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  • 1.
    Backman, Anders
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Bodin, Kenneth
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Janlert, Lars-Erik
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Maxhall, Marcus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Pederson, Thomas
    Innovative Communication Group, IT University of Copenhagen.
    Sjölie, Daniel
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Sondell, Björn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Surie, Dipak
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    easyADL – Wearable Support System for Independent Life despite Dementia2006In: ACM CHI 2006 Workshop onDesigning Technology for People with Cognitive Impairments, 2006Conference paper (Refereed)
    Abstract [en]

    This position paper outlines the easyADL project, a two-year project investigating the possibility of using wearable technology to assist people suffering the dementia disease in performing Activities of Daily Living (ADL). An introduction to the egocentric interaction modeling framework is provided and the virtual reality based development methodology is discusssed.

  • 2.
    Bergdahl, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Gustavsson, Janna M C
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Kallin, Kristina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    von Heideken Wågert, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Depression among the oldest old: the Umeå 85+ study2005In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 17, no 4, p. 557-575Article in journal (Refereed)
  • 3. Edlund, Agneta
    et al.
    Lundström, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Brännström, Benny
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Delirium before and after operation for femoral neck fracture2001In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 49, no 10, p. 1335-1340Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to investigate the differences between preoperative and postoperative delirium regarding predisposing, precipitating factors and outcome in older patients admitted to hospital with femoral neck fractures.

    DESIGN: A prospective clinical assessment of patients treated for femoral neck fractures.

    SETTING: Department of orthopedic surgery at Umeå University Hospital, Sweden.

    PARTICIPANTS: One hundred one patients, age 65 and older admitted to the hospital for treatment of femoral neck fractures.

    MEASUREMENTS: The Organic Brain Syndrome (OBS) Scale.

    RESULTS: Thirty patients (29.7%) were delirious before surgery and another 19 (18.8%) developed delirium postoperatively. Of those who were delirious preoperatively, all but one remained delirious postoperatively. The majority of those delirious before surgery were demented, had been treated with drugs with anticholinergic properties (mainly neuroleptics), had had previous episodes of delirium, and had fallen indoors. Patients who developed postoperative delirium had perioperative falls in blood pressure and had more postoperative complications such as infections. Male patients were more often delirious both preoperatively and postoperatively. Patients with preoperative delirium were more often discharged to institutional care and had poorer walking ability both on discharge and after 6 months than did patients with postoperative delirium only.

    CONCLUSIONS: Because preoperative and postoperative delirium are associated with different risk factors it is necessary to devise different strategies for their prevention.

  • 4.
    Edlund, Agneta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundström, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Brännström, Benny
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Delirium in older patients admitted to general internal medicine.2006In: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 19, no 2, p. 83-90Article in journal (Refereed)
  • 5.
    Edlund, Agneta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundström, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sandberg, Olov
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Brännström, Benny
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Symptom profile of delirium in older people with and without dementia.2007In: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 20, no 3, p. 166-171Article in journal (Refereed)
  • 6.
    Englund, Undis
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sondell, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    The beneficial effects of exercise on BMC are lost after cessation: a 5-year follow-up in older post-menopausal women2009In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 3, p. 381-388Article in journal (Refereed)
    Abstract [en]

    This study investigates whether the positive effects on bone mineral density (BMD, g/cm2) and neuromuscular function following a combined weight-bearing program are sustained in older women, a longer period after cessation of training. Thirty-four women (18 exercisers and 16 controls) aged 73–88 years, who completed a 12-month randomized-controlled trial, were invited to a 5-year follow-up assessment of BMD and neuromuscular function. Both groups sustained significant losses in BMD of the femoral neck, trochanter, and Ward's triangle during the follow-up period. Significant losses were also seen in all neuromuscular function tests. The inter-group change was, however, significant only for maximal walking speed where the exercise group had a significantly greater loss. In conclusion, this study suggests that gains in bone density and neuromuscular functions achieved by training are lost after cessation of training. Continuous high-intensity weight-loading physical activity is probably necessary to preserve bone density and neuromuscular function in older women.

