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  • 101.
    Andersson, Åsa
    et al.
    Department of Geriatrics, Örebro University Hospital, Örebro, Sweden; Department Neurotec, Karolinska Institutet, Stockholm, Sweden.
    Kamwendo, Kitty
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Seiger, Åke
    Department Neurotec, Karolinska Institutet, Stockholm, Sweden.
    Appelros, Peter
    Örebro universitet, Institutionen för klinisk medicin. Department Neurotec, Karolinska Institutet, Stockholm, Sweden.
    How to identify potential fallers in a stroke unit: validity indexes of 4 test methods2006Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, nr 3, s. 186-191Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of this study was to describe general characteristics of patients with stroke who have a tendency to fall and to determine whether certain test instruments can identify fallers. METHODS: Patients treated in a stroke unit during a 12-month period were included. At inclusion assessments were made with Berg Balance Scale Berg Balance Scale, Stops Walking When Talking, Timed Up & Go (TUG) and diffTUG. At follow-up 6 or 12 months later, patients who had fallen were identified. RESULTS: During the time from discharge to follow-up on 159 patients, 68 patients fell and 91 did not. Fallers fell more often during their initial hospital stay, used sedatives more often and were more visually impaired, compared with non-fallers. The Berg Balance Scale, Stops Walking When Talking and TUG results differed between fallers and non-fallers. The combined results of Berg Balance Scale and Stops Walking When Talking increased the possibility of identifying fallers. CONCLUSION: Berg Balance Scale, Stops Walking When Talking and TUG can be used to evaluate which patients have a tendency to fall in order to carry out preventive measures. Berg Balance Scale can be used in all patients. Stops Walking When Talking can give additional information if the patient is able to walk. TUG is a possible choice, but fewer patients can perform it.

  • 102.
    Andersson, Åsa
    et al.
    Karolinska institutet, Stockholm, Sweden; Örebro University Hospital, Örebro, Sweden.
    Seiger, Åke
    Karolinska institutet, Stockholm, Sweden.
    Appelros, Peter
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Karolinska institutet, Stockholm, Sweden; Örebro University Hospital, Örebro, Sweden.
    Hip fractures in persons with stroke2013Ingår i: Stroke Research and Treatment, ISSN 2090-8105, E-ISSN 2042-0056, Vol. 2013, artikel-id 954279Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Our aim was to determine the incidence of hip fractures within two years after stroke, to identify associated factors, to evaluate which test instruments that best could identify people at risk, and to describe the circumstances that prevailed when they sustained their hip fractures. Method. A total of 377 persons with first-ever stroke were followed up for a 24-month period. Stroke severity, cognition, and associated medical conditions were registered. The following test instruments were used: National Institutes of Health Stroke Scale, Mini-Mental State Examination, Berg Balance Scale, Timed Up & Go, and Stops Walking When Talking. Result. Sixteen of the persons fractured their hip within the study period, which corresponds to an incidence of 32 hip fractures per 1000 person-years. Persons with fractures more often had impaired vision and cognitive impairment and more had had previous fractures. Of the investigated test instruments, Timed Up & Go was the best test to predict fractures. Conclusion. The incidence of hip fractures in persons with stroke was high in this study. Persons with previous fractures, and visual and cognitive defects are at the greatest risk. Certain test instruments could be used in order to find people at risk, which should be targeted for fall preventive measures.

  • 103. Andreassen, Maria
    et al.
    Danielsson, Henrik
    Hemmingsson, Helena
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen. Linköping University, Sweden.
    Jaarsma, Tiny
    An interactive digital calendar with mobile phone reminders (RemindMe) for people with cognitive impairment: A pilot randomized controlled trial2022Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 29, nr 4, s. 270-281Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: People with cognitive impairment often need support to perform everyday-life activities. Interventions are available, but evidence-based interventions are lacking.

    Aim: This pilot RCT aimed to investigate use of an intervention with an interactive digital calendar with mobile phone reminders (RemindMe) in relation to change in outcomes and impact on occupational performance, independence, health-related quality of life, and psychosocial impact of the support for people with cognitive impairment.

    Method: The study design was a multi-centre parallel-group pilot RCT [ClinicalTrails.gov, identifier: NCT04470219]. Fifteen participants from primary rehabilitation centres in Sweden were recruited and randomly assigned to intervention group (n = 8) receiving the intervention with RemindMe, or control group (n = 7) receiving usual treatment by an occupational therapist. Data were collected at baseline, after two- and four months, and analysed using descriptive and non-parametric statistics.

    Result: The Canadian Occupational Performance Measure (COPM), and the Functional Independence Measure (FIM item n-r) showed significant differences. There were no significant differences in health-related quality of life nor in the psychosocial impact of the used support.

    Conclusion: Plausible changes in outcome measures were found in COPM and FIM (items n-r). These instruments indicate change in outcome measures and impact on occupational performance and independence.

  • 104.
    Angleman, Sara B.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    Santoni, Giola
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Von Strauss, Eva
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). The Swedish Red Cross University College, Sweden.
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). The Swedish Red Cross University College, Sweden.
    Temporal Trends of Functional Dependence and Survival Among Older Adults From 1991 to 2010 in Sweden: Toward a Healthier Aging2015Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 70, nr 6, s. 746-752Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Declines in functional dependence among older adults were observed before the 1990s, but there is uncertainty about subsequent trends. Our study aimed to verify the temporal trends in disability during 1991-2010 in an older Swedish population and to estimate the associated changes in survival. Methods. Functional status in octogenarians and nonagenarians was assessed at seven occasions with intervals of 2-3 years. Sample size varied at each assessment with an average of 646 (range 212-1096). Disability was defined as difficulty in one or more of personal activities of daily living. We compared prevalence and incidence, as well as mortality, and survival associated with disability over the 20-year period. Results. Sex-standardized prevalence of disability remained steady over time with a tendency toward a gradual decline, and a statistically significant decrease was present among nonagenarians. Sex-standardized cumulative incidence also remained steady. The proportion of people with prevalent disability who died <3 years remained stable, as did the survival time of people with incident disability. In contrast, among nondisabled persons, 3-year mortality decreased significantly, and for octogenarians median survival time was 1.3 years longer at the more recent assessment than a decade earlier. Conclusions. Both prevalence and incidence of disability remained stable over the last two decades in this urban Swedish population, with a trend toward a slow decline. Mortality remained steady among disabled persons but decreased among persons without disability, suggesting that increased life expectancy during the last two decades may be essentially driven by longer lives of functionally independent people.

  • 105. Anisimov, Vladimir N.
    et al.
    Egorov, Maxim V.
    Krasilshchikova, Marina S.
    Lyamzaev, Konstantin G.
    Manskikh, Vasily N.
    Moshkin, Mikhail P.
    Novikov, Evgeny A.
    Popovich, Irina G.
    Rogovin, Konstantin A.
    Shabalina, Irina G.
    Stockholms universitet, Naturvetenskapliga fakulteten, Wenner-Grens institut, Avdelningen för fysiologi.
    Shekarova, Olga N.
    Skulachev, Maxim V.
    Titova, Tatiana V.
    Vygodin, Vladimir A.
    Vyssokikh, Mikhail Yu.
    Yurova, Maria N.
    Zabezhinsky, Mark A.
    Skulachev, Vladimir P.
    Effects of the mitochondria-targeted antioxidant SkQ1 on lifespan of rodents2011Ingår i: Aging, ISSN 1945-4589, E-ISSN 1945-4589, Vol. 3, nr 11, s. 1110-1119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The effect of the mitochondria-targeted, plastoquinone-containing antioxidant SkQ1 on the lifespan of outbred mice and of three strains of inbred mice was studied. To this end, low pathogen (LP) or specific pathogen free (SPF) vivaria in St. Petersburg, Moscow, and Stockholm were used. For comparison, we also studied mole-voles and dwarf hamsters, two wild species of small rodents kept under simulated natural conditions. It was found that substitution of a LP vivarium for a conventional (non-LP) one doubled the lifespan of female outbred mice, just as SkQ1 did in a non-LP vivarium. SkQ1 prevented age-dependent disappearance of estrous cycles of outbred mice in both LP and non-LP vivaria. In the SPF vivarium in Moscow, male BALB/c mice had shorter lifespan than females, and SkQ1 increased their lifespan to the values of the females. In the females, SkQ1 retarded development of such trait of aging as heart mass increase. Male C57Bl/6 mice housed individually in the SPF vivarium in Stockholm lived as long as females. SkQ1 increased the male lifespan, the longevity of the females being unchanged. SkQ1 did not change food intake by these mice. Dwarf hamsters and mole-voles kept in outdoor cages or under simulated natural conditions lived longer if treated with SkQ1. The effect of SkQ1 on longevity of females is assumed to mainly be due to retardation of the age-linked decline of the immune system. For males under LP or SPF conditions, SkQ1 increased the lifespan, affecting also some other system(s) responsible for aging.

  • 106.
    Anjomshoae, Sule
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för datavetenskap. Umeå University.
    Pudas, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB). Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).
    Explaining graph convolutional network predictions for clinicians: an explainable AI approach to Alzheimer’s disease classification2024Ingår i: Frontiers in Artificial Intelligence, E-ISSN 2624-8212, Vol. 6, artikel-id 1334613Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Graph-based representations are becoming more common in the medical domain, where each node defines a patient, and the edges signify associations between patients, relating individuals with disease and symptoms in a node classification task. In this study, a Graph Convolutional Networks (GCN) model was utilized to capture differences in neurocognitive, genetic, and brain atrophy patterns that can predict cognitive status, ranging from Normal Cognition (NC) to Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Elucidating model predictions is vital in medical applications to promote clinical adoption and establish physician trust. Therefore, we introduce a decomposition-based explanation method for individual patient classification.

    Methods: Our method involves analyzing the output variations resulting from decomposing input values, which allows us to determine the degree of impact on the prediction. Through this process, we gain insight into how each feature from various modalities, both at the individual and group levels, contributes to the diagnostic result. Given that graph data contains critical information in edges, we studied relational data by silencing all the edges of a particular class, thereby obtaining explanations at the neighborhood level.

    Results: Our functional evaluation showed that the explanations remain stable with minor changes in input values, specifically for edge weights exceeding 0.80. Additionally, our comparative analysis against SHAP values yielded comparable results with significantly reduced computational time. To further validate the model's explanations, we conducted a survey study with 11 domain experts. The majority (71%) of the responses confirmed the correctness of the explanations, with a rating of above six on a 10-point scale for the understandability of the explanations.

    Discussion: Strategies to overcome perceived limitations, such as the GCN's overreliance on demographic information, were discussed to facilitate future adoption into clinical practice and gain clinicians' trust as a diagnostic decision support system.

