studies
Correlation of Data
Endothelin-1 - blood
Female
Fractures, Bone - blood
Humans
Independent Living - statistics & numerical data
Male
Middle Aged
Peptide Fragments - blood
Prospective Studies
Protein Precursors - blood
Reproducibility of Results
Risk assessment
Risk factors
Sweden
Vasopressins - blood
Abstract
To assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.
We analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.
Overall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p
Notes
CommentIn: Heart. 2019 Mar;105(6):427-428 PMID 30361269
PubMed ID
30322844 View in PubMed
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Characteristics and predictors for hospitalizations of home-dwelling older persons receiving community care: a cohort study from Norway.

https://arctichealth.org/en/permalink/ahliterature299876
Source
BMC Geriatr. 2018 09 03; 18(1):203
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-03-2018
Author
Martha Therese Gjestsen
Kolbjørn Brønnick
Ingelin Testad
Author Affiliation
Centre for age-related medicine (SESAM), Stavanger University Hospital, Stavanger, Norway. martha.therese.gjestsen@sus.no.
Source
BMC Geriatr. 2018 09 03; 18(1):203
Date
09-03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Delivery of Health Care, Integrated - organization & administration
Female
Frail Elderly
Geriatric Assessment
Home Care Services - organization & administration
Hospitalization - statistics & numerical data
Humans
Independent living
Male
Norway - epidemiology
Retrospective Studies
Abstract
Older persons are substantial consumers of both hospital- and community care, and there are discussions regarding the potential for preventing hospitalizations through high quality community care. The present study report prevalence and factors associated with admissions to hospital for community-dwelling older persons (>?67 years of age), receiving community care in a Norwegian municipality.
This was a cohort study of 1531 home-dwelling persons aged =67 years, receiving community care. We retrospectively scrutinized admissions to hospital for the study cohort over a one-year period in 2013. The frequency of admissions was evaluated with regard to association with age (age groups 67-79 years, 80-89 years and?=?90 year) and gender. The hospital admission incidence was calculated by dividing the number of admissions by the number of individuals included in the study cohort, stratified by age and gender. The association between age and gender as potential predictors and hospitalization (outcome) was first examined in univariate analyses followed by multinomial regression analyses in order to investigate the associations between age and gender with different causes of hospitalization.
We identified a total of 1457 admissions, represented by 739 unique individuals, of which 64% were women, and an estimated mean age of 83 years. Mean admission rate was 2 admissions per person-year (95% confidence interval (CI): 1.89-2.11). The admission rate varied with age, and hospital incidents rates were higher for men in all age groups. The overall median length of stay was 4 days. The most common reason for hospitalization was the need for further medical assessment (23%). We found associations between increasing age and hospitalizations due to physical general decline, and associations between male gender and hospitalizations due to infections (e.g., airways infections, urinary tract infections).
We found the main reasons for hospitalizations to be related to falls, infections and general decline/pain/unspecified dyspnea. Men were especially at risk for hospitalization as they age. Our study have identified some clinically relevant factors that are vital in understanding what health care personnel in community care need to be especially aware of in order to prevent hospitalizations for this population.
PubMed ID
30176794 View in PubMed
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Comparison of Summer and Winter Objectively Measured Physical Activity and Sedentary Behavior in Older Adults: Age, Gene/Environment Susceptibility Reykjavik Study.

https://arctichealth.org/en/permalink/ahliterature290965
Source
Int J Environ Res Public Health. 2017 10 21; 14(10):
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.
Date
10-21-2017
Author
Nanna Yr Arnardottir
Nina Dora Oskarsdottir
Robert J Brychta
Annemarie Koster
Dane R van Domelen
Paolo Caserotti
Gudny Eiriksdottir
Johanna E Sverrisdottir
Erlingur Johannsson
Lenore J Launer
Vilmundur Gudnason
Tamara B Harris
Kong Y Chen
Thorarinn Sveinsson
Author Affiliation
Faculty of Education, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland. nanna@unak.is.
Source
Int J Environ Res Public Health. 2017 10 21; 14(10):
Date
10-21-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.
Keywords
Accelerometry
Aged
Aged, 80 and over
Exercise
Female
Humans
Iceland
Independent Living - statistics & numerical data
Male
Seasons
Sedentary lifestyle
Abstract
In Iceland, there is a large variation in daylight between summer and winter. The aim of the study was to identify how this large variation influences physical activity (PA) and sedentary behavior (SB). Free living PA was measured by a waist-worn accelerometer for one week during waking hours in 138 community-dwelling older adults (61.1% women, 80.3 ± 4.9 years) during summer and winter months. In general, SB occupied about 75% of the registered wear-time and was highly correlated with age (ß = 0.36). Although the differences were small, more time was spent during the summer in all PA categories, except for the moderate-to-vigorous PA (MVPA), and SB was reduced. More lifestyle PA (LSPA) was accumulated in =5-min bouts during summer than winter, especially among highly active participants. This information could be important for policy makers and health professionals working with older adults. Accounting for seasonal difference is necessary in analyzing SB and PA data.
Notes
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PubMed ID
29065475 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 medication reviews on use of potentially inappropriate medications in elderly patients; a cross-sectional study in Swedish primary care.

