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Gustafson, Yngve
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Publications (10 of 166) Show all publications
Brännström, J., Lövheim, H., Gustafson, Y. & Nordström, P. (2019). Association Between Antidepressant Drug Use and Hip Fracture in Older People Before and After Treatment Initiation. JAMA psychiatry, 76(2), 172-179
Open this publication in new window or tab >>Association Between Antidepressant Drug Use and Hip Fracture in Older People Before and After Treatment Initiation
2019 (English)In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 76, no 2, p. 172-179Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Treatment with antidepressants has been associated with hip fracture. This association could restrict the treatment options, especially in older patients. OBJECTIVE: To investigate the association between antidepressant drug treatment and hip fracture starting 1 year before the initiation of treatment. DESIGN, SETTING, AND PARTICIPANTS: In this nationwide cohort study, 204 072 individuals in the Prescribed Drugs Register of Sweden's National Board of Health and Welfare aged 65 years or older who had a prescription of antidepressants filled between July 1, 2006, and December 31, 2011, were matched by birth year and sex to 1 control participant who was not prescribed antidepressants (for a total of 408 144 people in the register). Outcome data were collected from 1 year before to 1 year after the index date (date of prescription being filled). Data analysis was performed from July 1, 2005, to December 31, 2012. EXPOSURES: First filled prescription of an antidepressant drug. MAIN OUTCOMES AND MEASURES: Incident hip fractures occurring in the year before and year after initiation of antidepressant therapy were registered. Associations were investigated using multivariable conditional logistic regression models and flexible parametric models. RESULTS: Of the 408 144 people in the register who were included in the study, 257 486 (63.1%) were women, with a mean (SD) age of 80.1 (7.2) years. Antidepressant users sustained more than twice as many hip fractures than did nonusers in the year before and year after the initiation of therapy (2.8% vs 1.1% and 3.5% vs 1.3%, respectively, per actual incidence figures). In adjusted analyses, the odds ratios were highest for the associations between antidepressant use and hip fracture 16 to 30 days before the prescription was filled (odds ratio, 5.76; 95% CI, 4.73-7.01). In all separate analyses of age groups, of men and women, and of individual antidepressants, the highest odds ratios were seen 16 to 30 days before initiation of treatment, and no clear dose-response relationship was seen. CONCLUSIONS AND RELEVANCE: The present study found an association between antidepressant drug use and hip fracture before and after the initiation of therapy. This finding raises questions about the association that should be further investigated in treatment studies.

Place, publisher, year, edition, pages
American medical association, 2019
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-162516 (URN)10.1001/jamapsychiatry.2018.3679 (DOI)000457835000011 ()30601883 (PubMedID)
Available from: 2019-08-21 Created: 2019-08-21 Last updated: 2019-08-21Bibliographically approved
Strinnholm, S., Gustafson, Y. & Niklasson, J. (2019). Depressive Disorders and Religious Engagement in Very Old People. Gerontology and geriatric medicine, 5
Open this publication in new window or tab >>Depressive Disorders and Religious Engagement in Very Old People
2019 (English)In: Gerontology and geriatric medicine, E-ISSN 2333-7214, Vol. 5Article in journal (Refereed) Published
Abstract [en]

Objective: To examine associations between religious engagement and depressive disorders in very old people.

Method: This cross-sectional study uses data from the Umea 85+/Gerontological Regional Database (GERDA) study. Every other 85-year-old, every 90-year-old, and everyone more than 95 years from eight municipalities in northern Sweden and Finland were invited: 1,014 persons accepted participation. Data were gathered using questionnaires and assessment scales during structured home visits.

Results: The prevalence of depressive disorders was 35.8%. In a logistic regression model, several factors were adjusted for, such as demographic variables including social factors, diseases, and cognitive and physical functional level. A high level of self-reported religious engagement was independently associated with not having depressive disorders (odds ratio [OR] = 0.58, confidence interval [CI] = [0.38, 0.89]). After stratifying by gender, religious engagement was only significant for women (OR = 0.49, CI = [0.29, 0.82]).

