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Gustafson, Yngve
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Publications (10 of 160) Show all publications
Berggren, M., Karlsson, Å., Lindelöf, N., Englund, U., Olofsson, B., Nordstöm, P., . . . Stenvall, M. (2019). Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial. Clinical Rehabilitation, 33(1), 64-73
Open this publication in new window or tab >>Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial
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2019 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 1, p. 64-73Article in journal (Refereed) Published
Abstract [en]

Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

Design: Randomized controlled trial.

Setting: Geriatric department, participants' residential care facilities, and ordinary housing.

Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included.

Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively.

Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Falls, home rehabilitation, randomized controlled trial, hip fracture
National Category
Geriatrics Physiotherapy
Identifiers
urn:nbn:se:umu:diva-142127 (URN)10.1177/0269215518791003 (DOI)000454521300008 ()30064264 (PubMedID)2-s2.0-85052213545 (Scopus ID)
Note

Originally included in thesis in manuscript form with title: "Geriatric interdisciplinary home rehabilitation - effects on complications and readmissions after hip fracture: a randomized controlled trial"

Available from: 2017-11-22 Created: 2017-11-22 Last updated: 2019-01-14Bibliographically approved
Olofsson, H., Ulander, E. L., Gustafson, Y. & Hörnsten, C. (2018). Association between socioeconomic and health factors and edentulism in people aged 65 and older: a population-based survey. Scandinavian Journal of Public Health, 46(7), 690-698
Open this publication in new window or tab >>Association between socioeconomic and health factors and edentulism in people aged 65 and older: a population-based survey
2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 7, p. 690-698Article in journal (Refereed) Published
Abstract [en]

Aims: To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland.

Methods: In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study (n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism.

Results: The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden (p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas (p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds (p < 0.001), and was 23.8% in women, compared with 27% in men (p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31-3.58), low income level (OR 1.7, CI 1.09-1.47), residence in a rural area (OR 1.43, CI 1.23-1.66), male sex (OR 1.30, CI 1.12-1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25-1.74), social isolation (OR 1.52, CI 1.17-1.98) and poor self-experienced health (OR 1.38, CI 1.17-1.62).

Conclusions: One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Epidemiology, dental health survey, dental care for older people, edentulous mouth, educational level
National Category
Public Health, Global Health, Social Medicine and Epidemiology Dentistry
Identifiers
urn:nbn:se:umu:diva-154856 (URN)10.1177/1403494817717406 (DOI)000452488900003 ()28768459 (PubMedID)2-s2.0-85042129153 (Scopus ID)
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2019-01-09Bibliographically approved
Olofsson, B., Persson, M., Bellelli, G., Morandi, A., Gustafson, Y. & Stenvall, M. (2018). Development of dementia in patients with femoral neck fracture who experience postoperative delirium: A three-year follow-up study. International Journal of Geriatric Psychiatry, 33(4), 623-632
Open this publication in new window or tab >>Development of dementia in patients with femoral neck fracture who experience postoperative delirium: A three-year follow-up study
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2018 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 33, no 4, p. 623-632Article in journal (Refereed) Published
Abstract [en]

Objectives It remains unclear to what extent postoperative delirium (POD) affects the incidence of dementia in hip fracture patients, and the methods used to detect delirium and dementia require validation. The aim of this study was to investigate the development of dementia within 3 years of femoral neck fracture repair surgery, with a focus on POD as a potential predictive factor.

Methods Patients were assessed for cognition, delirium, depression, psychological well-being, and nutritional status during their hospitalization as well as 4, 12, and 36 months after the operation. Logistic regression models were used to analyse factors associated with POD and factors associated with the development of dementia.