  • 7.
    Englund, Undis
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sondell, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women2005In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 16, no 9, p. 1117-1123Article in journal (Refereed)
    Abstract [en]

    Forty-eight community living women 66–87 years old volunteered to participate in a 12-month prospective, randomized, controlled, trial. The aim was to determine if a combined weight-bearing training program twice a week would be beneficial to bone mineral density and neuromuscular function. The participants were pairwise age-matched and randomly assigned to either an exercise group (n=24) or a control group (n=24). Twenty-one subjects in the intervention group and 19 in the control group completed the study. The exercise program lasted for 50 min and consisted of a combination of strengthening, aerobic, balance and coordination exercises. The mean percentage of scheduled sessions attended for the exercise group was 67%. At the completion of the study, the intervention group showed significant increments in bone mineral density of the Wards triangle (8.4%, P<0.01) as well as improvement in maximum walking speed (11.4%, P<0.001) and isometric grip strength (9.9%, P<0.05), as compared to the control group. The conclusion was that a combined weight-bearing training program might reduce fracture risk factors by improving bone density as well as muscle strength and walking ability. This program could be suitable for older community living women in general, and might, therefore, have important implications for fracture prevention.

  • 8.
    Englund, Undis
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Svensson, Olle
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Pettersson Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Physical activity in middle-aged women and hip fracture risk: the UFO study2011In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 22, no 2, p. 499-505Article in journal (Refereed)
    Abstract [en]

    Summary: In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women.

    Introduction: In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture.

    Methods: The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years.

    Results: Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05–0.53 for walking and OR 0.19; 95% CI; 0.08–0.46, OR 0.17, 95% CI; 0.05–0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women.

    Conclusion: An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

  • 9.
    Fordell, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Bodin, Kenneth
    Umeå University, Faculty of Science and Technology, High Performance Computing Center North (HPC2N).
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    A virtual reality test battery for assessment and screening of spatial neglect2011In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 123, no 3, p. 167-174Article in journal (Refereed)
    Abstract [en]

    Background – There is a need for improved screening methods for spatial neglect.

    Aim – To construct a VR-test battery and evaluate its accuracy and usability in patients with acute stroke.

    Method –  VR-DiSTRO consists of a standard desktop computer, a CRT monitor and eye shutter stereoscopic glasses, a force feedback interface, and software, developed to create an interactive and immersive 3D experience. VR-tests were developed and validated to the conventional Star Cancellation test, Line bisection, Baking Tray Task (BTT), and Visual Extinction test. A construct validation to The Rivermead Behavioral Inattention Test, used as criterion of visuospatial neglect, was made. Usability was assessed according to ISO 9241-11.

    Results –  Thirty-one patients with stroke were included, 9/31 patients had neglect. The sensitivity was 100% and the specificity 82% for the VR-DiSTRO to correctly identify neglect. VR-BTT and VR-Extinction had the highest correlation (r2 = 0.64 and 0.78), as well as high sensitivity and specificity. The kappa values describing the agreement between traditional neglect tests and the corresponding virtual reality test were between 0.47–0.85. Usability was assessed by a questionnaire; 77% reported that the VR-DiSTRO was ‘easy’ to use. Eighty-eight percent reported that they felt ‘focused’, ‘pleased’ or ‘alert’. No patient had adverse symptoms. The test session took 15 min.

    Conclusions –  The VR-DiSTRO quickly and with a high accuracy identified visuospatial neglect in patients with stroke in this construct validation. The usability among elderly patients with stroke was high. This VR-test battery has the potential to become an important screening instrument for neglect and a valuable adjunct to the neuropsychological assessment.

  • 10. Grue, Else Vengnes
    et al.
    Ranhoff, Anette Hylen
    Noro, Anja
    Finne-Soveri, Harriet
    Jensdóttir, Anna Birna
    Ljunggren, Gunnar
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Björnson, Leif Jan
    Jonsén, Elisabeth
    Umeå University, Faculty of Medicine, Department of Nursing.
    Schroll, Marianne
    Jónsson, Palmi V
    Vision and hearing impairments and their associations with falling and loss of instrumental activities in daily living in acute hospitalized older persons in five Nordic hospitals2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 4, p. 635-643Article in journal (Refereed)
    Abstract [en]

    Background: Many older people believe sensory problems are inevitably, a part of growing old, and avoid assessment and help. Such problems are often also overlooked by health professionals. The aim of this study was to find the prevalence of hearing and vision impairment and their associations with loss of instrumental activities in daily living (IADL) and risk of falling in patients aged 75 years or older, admitted to a medical ward in an acute hospital in each of the five Nordic countries. Method: The Minimum Data Set for Acute Care was used for data collection in 770 patients. Premorbid data, admission data and history of falls over 3 months were obtained on admission by interview and observation. Hearing impairment was present if the patient required a quiet setting to be able to hear normal speech. Vision impairment was defined as unable to read regular print in a newspaper. Results: Bivariate and logistic regression analyses were performed. Forty-eight per cent of the patients had a hearing impairment, 32.3% had vision impairment and 20.1% had both. Hearing impairment was associated with falling but not in the logistic regression model. Hearing and vision impairment were associated with loss of IADL but only combined impairment was independently. Conclusion: Hearing and vision impairments were frequent among older patients in the medical wards. Falling was associated with hearing loss and IADL loss with hearing, vision and combined impairments. Sensory loss was also associated with fear of falling. It is recommended routinely to screen sensory functions in older patients in a medical setting. Intervention studies are needed to determine whether improvements in hearing and vision can prevent falls and further loss of function in this patient population.

