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Ambulatory cardiac arrhythmias in relation to mild hypokalaemia and prognosis in community dwelling middle-aged and elderly subjects.

https://arctichealth.org/en/permalink/ahliterature281049
Source
Europace. 2016 Apr;18(4):585-91
Publication Type
Article
Date
Apr-2016
Author
Nick Mattsson
Golnaz Sadjadieh
Preman Kumarathurai
Olav Wendelboe Nielsen
Lars Køber
Ahmad Sajadieh
Source
Europace. 2016 Apr;18(4):585-91
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Atrial Premature Complexes - etiology - mortality - physiopathology
Biomarkers - blood
Denmark
Disease-Free Survival
Diuretics - therapeutic use
Electrocardiography, Ambulatory
Female
Humans
Hypokalemia - blood - complications - diagnosis - drug therapy - mortality
Independent living
Kaplan-Meier Estimate
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Potassium - blood
Predictive value of tests
Proportional Hazards Models
Risk factors
Severity of Illness Index
Tachycardia, Supraventricular - etiology - mortality - physiopathology
Time Factors
Ventricular Premature Complexes - diagnosis - etiology - mortality - physiopathology
Abstract
Severe hypokalaemia can aggravate arrhythmia tendency and prognosis, but less is known about risk of mild hypokalaemia, which is a frequent finding. We examined the associations between mild hypokalaemia and ambulatory cardiac arrhythmias and their prognosis.
Subjects from the cohort of the 'Copenhagen Holter Study' (n = 671), with no history of manifest cardiovascular (CV) disease or stroke, were studied. All had laboratory tests and 48-h ambulatory electrocardiogram (ECG) recording. The median follow-up was 6.3 years. p-Potassium was inversely associated with frequency of premature ventricular complexes (PVCs) especially in combination with diuretic treatment (r = -0.22, P = 0.015). Hypokalaemia was not associated with supraventricular arrhythmias. Subjects at lowest quintile of p-potassium (mean 3.42, range 2.7-3.6 mmol/L) were defined as hypokalaemic. Cardiovascular mortality was higher in the hypokalaemic group (hazard ratio and 95% confidence intervals: 2.62 (1.11-6.18) after relevant adjustments). Hypokalaemia in combination with excessive PVC worsened the prognosis synergistically; event rates: 83 per 1000 patient-year in subjects with both abnormalities, 10 and 15 per 1000 patient-year in those with one abnormality, and 3 per 1000 patient-year in subjects with no abnormality. One variable combining hypokalaemia with excessive supraventricular arrhythmias gave similar results in univariate analysis, but not after multivariate adjustments.
In middle-aged and elderly subjects with no manifest heart disease, mild hypokalaemia is associated with increased rate of ventricular but not supraventricular arrhythmias. Hypokalaemia interacts synergistically with increased ventricular ectopy to increase the risk of adverse events.
PubMed ID
26293625 View in PubMed
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Attending an activity center: positive experiences of a group of home-dwelling persons with early-stage dementia.

https://arctichealth.org/en/permalink/ahliterature264606
Source
Clin Interv Aging. 2014;9:1923-31
Publication Type
Article
Date
2014
Author
Ulrika Söderhamn
Live Aasgaard
Bjørg Landmark
Source
Clin Interv Aging. 2014;9:1923-31
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Dementia - therapy
Exercise
Female
Humans
Independent Living - psychology
Interpersonal Relations
Male
Middle Aged
Norway
Patient satisfaction
Qualitative Research
Social Participation
Abstract
In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers.
The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis.
Four categories, ie, "appreciated activities", "praised nurses and volunteers", "being more active", and "being included in a fellowship", as well as the overall theme "participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being" emerged in the analysis. The informants appreciated the adapted physical and social activities and expressed their enjoyment and gratitude. They found the physical activities useful, and they felt themselves to be included in a fellowship through cheerful nurses and volunteers. The nurses were able to create a good atmosphere and spread joy in the center together with the volunteers. The informants felt themselves valued as the persons they were. These findings indicated that such activities may have had a positive influence on the informants' health and well-being.
In order to succeed with this kind of activity center, it is decisive that the nurses are able to tailor meaningful activities and create an environment where the persons with dementia can feel that they are respected and valued. The municipality health care service should implement such activity centers with specialist nurses in dementia care together with volunteers.
Notes
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Cites: Aging Ment Health. 2007 Mar;11(2):119-3017453545
PubMed ID
25419121 View in PubMed
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Attitudes to ageing among older Norwegian adults living in the community.