Results The study sample consisted of 135 patients without a history of dementia, of whom 20 (14.8%) were delirious preoperatively and 75 (55.5%) postoperatively. Three years after their operations, 43/135 patients (31.8%) were diagnosed with dementia. A greater portion of patients diagnosed with dementia (39/43, 90.6%) than patients with no dementia (36/92, 39.1%) were included among the 75 patients who had experienced POD (P<0.001). In a logistic regression model, after adjustment for covariates (age, sex, diabetes, delirium pre- and postoperatively, hyperactive delirium, days with delirium, urinary tract infection, and Mini Nutritional Assessment score), POD emerged an independent predictor for the development of new dementia (odds ratio, 15.6; 95% confidence interval, 2.6-91.6) within 3 years after the operation.

Conclusion Geriatric hip fracture patients who exhibit POD should be monitored closely for the development of dementia.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
cognitive impairment, femoral neck fracture, geriatrics, logistic regression, mortality
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:umu:diva-146141 (URN)10.1002/gps.4832 (DOI)000426505700008 ()29292537 (PubMedID)
Available from: 2018-05-15 Created: 2018-05-15 Last updated: 2019-01-08Bibliographically approved
Smulter, N., Lingehall, H. C., Gustafson, Y., Olofsson, B., Engström, K. G., Appelblad, M. & Svenmarker, S. (2018). Disturbances in Oxygen Balance During Cardiopulmonary Bypass: A Risk Factor for Postoperative Delirium. Journal of Cardiothoracic and Vascular Anesthesia, 32(2), 684-690
Open this publication in new window or tab >>Disturbances in Oxygen Balance During Cardiopulmonary Bypass: A Risk Factor for Postoperative Delirium
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2018 (English)In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 32, no 2, p. 684-690Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to determine risk factors for postoperative delirium after cardiac surgery, specifically associated with the conduct of cardiopulmonary bypass (CPB).

Design: Prospective observational study.

Setting: Heart Centre, University Hospital.

Participants: The study included 142 patients aged 70 years and older scheduled for elective cardiac surgery with CPB.

Interventions: Risk factor analysis comprised information collected from the hospital clinical and CPB dedicated databases in addition to the medical chart. Delirium was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criterion using the Mini Mental State Examination and the Organic Brain Syndrome scale.

Measurements and Main Results: Assessments of delirium diagnosis were executed preoperatively and on the following first and fourth postoperative days. Delirium occurred in 55% (78/142) of the patients. Patients with delirium were identified with significantly higher body weight and body surface area preoperatively, accompanied with longer CPB time, higher positive fluid balance per CPB, and lower systemic pump flow related to body surface area. Furthermore, the duration of the mixed venous oxygen saturation (SvO2) below 75% was significantly longer during CPB. The result from the multivariable logistic regression analysis included the duration of SvO2 below 75%, fluid balance per CPB and patient age as independent risk factors for postoperative delirium.

Conclusions: The influence of the SvO2 level during CPB, fluid balance, and patient age should be recognized as risk factors for postoperative delirium after cardiac surgery in patients 70 years and older.

Place, publisher, year, edition, pages
Saunders Elsevier, 2018
Keywords
cardiac surgery, cardiopulmonary bypass, mixed venous oxygen saturation, postoperative delirium, risk factors
National Category
Nursing Cardiac and Cardiovascular Systems Respiratory Medicine and Allergy Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-144659 (URN)10.1053/j.jvca.2017.08.035 (DOI)000429083200014 ()29153931 (PubMedID)
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2018-09-03Bibliographically approved
Sondell, A., Rosendahl, E., Gustafson, Y., Lindelöf, N. & Littbrand, H. (2018). The Applicability of a High-Intensity Functional Exercise Program among Older People with Dementia living in Nursing Homes. Journal of Geriatric Physical Therapy
Open this publication in new window or tab >>The Applicability of a High-Intensity Functional Exercise Program among Older People with Dementia living in Nursing Homes
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2018 (English)In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and Purpose: Exercise programs for people with dementia need to be optimized. We therefore evaluated the applicability of a high-intensity functional exercise program among people with dementia in nursing homes with regard to attendance, achieved exercise intensity, adverse events, a focus on dementia type, and whether symptoms of dementia or other medical conditions common in this population were associated with program applicability.