Discussion: There is an association between a high level of religious engagement and being free from diagnosis of depressive disorders among very old women.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
depression, aged, 80 and above, religion, salutogenesis
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-161864 (URN)10.1177/2333721419846576 (DOI)000475378500001 ()31192277 (PubMedID)
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-09-05Bibliographically approved
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
Näsman, M., Niklasson, J., Saarela, J., Nygård, M., Olofsson, B., Conradsson, M., . . . Nyqvist, F. (2019). Five-year change in morale is associated with negative life events in very old age. Aging & Mental Health, 84-91
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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2019 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, p. 84-91Article in journal (Refereed) Published
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.

Place, publisher, year, edition, pages
Routledge, 2019
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)000461682000012 ()29077486 (PubMedID)
Funder
Västerbotten County CouncilNorrbotten County CouncilForte, Swedish Research Council for Health, Working Life and Welfare, 2013-1512Swedish Research Council
Available from: 2017-11-17 Created: 2017-11-17 Last updated: 2019-05-17Bibliographically approved
Näsman, M., Niklasson, J., Nygård, M., Olofsson, B., Lövheim, H., Gustafson, Y. & Nyqvist, F. (2019). Risk factors for a decrease in high morale in very old peopleover a 5‑year period: data from two Nordic countries. European Journal of Ageing
Open this publication in new window or tab >>Risk factors for a decrease in high morale in very old peopleover a 5‑year period: data from two Nordic countries
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2019 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed) Epub ahead of print
Abstract [en]

High morale could be considered to be an essential part of aging well and increased knowledge of how to prevent a decreasein high morale in very old age could have important implications for policy, and social and health care development. Theobjective was to identify social and health-related risk factors for a decrease in morale over 5 years in very old peopleamong those with high morale at baseline. The study is based on data derived from the Umeå85+/GERDA study conductedin Northern Sweden and Western Finland. The final sample consisted of 174 individuals who were 85 years and older atbaseline and who had completed the follow-up 5 years later. Morale was measured with The Philadelphia Geriatric CenterMorale Scale (PGCMS). A set of social and health-related variables were used to test which factors were associated with adecrease in morale over 5 years. Linear regression was used for the multivariable analyses. The sample had a mean changeof − 1.3 (SD = 2.5) in PGCMS scores from T1 to T2. The results from the regression analyses showed that development ofdepressive disorders, increased feelings of loneliness and the death of a child during the follow-up period were associatedwith a decrease in morale. The results from our study indicate that preventing the development of depressive disorders andincreasing loneliness are key factors in preventing a decrease in high morale. Additionally, very old people who have recentlylost an adult child should receive adequate psychosocial support

Keywords
Longitudinal studies · Aged 80 and over · Subjective well-being · Quality of life
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-163940 (URN)10.1007/s10433-019-00521-1 (DOI)2-s2.0-85068004240 (Scopus ID)
Available from: 2019-10-09 Created: 2019-10-09 Last updated: 2019-10-10
Sondell, A., Rosendahl, E., Gustafson, Y., Lindelöf, N. & Littbrand, H. (2019). The Applicability of a High-Intensity Functional Exercise Program among Older People with Dementia living in Nursing Homes. Journal of Geriatric Physical Therapy, 42(4), E16-E24
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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2019 (English)In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, no 4, p. E16-E24Article in journal (Refereed) Published
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, 2019
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)000497704600003 ()29851748 (PubMedID)
Funder
Swedish Research Council, K2009-69P-21298-01-4Swedish Research Council, K2009-69X-21299-01-1Swedish Research Council, K2009-69P-21298-04-4Swedish Research Council, K2014-99X-22610-01-6Forte, Swedish Research Council for Health, Working Life and WelfareVårdal FoundationVästerbotten County Council
Available from: 2018-11-16 Created: 2018-11-16 Last updated: 2019-12-13Bibliographically approved
Toots, A., Wiklund, R., Littbrand, H., Nordin, E., Nordström, P., Lundin-Olsson, L., . . . Rosendahl, E. (2019). The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial. Journal of the American Medical Directors Association, 20(7), 835-842
Open this publication in new window or tab >>The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial
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2019 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 7, p. 835-842Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate exercise effects on falls in people with dementia living in nursing homes, and whether effects were dependent on sex, dementia type, or improvement in balance. A further aim was to describe the occurrence of fall-related injuries.

DESIGN: A cluster-randomized controlled trial.

SETTING AND PARTICIPANTS: The Umeå Dementia and Exercise study was set in 16 nursing homes in Umeå, Sweden and included 141 women and 45 men, a mean age of 85 years, and with a mean Mini-Mental State Examination score of 15.

