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  • 1.
    Eckerblad, Jeanette
    et al.
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Theander, Kersti
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Ekdahl, Anne
    Linkoping Univ, Dept Geriatr Med, Norrkoping, Sweden.;Linkoping Univ, Dept Social & Welf Studies, Norrkoping, Sweden.;Karolinska Inst KI, Div Clin Geriatr, Dept Neurobiol Care Sci & Soc NVS, Solna, Sweden..
    Unosson, Mitra
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Wirehn, Ann-Britt
    Linkoping Univ, Cty Council Ostergotland, Local Hlth Care Res & Dev Unit, Linkoping, Sweden..
    Milberg, Anna
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden.;Linkoping Univ, Dept Social & Welf Studies, Norrkoping, Sweden.;Linkoping Univ, Dept Adv Home Care, Norrkoping, Sweden.;Linkoping Univ, Palliat Educ & Res Ctr, Norrkoping, Sweden..
    Krevers, Barbro
    Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden..
    Jaarsma, Tiny
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Symptom burden in community-dwelling older people with multimorbidity: a cross-sectional study2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, article id 1Article in journal (Refereed)
    Abstract [en]

    Background: Globally, the population is ageing and lives with several chronic diseases for decades. A high symptom burden is associated with a high use of healthcare, admissions to nursing homes, and reduced quality of life. The aims of this study were to describe the multidimensional symptom profile and symptom burden in community-dwelling older people with multimorbidity, and to describe factors related to symptom burden. Methods: A cross-sectional study including 378 community-dwelling people >= 75 years, who had been hospitalized >= 3 times during the previous year, had >= 3 diagnoses in their medical records. The Memorial Symptom Assessment Scale was used to assess the prevalence, frequency, severity, distress and symptom burden of 31 symptoms. A multiple linear regression was performed to identify factors related to total symptom burden. Results: The mean number of symptoms per participant was 8.5 (4.6), and the mean total symptom burden score was 0.62 (0.41). Pain was the symptom with the highest prevalence, frequency, severity and distress. Half of the study group reported the prevalence of lack of energy and a dry mouth. Poor vision, likelihood of depression, and diagnoses of the digestive system were independently related to the total symptom burden score. Conclusion: The older community-dwelling people with multimorbidity in this study suffered from a high symptom burden with a high prevalence of pain. Persons with poor vision, likelihood of depression, and diseases of the digestive system are at risk of a higher total symptom burden and might need age-specific standardized guidelines for appropriate management.

  • 2.
    Hagglund, Patricia
    et al.
    Umea Univ, Fac Med, Dept Odontol, Oral & Maxillofacial Radiol, SE-90187 Umea, Sweden..
    Olai, Lena
    Dalarna Univ, Sch Educ Hlth & Social Sci, Falun, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Family Med & Prevent Med Sect, Uppsala, Sweden..
    Stahlnacke, Katri
    Publ Dent Hlth Serv, Orebro Cty Reg, Orebro, Sweden.;Orebro Univ, Fac Hlth & Med, Orebro, Sweden..
    Wentzel Persenius, Mona
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, Karlstad, Sweden..
    Hagg, Mary
    Cty Council Gavleborg, Hudiksvall Hosp, Speech & Swallowing Ctr, Dept Otorhinolaryngol, Hudiksvall, Sweden.;Uppsala Univ, Ctr Res & Dev, Uppsala, Sweden..
    Andersson, Maria
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Koistinen, Susanne
    Dalarna Univ, Sch Educ Hlth & Social Sci, Falun, Sweden.;Orebro Univ, Fac Hlth & Med, Sch Hlth Sci, Orebro, Sweden..
    Carlsson, Eva
    Rebro Univ, Fac Hlth & Med, Univ Hlth Care Res Ctr, Orebro, Sweden..
    Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial2017In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 78Article in journal (Refereed)
    Abstract [en]

    Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.

  • 3.
    Oien, Henning
    et al.
    Oslo Metropolitan University, Oslo.
    Jakobsson, Niklas
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School (from 2013).
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    The impact of community-based interventions for the older population: a quasi-experimental study of a hip-fracture prevention program in Norway2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, no 1, article id 311Article in journal (Refereed)
    Abstract [en]

    BackgroundHip fractures among older adults are a major public health problem in many countries. Hip fractures are associated with expensive health care treatments, and serious adverse effects on patients' health and quality-of-life. In this paper, we estimate the effect of a community-based hip fracture prevention program that was initiated in 16 Norwegian municipalities in 2007. Specifically, the participating municipalities implemented one or more of the following interventions: exercise programs for older adults, information and education campaigns to communicate how to effectively reduce falls to care workers and older adults, and preventive home safety assessment and modification help services.MethodsWe used a difference-in-difference design, and identified control municipalities by matching on pre-intervention trends in the outcome. The outcome measure was the incidence of hip-fractures among older adults (65years).ResultsWe found no statistically significant effects of the implemented program on the incidence of hip fractures, on average, in older subgroups (80years) or in municipality-specific analyses.ConclusionsIt is unclear whether the interventions managed to achieve a change in hip fracture rates at the population level.

  • 4.
    Sipila, Sarianna
    et al.
    University Jyvaskyla, Finland.
    Tirkkonen, Anna
    University Jyvaskyla, Finland.
    Hanninen, Tuomo
    Kuopio Univ Hospital, Finland.
    Laukkanen, Pia
    University Jyvaskyla, Finland.
    Alen, Markku
    Oulu Univ Hospital, Finland.
    Fielding, Roger A.
    Tufts University, Boston USA .
    Kivipelto, Miia
    Natl Inst Hlth & Welf, Dept Publ Hlth Solut, Chron Dis Prevent Unit, Helsinki, Finland.
    Kokko, Katja
    University Jyvaskyla, Finland.
    Kulmala, Jenni
    Natl Inst Hlth & Welf, Dept Publ Hlth Solut, Chron Dis Prevent Unit, Helsinki, Finland.
    Rantanen, Taina
    University Jyvaskyla, Finland.
    Sihvonen, Antti
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School (from 2013).
    Sillanpaa, Elina
    Umeå Universitet.
    Stigsdotter Neely, Anna
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Tormakangas, Timo
    University Jyvaskyla, Finland.
    Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, article id 215Article in journal (Refereed)
    Abstract [en]

    Background: Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70-85-year-old community-dwelling sedentary or at most moderately physically active men and women. Methods: Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyvaskyla will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics. Discussion: The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact.

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