Methods: The Umeå Dementia and Exercise study, a cluster-randomized controlled trial set in 16 nursing homes in Umeå, Sweden. Ninety-three people with dementia (mean [SD] Mini-Mental State Examination score of 15.4 [3.4]) were randomized to the exercise intervention. Thirty-four participants had Alzheimer's disease (AD) and 59 non-Alzheimer's dementia (non-AD). High-Intensity Functional Exercise (HIFE) program was conducted in groups of 3 to 8 participants. Two physiotherapists led 5 sessions (45 minutes each) per fortnight for 4 months (total 40 sessions).

Results: Median attendance rate was 82.5%. Lower limb strength exercises were performed at high or medium intensity at a median interquartile range of 94.7% (77.8%-100%) of attended sessions. Participants with non-AD performed more sessions with high intensity in strength exercises than participants with AD (median interquartile range, 53.8% [25.7%-80%] vs 34.9% [2.02%-62.9%]; P = .035). Balance exercises were performed at high intensity at a median interquartile range of 75% (33.3%-88.6%). Adverse events (all minor and temporary, mostly musculoskeletal) occurred during the exercise sessions in 16% of attended sessions. Low motivation was the most common barrier for attendance. Buildup period, low motivation, and pain were common barriers for achieving high intensity in balance and strength exercises, and fear was a barrier in balance exercises. Of medical conditions, only behavioral and psychological symptoms of dementia, including apathy, were negatively associated with applicability.

Conclusion: A group-based, supervised, and individualized high-intensity functional exercise program seems to be applicable with regard to attendance, achieved intensity, and adverse events during the exercise sessions, in people with mild to moderate dementia in nursing homes. Effective strategies to enhance motivation to participate in exercise, as well as prevention and treatment of pain and behavioral and psychological symptoms of dementia, are important when promoting exercise participation in this population.

Place, publisher, year, edition, pages
Wolters Kluwer, 2018
Keywords
dementia, exercise, long-term care, mobility limitation, rehabilitation
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-153347 (URN)10.1519/JPT.0000000000000199 (DOI)29851748 (PubMedID)
Available from: 2018-11-16 Created: 2018-11-16 Last updated: 2019-02-13
Nordström, P., Toots, A., Gustafson, Y., Thorngren, K.-G., Hommel, A. & Nordström, A. (2017). Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study. Journal of the American Medical Directors Association, 18(6), 515-521
Open this publication in new window or tab >>Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study
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2017 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 18, no 6, p. 515-521Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age.

DESIGN, SETTING, AND PARTICIPANTS: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals.

MAIN OUTCOME MEASURE: A new hip fracture.

RESULTS: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95% CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95% CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95% CI, 0.86-1.05).

CONCLUSION: Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.

Keywords
Hip fractures, bisphosphonates, cohort study, older individuals
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-134010 (URN)10.1016/j.jamda.2016.12.083 (DOI)000402431200009 ()28238673 (PubMedID)
Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2018-06-09Bibliographically approved
Johansson, H., Lundin-Olsson, L., Littbrand, H., Gustafson, Y., Rosendahl, E. & Toots, A. (2017). Cognitive function and walking velocity in people with dementia: a comparison of backward and forward walking. Gait & Posture, 58, 481-486
Open this publication in new window or tab >>Cognitive function and walking velocity in people with dementia: a comparison of backward and forward walking
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2017 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 58, p. 481-486Article in journal (Refereed) Published
Abstract [en]