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  • 107.
    Antelius, Eleonor
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen Åldrande och social förändring. Linköpings universitet, Filosofiska fakulteten.
    Dementia in the age of migration: cross-cultural perspectives2017Ingår i: Living with dementia: relations, responses and agency in everyday life / [ed] Lars-Christer Hydén, Eleonor Antelius, Basingstoke: Palgrave Macmillan, 2017, Vol. Sidorna 29-48, s. 29-48Kapitel i bok, del av antologi (Refereegranskat)
  • 108. Antonios, Gregory
    et al.
    Saiepour, Nasrin
    Bouter, Yvonne
    Richard, Bernhard C
    Paetau, Anders
    Verkkoniemi-Ahola, Auli
    Lannfelt, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Ingelsson, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Kovacs, Gabor G
    Pillot, Thierry
    Wirths, Oliver
    Bayer, Thomas A
    N-truncated Abeta starting with position four: early intraneuronal accumulation and rescue of toxicity using NT4X-167, a novel monoclonal antibody2013Ingår i: Acta neuropathologica communications, ISSN 2051-5960, Vol. 1, nr 1, s. 56-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The amyloid hypothesis in Alzheimer disease (AD) considers amyloid β peptide (Aβ) deposition causative in triggering down-stream events like neurofibrillary tangles, cell loss, vascular damage and memory decline. In the past years N-truncated Aβ peptides especially N-truncated pyroglutamate AβpE3-42 have been extensively studied. Together with full-length Aβ1-42 and Aβ1-40, N-truncated AβpE3-42 and Aβ4-42 are major variants in AD brain. Although Aβ4-42 has been known for a much longer time, there is a lack of studies addressing the question whether AβpE3-42 or Aβ4-42 may precede the other in Alzheimer's disease pathology.

    RESULTS: Using different Aβ antibodies specific for the different N-termini of N-truncated Aβ, we discovered that Aβ4-x preceded AβpE3-x intraneuronal accumulation in a transgenic mouse model for AD prior to plaque formation. The novel Aβ4-x immunoreactive antibody NT4X-167 detected high molecular weight aggregates derived from N-truncated Aβ species. While NT4X-167 significantly rescued Aβ4-42 toxicity in vitro no beneficial effect was observed against Aβ1-42 or AβpE3-42 toxicity. Phenylalanine at position four of Aβ was imperative for antibody binding, because its replacement with alanine or proline completely prevented binding. Although amyloid plaques were observed using NT4X-167 in 5XFAD transgenic mice, it barely reacted with plaques in the brain of sporadic AD patients and familial cases with the Arctic, Swedish and the presenilin-1 PS1Δ9 mutation. A consistent staining was observed in blood vessels in all AD cases with cerebral amyloid angiopathy. There was no cross-reactivity with other aggregates typical for other common neurodegenerative diseases showing that NT4X-167 staining is specific for AD.

    CONCLUSIONS: Aβ4-x precedes AβpE3-x in the well accepted 5XFAD AD mouse model underlining the significance of N-truncated species in AD pathology. NT4X-167 therefore is the first antibody reacting with Aβ4-x and represents a novel tool in Alzheimer research.

  • 109.
    Appelros, Peter
    Örebro universitet, Institutionen för klinisk medicin.
    Heart failure and stroke2006Ingår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 37, nr 7, s. 1637-1637Artikel i tidskrift (Refereegranskat)
  • 110.
    Appelros, Peter
    Örebro universitet, Institutionen för klinisk medicin.
    Prevalence and predictors of pain and fatigue after stroke: a population-based study2006Ingår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 29, nr 4, s. 329-333Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pain and fatigue are two often overlooked symptoms after stroke. Their prevalence and determinants are not well understood. In this study patients with first-ever stroke (n=377) were examined at baseline and after 1 year. General characteristics of the patients, as well as stroke type, stroke severity and risk factors were registered at baseline. After 1 year survivors (n=253) were examined with respect to residual impairment, disability, cognition and depression. They were asked whether they had experienced pain and/or fatigue which had started after the stroke, and which the patient felt to be stroke related. Twenty-eight patients (11%) had stroke-associated pain and 135 (53%) had stroke-associated fatigue. Pain was associated with depression and different manifestations of stroke severity, especially degree of paresis at baseline. Fatigue was more associated with physical disability. In univariate analysis, fatigue was also associated with sleep disturbances. In conclusion, it is important to be aware of the occurrence of pain and fatigue after stroke, because these symptoms are common, they impair quality of life and they are potentially treatable. Post-stroke depression may coexist with pain and fatigue. The detection of one symptom should lead to consideration of the others. Follow-up and individual assessment of stroke patients is crucial.

  • 111.
    Appelros, Peter
    et al.
    Örebro University Hospital, Örebro, Sweden; Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    Andersson, Åsa
    Örebro University Hospital, Örebro, Sweden; Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    Changes in mini mental state examination score after stroke: lacunar infarction predicts cognitive decline2006Ingår i: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 13, nr 5, s. 491-495Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Stroke and cognitive impairment are inter-related. The purpose of this study was to show the natural evolution of cognitive performance during the first year after a stroke, and to show which factors that predict cognitive decline. Subjects were patients with a first-ever stroke who were treated in a stroke unit. A total of 160 patients were included. At baseline patients were evaluated with regard to stroke type, stroke severity, pre-stroke dementia and other risk factors. Mini Mental State Examinations (MMSE) were performed after 1 week and after 1 year. Patients had a median increase of 1 point (range -8 to +9) on the MMSE. Thirty-two pre cent of the patients deteriorated, 13% were unchanged, and 55% improved. Lacunar infarction (LI) and left-sided stroke were associated with a failure to exhibit improvement. Patients with LI had an average decline of 1.7 points, whilst patients with other stroke types had an average increase of 1.8 points. Most stroke survivors improve cognitively during the first year after the event. The outcome for LI patients is worse, which suggests that LI may serve as a marker for concomitant processes that cause cognitive decline.

  • 112.
    Appelros, Peter
    et al.
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Matérne, Marie
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Stroke prevalence in a medium-sized Swedish municipality2021Ingår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 143, nr 2, s. 210-216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Many patients who have had stroke survive with functional disability for years. Stroke prevalence is a fundamental measure of the impact of stroke in society. Stroke prevalence has never been evaluated in Sweden.

    MATERIALS & METHODS: 2019 with respect to stroke survivors (ICD-10 I60-I69) living in Kumla (population 21,738), a municipality well representative of Sweden.

    RESULTS: 330 individuals with stroke were found, of which 42% were women. The mean age was 74.1 years in men and 75.1 years in women. 11.5% of the patients had more than one stroke. The mean duration since the first stroke was 8.3 years. The crude prevalence per 100,000 was 1754 in men, 1281 in women and 1518 in both sexes. Adjusted to the European population, the ratio was 1570 per 100,000, and to the World population 936 per 100,000.

    CONCLUSIONS: In spite of a declining stroke incidence in Sweden, the stroke prevalence in Kumla, Sweden, is relatively high. Comparisons with other studies indicate that a decline in prevalence may have occurred since the early 2000s. Modern registers can support data collection, but the index stroke may have occurred almost forty years back in time.

  • 113.
    Appelros, Peter
    et al.
    Örebro universitet, Institutionen för klinisk medicin.
    Nydevik, Ingegerd
    Terént, Andreas
    Living setting and utilisation of ADL assistance one year after a stroke with special reference to gender differences2006Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, nr 1, s. 43-49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To examine living setting and need for ADL assistance before and one year after a first-ever stroke with special focus on gender differences. METHODS: One-year survivors from a population-based stroke study (n = 377) were studied with regard to place of living, need for ADL assistance and who provided the help. Stroke severity, cognitive impairment, post-stroke depression as well as risk factors were evaluated. RESULTS: Before the stroke 48 patients (13%) lived in special housing (service flats or nursing homes), and one year after the stroke, 50 of the survivors (20%) lived in such accommodations. Before the stroke, 80 (21%) of the patients needed help with their personal ADL, while 90 (36%) needed help after one year. The increased need was fulfilled by relatives. Female spouses more often helped their male counterparts, and they tended to accept a heavier burden. Age, living alone, stroke severity, cognitive impairment, pre-stroke ADL dependency and depression were predictors for special housing. CONCLUSIONS: In a time when more and more stroke survivors are cared for at home, it is important to pay attention to the situation of the caregivers. Female caregivers seem to be in an especially exposed position by accepting a heavier burden.

  • 114.
    Archer, Trevor
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Josefsson, Torbjörn
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Lindwall, Magnus
    University of Gothenburg, Gothenburg, Sweden.
    Effects of physical exercise on depressive symptoms and biomarkers in depression2014Ingår i: CNS & Neurological Disorders: Drug Targets, ISSN 1871-5273, E-ISSN 1996-3181, Vol. 13, nr 10, s. 1640-1653Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Regular physical exercise/activity has been shown repeatedly to promote positive benefits in cognitive, emotional and motor domains concomitant with reductions in distress and negative affect. It exerts a preventative role in anxiety and depressive states and facilitates psychological well-being in both adolescents and adults. Not least, several meta-analyses attest to improvements brought about by exercise. In the present treatise, the beneficial effects of exercise upon cognitive, executive function and working memory, emotional, self-esteem and depressed mood, motivational, anhedonia and psychomotor retardation, and somatic/physical, sleep disturbances and chronic aches and pains, categories of depression are discussed. Concurrently, the amelioration of several biomarkers associated with depressive states: hypothalamic-pituitary-adrenal (HPA) axis homeostasis, anti-neurodegenerative effects, monoamine metabolism regulation and neuroimmune functioning. The notion that physical exercise may function as "scaffolding" that buttresses available network circuits, anti-inflammatory defences and neuroreparative processes, e.g. brain-derived neurotrophic factor (BDNF), holds a certain appeal. © 2014 Bentham Science Publishers.

