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Aspects of housing and perceived health among ADL independent and ADL dependent groups of older people in three national samples.

https://arctichealth.org/en/permalink/ahliterature113316
Source
Aging Clin Exp Res. 2013 Jun;25(3):317-28
Publication Type
Article
Date
Jun-2013
Author
Signe Tomsone
Vibeke Horstmann
Frank Oswald
Susanne Iwarsson
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden. Signe.Tomsone@med.lu.se
Source
Aging Clin Exp Res. 2013 Jun;25(3):317-28
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Aging - psychology
Dependency (Psychology)
Female
Geriatric Assessment
Germany
Health status
Housing
Humans
Independent Living - psychology
Latvia
Male
Regression Analysis
Residence Characteristics
Self Concept
Sweden
Abstract
Good housing solutions are important for the ageing population in order to promote health and maintain functional ability. The objective of this study was to investigate whether and how objective and perceived aspects of housing were related to perceived health among ADL independent and ADL dependent groups of older, single-living people within three national samples.
The current study was based on national samples (German, n = 450; Latvian, n = 303; Swedish, n = 397) from the European ENABLE-AGE Project, using data on ADL dependence, perceived health, objective and perceived aspects of housing. Descriptive statistics, correlations and multivariate ordinal regression models were used to analyze the data.
The participants in the ADL dependent groups generally were older, had more functional limitations and perceived their health as poorer compared to ADL independent groups. With regard to perceived housing, usability as well as meaning of home indicators was often lower in the ADL dependent groups, housing satisfaction was at the same level while housing-related external control beliefs were higher. The differences among the national samples were highly significant for both ADL groups, for all variables except number of outdoor environmental barriers in the ADL independent groups. The relations between perceived health on one hand and objective and perceived aspects of housing on the other show great diversities among the ADL groups and the national samples.
The results serve to alert health care practitioners that it is important to draw attention to how older people perceive their housing situation and to the fact that different levels of functional independence demand different interventions.
PubMed ID
23740591 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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Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature273603
Source
Age Ageing. 2015 Sep;44(5):784-9
Publication Type
Article
Date
Sep-2015
Author
Saija Karinkanta
Pekka Kannus
Kirsti Uusi-Rasi
Ari Heinonen
Harri Sievänen
Source
Age Ageing. 2015 Sep;44(5):784-9
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Age Factors
Aged
Aging
Female
Finland - epidemiology
Follow-Up Studies
Fractures, Bone - diagnosis - epidemiology - physiopathology - prevention & control
Geriatric Assessment
Humans
Incidence
Independent living
Kaplan-Meier Estimate
Muscle strength
Odds Ratio
Postural Balance
Proportional Hazards Models
Prospective Studies
Registries
Resistance Training
Risk factors
Time Factors
Treatment Outcome
Women's health
Abstract
previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures.
five-year health-care register-based follow-up study after a 1-year, four-arm RCT.
community-dwelling older women in Finland.
one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning.
participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR).
eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97).
home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies.
PubMed ID
25990940 View in PubMed
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Community-dwelling older people with an injurious fall are likely to sustain new injurious falls within 5 years--a prospective long-term follow-up study.

https://arctichealth.org/en/permalink/ahliterature264015
Source
BMC Geriatr. 2014;14:120
Publication Type
Article
Date
2014
Author
Petra Pohl
Ellinor Nordin
Anders Lundquist
Ulrica Bergström
Lillemor Lundin-Olsson
Source
BMC Geriatr. 2014;14:120
Date
2014
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Aged
Aged, 80 and over
Female
Follow-Up Studies
Geriatric Assessment
Humans
Incidence
Independent living
Male
Motor Activity - physiology
Prospective Studies
Risk factors
Sweden - epidemiology
Time Factors
Abstract
Fall-related injuries in older people are a leading cause of morbidity and mortality. Self-reported fall events in the last year is often used to estimate fall risk in older people. However, it remains to be investigated if the fall frequency and the consequences of the falls have an impact on the risk for subsequent injurious falls in the long term. The objective of this study was to investigate if a history of one single non-injurious fall, at least two non-injurious falls, or at least one injurious fall within 12 months increases the risk of sustaining future injurious falls.
Community-dwelling individuals 75-93 years of age (n = 230) were initially followed prospectively with monthly calendars reporting falls over a period of 12 months. The participants were classified into four groups based on the number and type of falls (0, 1, =2 non-injurious falls, and =1 injurious fall severe enough to cause a visit to a hospital emergency department). The participants were then followed for several years (mean time 5.0 years ±1.1) regarding injurious falls requiring a visit to the emergency department. The Andersen-Gill method of Cox regression for multiple events was used to estimate the risk of injurious falls.
During the long-term follow-up period, thirty per cent of the participants suffered from at least one injurious fall. Those with a self-reported history of at least one injurious fall during the initial 12 months follow-up period showed a significantly higher risk for sustaining subsequent injurious falls in the long term (hazard ratio 2.78; 95% CI, 1.40-5.50) compared to those with no falls. No other group showed an increased risk.
In community-dwelling people over 75 years of age, a history of at least one self-reported injurious fall severe enough to cause a visit to the emergency department within a period of 12 months implies an increased risk of sustaining future injurious falls. Our results support the recommendations to offer a multifactorial fall-risk assessment coupled with adequate interventions to community-dwelling people over 75 years who present to the ED due to an injurious fall.
Notes
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PubMed ID
25407714 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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Forgotten resources of older home care clients: focus group study in Finland.