  • 11.
    Jonsén, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ljunggren, Gunnar
    Jonsson, Palmi V
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Functional status in elderly people after acute care and quality of life at one-year follow-up.2007In: Health Science Journal, Vol. 1, no January-March, p. 1-14Article in journal (Refereed)
  • 12. Jónsson, Pálmi V
    et al.
    Finne-Soveri, Harriet
    Jensdóttir, Anna B
    Ljunggren, Gunnar
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Grue, Else V
    Noro, Anja
    Björnson, Jan
    Jonsén, Elizabeth
    Umeå University, Faculty of Medicine, Department of Nursing.
    Schroll, Marianne
    Co-morbidity and functional limitation in older patients underreported in medical records in Nordic Acute Care Hospitals when compared with the MDS-AC instrument2006In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 35, no 4, p. 434-438Article in journal (Refereed)
    Abstract [en]

    SIR—Older persons are characterised by age-related changes, multiple diseases, multiple drug use and functional deficits. For optimal care, a holistic approach is needed; however, the health care systems of today are still essentially organised to provide acute medical care to relatively younger populations with little or no co-morbidity [ 1]. Health systems will have to adapt to this new situation.

    The value of geriatric assessment has been proven, where targeting is the key to success [ 2]. With shorter hospital stays, it is of importance to do this targeting quickly and effectively. According to a systematic literature review in the older patients, the most important predictors for adverse outcomes of acute care (mortality, frequent readmissions, institutionalisation and long length of stay) are current illness, decline in physical functions and age. In addition, illness severity, co-morbidity, polypharmacy, cognitive decline, poor nutrition and gender are predictive for one or more of the outcomes [ 3].

    The Minimum Data Set for Acute Care (MDS-AC) instrument was developed to guide care within the hospital and to facilitate the transfer and sharing of information to the next provider of care, thus supporting integrated care. The MDS-AC instrument provides an opportunity to systematically collect information that is reliable on function and co-morbidity and could thus be a valuable addition to the future electronic medical record [ 4].

    The aim of this study is to investigate to what degree important predictors of adverse outcomes, if present according to the MDS-AC instrument during the first 24 h of care for older patients, were not documented in traditional hospital records in acute care wards in five Nordic countries. Hence, the MDS-AC information is assumed to be a gold standard. A secondary aim is to show that suspected deficient documentation is an international issue.

  • 13. Jónsson, Pálmi V
    et al.
    Noro, Anja
    Finne-Soveri, Harriet
    Jensdóttir, Anna B
    Ljunggren, Gunnar
    Bucht, Gösta
    Grue, Else V
    Björnson, Jan
    Jonsén, Elisabeth
    Umeå University, Faculty of Medicine, Department of Nursing.
    Schroll, Marianne
    Admission profile is predictive of outcome in acute hospital care.2008In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, no 6, p. 533-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: The purpose of this study is to describe predictors for discharge and one-year outcomes of acute-care hospital patients, 75 years of age or over, based on admission status information. We carried out a prospective study of a randomly selected patient population, from one urban acute-care hospital in each of the Nordic countries. 763 persons aged 75+ were randomly selected from acute admissions to the participating hospitals. 749 observations at discharge and 655 observations at one year were used in analyses. METHODS: Data were collected with the MDS-AC 1.1 instrument within 24 hours of admission, and at day 7 or discharge, whichever came first. Outcome information was collected either by interviewing the patient or from patient records or registers. Discharge and one-year outcome (home, institution, death) were modeled by multinomial logistic regression, with admission status variables as predictors. RESULTS: At discharge, 84% of subjects returned home, 11% went to an institution and 5.6% had died. At one year, 64% were still living at home, 24% had died, and 12% had moved to an institution. For discharge outcome, those having hospital admission due to a new problem or exacerbation of an old one had a higher risk of dying (OR 3.3) than returning home. Moderate to severe cognitive problems predicted death (OR 2.2) and institutionalization (OR 8.6) compared with discharge home. Problems in instrumental activities of daily living predicted death (OR 3.1) and institutionalization (OR 6.0). At one year, those with exacerbation of an old problem (OR 2.1) or with a new or exacerbated existing problem (OR 2.3) had a higher risk of dying than of institutionalization or discharge home. Having some cognitive problems (OR 2.8) or moderate to severe cognitive problems (OR 6.6) predicted institutionalization, but not dying or discharge home. Those with some problems in activities of daily living had a higher risk of both dying (OR 1.7) and of institutional care (OR 2.7). Those with moderate to severe problems in activities of daily living had also a higher risk of institutional care (OR 4.7) compared with those living at home. CONCLUSIONS: Evidence predictive of discharge and one-year outcomes in older acute hospital medical care patients seems to be visible from the beginning of the hospital stay. In order to increase the efficient use of health care services and quality of care, systematic standardized and streamlined assessment should be performed during the admission process.