How forward and backward walking, both central to everyday life, relate to cognition are relatively unexplored in people with dementia. This study aimed to investigate if forward and backward walking velocity respectively, associated with global cognition and executive function in people with dementia, and whether the association differed according to walking aid use or dementia type. Using a cross-sectional design, 161 participants (77% women), a mean Mini-Mental State Examination (MMSE) score of 15, and mean age of 85.5 years and living in nursing homes were included. Self-paced forward walking (FW) and backward walking (BW) velocity over 2.4 m was measured. Global cognitive outcome measurements included MMSE and Alzheimer Disease Assessment Scale - Cognitive subscale (ADAS-Cog). Executive function was measured using Verbal Fluency (VF). In comprehensively adjusted multivariate linear regression analyses, FW was independently associated with VF (p = 0.001), but not MMSE (p = 0.126) or ADAS-Cog (p = 0.818). BW was independently associated with VF (p = 0.043) and MMSE (p = 0.022), but not ADAS-Cog (p = 0.519). Interaction analyses showed that the association between BW velocity and executive function were stronger in participants who walked without a walking aid. No associations differed according to dementia type. In conclusion, executive function appears important to walking velocity, both forward and backward, in people with dementia with mild to moderately severe cognitive impairment. Global cognitive function was associated with backward walking only, perhaps due to it being more challenging. The association between BW velocity and executive function differed according to use of walking aids, which appeared to attenuate the association.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Cognition, Walking aids, Frail elderly, Dementia, Walking speed, Nursing homes
National Category
Neurology Orthopaedics Sport and Fitness Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-142473 (URN)10.1016/j.gaitpost.2017.09.009 (DOI)000415234200080 ()28926815 (PubMedID)
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2018-06-09Bibliographically approved
Toots, A., Littbrand, H., Boström, G., Hörnsten, C., Holmberg, H., Lundin-Olsson, L., . . . Rosendahl, E. (2017). Effects of exercise on cognitive function in older people with dementia: a randomized controlled trial. Journal of alzheimers disease, 60(1), 323-332
Open this publication in new window or tab >>Effects of exercise on cognitive function in older people with dementia: a randomized controlled trial
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2017 (English)In: Journal of alzheimers disease, ISSN 1387-2877, Vol. 60, no 1, p. 323-332Article in journal (Refereed) Published
Abstract [en]

Background: Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia. Objectives: To investigate effects of exercise on cognitive function in people with dementia. Method: The Umea a Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umea, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean MiniMental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity. Blinded assessors measured global cognitive function using the MMSE and the Alzheimer's disease Assessment Scale -Cognitive subscale (ADAS-Cog), and executive function using Verbal fluency (VF) at baseline and 4 months (directly after intervention completion), and MMSE and VF at 7 months. Results: Linear mixed models showed no between-group effects in mean difference from baseline (95% confidence intervals, CI) at 4 months in MMSE (-0.27; 95% CI -1.4 to 0.87, p = 0.644), ADAS-Cog (-1.04, 95% CI -4 to 1.92, p = 0.491), or VF (-0.53, 95% CI -1.42 to 0.35, p = 0.241) or at 7 months in MMSE (-1.15, 95% CI -2.32 to 0.03, p = 0.056) or VF (-0.18, 95% CI -1.09 to 0.74, p = 0.707). Conclusion: A 4-month, high-intensity functional exercise program had no superior effects on global cognition or executive function in people with dementia living in nursing homes when compared with an attention control activity.

Place, publisher, year, edition, pages
IOS Press, 2017
Keywords
Cognition, dementia, exercise, residential facilities
National Category
Physiotherapy Geriatrics
Identifiers
urn:nbn:se:umu:diva-128727 (URN)10.3233/JAD-170014 (DOI)000408582800026 ()28800328 (PubMedID)
Note

Originally published in manuscript form with title [Effects of exercise on cognitive function in older people with dementia: a randomized controlled study]

Available from: 2016-12-13 Created: 2016-12-13 Last updated: 2018-06-09Bibliographically approved
Unneby, A., Svensson, O., Gustafson, Y. & Olofsson, B. (2017). Femoral nerve block in a representative sample of elderly people with hip fracture: a randomised controlled trial. Injury, 48(7), 1542-1549
Open this publication in new window or tab >>Femoral nerve block in a representative sample of elderly people with hip fracture: a randomised controlled trial
2017 (English)In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, no 7, p. 1542-1549Article in journal (Refereed) Published
Abstract [en]