  • 115.
    Ardo, Jessica
    et al.
    Univ Calif Irvine, CA USA.
    Lee, Jung-Ah
    Univ Calif Irvine, CA USA.
    Hildebrand, Janett A.
    Univ Southern Calif, CA 90007 USA.
    Guijarro, Diana
    Univ Calif Irvine, CA USA.
    Ghasemazadeh, Hassan
    Washington State Univ, WA USA.
    Strömberg, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärtcentrum, Kardiologiska kliniken US.
    Evangelista, Lorraine S.
    Univ Texas Med Branch, TX 77555 USA.
    Codesign of a cardiovascular disease prevention text message bank for older adults2021Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 104, nr 11, s. 2772-2784Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Develop and validate a text message bank to support healthier lifestyle behaviors in older adults at risk for cardiovascular disease utilizing a codesign approach. Methods: Initially, the researchers, based on literature, developed a bank of 68 SMS text messages focusing on healthy eating (24 messages), physical activity (24 messages), and motivational feedback (20 messages), based on a scoping review of the literature on promoting behavioral change to engage in healthy lifestyle behaviors. In the next step, a panel of five experts analyzed every subset of SMS text messages. Further validation was conducted by nine older adults (&gt;= 60 years). The user demographics, telephone literacy, understanding, and appeal for every SMS text message were evaluated using a 31-item questionnaire. Results: Participants provided an acceptable understanding of the critical concept found in the 49 SMS text message (physical activity M = 1.73 +/- 0.18; diet M = 1.73 +/- 0.26; motivation M = 1.85 +/- 0.25; range 0-2). The average ratings for physical activity (i.e., likability), healthy eating, and motivation were 8.62 +/- 0.64, 8.57 +/- 0.76, and 8.40 +/- 0.83, respectively (range 0-10). Conclusion: Co-designers were able to identify the technological and content requirements for each text message and infographic to enhance understanding and appeal. Practice implications: A feasibility study will need to be conducted as a next step to testing the effectiveness of text messages in a mobile-based intervention to promote healthy behaviors in older adults at high CVD risk. (C) 2021 Elsevier B.V. All rights reserved.

  • 116. Arfwidson, Samuel
    et al.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Nordqvist, Persy
    Vårdbehov, sjukdomsdiagnoser och medicinkonsumtion bland äldre på ålderdomshem i Jönköpings län: en 7-årsuppföljning1976Rapport (Övrig (populärvetenskap, debatt, mm))
  • 117. Arkkukangas, Marina
    et al.
    Söderlund, Anne
    Eriksson, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Johansson, Ann-Christin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up2019Ingår i: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, nr 1, s. 9-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND PURPOSE: In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency.

    METHOD: A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization.

    RESULTS AND DISCUSSION: A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups.

    CONCLUSION: In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

  • 118. Arkkukangas, Marina
    et al.
    Söderlund, Anne
    Eriksson, Staffan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
    Johansson, Ann-Christin
    Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up2019Ingår i: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, nr 1, s. 9-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Purpose: In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency.

    Method: A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization.

    Results and Discussion: A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups.

    Conclusion: In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

  • 119.
    Arkkukangas, Marina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Tuvemo Johnson, Susanna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Hellström, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Anens, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Tonkonogi, Michail
    Larsson, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Fall Prevention Exercises With or Without Behavior Change Support for Community-Dwelling Older Adults: A 2-Year Follow-Up of a Randomized Controlled Trial2020Ingår i: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 28, nr 1, s. 34-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigates the effectiveness of two fall prevention exercise interventions targeting physical performance, activity level, fall-related self-efficacy, health-related quality of life, and falls: the Otago Exercise Programme (OEP) with and the OEP without behavior change support. In this randomized controlled trial (RCT), 175 participants were randomised into two intervention groups and one control group. A total of 124 community-dwelling older adults over the age of 75 who needed walking aids or home support participated in the two-year follow-up. The OEP with and the OEP without support for behavior change displayed no long-term benefits on physical performance, fall-related self-efficacy, health-related quality of life, and falls compared to a control group. Although no significant differences were detected between the groups, the results implied the control group's physical activity level decreased compared to the intervention groups at two-year follow up.

  • 120.
    Artzi-Medvedik, Rada
    et al.
    Ben-Gurion University of the Negev, Beer-Sheva, Israel; Maccabi Health Services, Southern District, Omer, Israel.
    Kob, Robert
    Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
    Di Rosa, Mirko
    Italian National Research Center on Aging (IRCCS INRCA), Ancona, Italy.
    Lattanzio, Fabrizia
    Italian National Research Center on Aging (IRCCS INRCA), Ancona, Italy.
    Corsonello, Andrea
    Italian National Research Center on Aging (IRCCS INRCA), Ancona, Italy.
    Yehoshua, Ilan
    Maccabi Health Services, Southern District, Omer, Israel.
    Roller-Wirnsberger, Regina E
    Medical University of Graz, Graz, Austria.
    Wirnsberger, Gerhard H
    Medical University of Graz, Graz, Austria.
    Mattace-Raso, Francesco U S
    University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Tap, Lisanne
    University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Gil, Pedro G
    Hospital Clinico San Carlos, Madrid, Spain.
    Formiga, Francesc
    Bellvitge University Hospital-IDIBELL-L'Hospitalet de Llobregat, Barcelona, Spain.
    Moreno-González, Rafael
    Bellvitge University Hospital-IDIBELL-L'Hospitalet de Llobregat, Barcelona, Spain.
    Kostka, Tomasz
    Medical University of Lodz, Lodz, Poland.
    Guligowska, Agnieszka
    Medical University of Lodz, Lodz, Poland.
    Ärnlöv, Johan
    Högskolan Dalarna, Institutionen för hälsa och välfärd, Medicinsk vetenskap. Karolinska Institutet, Huddinge.
    Carlsson, Axel C
    Karolinska Institutet, Huddinge; Stockholm Region, Stockholm.
    Freiberger, Ellen
    Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
    Melzer, Itshak
    Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Quality of Life and Kidney Function in Older Adults: Prospective Data of the SCOPE Study2023Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, nr 12, artikel-id 3959Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A longitudinal alteration in health-related quality of life (HRQoL) over a two-year period and its association with early-stage chronic kidney disease (CKD) progression was investigated among 1748 older adults (>75 years). HRQoL was measured by the Euro-Quality of Life Visual Analog Scale (EQ-VAS) at baseline and at one and two years after recruitment. A full comprehensive geriatric assessment was performed, including sociodemographic and clinical characteristics, the Geriatric Depression Scale-Short Form (GDS-SF), Short Physical Performance Battery (SPPB), and estimated glomerular filtration rate (eGFR). The association between EQ-VAS decline and covariates was investigated by multivariable analyses. A total of 41% of the participants showed EQ-VAS decline, and 16.3% showed kidney function decline over the two-year follow-up period. Participants with EQ-VAS decline showed an increase in GDS-SF scores and a greater decline in SPPB scores. The logistic regression analyses showed no contribution of a decrease in kidney function on EQ-VAS decline in the early stages of CKD. However, older adults with a greater GDS-SF score were more likely to present EQ-VAS decline over time, whereas an increase in the SPPB scores was associated with less EQ-VAS decline. This finding should be considered in clinical practice and when HRQoL is used to evaluate health interventions among older adults.

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  • 121.
    Artzi-Medvedik, Rada
    et al.
    Ben Gurion Univ Negev, Recanati Sch Community Hlth Profess, Fac Hlth Sci, Dept Nursing, Beer Sheva, Israel.;Ben Gurion Univ Negev, Recanati Sch Community Hlth Profess, Fac Hlth Sci, Dept Phys Therapy, Beer Sheva, Israel..
    Kob, Robert
    Friedrich Alexander Univ Erlangen Nurnberg, Dept Internal Med Geriatr, Inst Biomed Aging, Krankenhaus Barmherzige Bruder, Koberger Str 60, D-90408 Nurnberg, Germany..
    Fabbietti, Paolo
    Italian Natl Res Ctr Aging IRCCS INRCA, Ancona, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Fermo, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Cosenza, Italy.;IRCCS INRCA, Lab Geriatr Pharmacoepidemiol & Biostat, Via S Margherita 5, I-60124 Ancona, Italy..
    Lattanzio, Fabrizia
    Italian Natl Res Ctr Aging IRCCS INRCA, Ancona, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Fermo, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Cosenza, Italy..
    Corsonello, Andrea
    Italian Natl Res Ctr Aging IRCCS INRCA, Ancona, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Fermo, Italy.;Italian Natl Res Ctr Aging IRCCS INRCA, Cosenza, Italy..
    Melzer, Yehudit
    Ben Gurion Univ Negev, Recanati Sch Community Hlth Profess, Fac Hlth Sci, Dept Phys Therapy, Beer Sheva, Israel.;Maccabi Hlth Org, Tel Aviv, Israel..
    Roller-Wirnsberger, Regina
    Med Univ Graz, Dept Internal Med, Graz, Austria..
    Wirnsberger, Gerhard
    Med Univ Graz, Div Nephrol, Dept Internal Med, Graz, Austria..
    Mattace-Raso, Francesco
    Erasmus MC, Univ Med Ctr Rotterdam, Geriatr Med Sect, Dept Internal Med, Rotterdam, Netherlands..
    Tap, Lisanne
    Erasmus MC, Univ Med Ctr Rotterdam, Geriatr Med Sect, Dept Internal Med, Rotterdam, Netherlands..
    Gil, Pedro
    Hosp Clin San Carlos, Dept Geriatr Med, Madrid, Spain..
    Martinez, Sara Lainez
    Hosp Clin San Carlos, Dept Geriatr Med, Madrid, Spain..
    Formiga, Francesc
    Bellvitge Univ Hosp, IDIBELL, Dept Internal Med, Geriatr Unit, Barcelona, Spain..
    Moreno-Gonzalez, Rafael
    Bellvitge Univ Hosp, IDIBELL, Dept Internal Med, Geriatr Unit, Barcelona, Spain..
    Kostka, Tomasz
    Med Univ Lodz, Hlth Ageing Res Ctr, Dept Geriatr, Lodz, Poland..
    Guligowska, Agnieszka
    Med Univ Lodz, Hlth Ageing Res Ctr, Dept Geriatr, Lodz, Poland..
    Ärnlöv, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Huddinge, Sweden..
    Carlsson, Axel C
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Huddinge, Sweden..
    Freiberger, Ellen
    Friedrich Alexander Univ Erlangen Nurnberg, Dept Internal Med Geriatr, Inst Biomed Aging, Krankenhaus Barmherzige Bruder, Koberger Str 60, D-90408 Nurnberg, Germany..
    Melzer, Itshak
    Ben Gurion Univ Negev, Recanati Sch Community Hlth Profess, Fac Hlth Sci, Dept Phys Therapy, Beer Sheva, Israel..
    Impaired kidney function is associated with lower quality of life among community-dwelling older adults The screening for CKD among older people across Europe (SCOPE) study2020Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, artikel-id 340Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Quality of life (QoL) refers to the physical, psychological, social and medical aspects of life that are influenced by health status and function. The purpose of this study was to measure the self-perceived health status among the elderly population across Europe in different stages of Chronic Kidney Disease (CKD). Methods Our series consisted of 2255 community-dwelling older adults enrolled in the Screening for Chronic Kidney Disease (CKD) among Older People across Europe (SCOPE) study. All patients underwent a comprehensive geriatric assessment (CGA), including included demographics, clinical and physical assessment, number of medications taken, family arrangement, Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale, History of falls, Lower urinary tract symptoms, and Short Physical Performance Battery (SPPB). Estimated glomerular filtration rate (eGFR) was calculated by Berlin Initiative Study (BIS) equation. Quality of life was assessed by Euro Qol questionnaire (Euro-Qol 5D) and EQ-Visual Analogue Scale (EQ-VAS). The association between CKD (eGFR < 60, < 45 ml or < 30 ml/min/1.73m(2)) and low EQoL-VAS was investigated by multivariable logistic regression models. Results CKD was found to be significantly associated with low EQoL-VAS in crude analysis (OR = 1.47, 95%CI = 1.16-1.85 for eGFR< 60; OR = 1.38, 95%CI = 1.08-1.77 for eGFR< 45; OR = 1.57, 95%CI = 1.01-2.44). Such association was no longer significant only when adjusting for SPPB (OR = 1.20, 95%CI = 0.93-1.56 for eGFR< 60; OR = 0.87, 95%CI = 0.64-1.18 for eGFR< 45; OR = 0.84, 95%CI = 0.50-1.42), CIRS and polypharmacy (OR = 1.16, 95%CI = 0.90-1.50 for eGFR< 60; OR = 0.86, 95%CI = 0.64-1.16 for eGFR< 45; OR = 1.11, 95%CI = 0.69-1.80) or diabetes, hypertension and chronic obstructive pulmonary disease (OR = 1.28, 95%CI = 0.99-1.64 for eGFR< 60; OR = 1.16, 95%CI = 0.88-1.52 for eGFR< 45; OR = 1.47, 95%CI = 0.92-2.34). The association between CKD and low EQoL-VAS was confirmed in all remaining multivariable models. Conclusions CKD may significantly affect QoL in community-dwelling older adults. Physical performance, polypharmacy, diabetes, hypertension and COPD may affect such association, which suggests that the impact of CKD on QoL is likely multifactorial and partly mediated by co-occurrent conditions/risk factors.

