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  • 1.
    Abramsson, Linnea
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Gustafsson, Maria
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Adherence to Bisphosphonates among People Admitted to an Orthopaedic and Geriatric Ward at a University Hospital in Sweden2018In: Pharmacy, ISSN 2226-4787, E-ISSN 1913-4711, Vol. 6, no 1, article id 20Article in journal (Refereed)
    Abstract [en]

    Oral bisphosphonates are the first choice of therapy to reduce the risk of osteoporotic fractures. These medications have generally poor oral bioavailability, which may further be reduced by concomitant intake of certain foods and drugs; therefore, it is vital to follow specific instructions. The aim with this study was to assess general adherence to oral bisphosphonates and adherence to specific administration instructions among people admitted to two wards at Umeå University hospital in Sweden. This interview study focuses on elderly patients living at home and prescribed oral bisphosphonates. Invited were 27 patients admitted to an orthopaedic ward and a geriatric ward during the period 28 March 2017 and 5 December 2017. In total, 21 patients were interviewed regarding their adherence to oral bisphosphonates. Out of 21 patients, 13 (62%) were considered non-adherent. The most common reason was calcium intake less than 2 h after oral administration of bisphosphonate (54%). The number of regularly prescribed drugs was significantly higher among patients rated non-adherent to bisphosphonates compared to those rated adherent (p = 0.004). Adherence to bisphosphonates administration instruction among elderly people living at home was limited. More research is needed to confirm these results and to investigate the reasons for non-adherence and how adherence to bisphosphonates can be improved.

  • 2.
    Agahi, Neda
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Shaw, Benjamin A.
    Smoking and Physical Inactivity as Predictors of Mobility Impairment During Late Life: Exploring Differential Vulnerability Across Education Level in Sweden2018In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 73, no 4, p. 675-683Article in journal (Refereed)
    Abstract [en]

    Objectives: To test whether older adults from high and low educational groups are differentially vulnerable to the impact of smoking and physical inactivity on the progression of mobility impairment during old age.

    Methods: A nationally representative sample of older Swedish adults (n = 1,311), aged 57-76 years at baseline (1991), were followed for up to 23 years (2014). Multilevel regression was used to estimate individual trajectories of mobility impairment over the study period and to test for differences in the progression of mobility impairment on the basis of smoking status, physical activity status, and level of education.

    Results: Compared to nonsmokers, heavy smokers had higher levels and steeper increases in mobility impairment with advancing age. However, there were only small and statistically nonsignificant differences in the impact of heavy smoking on mobility impairment in high versus low education groups. A similar pattern of results was found for physical inactivity.

    Discussion: Differential vulnerability to unhealthy behaviors may vary across populations, age, time-periods, and health outcomes. In this study of older adults in Sweden, low and high education groups did not differ significantly in their associations between heavy smoking or physical inactivity, and the progression of mobility impairment.

  • 3.
    Akner, G.
    et al.
    School of Health and Medical Sciences, Örebro University, 70185 Örebro, Sweden.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Personalized geriatric medicine2014In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 5, no 3, p. 145-146Article in journal (Other academic)
  • 4.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Analys och handläggning av äldres multisjuklighet måste samordnas [Analysis and management of comorbidity among the elderly must be coordinated]: med DBU-metod tillämpad vid äldrevårdscentral kan behandling utvärderas [Treatment can be evaluated with the DBU method implemented at community centers for the aged]2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 10, p. 758-765Article in journal (Refereed)
  • 5.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Analysis of multimorbidity in individual elderly nursing home residents: development of a multimorbidity matrix2009In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 49, no 3, p. 413-419Article in journal (Refereed)
    Abstract [en]

    The chronic multimorbidity in individual elderly people is rarely documented in its entirety in present medical records, neither as cross-sectional overview nor as longitudinal time-course of various health problems. This obviously hampers an integrated clinical analysis. This work was aimed at evaluating the chronic multimorbidity in individual elderly patients and developing a method to map, quantify and grade the prevalence of the multimorbidity. An explorative study in 70 nursing home residents (55 women), mean age 85 was performed. Information on health problems was obtained through history, clinical examination and medical records. A 19-item multimorbidity matrix that maps, quantifies and grades the chronic morbidity in individual patients is presented. The 70 residents exhibited 275 different health problems; the top 3 items being neuropsychiatric, cardiovascular and gastrointestinal ones. The residents had a mean of 17 different chronic health problems and were prescribed a mean of 6.6 continuous medications per day. There was a significant correlation between the number of continuous drug prescriptions and both quantitative and graded multimorbidity-scores. The presented multimorbidity matrix provides a useful taxonomic overview over the health situation in individual multimorbid elderly and constitutes the basis for ongoing work to develop and renew the electronic health record into an "interactive health analysis system".