INTERVENTION: Participants were randomized to the high-intensity functional exercise program or a seated attention control activity; each conducted 2-3 times per week for 4 months.

MEASURES: Falls and fall-related injuries were followed for 12 months (after intervention completion) by blinded review of medical records. Injuries were classified according to severity.

RESULTS: During follow-up, 118(67%) of the participants fell 473 times in total. At the interim 6-month follow-up, the incidence rate was 2.7 and 2.8 falls per person-year in exercise and control group, respectively, and at 12-month follow-up 3.0 and 3.2 falls per person-year, respectively. Negative binomial regression analyses indicated no difference in fall rate between groups at 6 or 12 months (incidence rate ratio 0.9, 95% confidence interval (CI) 0.5-1.7, P = .838 and incidence rate ratio 0.9, 95% CI 0.5-1.6, P = .782, respectively). No differences in exercise effects were found according to sex, dementia type, or improvement in balance. Participants in the exercise group were less likely to sustain moderate/serious fall-related injuries at 12-month follow-up (odds ratio 0.31, 95% CI 0.10-0.94, P = .039).

CONCLUSIONS/IMPLICATIONS: In older people with dementia living in nursing homes, a high-intensity functional exercise program alone did not prevent falls when compared with an attention control group. In high-risk populations, in which multimorbidity and polypharmacy are common, a multifactorial fall-prevention approach may be required. Encouraging effects on fall-related injuries were observed, which merits future investigations.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Alzheimer disease, Falls, dementia, exercise, fractures, residential facilitie
National Category
Physiotherapy Geriatrics
Identifiers
urn:nbn:se:umu:diva-159680 (URN)10.1016/j.jamda.2018.10.009 (DOI)000472596100008 ()30503589 (PubMedID)
Funder
Swedish Research Council, K2009-69P-21298-01-4Swedish Research Council, K2009-69X-21299-01-1Swedish Research Council, K2009-69P-21298-04-4Swedish Research Council, K2014-99X-22610-01-6Forte, Swedish Research Council for Health, Working Life and WelfareVårdal FoundationThe Dementia Association - The National Association for the Rights of the DementedVästerbotten County Council
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-08-06Bibliographically approved
Smulter, N., Claesson Lingehall, H., Gustafson, Y., Olofsson, B. & Engström, K. G. (2019). The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery: a retrospective observational study. Journal of Clinical Nursing, 28(11-12), 2309-2318
Open this publication in new window or tab >>The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery: a retrospective observational study
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2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 11-12, p. 2309-2318Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: This study analyzed postoperative delirium (POD) in clinical practice after cardiac surgery, how it is detected and documented and if the use of a screening scale improves the detection rate.

BACKGROUND: Cardiac surgery is considered a routine procedure with few complications. However, POD remains a concern, although often being overlooked in clinical practice.

DESIGN: Retrospective observational analysis.

METHODS: Patients 70 years and older with POD (n=78) undergoing cardiac surgery were included in the study. Discharge summaries of both nurses and physicians were reviewed together with the clinical database for information about POD, to be compared with symptom screening using the Nursing Delirium Screening Scale (Nu-DESC). A quantitative content analysis was used for the review of discharge summaries, with a coding scheme adopted from the Nu-DESC method. The STROBE checklist was followed.

RESULTS: In discharge summaries 41 of the 78 POD patients were correctly recognized, and 22 of these were identified in the clinical database. Screening by the Nu-DESC identified delirium at a measurably higher rate, 56/78 patients. The review of discharge summaries showed that patients expressing 'inappropriate behaviour' was the most easily identified sign for POD for both nurses and physicians.

CONCLUSIONS: Healthcare professionals underdiagnose delirium after cardiac surgery, with a low detection rate described in both discharge summaries and in the clinical database. Recognition of delirium improved when Nu-DESC was used for systematic screening.

RELEVANCE TO CLINICAL PRACTICE: This study emphasizes the need for better screening for the detection of delirium in daily clinical practice. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Assessments scales, Cardiac surgery, Clinical database, Documentation, Postoperative delirium
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-157010 (URN)10.1111/jocn.14838 (DOI)000467448000026 ()30791158 (PubMedID)2-s2.0-85062685218 (Scopus ID)
Note

Originally included in thesis in manuscript form

Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-08-06Bibliographically 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
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