https://arctichealth.org/en/permalink/ahliterature283443
Source
Br J Community Nurs. 2017 May 02;22(5):238-245
Publication Type
Article
Date
May-02-2017
Author
Mary H Kalfoss
Source
Br J Community Nurs. 2017 May 02;22(5):238-245
Date
May-02-2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adaptation, Psychological
Aged
Aged, 80 and over
Aging - psychology
Attitude of Health Personnel
Attitude to Health
Depression - psychology
Female
Humans
Independent living
Loneliness
Male
Middle Aged
Norway
Nurses
Surveys and Questionnaires
Abstract
Attitudes toward ageing have powerful influences and impact older adults' own perception of health, quality of life and utilisation of health and social care services. This study describes attitudes to ageing among 490 Norwegian older adults living in the community who responded to The Attitudes to Ageing Questionnaire. Results showed that in spite of physical changes and psychological losses, the attitudes of older adults support life acceptance with gained wisdom in feeling that there were many pleasant things about growing older and that their identity was not defined by their age. They demonstrated the ability to incorporate age-related changes within their identities and at the same time maintain a positive view of self. Although they acknowledged that old age represented a time of loss with decreasing physical independence, they meant that their lives had made a difference, they wanted to give a good example to younger persons and felt it was a privilege to grow old.
PubMed ID
28467243 View in PubMed
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The average cost of pressure ulcer management in a community dwelling spinal cord injury population.

https://arctichealth.org/en/permalink/ahliterature123254
Source
Int Wound J. 2013 Aug;10(4):431-40
Publication Type
Article
Date
Aug-2013
Author
Brian C Chan
Natasha Nanwa
Nicole Mittmann
Dianne Bryant
Peter C Coyte
Pamela E Houghton
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Source
Int Wound J. 2013 Aug;10(4):431-40
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Cost-Benefit Analysis
Female
Health Care Costs
Hospital Costs
Hospitalization - economics
Humans
Independent living
Male
Middle Aged
Ontario
Patient Readmission - economics
Pilot Projects
Pressure Ulcer - economics - etiology - therapy
Residence Characteristics
Risk assessment
Severity of Illness Index
Spinal Cord Injuries - complications - diagnosis - economics
Young Adult
Abstract
Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs.
PubMed ID
22715990 View in PubMed
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Can we move beyond burden and burnout to support the health and wellness of family caregivers to persons with dementia? Evidence from British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature132042
Source
Health Soc Care Community. 2012 Jan;20(1):103-12
Publication Type
Article
Date
Jan-2012
Author
Meredith B Lilly
Carole A Robinson
Susan Holtzman
Joan L Bottorff
Author Affiliation
Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. meredith.lilly@mcmaster.ca
Source
Health Soc Care Community. 2012 Jan;20(1):103-12
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
British Columbia
Burnout, Professional - epidemiology
Caregivers - psychology
Dementia - therapy
Family - psychology
Family Relations
Female
Home Care Services
Humans
Independent living
Male
Middle Aged
Qualitative Research
Sex Factors
Socioeconomic Factors
Abstract
After more than a decade of concerted effort by policy-makers in Canada and elsewhere to encourage older adults to age at home, there is recognition that the ageing-in-place movement has had unintended negative consequences for family members who care for seniors. This paper outlines findings of a qualitative descriptive study to investigate the health and wellness and support needs of family caregivers to persons with dementia in the Canadian policy environment. Focus groups were conducted in 2010 with 23 caregivers and the health professionals who support them in three communities in the Southern Interior of British Columbia. Thematic analysis guided by the constant comparison technique revealed two overarching themes: (1) forgotten: abandoned to care alone and indefinitely captures the perceived consequences of caregivers' failed efforts to receive recognition and adequate services to support their care-giving and (2) unrealistic expectations for caregiver self-care relates to the burden of expectations for caregivers to look after themselves. Although understanding about the concepts of caregiver burden and burnout is now quite developed, the broader sociopolitical context giving rise to these negative consequences for caregivers to individuals with dementia has not improved. If anything, the Canadian homecare policy environment has placed caregivers in more desperate circumstances. A fundamental re-orientation towards caregivers and caregiver supports is necessary, beginning with viewing caregivers as a critical health human resource in a system that depends on their contributions in order to function. This re-orientation can create a space for providing caregivers with preventive supports, rather than resorting to costly patient care for caregivers who have reached the point of burnout and care recipients who have been institutionalised.
PubMed ID
21851447 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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Community-dwelling older adults with memory loss: needs assessment.