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  • 122.
    Ascencao, Raquel
    et al.
    Univ Lisbon, Fac Med, Lab Farmacol Clin & Terapeut, Ave Prof Egas Moniz, P-1649028 Lisbon, Portugal..
    Nogueira, Paulo
    Univ Nova Lisboa, Escola Nacl Saude Publ, Lisbon, Portugal..
    Sampaio, Filipa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Henriques, Adriana
    Nursing Res Innovat & Dev Ctr Lisbon CIDNUR, Nursing Sch Lisbon, Lisbon, Portugal..
    Costa, Andreia
    Univ Lisbon, Fac Med, Inst Saude Ambiental ISAMB, Lisbon, Portugal..
    Adverse drug reactions in hospitals: population estimates for Portugal and the ICD-9-CM to ICD-10-CM crosswalk2023Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, nr 1, artikel-id 1222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundAdverse drug reactions (ADR), both preventable and non-preventable, are frequent and pose a significant burden. This study aimed to produce up-to-date estimates for ADR rates in hospitals, in Portugal, from 2010 to 2018. In addition, it explores possible pitfalls when crosswalking between ICD-9-CM and ICD-10-CM code sets for ADR identification.MethodsThe Portuguese Hospital Morbidity Database was used to identify hospital episodes (outpatient or inpatient) with at least one ICD code of ADR. Since the study period spanned from 2010 to 2018, both ICD-9-CM and ICD-10-CM codes based on previously published studies were used to define episodes. This was an exploratory study, and descriptive statistics were used to provide ADR rates and summarise episode features for the full period (2010-2018) as well as for the ICD-9-CM (2010-2016) and ICD -10-CM (2017-2018) eras.ResultsBetween 2010 and 2018, ADR occurred in 162,985 hospital episodes, corresponding to 1.00% of the total number of episodes during the same period. Higher rates were seen in the oldest age groups. In the same period, the mean annual rate of episodes related to ADR was 174.2/100,000 population. The episode rate (per 100,000 population) was generally higher in males, except in young adults (aged '15-20', '25-30' and '30-35' years), although the overall frequency of ADR in hospital episodes was higher in females.ConclusionsDespite the ICD-10-CM transition, administrative health data in Portugal remain a feasible source for producing up-to-date estimates on ADR in hospitals. There is a need for future research to identify target recipients for preventive interventions and improve medication safety practices in Portugal.

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  • 123.
    Asp, M.
    et al.
    School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden.
    Simonsson, B.
    Competence Centre for Health, Region Västmanland, Västerås, Sweden.
    Larm, P.
    School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden; Centre for Clinical Research, Uppsala University, Region Västmanland, Västerås, Sweden.
    Molarius, Anu
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Competence Centre for Health, Region Västmanland, Västerås, Sweden.
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017Ingår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, s. 84-91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine how physical activity and physical mobility are related to obesity in the elderly. Study design: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods: Obesity (body mass index >= 30 kg/m(2)) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 124.
    Asplund, R.
    et al.
    Family Medicine Stockholm, Karolinska Institute, Huddinge, Sweden; Research and Development Unit, Jämtland County Council, Östersund, Sweden.
    Lindblad, Birgitta Ejdervik
    Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Sleep and sleepiness 1 and 9 months after cataract surgery2004Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 38, nr 1, s. 69-75Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study was undertaken to analyze sleep development in a group of patients during the first 9 months after cataract extraction. Men and women (n=407) undergoing cataract surgery at the Department of Ophthalmology, Sundsvall Hospital during two periods in 2000-2002 were asked to complete a questionnaire on the state and change of sleep and sleepiness 1 and 9 months after the operation. The response rate was 90.8%. The mean ages of the participating men and women were 74.5 and 75.6 years, respectively. One week after cataract extraction the visual acuity in the treated eye was 0.67 (+/-0.31) in men and 0.69 (+/-0.28) in women (NS), and showed an inverse relationship to age in both men (P<0.01) and women (P<0.0001). One month after cataract extraction 28.3% of the men and 37.5% of the women experienced poor sleep, and after 9 months the figures were 15.8 and 31.4%, respectively. Frequent awakenings and difficulty in falling asleep after nocturnal awakenings improved correspondingly. Being well rested in the morning increased and daytime sleepiness decreased. The results indicate that in elderly persons with cataract sleep is improved 1 month after cataract extraction and further improvement during the first 9 months may be experienced.

  • 125.
    Asplund, R.
    et al.
    Family Medicine Stockholm, Karolinska Institute, Huddinge, Sweden; Research and Development Unit (Forsknings- och utvecklingsenheten), Jämtland County Council, Östersund, Sweden.
    Lindblad, Birgitta Ejdervik
    Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    The development of sleep in persons undergoing cataract surgery2002Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 35, nr 2, s. 179-187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study was undertaken in order to analyse sleep in a group of patients who were operated on for cataract. All patients (n=328) undergoing cataract surgery at the Department of Ophthalmology, Sundsvall Hospital during a 4-month period were asked to complete a questionnaire on the state and change of sleep and sleepiness 1 month after the operation. Twelve persons were unable or declined to participate. The response rate was 97.2%. The mean ages of the participating men and women were 74.5 and 76.3 years, respectively. Pre-operative visual acuity in the operated eye was 0.16 in men and 0.18 in women. After cataract extraction sleep was improved in 12.0% of the men and in 26.3% of the women. Nevertheless poor sleep 1 month post-operatively was reported by 29.3% of the men and 42.6% of the women (P<0.05). There was no age-related increase in sleep complaints. The results indicate that in elderly persons with cataract sleep is impaired, and that 1 month after cataract extraction improved sleep may be experienced.

  • 126. Axelsson, Johan
    et al.
    Elmståhl, Sölve
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    Geriatrik är ett försummat ämne i svensk läkarutbildning [Geriatrics neglected in Swedish medical education.]: "äldreparadoxen" kräver rejäl satsning ["The elderly paradox" requires a substantial effort]2006Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, nr 44, s. 3361-3365Artikel i tidskrift (Refereegranskat)
  • 127.
    Axenhus, Michael
    et al.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden.
    Schedin-Weiss, Sophia
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden.
    Tjernberg, Lars
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden.
    Wimo, Anders
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden; The primary care of Hudiksvall-Nordanstig, the Region of Gävleborg, Gävle, Sweden.
    Eriksdotter, Maria
    Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
    Bucht, Gösta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Winblad, Bengt
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden.
    Changes in dementia diagnoses in Sweden during the COVID-19 pandemic2022Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 22, nr 1, artikel-id 365Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The COVID-19 pandemic has caused large disruptions to healthcare systems. Refocus on COVID-19 related care might have contributed to indirect effects on other healthcare areas. Care focused on acute conditions have been negatively affected although research into the effects on chronic and care intensive patient groups such as patients with dementia diseases is lacking. In this study we evaluated dementia diagnosis trends in Sweden during 2015–2020 according to International Classification of Disease version 10 coding of common dementia diseases.

    Methods: Regional and national statistics in the form of International Classification of Disease version 10 coding, COVID-19 incidence, mortality data, and population census data were collected from the National Institute of Health and Welfare. Logistic regression analysis was performed to identify trends of dementia diagnosis during 2015–2020. Correlation test was performed between COVID-19 incidence, mortality rates, and dementia coding.

    Results: Dementia diagnosis incidence has been declining since 2015 and further decline was noted in many regions in Sweden during 2020. As COVID-19 incidence increased, fewer cases of dementia were diagnosed, a decrease that differentially impacted women and those who were advanced in age.

    Conclusions: Dementia diagnosis incidence in Sweden has been on a decline since 2015. The COVID-19 pandemic caused a further larger decline in dementia diagnosis incidence during 2020. COVID-19 incidence, but not mortality, was associated with decrease in dementia diagnosis incidence. There might be a large number of undiagnosed patients with dementia and healthcare reforms should be enacted to address this. Women and elderly are particularly vulnerable groups.