Introduction: The number of elderly people with hip fracture and dementia is increasing, and many of these patients suffer from pain. Opioids are difficult to adjust and side effects are common, especially with increased age and among patients with dementia. Preoperative femoral nerve block is an alternative pain treatment. Aim: To investigate whether preoperative femoral nerve block reduced acute pain and opioid use after hip fracture among elderly patients, including those with dementia. Patients and methods: In this randomised controlled trial involving patients aged >= 70 years with hip fracture (trochanteric and cervical), including those with dementia, we compared femoral nerve block with conventional pain management, with opioid use if required. The primary outcome was preoperative pain, measured at five timepoints using a visual analogue scale (VAS). Preoperative opioid consumption was also registered. Results: The study sample comprised 266 patients admitted consecutively to the Orthopaedic Ward. The mean age was 84.1 (+/- 6.9) years, 64% of participants were women, 44% lived in residential care facilities, and 120 (45.1%) had dementia diagnoses. Patients receiving femoral nerve block had significantly lower self-rated pain scores from baseline to 12 h after admission than did controls. Self-rated and proxy VAS pain scores decreased significantly in these patients from baseline to 12 h compared with controls (p < 0.001 and p = 0.003, respectively). Patients receiving femoral nerve block required less opioids than did controls, overall (2.3 +/- 4.0 vs. 5.7 +/- 5.2 mg, p < 0.001) and in the subgroup with dementia (2.1 +/- 3.3 vs. 5.8 +/- 5.0 mg, p < 0.001). Conclusion: Patients with hip fracture, including those with dementia, who received femoral nerve block had lower pain scores and required less opioids before surgery compared with those receiving conventional pain management. Femoral nerve block seems to be a feasible pain treatment for elderly people, including those with dementia. 

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2017
Keywords
Hip fracture, Femoral neck fracture, Femoral nerve block, Pain, Opioid, Preoperative period, Frail derly, Dementia
National Category
Orthopaedics Nursing
Identifiers
urn:nbn:se:umu:diva-138233 (URN)10.1016/j.injury.2017.04.043 (DOI)000405997100041 ()28501287 (PubMedID)
Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2018-06-09Bibliographically approved
Näsman, M., Niklasson, J., Saarela, J., Nygård, M., Olofsson, B., Conradsson, M., . . . Nyqvist, F. (2017). Five-year change in morale is associated with negative life events in very old age. Aging & Mental Health, 1-8
Open this publication in new window or tab >>Five-year change in morale is associated with negative life events in very old age
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2017 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, p. 1-8Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: The objectives were to study changes in morale in individuals 85 years and older, and to assess the effect of negative life events on morale over a five-year follow-up period.

METHOD: The present study is based on longitudinal data from the Umeå85+/GERDA-study, including individuals 85 years and older at baseline (n = 204). Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). Negative life events were assessed using an index including 13 negative life events occurring during the follow-up period. Linear regression was used for the multivariate analyses.

RESULTS: The majority of the sample (69.1%) had no significant changes in morale during the five-year follow-up. However, the accumulation of negative life events was significantly associated with a greater decrease in PGCMS. A higher baseline PGCMS score did not attenuate the adverse effect negative life events had on morale.

CONCLUSION: Morale seemed to be mainly stable in a five-year follow-up of very old people. It seems, nonetheless, that individuals are affected by negative life events, regardless of level of morale. Preventing negative life events and supporting individuals who experience multiple negative life events could have important implications for the care of very old people.

Keywords
Longitudinal studies, life events, mental health, morale
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-142034 (URN)10.1080/13607863.2017.1393795 (DOI)29077486 (PubMedID)
Available from: 2017-11-17 Created: 2017-11-17 Last updated: 2019-02-22
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