  • 6.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Arbetsmetod2003In: Evidensbaserad äldrevård: en inventering av det vetenskapliga underlaget / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, p. 45-50Chapter in book (Other academic)
  • 7.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Background2003In: Geriatric care and treatment: a systematic compilation of existing scientific literature / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, p. 23-42Chapter in book (Other academic)
  • 8.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Bakgrund2003In: Evidensbaserad äldrevård: en inventering av det vetenskapliga underlaget / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, p. 25-44Chapter in book (Other academic)
  • 9.
    Akner, Gunnar
    Örebro University Hospital.
    Bräcklighet och multisjuklighet: nödvändigt att flytta fokus från handläggning av isolerade sjukdomar till multipla hälsoproblem inom en individualiserad, integrerad och målstyrd process över tid2012In: Svensk Geriatrik, ISSN 2001-2047, Vol. 1, no 1, p. 7-12Article in journal (Other academic)
  • 10.
    Akner, Gunnar
    Geriatriska kliniken, Universitetssjukhuset, Örebro, Sweden.
    Bräcklighet och multisjuklighet: nödvändigt att flytta fokus från handläggning av isolerade sjukdomar till multipla hälsoproblem inom en individualiserad, integrerad och målstyrd process över tid2012In: Svensk Geriatrik, ISSN 2001-2047, Vol. 1, no 1, p. 7-12Article in journal (Other academic)
  • 11.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Bräckligt åldrande och multisjuklighet drabbar allt fler [Frail aging and multimorbidity affect more and more]: fokus måste flyttas från isolerade sjukdomar till komplexa hälsoproblem : klinisk översikt [Focus must be moved from isolated diseases to complex health problems]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 44, p. 2707-2711Article in journal (Refereed)
  • 12.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Evidensbaserad behandling behövs inom äldrevården  [Evidence-based treatment is necessary in geriatric health care]: multibehandling av multisjuka äldre ställer stora krav på samordning [Multitreatment of elderly with multiple illness puts great demands on cooperation]2003In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 100, no 34, p. 2592-2596Article in journal (Other academic)
  • 13.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Evidensbaserad äldrevård: en inventering av det vetenskapliga underlaget2003Collection (editor) (Other academic)
  • 14.
    Akner, Gunnar
    Örebro University.
    Frailty and multimorbidity in elderly people: a shift in management approach2013In: Clinical Geriatrics, ISSN 1095-1598, Vol. 21, no 9Article in journal (Refereed)
    Abstract [en]

    Frailty and multimorbidity may be regarded as a homeostatic failure of a complex system, and these conditions are commonly encountered in elderly people. The concept of “frailty” has been used to describe an individual’s biological age, and the concept of “multimorbidity” is reserved for the simultaneous presence of two or more chronic health problems in one person. As frailty and multimorbidity are being better understood, optimal management of frail, multimorbid elderly patients is being re-evaluated. In this article, the author provides an overview of frailty, chronic disease, and multimorbidity, and describes how their optimal management can serve as a foundation for developing more expedient, organized, and goal-oriented care of elderly people with complex health problems. The author also describes important challenges for future research and development regarding the management of complex health issues in elderly people; these include transitioning from single disease management to multiple disease management, and expanding the conventional organ-based work-up and treatment plan with repeated evaluations of different systems and functional domains using the comprehensive geriatric assessment method. As noted, one particular challenge that must be addressed is the development of medical records that can serve as a much-needed “geroscope,” enabling an overview of the patient’s health situation, disease management, and follow-up care.

  • 15.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Geriatric care and treatment: a systematic compilation of existing scientific literature2003Collection (editor) (Other academic)
  • 16.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Geriatric care in Sweden2014In: Current Diagnosis & Treatment: Geriatrics / [ed] Williams B, Chang A, Ahalt C, Conant R, Richie C, Chen H, Landefeld S, Yukawa M, USA: McGraw-Hill, 2014, p. 539-542Chapter in book (Refereed)
  • 17.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Geriatric medicine in Sweden: a study of the organisation, staffing and care production in 2000-20012004In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 33, no 4, p. 338-341Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: the organisation of long-term medicine and geriatric medicine has undergone many changes during the last 15 years. The aim of this study is to gain an overall perspective of the present organisation of geriatric medicine in Sweden.

    DESIGN: questionnaire survey.

    METHODS: The Swedish Society for Geriatric Medicine and Gerontology, in collaboration with the Federation of County Councils and the Swedish Association of Local Authorities, sent out a survey to people in all county councils in Sweden. The subject of the survey was the speciality of geriatric medicine in the Swedish healthcare system, with regard to healthcare organisation, staffing and care production in 2000/2001.