https://arctichealth.org/en/permalink/ahliterature115670
Source
Nurs Health Sci. 2013 Sep;15(3):333-9
Publication Type
Article
Date
Sep-2013
Author
Riitta Turjamaa
Sirpa Hartikainen
Anna-Maija Pietilä
Author Affiliation
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Source
Nurs Health Sci. 2013 Sep;15(3):333-9
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Evaluation Studies as Topic
Female
Finland
Focus Groups
Frail Elderly - psychology
Geriatric Assessment
Health Resources - organization & administration
Home Care Services - organization & administration
Humans
Independent Living - psychology
Interpersonal Relations
Male
Nurses, Community Health - organization & administration
Quality of Life
Self-Help Groups
Abstract
In this qualitative focus group study, the resources available to older home-dwelling people, particularly incoming and existing home care clients, are described from the viewpoint of home care professionals (n?=?32). The data were analyzed using inductive content analysis. There were three categories of older people requiring resources from the viewpoint of interviewers: home-dwelling people, incoming home care clients, and existing home care clients. Based on the analysis, the resources of older home-dwelling people were categorized in terms of support, meaningful life, everyday activities, and environment. Incoming home care client resources were support, out-of-home activities, in-home activities, and environment. Existing client resources were described in terms of support, everyday activities, and environment. Home care professionals described the resources of the older home-dwelling people in diverse ways, but those of the perspective of existing clients were reduced. The biggest difference was in everyday activities. Psychological and social resources, including meaningful life and social relationships, seemed to be forgotten. All available resources must be taken into account, especially in the everyday home care services for existing home care clients.
PubMed ID
23480058 View in PubMed
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Glycemic control and health-related quality of life among older home-dwelling primary care patients with diabetes.

https://arctichealth.org/en/permalink/ahliterature293508
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Publication Type
Journal Article
Date
Dec-2017
Author
Anna-Kaisa Aro
Merja Karjalainen
Miia Tiihonen
Hannu Kautiainen
Juha Saltevo
Maija Haanpää
Pekka Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland; Rantakylä Health Center, Siunsote, Finland. Electronic address: koistine@student.uef.fi.
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging
Biomarkers - blood
Blood Glucose - metabolism
Cognition
Cross-Sectional Studies
Diabetes Mellitus - blood - diagnosis - psychology - therapy
Female
Finland
Geriatric Assessment
Glycated Hemoglobin A - metabolism
Humans
Independent living
Male
Mental health
Mental Status and Dementia Tests
Mobility Limitation
Predictive value of tests
Primary Health Care
Quality of Life
Risk factors
Self Care - methods
Time Factors
Treatment Outcome
Abstract
To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients.
Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15).
EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c.
Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
PubMed ID
28754430 View in PubMed
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More attention to pain management in community-dwelling older persons with chronic musculoskeletal pain.

https://arctichealth.org/en/permalink/ahliterature264106
Source
Age Ageing. 2014 Nov;43(6):845-50
Publication Type
Article
Date
Nov-2014
Author
Niina Maria Karttunen
Juha Turunen
Riitta Ahonen
Sirpa Hartikainen
Source
Age Ageing. 2014 Nov;43(6):845-50
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Analgesics - therapeutic use
Attitude of Health Personnel
Chi-Square Distribution
Chronic Pain - diagnosis - physiopathology - therapy
Female
Finland
Geriatric Assessment
Health Knowledge, Attitudes, Practice
Humans
Independent living
Logistic Models
Male
Musculoskeletal Pain - diagnosis - physiopathology - psychology - therapy
Odds Ratio
Pain Management - methods
Pain Measurement
Patient satisfaction
Patients - psychology
Physician's Role
Time Factors
Treatment Outcome
Abstract
persistent pain is a major problem in older people, but little is known about older persons' opinion about the treatment of persistent pain.
the objective of this study was to investigate the factors associated with older participants having chronic musculoskeletal pain and hoping persistently that physician would pay more attention to the pain management.
this 3-year follow-up study was a part of large population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) study. The population sample (n = 1000) of the GeMS study was randomly selected from older inhabitants (=75 years) of Kuopio city, Finland, and participants were interviewed annually in the municipal health centre or in the participant's current residence by three study nurses. The current substudy included participants with chronic musculoskeletal pain (n = 270). Participants were asked specifically whether they hoped that more attention would be paid to pain management by the physician.
at baseline, 41% of the community-dwelling older participants with chronic musculoskeletal pain hoped the physician would pay more attention to pain management. Of those participants, 49% were still continuing to hope after 1 year and 31% after 2 years. A persistent hope to receive more attention to pain management was associated with poor self-rated health (OR: 2.94; 95% CI: 1.04-8.30), moderate-to-severe pain (OR: 3.46; 95% CI: 1.42-8.44), and the daily use of analgesics (OR: 4.16; 95% CI: 1.08-16.09).
physicians need to take a more active role in the process of recognising, assessing and controlling persistent pain in older people.
PubMed ID
24814961 View in PubMed
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15 records – page 1 of 2.