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Morale in the oldest old: the Umeå 85+ study
Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
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2005 (English)In: Age and Ageing, ISSN 0002-0729, Vol. 34, no 3, 249-255 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: to describe morale among the oldest old, and to investigate which social, functional and medical factors are associated with morale in this population. DESIGN: a cross-sectional study. SETTING: a population-based study in the municipality of Umeå, a city in Northern Sweden. SUBJECTS: half of the 85-year-old population, and the total population of 90-year-olds and > or = 95-year-olds (95-103) were asked to participate (n = 319) and 238 were interviewed. METHODS: structured interviews and assessments during home visits, interviews with relatives and caregivers and review of medical charts. The 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) was used to measure morale. Participants were assessed with the Barthel Activities of Daily Living (ADL) Index, Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), and a symptom questionnaire. Multiple regression analyses were conducted to find independent factors to explain the variation in the PGCMS score. RESULTS: eighty-four per cent (n = 199) of those interviewed answered the PGCMS. Three-quarters had middle range or high morale. GDS score, type of housing, previous stroke, loneliness and number of symptoms, adjusted for age group and sex, explained 49.3% of the variance of total PGCMS score. CONCLUSIONS: a large proportion of the oldest old had high morale. The most important factors for high morale were the absence of depressive symptoms, living in ordinary housing, having previously had a stroke and yet still living in ordinary housing, not feeling lonely and low number of symptoms. The PGCMS seems applicable in the evaluation of morale among the oldest old.

Place, publisher, year, edition, pages
2005. Vol. 34, no 3, 249-255 p.
Keyword [en]
Activities of Daily Living/psychology, Aged, Aged; 80 and over, Depression/epidemiology/psychology, Geriatric Assessment, Health Status, Humans, Interviews as Topic, Morale, Psychological Tests, Sweden/epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-6578DOI: doi:10.1093/ageing/afi044PubMedID: 15784647OAI: oai:DiVA.org:umu-6578DiVA: diva2:146247
Available from: 2008-01-15 Created: 2008-01-15 Last updated: 2016-02-01Bibliographically approved
In thesis
1. Health, physical ability, falls and morale in very old people: the Umeå 85+ Study
Open this publication in new window or tab >>Health, physical ability, falls and morale in very old people: the Umeå 85+ Study
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The very old, aged 80 years and over, is the fastest growing age group today, and the demands for healthcare and services will be even higher in the future. It is, therefore, of great importance to advance our knowledge about this group. The main purpose of this thesis was to describe living conditions and health, with a special focus on physical ability, falls and morale, in women and men in three different age groups of very old people in northern Sweden.

Half the population aged 85, and the total population aged 90 and ≥95 (-103) in the municipality of Umeå were selected for participation (n=348) in this population-based cross-sectional study, entitled the Umeå 85+ Study. Structured interviews and assessments were performed with the participants in their homes, and data were also collected from next-of-kins, caregivers and medical charts. Cognition was screened for using the Mini-Mental State Examination (MMSE), depressive symptoms using the Geriatric Depression Scale-15 (GDS-15), and nutritional status using the Mini Nutritional Assessment (MNA). Activities of Daily Living (ADL) were assessed using the Staircase of ADL (including the Katz Index of ADL) and morale using the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants also rated their own health and answered a questionnaire about symptoms. Physical ability was assessed using a gait speed test over 2.4 meters (8 feet), three consecutive chair stands, and the Berg Balance Scale (BBS). A follow-up study for falls was performed during a period of six months with fall calendars and telephone calls.

The very old people in this northern population have more depression, hypertension and hip fractures, as well as a higher consumption of drugs than comparable, more southern populations. In general, younger participants had lower rates of diagnoses and prescribed drugs, were less dependent in ADL and other functional variables than older participants, and men had lower rates of diagnoses and reported symptoms than women. However, there were no age or sex differences in self-rated health or morale, which were both rated as good by the majority of the participants.

There was a wide range of physical ability among these very old people, especially in women, where an age-related decline was seen. The results also demonstrate that men had greater physical ability than women. The BBS had no floor or ceiling effects in the present sample. In contrast, a large proportion was unable to perform the gait speed and chair stands test, resulting in a floor effect for the timed performances, especially in women.

Falling is a major public health problem in very old people. From the results of the present study, it could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture over a period of one year. The independent explanatory risk factors for time to first fall in this sample of very old people were dependency in personal (P-) ADL but not bedridden, thyroid disorders, treatment with Selective Serotonin Reuptake Inhibitors (SSRIs) and occurrence of fall/s in the preceding year. These factors should all be considered in fall prevention programmes.

The morale of very old people was found in this study to be rather high, with similar scores among age groups and sexes. The most important factors for high morale were the absence of depressive symptoms, living in ordinary housing, having previously had a stroke and yet still living in ordinary housing, not feeling lonely and having few symptoms. The PGCMS seems applicable in the evaluation of morale in very old people.

In conclusion, there were wide variations in health status and physical ability in this northern population of very old people. Women had poorer health and physical ability than men. Falls and fractures were common and serious health problems. Morale seemed to be high, despite the fact that a large proportion of the participants suffered from many diseases and functional decline.

Place, publisher, year, edition, pages
Umeå: Samhällsmedicin och rehabilitering, 2006. 89 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1038
Keyword
Aged, 80 and over, accidental falls, epidemiological studies, geriatric assessment, health status, morale, physical ability, population characteristics, reference values
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-871 (URN)91-7264-130-4 (ISBN)
Public defence
2006-10-28, Aulan, Vårdvetarhuset, Umeå Universitet, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2006-09-25 Created: 2006-09-25 Last updated: 2009-10-30Bibliographically approved

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