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  • 128.
    Axmon, Anna
    et al.
    Lunds Universitet, SWE.
    Kristensson, Jimmie
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Ahlström, Gerd
    Lunds Universitet, SWE.
    Midlöv, Patrik
    Lunds Universitet, SWE.
    Use of antipsychotics, benzodiazepine derivatives, and dementia medication among older people with intellectual disability and/or autism spectrum disorder and dementia2017Ingår i: Research in Developmental Disabilities, ISSN 0891-4222, Vol. 62, s. 50-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Although people with intellectual disability (ID) and people with dementia have high drug prescription rates, there is a lack of studies investigating drug use among those with concurrent diagnoses of ID and dementia. Aim To investigate the use of antipsychotics, benzodiazepine derivatives, and drugs recommended for dementia treatment (anticholinesterases [AChEIs] and memantine) among people with ID and dementia. Methods and procedures Having received support available for people with ID and/or autism spectrum disorder (ASD) was used as a proxy for ID. The ID cohort consisted of 7936 individuals, aged at least 55 years in 2012, and the referent cohort of age- and sex-matched people from the general population (gPop). People with a specialists’ diagnosis of dementia during 2002–2012 were identified (ID, n = 180; gPop, n = 67), and data on prescription of the investigated drugs during the period 2006–2012 were collected. Outcome and results People with ID/ASD and dementia were more likely than people with ID/ASD but without dementia to be prescribed antipsychotics (50% vs 39% over the study period; odds ratio (OR) 1.85, 95% confidence interval 1.13–30.3) and benzodiazepine derivatives (55% vs 36%; OR 2.42, 1.48–3.98). They were also more likely than people with dementia from the general population to be prescribed antipsychotics (50% vs 25%; OR 3.18, 1.59–6.34), but less likely to be prescribed AChEIs (28% vs 45%; OR 0.32, 0.16–0.64).

  • 129.
    Backman, Annica C.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe Univ, Melbourne, Vic, Australia.
    Leadership behavior in relation to person-centeredness and person-centered climate - a cross-sectional study in residential aged care in Sweden2015Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, s. 806-807Artikel i tidskrift (Övrigt vetenskapligt)
  • 130.
    Backman, Annica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.  School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
    Characteristics of highly rated leadership in Swedish nursing homes2016Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 56, s. 283-283Artikel i tidskrift (Övrigt vetenskapligt)
  • 131.
    Bajraktari, Saranda
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Zingmark, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden.
    Pettersson, Beatrice
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Lundin-Olsson, Lillemor
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Sandlund, Marlene
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Reaching older people with a digital fall prevention intervention in a Swedish municipality context: an observational study2022Ingår i: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, artikel-id 857652Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is robust evidence that falls in old age can be prevented by exercise programs that include balance training, functional exercises, and strength training. For the interventions to have a population health impact, outreach to the population of focus with suitable interventions is needed. While digital interventions are promising there is limited knowledge on the characteristics of who is reached. The aim of this study was to describe the recruitment process, estimate reach rate at the population level and to describe participants characteristics and representativeness in a digital fall prevention intervention study.

    Methods: In a municipality-based observational study, reach of a digital fall prevention intervention was evaluated. The intervention included a digital exercise programme (Safe Step) and optional supportive strategies, complemented with a range of recruitment strategies to optimize reach. Recruitment during a period of 6 months was open to people 70 years or older who had experienced a fall or a decline in balance the past year. Reach was based on data from the baseline questionnaire including health and demographic characteristics of participants. Representativeness was estimated by comparing participants to a sample of older people from the Swedish National Public Health Survey.

    Results: The recruitment rate was 4.7% (n = 173) in relation to the estimated population of focus (n = 3,706). Most participants signed up within the first month of the intervention (n = 131). The intervention attracted primarily women, older people with high education, individuals who used the internet or digital applications almost every day and those perceiving their balance as fair or poor. Safe step participants lived more commonly alone and had higher education and better walking ability in comparison to the Swedish National Public Health Survey.

    Conclusions: With a range of recruitment strategies most participants were recruited to a digital fall intervention during the first month. The intervention attracted primarily highly educated women who frequently used the internet or smart technologies. In addition to digital fall prevention interventions, a higher diversity of intervention types (digital and non-digital) is more likely to reach a larger group of older people with different needs.

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  • 132. Balducci, Marco
    et al.
    Locatelli, Edoardo
    Barbieri, Maria Giorgia
    Ferrighi, Elena
    Scardina, Serena
    Barrile, Giulia
    Sganga, Federica
    Mattioli, Irene
    Remelli, Francesca
    Maggi, Stefania
    Volpato, Stefano
    Trevisan, Caterina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). University of Ferrara, Italy; Azienda Ospedaliero-Universitaria of Ferrara, Italy.
    SARS-CoV-2 vaccination and risk of infectious diseases in hospitalized older patients2024Ingår i: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose Vaccinations, for example flu vaccine, may be a cause of cross-reactive immunostimulation that prevents a larger spectrum of infections. However, whether SARS-CoV-2 vaccinations may also determine this effect is unclear. This study aims, first, to assess the incidence of infections at hospital admission and during the hospitalization in older inpatients vaccinated and unvaccinated against SARS-CoV-2; second, to compare length of hospital stay and in-hospital mortality between vaccinated and unvaccinated individuals.

    Methods This retrospective study included 754 older inpatients admitted to the Geriatrics and Orthogeriatrics Units of the University Hospital of Ferrara (Italy) between March 2021 and November 2021. Sociodemographic and health-related data, and the diagnosis of infections at hospital admission and during hospitalization were collected from medical records.

    Results The sample’s mean age was 87.2 years, 59.2% were females, and 75.5% were vaccinated against SARS-CoV-2. Vaccinated individuals had 36% lower odds of intra-hospital infections (OR = 0.64, 95%CI 0.44–0.94) and 39% lower in-hospital death (HR = 0.61, 95%CI 0.39–0.95), also after adjusting for potential confounders, while no significant results emerged about infections at hospital admission. Considering the hospitalization’s endpoints, SARS-CoV-2 vaccination was associated with a lower probability of being transferred to long-term care or other hospital departments than returning home (OR = 0.63, 95%CI 0.40–0.99).

    Conclusions In older inpatients, SARS-CoV-2 vaccination seems to be associated with a lower likelihood of intra-hospital infectious diseases not caused by SARS-CoV-2 and all-cause in-hospital mortality. The vaccination coverage in the older population could limit not only the onset and severity of COVID-19 but also the occurrence of other infectious diseases.

  • 133.
    Ballesteros, Soledad
    et al.
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Prieto, Antonio
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Mayes, Julia
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Toril, Pilar
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Pita, Carmen
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Ponce de León, Laura
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Reales, José
    Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
    Waterworth, John
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för informatik.
    Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial2014Ingår i: Frontiers in Aging Neuroscience, ISSN 1663-4365, E-ISSN 1663-4365, Vol. 6, artikel-id 277Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-hr non-action video game training sessions with games selected from a commercially available package (Lumosity) on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended two meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time), attention (reduction of distraction and increase of alertness), immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM) and executive control (shifting strategy) did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others.

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  • 134.
    Ballin, Marcel
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Physical activity, visceral adipose tissue, and cardiovascular disease in older adults: associations and effects2023Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    BACKGROUND: Cardiovascular disease (CVD) poses a substantial public health burden and is the leading cause of mortality in older adults. With the population aging rapidly, interventions aimed at improving modifiable risk factors for CVD, such as physical inactivity and visceral obesity, could play an important role in reducing its burden, provided they are proven effective.

    PURPOSE AND AIMS: The overall purpose of this thesis was to create a deeper understanding of the links between physical activity, visceral adipose tissue (VAT), and CVD in older adults, by studying it from both an observational and an interventional perspective. The specific aims were to investigate the associations of objectively measured physical activity and VAT with the risk of CVD and all-cause mortality, to investigate the effect of structured physical activity (exercise) on VAT, and to review the effects of exercise on CVD and all-cause mortality based on evidence from randomized controlled trials (RCTs).

    METHODS: This thesis comprised two prospective cohort studies, one RCT, and one narrative review of evidence from RCTs. The cohort studies included about 3,300 men and women aged 70 years with baseline data on physical activity and VAT mass, as obtained using accelerometry and dual-energy X-ray absorptiometry, respectively. Cases of stroke, myocardial infarction, and all-cause mortality during follow-up were collected from Swedish nationwide registers. The RCT included 77 men and women aged 70 years with visceral obesity who were randomly allocated to either 10 weeks of supervised vigorous-intensity exercise or to no exercise, with VAT mass measured before and after the intervention. In the review, evidence from published RCTs and meta-analyses of RCTs reporting on the effects of exercise on CVD (N=19,162) and all-cause mortality (N=37,443) in general older adults and in individuals with chronic conditions (such as obesity, type 2 diabetes, and preexisting CVD) were reviewed.

    MAIN FINDINGS: In the cohort studies, greater amounts of physical activity of any intensity, but especially that of moderate to vigorous intensity, were associated with lower risk of stroke, myocardial infarction, and all-cause mortality. Conversely, greater VAT mass was associated with higher risk of stroke or myocardial infarction. In the RCT, short-term vigorous-intensity exercise seemed to decrease VAT mass slightly, but the effect was not statistically significant. Finally, the review showed that there is currently no convincing evidence from RCTs that exercise effectively reduces the risk of CVD or all-cause mortality, which stands in sharp contrast to the strong associations typically reported in observational studies. The reasons for the conflicting findings are likely complex and multifactorial. In the RCTs, a lack of statistical power could partly explain why no effects have been detected in the general population of older adults, but it is unlikely to explain the null findings in clinical populations, as some of these trials, including meta-analyses of such trials, have been large. Other potential explanations could be a ceiling effect due to the inclusion of participants who were healthier and more physically active than the general population, or that an effect of exercise was masked by the use of effective medications such as antihypertensives and lipid-lowering agents. On the other hand, observational studies have likely overestimated the benefits of physical activity, because these studies are vulnerable to selection bias, reverse causation, and unmeasured confounding, such as from heritable influences.

    CONCLUSIONS AND IMPLICATIONS: Despite strong associations, the protective effect of physical activity as a single intervention against CVD and all-cause mortality in older adults is probably not as substantial as is commonly presumed. To uncover the true role of physical activity in preventing CVD, further high-quality trials would be valuable. However, because these trials are very difficult and resource demanding, they should be complemented by innovative observational studies that seek to strengthen causal inference through addressing sources of bias and confounding that are often incompletely accounted for in conventional observational studies. This could include a variety of methodologies, such as utilizing negative control outcomes, instrumental variables, sibling comparisons, and other genetically informed designs. As the aging population continues to grow, it becomes increasingly important to take these scientific steps in order to provide a more definitive answer to the question of the extent to which physical activity alone can reduce the risk of CVD.

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  • 135.
    Ballin, Marcel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Hult, Andreas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Björk, Sabine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Lundberg, Emmy
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Nordström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa. School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway..
    Web-based exercise versus supervised exercise for decreasing visceral adipose tissue in older adults with central obesity: a randomized controlled trial2020Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, nr 1, artikel-id 173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Visceral adipose tissue (VAT) is a strong risk factor for cardiovascular disease and increases with age. While supervised exercise (SE) may be an effective approach, web-based exercise (WE) have other advantages such as being more readily accessible. Therefore, we evaluated the effects of WE on VAT, body composition and cardiometabolic risk markers in centrally obese older adults and compared the effects of WE to SE. We also explored the feasibility of WE.