  • 14.
    Lundström, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Edlund, Agneta
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Dementia after delirium in patients with femoral neck fractures.2003In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 51, no 7, p. 1002-1006Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate whether delirium in older patients with femoral neck fractures is associated with an increased risk of developing dementia and a higher mortality rate.

    DESIGN: A 5-year prospective follow-up study.

    SETTING: Department of Orthopedic Surgery at the University Hospital in Umeå, Sweden.

    PARTICIPANTS: Seventy-eight nondemented patients aged 65 and older operated on for femoral neck fractures were followed for 5 years.

    MEASUREMENTS: The patients were assessed using the Organic Brain Syndrome (OBS) Scale pre- and postoperatively. Medical and social data were collected from the patients, their caregivers, and medical records, and the survivors were visited and assessed with the OBS Scale and the Mini-Mental State Examination in their homes 5 years after the fracture.

    RESULTS: Thirty of 78 (38.5%) nondemented patients with a femoral neck fracture developed dementia within a 5-year period. Twenty of 29 (69%) who were delirious postoperatively developed dementia, compared with 10 of 49 (20%) who were not delirious during their hospital stay (P <.001). Twenty-one (72.4%) of those with postoperative delirium died within 5 years, compared with 17 of 49 (34.7%) of those who remained lucid postoperatively (P =.001).

    CONCLUSION: Delirium in nondemented femoral neck fracture patients is associated with the development of dementia and a higher mortality rate. Patients with preoperative or postoperative delirium should therefore be assessed not only for the etiology of the delirium but also for any underlying organic brain disorder. Questions that remain unanswered are whether postoperative delirium is a marker of undetected dementia and whether postoperative delirium contributes to the development of dementia.

  • 15.
    Lundström, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Edlund, Agneta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Brännström, Benny
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients.2005In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 53, no 4, p. 622-628Article in journal (Refereed)
  • 16. Nyberg, Lars
    et al.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Sondell, Björn
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Backman, Anders
    Holmlund, Kenneth
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Maxhall, Marcus
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Using a virtual reality system to study balance and walking in a virtual outdoor environment: a pilot study.2006In: Cyberpsychology & behavior, ISSN 1094-9313, Vol. 9, no 4, p. 388-95Article in journal (Refereed)
  • 17.
    Nyberg, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sondell, Björn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Backman, Anders
    Holmlund, Kenneth
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Maxhall, Marcus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Development of a virtual reality system to study tendency of falling among older people2004In: Proc 5th International Conference Series on Disability Virtual Reality and Associated Technologies, p. 315-320Article in journal (Other academic)
  • 18.
    Pellfolk, Tony
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Nursing.
    Effects of a restraint minimization program on staff knowledge, attitudes, and practice: a cluster randomized trial2010In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 58, no 1, p. 62-69Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the effects of a restraint minimization education program on staff knowledge and attitudes and use of physical restraints.

    DESIGN: Cluster-randomized controlled trial with nursing units as the basis for randomization.

    SETTING: Forty group dwelling units for people with dementia.

    PARTICIPANTS: At baseline, there were 184 staff and 191 residents in the intervention group and 162 staff and 162 residents in the control group. At the 6-month follow-up, there were 156 staff and 185 residents (36 newly admitted) in the intervention group and 133 staff and 165 residents (26 newly admitted) in the control group.

    INTERVENTION: A 6-month education program for all nursing staff.

    MEASUREMENTS: Staff knowledge and attitudes and physical restraint use were measured before and after the education program.

    RESULTS: In the intervention group, staff knowledge about and attitudes toward restraint use changed, and the overall use of physical restraints decreased. A comparison including only residents present during the whole study period showed that the level of use was similar between the groups at baseline, whereas it was significantly lower in the intervention group at follow-up. Adjusted analyses showed that the odds of being restrained at follow-up were lower in the intervention group than in the control group. There was no significant change in the number of falls or use of psychoactive medication.