https://arctichealth.org/en/permalink/ahliterature298045
Source
BMC Health Serv Res. 2018 08 07; 18(1):616
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-07-2018
Author
Cecilia Lenander
Åsa Bondesson
Nina Viberg
Anders Beckman
Patrik Midlöv
Author Affiliation
Department of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden. cecilia.lenander@med.lu.se.
Source
BMC Health Serv Res. 2018 08 07; 18(1):616
Date
08-07-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Drug Utilization Review
Female
General practitioners
Geriatrics - standards
Humans
Inappropriate Prescribing - prevention & control
Independent living
Male
Nurses
Nursing Homes
Pharmacists
Psychotropic Drugs - therapeutic use
Sweden
Abstract
Drug use among the elderly population is generally extensive and the use of potentially inappropriate medications (PIMs) is common, which increases the risk for drug-related problems (DRP). Medication reviews are one method to improve drug therapy by identifying, preventing and solving DRPs. The aim of this study was to evaluate the effect of medication reviews on total drug use and potentially inappropriate drug use in elderly patients, as well as describe the occurrence and types of drug-related problems.
This was a cross-sectional analysis to study medication reviews conducted by trained clinical pharmacists followed by team-based discussions with general practitioners (GPs) and nurses, for elderly primary care patients in Skåne, Sweden. Included in the analysis were patients =75 years living in nursing homes or in their own homes with home care, who received a medication review during 2011-2012. Documented DRPs were described as both the type of DRPs and as pharmacists' recommendations to the GP. The usage of =3 psychotropics and PIMs (antipsychotics, anticholinergics, long-acting benzodiazepines, tramadol and propiomazine) at baseline and after medication review were also studied.
The analysis included a total of 1720 patients. They were on average aged 87.5 years, used typically 11.3 drugs (range 1-35) and 61% of them used 10 drugs or more. Of the patients, 84% had at least one DRP with a mean of 2.2 DRPs/patient. Of the DRPs, 12% were attributable to PIMs. The proportion of patients with = one PIM was reduced significantly (p?
PubMed ID
30086742 View in PubMed
Less detail

Frequent pain in older people with and without diabetes - Finnish community based study.

https://arctichealth.org/en/permalink/ahliterature294408
Source
BMC Geriatr. 2018 03 15; 18(1):73
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
03-15-2018
Author
M Karjalainen
J Saltevo
M Tiihonen
M Haanpää
H Kautiainen
P Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland.
Source
BMC Geriatr. 2018 03 15; 18(1):73
Date
03-15-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Comorbidity
Cross-Sectional Studies
Depression - diagnosis - epidemiology - psychology
Diabetes Mellitus - diagnosis - epidemiology - psychology
Female
Finland - epidemiology
Humans
Independent Living - psychology
Male
Pain - diagnosis - epidemiology - psychology
Pain Measurement - methods - psychology
Primary Health Care - methods
Surveys and Questionnaires
Abstract
The association between pain and diabetes in older people has been largely unexplored. The aim of this survey was to analyze the prevalence and characteristics of pain among Finnish men and women 65 or older with and without diabetes in primary care.
All home-dwelling persons 65 years or older with diabetes (N?=?527) and age and gender matched controls (N?=?890) were identified from electronic patient records. Frequent pain was regarded as any pain experienced more often than once a week, and it was divided into pain experienced several times a week but not daily and pain experienced daily or continuously. The Numeric Rating Scale (0-10) (NRS) was used to assess the intensity and interference of the pain.
The number of subjects who returned the questionnaire was 1084 (76.5%). The prevalence of frequent pain in the preceding week was 50% among women without diabetes and 63% among women with diabetes (adjusted, p?=?0.22). In men, the corresponding proportions were 42% without diabetes and 47% with diabetes (adjusted, p?=?0.58). In both genders, depressive symptoms and the number of comorbidities were associated with pain experienced more often than once a week and with daily pain. Diabetes was not associated with pain intensity or pain interference in either women or men.
Pain in older adults is associated with depressive symptoms and the number of comorbidities more than with diabetes itself.
Notes
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PubMed ID
29544464 View in PubMed
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Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.

https://arctichealth.org/en/permalink/ahliterature299773
Source
J Appl Gerontol. 2017 08; 36(8):971-992
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-2017
Author
Sara Cederbom
Charlotta Thunborg
Eva Denison
Anne Söderlund
Petra von Heideken Wågert
Author Affiliation
1 School of Healt, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
Source
J Appl Gerontol. 2017 08; 36(8):971-992
Date
08-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Activities of Daily Living
Adult
Female
Focus Groups
Health Knowledge, Attitudes, Practice
Health promotion
Home Care Services - organization & administration
Humans
Independent living
Interviews as Topic
Male
Middle Aged
Professional Role
Qualitative Research
Sweden
Abstract
The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.
PubMed ID
26209706 View in PubMed
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