https://arctichealth.org/en/permalink/ahliterature115614
Source
Can Fam Physician. 2013 Mar;59(3):278-85
Publication Type
Article
Date
Mar-2013
Author
Karen Parsons
Aimee Surprenant
Anne-Marie Tracey
Marshall Godwin
Author Affiliation
Memorial University of Newfoundland, St John's, NL A1B 3V6. karenp@mun.ca
Source
Can Fam Physician. 2013 Mar;59(3):278-85
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Attitude to Health
Family Practice
Female
Focus Groups
Health Services for the Aged
Humans
Independent living
Interviews as Topic
Male
Memory Disorders - psychology - therapy
Middle Aged
Needs Assessment
Newfoundland and Labrador
Physician-Patient Relations
Qualitative Research
Social Support
Abstract
To identify the health-related needs of community-dwelling older adults with mild memory loss.
Qualitative study using semistructured, audiotaped, face-to-face interviews and focus groups.
A large community in Newfoundland.
Twenty-two adults between the ages of 58 and 80 years.
This needs assessment used a qualitative methodology of collecting and analyzing narrative data to develop an understanding of the issues, resources, and constraints of community-dwelling older adults with mild memory loss. Data were collected through semistructured, audiotaped, face-to-face interviews and focus groups. Transcripts of the interviews were analyzed using interpretive phenomenologic analysis.
Three constitutive patterns with relational themes and subthemes were identified: forgetting and remembering, normalizing yet questioning, and having limited knowledge of resources. Participants described many examples of how their daily lives were affected by forgetfulness. They had very little knowledge of resources that provided information or support. Most of the participants believed they could not discuss their memory problems with their family doctors.
It is important for older adults with mild memory loss to have access to resources that will assist them in understanding their condition and make them feel supported.
Notes
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Cites: West J Nurs Res. 2007 Dec;29(8):976-9217984481
PubMed ID
23486801 View in PubMed
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Dependency and transfer incomes in idiopathic Parkinson's disease.

https://arctichealth.org/en/permalink/ahliterature263808
Source
Dan Med J. 2014 Oct;61(10):A4915
Publication Type
Article
Date
Oct-2014
Author
Charlotte Starhof
Niels Anker
Tove Henriksen
Christina Funch Lassen
Source
Dan Med J. 2014 Oct;61(10):A4915
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Denmark - epidemiology
Employment - statistics & numerical data
Female
Humans
Income - statistics & numerical data
Independent Living - statistics & numerical data
Male
Middle Aged
Nursing Homes - statistics & numerical data - utilization
Parkinson Disease - economics - epidemiology
Registries
Young Adult
Abstract
Idiopathic Parkinson's disease (IPD) is a progressive neurodegenerative disorder affecting approximately 1% of the population above 65 years of age. The aim of this study was to define the estimated Danish IPD population and to elucidate source of income and labour market affiliation for working-age IPD patients.
IPD cases were included through the Danish Register of Medicinal Product Statistics. The participants had to be alive by the end of 2010 and at least twice have cashed in prescriptions on IPD medication in the 2009-2010 period. Information on employment status and transfer income was retrieved through the DREAM database under the Danish Ministry of Employment.
A total of 7,033 estimated IPD patients were identified. The mean age at time of registration (2010, week 50) was 72 years. Overall, 7% of the IPD patients were employed and 5% were self-supportive. In the working age range (18-64 years), 25% were employed and 10% enrolled in supported employment. Compared with the age-adjusted general population, twice as many IPD patients were outside the ordinary labour market and, furthermore, the proportion receiving anticipatory pension was increased threefold. The majority (89%) of the patients were living at home with a spouse (59%). 11% were nursing home residents.
The working age IPD population was more prone to be outside employment and to receive public transfer income than an age-adjusted population sample.
The study was funded by the Danish Parkinson Association.
not relevant.
PubMed ID
25283617 View in PubMed
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Do personal assistance activities promote participation for persons with disabilities in Sweden?