    CONCLUSION: The results indicate that staff education can increase knowledge, change attitudes, and reduce the use of physical restraints without any change in the incidence of falls or use of psychoactive drugs.

  • 19.
    Sahlin, Carin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Sandberg, Olov
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Carlberg, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Franklin, Karl
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up2008In: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 168, no 3, p. 297-301Article in journal (Refereed)
    Abstract [en]

     

    Background: Sleep apnea occurs frequently among stroke patients, but it is still unknown whether a diagnosis of sleep apnea is an independent risk factor for mortality. We aimed to investigate whether obstructive or central sleep apnea was related to a reduced long-term survival among stroke patients.

    Methods: One hundred and thirty-two of 151 patients admitted for in-hospital stroke rehabilitation in the catchment area of Umeå from 1 April 1995 to 1 May 1997 underwent overnight sleep apnea recordings at 23 ± 8 days after onset of stroke. All patients were followed-up prospectively for a mean (SD) of 10.0 ± 0.6 years, with death as the primary outcome and no one was lost to follow-up. Obstructive sleep apnea was defined when the obstructive apnea-hypopnea index was over 15 and central sleep apnea when the central apnea-hypopnea index was over 15. Patients with an obstructive and a central apnea-hypopnea index below 15 served as controls.

    Results: Of 132 enrolled patients, 116 had died at follow-up. The risk of death was higher among the 23 patients with obstructive sleep apnea than controls (adjusted hazard ratio, 1.76; 95% confidence interval 1.05 to 2.95, p=0.03), independent of age, gender, body-mass index, smoking, hypertension, diabetes mellitus, atrial fibrillation, mini-mental state examination and Barthel activity of daily living There was no difference in mortality between the 28 patients with central sleep apnea and controls (adjusted hazard ratio, 1.07; 95 percent confidence interval 0.65 to 1.76, p=0.053).

    Conclusions: Stroke patients with obstructive sleep apnea run an increased risk of early death. Central sleep apnea was not related to early death among the present patients.

  • 20.
    Sondell, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Engström, Björn
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Backman, Anders
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Holmlund, Kenneth
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Altered walking pattern in a virtual environment2005In: Presence - Teleoperators and Virtual Environments, ISSN 1054-7460, E-ISSN 1531-3263, Vol. 14, no 2, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Falls and fractures among elderly persons constitute a major health problem. Many falls occur while walking and falls that occur during turning often result in a fracture. Methods aimed at understanding the complex mechanisms involved in walking should therefore assess tested individuals during walks and turns. In order to identify persons at risk and take the correct preventive measures, it is important to find methods that quantify movements as the tested persons are processing multisensory input. In a clinical setting this is sometimes difficult to achieve in a controlled manner, since tests are difficult to set exactly the same from one time to another. Using a virtual environment (VE) and a tracker system, conditions such as light, sound, events, body movements, and room size can be controlled and measured. Tests in VE can therefore be identically reproduced over and over again to evaluate if a person can withstand changing outer demands at any given moment. In order to perform quantitative measures 8 persons (21-74 years) were tested in immersive virtual reality. The VE was a corridor in which expected and unexpected events could be produced. Events studied were doors swinging open in front of the subjects during a walk and a virtual tilting of the environment. Trackers were used for collecting and analyzing the movement data. Our results show that the system was well tolerated among the subjects and that there was a clear tendency that the system could generate fall tendency among the subjects. There was also a difference among the subjects regarding walking strategies when subjected to the various events.

  • 21.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Norberg, Lennart
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurse-doctor interaction in teleconsultations between a hospital and a geriatric nursing home2002In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 8, no 1, p. 11-18Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to elucidate both the interactionbetween a doctor and five registered nurses and the problemsor tasks dealt with in teleconsultations between a universityclinic for geriatric medicine and a nursing home for the elderlyin northern Sweden. The interaction and problems or tasks werestudied through analyses of video-recorded teleconsultationsand through open interviews with the participating staff. Theresults indicated that teleconsultations between a geriatricianand the nurses at a nursing home for the elderly can be a usefultool for providing medical services. Teleconsultations alterboth the 'power-control' and 'practice spheres' for the doctorand the nurses, and must be based on mutual trust. The use ofteleconsultations gives the nurse a larger role as the presenterof medical problems, and gives the doctor the role of remoteconsultant.

  • 22.
    Åström, Sture
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sandvide, Asa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Eisemann, Martin
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Staff's experience of and the management of violent incidents in elderly care.2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 4, p. 410-6Article in journal (Refereed)
1 - 22 of 22
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