    METHODS: In a randomized controlled trial conducted in Umeå, Sweden during January 2018 - November 2018, N = 77, 70-year-old men and women with central obesity (> 1 kg VAT for women, > 2 kg for men) were randomized to an intervention group (n = 38) and a wait-list control group (n = 39). The intervention group received 10 weeks of SE while the wait-list control group lived as usual. Following a 10-week wash-out-period, the wait-list control group received 10 weeks of WE. The primary outcome was changes in VAT. Secondary outcomes included changes in fat mass (FM), lean body mass (LBM), blood lipids, fasting blood glucose. Additionally, we explored the feasibility of WE defined as adherence and participant experiences.

    RESULTS: WE had no significant effect on VAT (P = 0.5), although it decreased FM by 450 g (95% confidence interval [CI], 37 to 836, P < 0.05). The adherence to WE was 85% and 87-97% of the participants rated aspects of the WE intervention > 4 on a scale of 1-5. Comparing SE to WE, there was no significant difference in decrease of VAT (Cohen's δ effect size [ES], 0.5, 95% CI, - 24 to 223, P = 0.11), although SE decreased FM by 619 g (ES, 0.5, 95% CI, 22 to 1215, P < 0.05) compared to WE.

    CONCLUSIONS: Ten weeks of vigorous WE is insufficient to decrease VAT in centrally obese older adults, but sufficient to decrease FM while preserving LBM. The high adherence and positive experiences of the WE intervention implies that it could serve as an alternative exercise strategy for older adults with central obesity, with increased availability for a larger population.

    TRIAL REGISTRATION: ClinicalTrials.gov (NCT03450655), retrospectively registered February 28, 2018.

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  • 136.
    Ballin, Marcel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lundberg, Emmy
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sörlén, Niklas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Hult, Andreas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. School of Sport Sciences, The Arctic University of Norway, Tromsø, Norway..
    Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70-Year-Old Individuals: A Randomized Controlled Trial2019Ingår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 67, nr 8, s. 1625-1631Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the effects of 10 weeks of progressive vigorous-intensity interval training as a single intervention on body composition among 70-year-old individuals with central obesity.

    DESIGN: Randomized controlled trial (ClinicalTrials.gov registration No. NCT03450655).

    SETTING: Community-dwelling 70-year-old men and women living in the Umeå municipality in Sweden.

    PARTICIPANTS: Seventy-seven 70-year-old men and women with central obesity (greater than 1 kg visceral adipose tissue [VAT] for women and greater than 2 kg VAT for men).

    INTERVENTION: Participants allocated to the intervention group were offered a 10-week progressive concurrent exercise program performed three times per week. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation.

    MEASUREMENTS: The primary outcome was changes in VAT, and secondary outcomes included changes in total fat mass (FM), total lean body mass (LBM), and body mass index.

    RESULTS: Comparing the groups, there were no significant differences in decrease of VAT mass (P = .10), although the intervention group significantly decreased FM by 716 g (P = .01) and gained LBM by 508 g (P = .03), compared to the control group. Furthermore, the effects of the training were significantly greater in the male subcohort (P < .05 for interaction), with positive effects also on VAT and FM, where men in the intervention group decreased VAT by 175 g (P < .05) and FM by 1364 g (P = .004), compared to the male controls.

    CONCLUSIONS: The present trial demonstrates that 10 weeks of progressive vigorous interval training is sufficient to significantly decrease FM in older adults with central obesity, with positive effects also on LBM.

  • 137.
    Ballin, Marcel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Niklasson, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Nordström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa. School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Associations of Objectively Measured Physical Activity and Sedentary Time with the Risk of Stroke, Myocardial Infarction or All‑Cause Mortality in 70‑Year‑Old Men and Women: A Prospective Cohort Study2020Ingår i: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 51, nr 2, s. 339-349Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study the associations of objectively measured physical activity (PA) and sedentary time (ST) with the combined outcome of incident stroke, myocardial infarction (MI) or all-cause mortality in older adults.

    Methods: N = 3343 men and women aged 70 who participated in a health survey between 2012 and 2017 were included. Actigraph GT3X+ accelerometers were used to measure light-intensity PA (LPA), moderate-intensity PA (MPA) and ST for 1 week. Incident cases of cardiovascular disease (CVD) in terms of stroke or MI, and all-cause mortality were identified using national registers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable-adjusted Cox regressions.

    Results: During a mean follow-up of 2.7 years (0.1–5.6), there were 124 events of CVD or all-cause mortality. After adjusting for potential confounders and mediators, every 30-min/day increment in LPA was associated with 11% lower risk of CVD or all-cause mortality (HR 0.89, 95% CI 0.82–0.97), and every 30-min/day increment in MPA was associated with 36% lower risk (HR 0.64, 95% CI 0.48–0.84). Every 1-h/day increment in ST increased the risk of the outcomes by 33% (HR 1.33, 95% CI 1.14–1.56), although there was no significant association among participants who performed ≥ 30 min/day MPA (HR 1.11, 95% CI 0.82–1.50, P = 0.034 for interaction). None of the associations were modified by sex (P > 0.4 for all).

    Conclusion: Objectively measured LPA and MPA are each associated with lower risk of stroke, MI or all-cause mortality in 70-year-old individuals, while ST is associated with increased risk. The greatest risk reduction is observed for MPA, which also appears to attenuate some of the increased risks associated with ST.

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  • 138. Bamia, Christina
    et al.
    Orfanos, Philippos
    Juerges, Hendrik
    Schoettker, Ben
    Brenner, Hermann
    Lorbeer, Roberto
    Aadahl, Mette
    Matthews, Charles E.
    Klinaki, Eleni
    Katsoulis, Michael
    Lagiou, Pagona
    Bueno-de-mesquita, H. B.
    Eriksson, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Mons, Ute
    Saum, Kai-Uwe
    Kubinova, Ruzena
    Pajak, Andrzej
    Tamosiunas, Abdonas
    Malyutina, Sofia
    Gardiner, Julian
    Peasey, Anne
    de Groot, Lisette C. P. G. M.
    Wilsgaard, Tom
    Boffetta, Paolo
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium2017Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 103, s. 37-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.

    Study design: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.

    Main outcome measures: All-cause, cardiovascular and cancer mortality.

    Results: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).

    Conclusion: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”.

  • 139.
    Barazzoni, Rocco
    et al.
    Univ Trieste, Dept Med Surg & Hlth Sci, Internal Med, Trieste, Italy.;Azienda Sanit Univ Integrata Trieste ASUITS, Trieste, Italy.;Univ Trieste, Dept Med Surg & Hlth Sci, Str Fiume 447, I-34149 Trieste, Italy..
    Cederholm, Tommy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism. Karolinska Univ Hosp, Stockholm, Sweden..
    Zanetti, Michela
    Univ Trieste, Dept Med Surg & Hlth Sci, Internal Med, Trieste, Italy.;Azienda Sanit Univ Integrata Trieste ASUITS, Trieste, Italy..
    Cappellari, Gianluca Gortan
    Univ Trieste, Dept Med Surg & Hlth Sci, Internal Med, Trieste, Italy.;Azienda Sanit Univ Integrata Trieste ASUITS, Trieste, Italy..
    Defining and diagnosing sarcopenia: Is the glass now half full?2023Ingår i: Metabolism: Clinical and Experimental, ISSN 0026-0495, E-ISSN 1532-8600, Vol. 143, artikel-id 155558Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Low muscle mass and function exert a substantial negative impact on quality of life, health and ultimately survival, but their definition, identification and combination to define sarcopenia have suffered from lack of universal consensus. Methodological issues have also contributed to incomplete agreement, as different approaches, techniques and potential surrogate measures inevitably lead to partly different conclusions. As a consequence: 1) awareness of sarcopenia and implementation of diagnostic procedures in clinical practice have been limited; 2) patient identification and evaluation of therapeutic strategies is largely incomplete. Significant progress has however recently occurred after major diagnostic algorithms have been developed, with common features and promising perspectives for growing consensus. At the same time, the need for further refinement of the sarcopenia concept has emerged, to address its increasingly recognized clinical heterogeneity. This includes potential differential underlying mechanisms and clinical features for age-and disease-driven sarcopenia, and the emerging challenge of sarcopenia in persons with obesity. Here, we will review existing algorithms to diagnose sarcopenia, and major open methodological issues to assess skeletal muscle mass and function under different clinical conditions, in order to highlight similarities and differences. Potential for consensus on sarcopenia diagnosis as well as emerging new challenges will be discussed.

  • 140.
    Bask, Miia
    Department of Sociology, University of Bergen, Bergen, Norway.
    Patterns of Psycho-Social Distress Among Ageing Swedes2015Ingår i: Journal of Population Ageing, ISSN 1874-7884, E-ISSN 1874-7876, Vol. 8, nr 4, s. 261-278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper examines psycho-social distress among middle-aged and elderly Swedes. We analysed data on 3221 individuals who were 55 to 99 years old. Based on a latent class analysis, we identified four latent classes. Two classes were associated with higher levels of psycho-social problem accumulation. The class with the lowest level of problem accumulation contained the greatest number of individuals, whereas the classes with the highest level of psycho-social distress contained the least number of individuals. The analysis showed that being a man, being married, being a native Swede, or having several hobbies was associated with a low likelihood of belonging to a latent class that was characterised by psycho-social distress. Moreover, being a woman, being between 55 and 65 years of age, or being a widow was associated with a high likelihood of belonging to a latent class that was characterised by the highest levels of problem accumulation.

  • 141.
    Bask, Miia
    Department of Sociology, University of Bergen, Bergen, Norway.
    Patterns of Psycho-Social Distress Among Ageing Swedes2015Ingår i: Journal of Population Ageing, ISSN 1874-7884, E-ISSN 1874-7876, Vol. 8, nr 4, s. 261-278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper examines psycho-social distress among middle-aged and elderly Swedes. We analysed data on 3221 individuals who were 55 to 99 years old. Based on a latent class analysis, we identified four latent classes. Two classes were associated with higher levels of psycho-social problem accumulation. The class with the lowest level of problem accumulation contained the greatest number of individuals, whereas the classes with the highest level of psycho-social distress contained the least number of individuals. The analysis showed that being a man, being married, being a native Swede, or having several hobbies was associated with a low likelihood of belonging to a latent class that was characterised by psycho-social distress. Moreover, being a woman, being between 55 and 65 years of age, or being a widow was associated with a high likelihood of belonging to a latent class that was characterised by the highest levels of problem accumulation.