    RESULTS: there were 52 separate geriatric units, 41 independent 'clinics' and 11 'sections' within other departments. There were a total of 3,101 geriatric inpatient beds. On average, there was one geriatric bed for every 799 individuals within the local population aged 65 years and over, with a 10-fold variation between counties. Four counties had no geriatric provision. The 'geriatric clinics' were mainly located in university towns and averaged 85 beds per clinic, again with a 10-fold variation. There were 604 established positions for doctors within geriatrics, of which 63% were at geriatric clinics. On average, the clinics had 16 positions each (of which 75% were filled with geriatric specialists) with 7 beds per doctor. The corresponding averages for nurses and paramedics could not be summarised due to organisational differences between the county councils. In general, there were very few nurses with specialist training in geriatric medicine.

    CONCLUSIONS: the field of geriatric medicine in Sweden is very heterogeneous regarding terminology, designations, structure, staffing and care production. There is no overall structural plan for the role of geriatric medicine in Swedish healthcare, with the desired close connection between content and dimensioning of geriatric specialist training and the practical organisation of the activities. The county councils designate geriatric medicine so differently that it is hardly possible to compare different geriatric facilities today. Considering how many patients at hospitals today are elderly and suffer from multiple illnesses, it is a major quality issue to ensure that these patients have access to geriatric specialists.

  • 18.
    Akner, Gunnar
    Örebro University.
    International Perspectives in Geriatric Care: Geriatric Care in Sweden2014In: Current Diagnosis & Treatment: Geriatrics / [ed] Brie A. Williams, Anna Chang, Cyrus Ahalt, Helen Chen, Rebecca Conant, C. Seth Landefeld, Christine Richie, Michi Yukawa, McGraw-Hill, 2014, p. 539-542Chapter in book (Refereed)
  • 19.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Karolinska Institutet.
    Kvarboendeprincipen2016In: Svensk Geriatrik, ISSN 2001-2047, no 2, p. 6-6Article in journal (Other academic)
  • 20.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Malnutrition2003In: Geriatric care and treatment: a systematic compilation of existing scientific literature / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, 1, p. 257-264Chapter in book (Other academic)
  • 21.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Methods2003In: Geriatric care and treatment: a systematic compilation of existing scientific literature / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, p. 43-48Chapter in book (Other academic)
  • 22.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Multidomän-analys av multisjuka äldre personer måste baseras på sedvanlig klinisk analys och får inte ersättas av skattningsskalor.2017In: Svensk Geriatrik, ISSN 2001-2047, no 2, p. 6-Article in journal (Other academic)
  • 23.
    Akner, Gunnar
    Örebro University.
    Multimorbidity in elderly: analysis, management and proposal of a geriatric care center2011 (ed. 1)Book (Other (popular science, discussion, etc.))
  • 24.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Multisjuklighet hos äldre: analys, handläggning och förslag om äldrevårdscentral2004 (ed. 1)Book (Other (popular science, discussion, etc.))
  • 25.
    Akner, Gunnar
    Örebro University ; Örebro University Hospital.
    Multisjuklighet hos äldre personer2012In: Äldres hälsa: ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik, Lund: Studentlitteratur AB, 2012, 1, p. 367-382Chapter in book (Other academic)
  • 26.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Multisjuklighet hos äldre personer2012In: Äldres hälsa: ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik, Lund: Studentlitteratur AB, 2012, 1, p. 367-382Chapter in book (Other academic)
  • 27.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Mår de allra äldsta verkligen sämre idag? [Is the health of the elderly really worse nowadays?]: medicinsk kommentar2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 17, p. 1470-1471Article in journal (Other academic)
  • 28.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nationella kvalitetsregister – möjligheter och risker.2017In: Svensk Geriatrik, ISSN 2001-2047, no 1, p. 6-6Article in journal (Other academic)
  • 29.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nutrition hos ”sköra”, äldre personer2017In: Svensk Geriatrik, ISSN 2001-2047, no 3, p. 30-35Article in journal (Other academic)
  • 30.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nödvändigt att förbättra förbättringsarbetet kring läkemedel: Back to basics2017In: Svensk Geriatrik, ISSN 2001-2047, no 3, p. 6-6Article in journal (Other academic)
  • 31.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Orsaker till mat- och nutritionsproblem inom äldrevården samt förslag till utveckling och förbättringsarbete2006In: Nordisk Geriatrik, no 4, p. 36-41Article in journal (Other academic)
  • 32.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Rapport från framtidens geriatrik och äldrevård2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 43-44, p. 1850-1852Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    I denna rapport från framtiden kan vi visa redan nu, hur man i framtiden – utan nämnvärda svårigheter – lyckades utforma ett integrerat, koordinerat och mänskligt vårdsystem, baserat på kunskapsområdet geriatrik och anpassat för äldre personer med multipla, ofta komplexa, hälsoproblem. Det är påtagligt hur smidigt reformeringen kunde ske när man utgick från de enskilda äldre personerna i stället för från organisation, ekonomi och styrning.