https://arctichealth.org/en/permalink/ahliterature294940
Source
Disabil Rehabil. 2017 12; 39(24):2512-2521
Publication Type
Journal Article
Date
12-2017
Author
Heléne von Granitz
Ieva Reine
Karin Sonnander
Ulrika Winblad
Author Affiliation
a Department of Public Health and Caring Sciences , Uppsala University , Uppsala , Sweden.
Source
Disabil Rehabil. 2017 12; 39(24):2512-2521
Date
12-2017
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Child
Disabled Persons - psychology - rehabilitation - statistics & numerical data
Female
Healthcare Disparities
Human Rights - standards
Humans
Independent Living - standards
Interpersonal Relations
Male
Middle Aged
Needs Assessment
Public Policy
Social Participation
Social Security - standards
Surveys and Questionnaires
Sweden - epidemiology
Abstract
To examine how the right to participation according to Article 19 of the United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD) is promoted by personal assistance use in Sweden across age, gender and eligible person categories.
Register data and data from a questionnaire were used (N?=?15,289). Principal component analysis was performed and the internal consistency was tested. Descriptive statistics (?2 test) were used across age, gender and eligible person categories and components.
An uneven distribution of personal assistance across the components Health and Care; Home, Leisure and Social Interaction; and Daily Occupation was found. Significant differences in personal assistance reported were found between children and adults, men and women and between the three eligible person categories.
The discrepancy between reported and expected outcome of personal assistance indicates that Article 19 of the UNCRPD has not been met. The unequal access to participation across age, gender and eligible person categories would seem to further signify that the Act concerning Support and Service for Persons with Certain Functional Impairments is promoting activities of a caring nature rather than fulfilling Article 19 of the UNCRPD, i.e. ensuring full participation in society. IMPLICATIONS FOR REHABILITATION Government assistance allowance were granted for predominantly health and care, i.e. basic needs presenting risk of undermining the intention of participation in society. Men reported more personal assistance use for activities promoting participation than women. The discrepancy found between reported and expected outcome of personal assistance underlines the importance of service providers and administrative officials being sensitive to policy intentions. There is a need of guidelines for service providers and administrative officials to promote disability rights of participation for persons eligible for personal assistance.
PubMed ID
27796138 View in PubMed
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Factors associated with active aging in Finland, Poland, and Spain.

https://arctichealth.org/en/permalink/ahliterature260487
Source
Int Psychogeriatr. 2014 Aug;26(8):1363-75
Publication Type
Article
Date
Aug-2014
Author
Perales J
Martin S
Ayuso-Mateos JL
Chatterji S
Garin N
Koskinen S
Leonardi M
Miret M
Moneta V
Olaya B
Tobiasz-Adamczyk B
Haro JM
Source
Int Psychogeriatr. 2014 Aug;26(8):1363-75
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aging - physiology - psychology
Cross-Cultural Comparison
Cross-Sectional Studies
Educational Status
Ethnopsychology - methods
Female
Finland - epidemiology
Health status
Health Surveys
Humans
Independent Living - psychology - statistics & numerical data
Male
Marital Status - statistics & numerical data
Middle Aged
Occupations - statistics & numerical data
Poland - epidemiology
Sex Factors
Social Behavior
Spain - epidemiology
Abstract
Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA.
The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed.
Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain.
Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country.
PubMed ID
24735743 View in PubMed
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35 records – page 1 of 4.