  • 142.
    Bask, Miia
    Department of Sociology, University of Bergen, Bergen, Norway.
    Patterns of Psycho-Social Distress among Middle-Aged and Elderly Swedes2015Konferensbidrag (Refereegranskat)
  • 143.
    Bask, Miia
    Department of Sociology, University of Bergen, Bergen, Norway.
    Patterns of Psycho-Social Distress among Middle-Aged and Elderly Swedes2015Konferensbidrag (Refereegranskat)
  • 144.
    Bass, Gary Alan
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Leonard Davis Institute of Health Economics (LDI), University of Pennsylvania, Philadelphia, USA; Center for Peri-Operative Outcomes Research and Transformation (CPORT), University of Pennsylvania, Philadelphia, USA.
    Duffy, Caoimhe C.
    Leonard Davis Institute of Health Economics (LDI), University of Pennsylvania, Philadelphia, USA; Center for Peri-Operative Outcomes Research and Transformation (CPORT), University of Pennsylvania, Philadelphia, USA.
    Kaplan, Lewis J.
    Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Department of Anesthesia and Critical Care, University of Pennsylvania, Philadelphia, USA; Corporal Michael Cresenscz Veterans Affairs Medical Center (CMCVAMC), Philadelphia, USA.
    Sarani, Babak
    Center for Trauma and Critical Care, George Washington University School of Medicine & Health Sciences, Washington D.C., USA.
    Martin, Niels D.
    Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
    Mohammad Ismail, Ahmad
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Clinical Epidemiology and Biostatistics.
    Forssten, Maximilian Peter
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Trauma & Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    The revised cardiac risk index is associated with morbidity and mortality independent of injury severity in elderly patients with rib fractures2023Ingår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 54, nr 1, s. 56-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Risk factors for mortality and in-hospital morbidity among geriatric patients with traumatic rib fractures remain unclear. Such patients are often frail and demonstrate a high comorbidity burden. Moreover, outcomes anticipated by current rubrics may reflect the influence of multisystem injury or surgery, and thus not apply to isolated injuries in geriatric patients. We hypothesized that the Revised Cardiac Risk Index (RCRI) may assist in risk-stratifying geriatric patients following rib fracture.

    METHODS: All geriatric patients (age ≥65 years) with a conservatively managed rib fracture owing to an isolated thoracic injury (thorax AIS ≥1), in the 2013-2019 TQIP database were assessed including demographics and outcomes. The association between the RCRI and in-hospital morbidity as well as mortality was analyzed using Poisson regression models while adjusting for potential confounders.

    RESULTS: 96,750 geriatric patients sustained rib fractures. Compared to those with RCRI 0, patients with an RCRI score of 1 had a 16% increased risk of in-hospital mortality [adjusted incidence rate ratio (adj-IRR), 95% confidence interval (CI): 1.16 (1.02-1.32), p=0.020]. An RCRI score of 2 [adj-IRR (95% CI): 1.72 (1.44-2.06), p<0.001] or ≥3 [adj-IRR (95% CI): 3.07 (2.31-4.09), p<0.001] was associated with an even greater mortality risk. Those with an increased RCRI also exhibited a higher incidence of myocardial infarction, cardiac arrest, stroke, and acute respiratory distress syndrome.

    CONCLUSIONS: Geriatric patients with rib fractures and an RCRI ≥1 represent a vulnerable and high-risk group. This index may inform the decision to admit for inpatient care and can also guide patient and family counseling as well as computer-based decision-support.

  • 145.
    Bateman, Daniel R.
    et al.
    Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Center for Aging Research, Regenstrief Institute, Indianapolis, Indiana, USA.
    Sascha, Gill
    Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
    Hu, Sophie
    Community Health Sciences, and O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
    Foster, Erin D.
    Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, Indiana, USA; University of California Berkeley, Berkeley, CA, USA.
    Ruthirakuhan, Myuri T.
    Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Ontario, Canada.
    Sellek, Allis F.
    The Alzheimer Foundation of Costa Rica, Costa Rica.
    Mortby, Moyra E.
    School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia.
    Matušková, Veronika
    International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic; Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
    Pin, Kok
    Department of Neurology, National Neuroscience Institute, Singapore, Singapore.
    Tarawneh, Rawan M.
    Department of Neurology, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
    Freund-Levi, Yvonne
    Örebro universitet, Institutionen för medicinska vetenskaper. Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Kumar, Sanjeev
    Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Ontario, Canada.
    Gauthier, Serge
    McGill Center for Studies in Aging, McGill University, Montreal, Quebec, Canada.
    Rosenberg, Paul B.
    Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral, Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
    Ferreira deOliveira, Fabricio
    Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil.
    Devanand, D. P.
    New York State Psychiatric Institute and Department of Psychiatry and Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
    Ballard, Clive
    College of Medicine and Health, The University of Exeter, Exeter, UK.
    Ismail, Zahinoor
    Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Community Health Sciences, and O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, and the Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
    Agitation and impulsivity in mid and late life as possible riskmarkers for incident dementia2020Ingår i: Alzheimer’s & Dementia: Translational Research & Clinical Interventions, E-ISSN 2352-8737, Vol. 6, nr 1, artikel-id e12016Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    To identify knowledge gaps regarding new-onset agitation and impulsivity prior to onsetof cognitive impairment or dementia the International Society to Advance Alzheimer’sResearch and Treatment Neuropsychiatric Syndromes (NPS) Professional InterestAreaconducted a scoping review. Extending a series of reviews exploring the pre-dementiarisk syndrome Mild Behavioral Impairment (MBI), we focused on late-onset agitationand impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitivedecline and dementia. This scoping review of agitation and impulsivity pre-dementiasyndromes summarizes the current biomedical literature in terms of epidemiology,diagnosis andmeasurement, neurobiology, neuroimaging, biomarkers, course and prognosis,treatment, and ongoing clinical trials. Validations for pre-dementia scales suchas the MBI Checklist, and incorporation into longitudinal and intervention trials, areneeded to better understand impulse dyscontrol as a risk factor for mild cognitiveimpairment and dementia.

  • 146.
    Bauckneht, Matteo
    et al.
    IRCCS Osped Policlin San Martino, Italy.
    Chincarini, Andrea
    Natl Inst Nucl Phys INFN, Italy.
    Brendel, Matthias
    Ludwig Maximilians Univ Munchen, Germany.
    Rominger, Axel
    Ludwig Maximilians Univ Munchen, Germany; Univ Hosp Bern, Switzerland.
    Beyer, Leonie
    Ludwig Maximilians Univ Munchen, Germany.
    Bruffaerts, Rose
    Katholieke Univ Leuven, Belgium; Univ Hosp Leuven, Belgium; Hasselt Univ, Belgium.
    Vandenberghe, Rik
    Katholieke Univ Leuven, Belgium; Univ Hosp Leuven, Belgium.
    Kramberger, Milica G.
    Univ Med Ctr Ljubljana, Slovenia; Univ Ljubljana, Slovenia.
    Trost, Maja
    Univ Med Ctr Ljubljana, Slovenia; Univ Ljubljana, Slovenia.
    Garibotto, Valentina
    Univ Geneva, Switzerland; Univ Geneva, Switzerland.
    Nicastro, Nicolas
    Geneva Univ Hosp, Switzerland; Univ Cambridge, England.
    Frisoni, Giovanni B.
    Geneva Univ Hosp, Switzerland.
    Lemstra, Afina W.
    Vrije Univ Amsterdam, Netherlands.
    Berckel, Bart N. M.
    Vrije Univ Amsterdam, Netherlands.
    Pilotto, Andrea
    Univ Brescia, Italy; Isidoro Hosp, Italy.
    Padovani, Alessandro
    Univ Brescia, Italy.
    Ochoa-Figueroa, Miguel A.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Röntgenkliniken i Linköping. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Region Östergötland, Hjärtcentrum, Fysiologiska kliniken US.
    Davidsson, Anette
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för diagnostik och specialistmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärtcentrum, Fysiologiska kliniken US.
    Camacho, Valle
    Univ Autonoma Barcelona, Spain.
    Peira, Enrico
    Natl Inst Nucl Phys INFN, Italy; Univ Genoa, Italy.
    Arnaldi, Dario
    Univ Genoa, Italy; IRCCS Osped Policlin San Martino, Italy.
    Pardini, Matteo
    Univ Genoa, Italy; IRCCS Osped Policlin San Martino, Italy.
    Donegani, Maria Isabella
    Univ Genoa, Italy.
    Raffa, Stefano
    Univ Genoa, Italy.
    Miceli, Alberto
    Univ Genoa, Italy.
    Sambuceti, Gianmario
    IRCCS Osped Policlin San Martino, Italy; Univ Genoa, Italy.
    Aarsland, Dag
    Stavanger Univ Hosp, Norway; Kings Coll London, England.
    Nobili, Flavio
    Univ Genoa, Italy; IRCCS Osped Policlin San Martino, Italy.
    Morbelli, Silvia
    IRCCS Osped Policlin San Martino, Italy; Univ Genoa, Italy.
    Associations among education, age, and the dementia with Lewy bodies (DLB) metabolic pattern: A European-DLB consortium project2021Ingår i: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 17, nr 8, s. 1277-1286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction We assessed the influence of education as a proxy of cognitive reserve and age on the dementia with Lewy bodies (DLB) metabolic pattern. Methods Brain 18F-fluorodeoxyglucose positron emission tomography and clinical/demographic information were available in 169 probable DLB patients included in the European DLB-consortium database. Principal component analysis identified brain regions relevant to local data variance. A linear regression model was applied to generate age- and education-sensitive maps corrected for Mini-Mental State Examination score, sex (and either education or age). Results Age negatively covaried with metabolism in bilateral middle and superior frontal cortex, anterior and posterior cingulate, reducing the expression of the DLB-typical cingulate island sign (CIS). Education negatively covaried with metabolism in the left inferior parietal cortex and precuneus (making the CIS more prominent). Discussion These findings point out the importance of tailoring interpretation of DLB biomarkers considering the concomitant effect of individual, non-disease-related variables such as age and cognitive reserve.