  • 33.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Sammanfattning2003In: Evidensbaserad äldrevård: en inventering av det vetenskapliga underlaget / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, 1, p. 9-24Chapter in book (Other academic)
  • 34.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Skattning av risk för undernäringstillstånd.2017In: Svensk Geriatrik, ISSN 2001-2047, no 2, article id 22-23Article in journal (Other academic)
  • 35.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Summary2003In: Geriatric care and treatment: a systematic compilation of existing scientific literature / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, 1, p. 9-22Chapter in book (Other academic)
  • 36.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    SWOT-analys av geriatriken i Sverige2006In: Nordisk Geriatrik, no 2, p. 42-43Article in journal (Other academic)
  • 37.
    Akner, Gunnar
    Örebro University.
    Undernutritionstillstånd vid KOL2014In: KOL: Kroniskt obstruktiv lungsjukdom / [ed] Kjell Larsson, Stockholm: Studentlitteratur AB, 2014, 3, p. 497-508Chapter in book (Other academic)
  • 38.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Undernutritionstillstånd vid KOL2014In: KOL: Kroniskt obstruktiv lungsjukdom / [ed] Kjell Larsson, Stockholm: Studentlitteratur AB, 2014, 3, p. 497-508Chapter in book (Other academic)
  • 39.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Undernäringstillstånd2003In: Evidensbaserad äldrevård: en inventering av det vetenskapliga underlaget / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, 1, p. 257-264Chapter in book (Other academic)
  • 40.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Karolinska Institutet.
    Vad tycker äldre personer om "lämpligt boende" för äldre personer?2016In: Svensk Geriatrik, ISSN 2001-2047, no 1, p. 6-6Article in journal (Other academic)
  • 41.
    Akner, Gunnar
    Örebro University.
    Vilka evidens finns för dagens styrning av äldrevården?2014In: Sjukhusläkaren, ISSN 1651-2715, no 4, p. 34-34Article in journal (Other academic)
  • 42.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Vilka evidens finns och används för dagens styrning av äldrevården?2014In: Sjukhusläkaren, ISSN 1651-2715, no 4, p. 34-34Article in journal (Other (popular science, discussion, etc.))
  • 43.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Vision för framtidens geriatrik2016In: Svensk Geriatrik, ISSN 2001-2047, no 4, article id 9-13Article in journal (Other academic)
  • 44.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Visualization of evaluation and management of the 'nutrition process' in individual elderly, multimorbid patients2010In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 14, no 6, p. 502-502Article in journal (Refereed)
  • 45.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Äldrevård måste grundas på etik [Health services for the aged must be based on ethical foundations]: den enskilde patientens bästa skall alltid stå i fokus : medicinsk kommentar [Focused on the best for the individual patient]2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 41, p. 3068-3069Article in journal (Other (popular science, discussion, etc.))
  • 46.
    Akner, Gunnar
    Örebro University.
    Äldrevården måste bli mer proaktiv och personinriktad2014In: Sjukhusläkaren, ISSN 1651-2715, no 6, p. 17-17Article in journal (Other (popular science, discussion, etc.))
  • 47.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Äldrevården måste bli mer proaktiv och personinriktad2014In: Sjukhusläkaren, ISSN 1651-2715, no 6, p. 17-17Article in journal (Other (popular science, discussion, etc.))
  • 48.
    Akner, Gunnar
    et al.
    Örebro University, School of Health and Medical Sciences.
    Boréus, Lars
    Drug treatment2003In: Geriatric care and treatment: a systematic compilation of existing scientific literature / [ed] Gunnar Akner, Stockholm: Statens beredning för medicinsk utvärdering (SBU) , 2003, 1, p. 233-256Chapter in book (Other academic)
  • 49.
    Akner, Gunnar
    et al.
    Örebro University, School of Health and Medical Sciences.
    Boréus, Lars
    Läkemedelsbehandling2003In: Evidensbaserad äldrevård: en inventering av det vetenskapliga underlaget / [ed] Gunnar Akner, Stockholm: SBU , 2003, 1, p. 233-256Chapter in book (Other academic)
  • 50.
    Akner, Gunnar
    et al.
    Örebro University ; Karolinska Institutet.
    Boström, Anne-Marie
    Karolinska Institutet.
    Krachler, Benno
    Kalix sjukhus.
    Orrevall, Ylva
    Karolinska University Hospital.
    Rundgren, Åke
    University of Gothenburg.
    Sahlin, Nils-Eric
    Lund University.
    Kosttillägg för undernärda äldre: en systematisk litteraturöversikt2014Report (Other academic)
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