  • 147.
    Bauer, Juergen M.
    et al.
    Carl von Ossietzky Univ Oldenburg, Dept Geriatr Med, D-26133 Oldenburg, Germany..
    Verlaan, Sjors
    Nutricia Adv Med Nutr, Nutricia Res, Utrecht, Netherlands.;Vrije Univ Amsterdam, Med Ctr, Dept Internal Med, Sect Gerontol & Geriatr, Amsterdam, Netherlands..
    Bautmans, Ivan
    Vrije Univ Brussel, Frailty Ageing Res Grp FRIA, Brussels, Belgium..
    Brandt, Kirsten
    Newcastle Univ, Inst Ageing, Sch Agr Food & Rural Dev, Human Nutr Res Ctr, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England..
    Donini, Lorenzo M.
    Univ Roma La Sapienza, Sect Med Pathophysiol Endocrinol & Human Nutr, Dept Expt Med, I-00185 Rome, Italy..
    Maggio, Marcello
    Univ Parma, Univ Hosp, Dept Clin & Expt Med, Sect Geriatr,Movement Disorders & Prevent Disabil, I-43100 Parma, Italy.;Univ Parma, Univ Hosp, Dept Clin & Expt Med, Sect Geriatr,Food Sci Unit, I-43100 Parma, Italy.;Univ Parma, Univ Hosp, Dept Clin & Expt Med, Sect Geriatr,Endocrinol Aging Unit, I-43100 Parma, Italy..
    McMurdo, Marion E. T.
    Univ Dundee, Ninewells Hosp & Med Sch, Ninewells Hosp, Ageing & Hlth, Dundee DD1 9SY, Scotland..
    Mets, Tony
    Vrije Univ Brussel, Frailty Ageing Res Grp FRIA, Brussels, Belgium..
    Seal, Chris
    Newcastle Univ, Inst Ageing, Sch Agr Food & Rural Dev, Human Nutr Res Ctr, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England..
    Wijers, Sander L.
    Nutricia Adv Med Nutr, Nutricia Res, Utrecht, Netherlands..
    Ceda, Gian Paolo
    Univ Parma, Univ Hosp, Dept Clin & Expt Med, Sect Geriatr,Movement Disorders & Prevent Disabil, I-43100 Parma, Italy.;Univ Parma, Univ Hosp, Dept Clin & Expt Med, Sect Geriatr,Food Sci Unit, I-43100 Parma, Italy.;Univ Parma, Univ Hosp, Dept Clin & Expt Med, Sect Geriatr,Endocrinol Aging Unit, I-43100 Parma, Italy..
    De Vito, Giuseppe
    Univ Coll Dublin, Inst Sport & Hlth, Dublin 2, Ireland..
    Donders, Gilbert
    Femicare, Clin Res Women, Tienen, Belgium..
    Drey, Michael
    Klinikum Univ Munchen LMU, Schwerpunkt Akutgeriatrie, Med Klin & Poliklin 4, Munich, Germany..
    Greig, Carolyn
    Univ Birmingham, Sch Sport Exercise & Rehabil Sci, Birmingham, W Midlands, England.;Univ Birmingham, Ctr Musculoskeletal Ageing Res, Birmingham, W Midlands, England..
    Holmbäck, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Narici, Marco
    Univ Nottingham, Royal Derby Hosp, MRC ARUK Ctr Musculoskeletal Ageing Res, Fac Med, Derby, England..
    McPhee, Jamie
    Manchester Metropolitan Univ, Sch Healthcare Sci, All Saints, Manchester M15 6BH, Lancs, England..
    Poggiogalle, Eleonora
    Univ Roma La Sapienza, Sect Med Pathophysiol Endocrinol & Human Nutr, Dept Expt Med, I-00185 Rome, Italy..
    Power, Dermot
    Mater Misericordiae Univ Hosp, Dept Med Older Persons, Dublin, Ireland.;Univ Coll Dublin, Dublin 2, Ireland..
    Scafoglieri, Aldo
    Vrije Univ Brussel, Frailty Ageing Res Grp FRIA, Brussels, Belgium..
    Schultz, Ralf
    St Marien Hosp, Clin Geriatr, Cologne, Germany..
    Sieber, Cornel C.
    Univ Erlangen Nurnberg, Inst Biomed Ageing, Nurnberg, Germany..
    Cederholm, Tommy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial2015Ingår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 16, nr 9, s. 740-747Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Age-related losses of muscle mass, strength, and function (sarcopenia) pose significant threats to physical performance, independence, and quality of life. Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability. Objective: To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of sarcopenia. Design: A multicenter, randomized, controlled, double-blind, 2 parallel-group trial among 380 sarcopenic primarily independent-living older adults with Short Physical Performance Battery (SPPB; 0-12) scores between 4 and 9, and a low skeletal muscle mass index. The active group (n = 184) received a vitamin D and leucine-enriched whey protein nutritional supplement to consume twice daily for 13 weeks. The control group (n = 196) received an iso-caloric control product to consume twice daily for 13 weeks. Primary outcomes of handgrip strength and SPPB score, and secondary outcomes of chair-stand test, gait speed, balance score, and appendicular muscle mass (by DXA) were measured at baseline, week 7, and week 13 of the intervention. Results: Handgrip strength and SPPB improved in both groups without significant between-group differences. The active group improved more in the chair-stand test compared with the control group, between-group effect (95% confidence interval): -1.01 seconds (-1.77 to -0.19), P = .018. The active group gained more appendicular muscle mass than the control group, between-group effect: 0.17 kg (0.004-0.338), P = .045. Conclusions: This 13-week intervention of a vitamin D and leucine-enriched whey protein oral nutritional supplement resulted in improvements in muscle mass and lower-extremity function among sarcopenic older adults. This study shows proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients, especially relevant for those who are unable to exercise. These results warrant further investigations into the role of a specific nutritional supplement as part of a multimodal approach to prevent adverse outcomes among older adults at risk for disability.

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  • 148.
    Beckman, Linda
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). University of Florida, USA.
    Gustavsson, Johanna
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Centrum för forskning om samhällsrisker, CSR (från 2020).
    Coping strategies for increased wellbeing and mental health among older adults during the COVID-19 pandemic - a Swedish qualitative study2023Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Older adults were particularly vulnerable to the COVID-19 pandemic, necessitating significant efforts to avoid contamination. This extraordinary situation posed an increased risk of mental pressure, and the ability to handle stressful situations is affected by several aspects. Therefore, this study aims to explore the coping strategies employed by older adults during the early months of the COVID-19 pandemic. A sample of 41 Swedish older adults aged 70-85 participated in phone interviews regarding their experiences with social distancing due to COVID-19. The interviews were conducted between April and May 2020, with nine follow-up interviews conducted in November and December 2020. The findings revealed results that despite the challenging circumstances, the participants demonstrated a strong mindset and resilience. Strategies utilised to improve their wellbeing and manage the situation included following recommendations, accepting the situation and maintaining a positive outlook. The influence of previous experiences on their coping strategies was evident. Additionally, the participants expressed a longing for their relatives and a need to adopt new technologies to manage their everyday lives. The follow-up interviews indicated no significant changes in worry or behaviour; if anything, participants were less worried at the beginning of the pandemic. This study contributes to the ongoing discussion on vulnerability among older adults by highlighting the diverse range of coping strategies employed during a prolonged crisis such as the COVID-19 pandemic. It demonstrated that though they are medically vulnerable, they are situationally resilient and, in many ways, well set to handle a challenging situation. During crises, older adults might need practical assistance. On the other hand, they can be a resource regarding mental preparedness during crises. Further research should explore the possibilities of balancing the needs of older adults and, at the same time, viewing them as a resource during long-time crises. 

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  • 149.
    Behrens, Anders
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Sanmartin Berglund, Johan
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Anderberg, Peter
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    CoGNIT Automated Tablet Computer Cognitive Testing in Patients With Mild Cognitive Impairment: Feasibility Study2022Ingår i: JMIR Formative Research, E-ISSN 2561-326X, Vol. 6, nr 3, artikel-id e23589Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Early diagnosis of cognitive disorders is becoming increasingly important. Limited resources for specialist assessment and an increasing demographical challenge warrants the need for efficient methods of evaluation. In response, CoGNIT, a tablet app for automatic, standardized, and efficient assessment of cognitive function, was developed. Included tests span the cognitive domains regarded as important for assessment in a general memory clinic (memory, language, psychomotor speed, executive function, attention, visuospatial ability, manual dexterity, and symptoms of depression). Objective: The aim of this study was to assess the feasibility of automatic cognitive testing with CoGNIT in older patients with symptoms of mild cognitive impairment (MCI). Methods: Patients older than 55 years with symptoms of MCI (n=36) were recruited at the research clinic at the Blekinge Institute of Technology (BTH), Karlskrona, Sweden. A research nurse administered the Mini-Mental State Exam (MMSE) and the CoGNIT app on a tablet computer. Technical and testing issues were documented. Results: The test battery was completed by all 36 patients. One test, the four-finger-tapping test, was performed incorrectly by 42% of the patients. Issues regarding clarity of instructions were found in 2 tests (block design test and the one finger-tapping test). Minor software bugs were identified. Conclusions: The overall feasibility of automatic cognitive testing with the CoGNIT app in patients with symptoms of MCI was good. The study highlighted tests that did not function optimally. The four-finger-tapping test will be discarded, and minor improvements to the software will be added before further studies and deployment in the clinic. © 2022 JMIR Publications Inc.. All right reserved.

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  • 150.
    Behrens, Anders
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    CoGNIT Automated Tablet Computer Cognitive Testing in Patients With Mild Cognitive Impairment: Feasibility Study2022Ingår i: JMIR Formative Research, E-ISSN 2561-326X, Vol. 6, nr 3, artikel-id e23589Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Early diagnosis of cognitive disorders is becoming increasingly important. Limited resources for specialist assessment and an increasing demographical challenge warrants the need for efficient methods of evaluation. In response, CoGNIT, a tablet app for automatic, standardized, and efficient assessment of cognitive function, was developed. Included tests span the cognitive domains regarded as important for assessment in a general memory clinic (memory, language, psychomotor speed, executive function, attention, visuospatial ability, manual dexterity, and symptoms of depression). Objective: The aim of this study was to assess the feasibility of automatic cognitive testing with CoGNIT in older patients with symptoms of mild cognitive impairment (MCI). Methods: Patients older than 55 years with symptoms of MCI (n=36) were recruited at the research clinic at the Blekinge Institute of Technology (BTH), Karlskrona, Sweden. A research nurse administered the Mini-Mental State Exam (MMSE) and the CoGNIT app on a tablet computer. Technical and testing issues were documented. Results: The test battery was completed by all 36 patients. One test, the four-finger-tapping test, was performed incorrectly by 42% of the patients. Issues regarding clarity of instructions were found in 2 tests (block design test and the one finger-tapping test). Minor software bugs were identified. Conclusions: The overall feasibility of automatic cognitive testing with the CoGNIT app in patients with symptoms of MCI was good. The study highlighted tests that did not function optimally. The four-finger-tapping test will be discarded, and minor improvements to the software will be added before further studies and deployment in the clinic. © 2022 JMIR Publications Inc.. All right reserved.

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