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Gustafson, Yngve
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Bergfrid, M., Gustafson, Y., Littbrand, H., Olofsson, B. & Weidung, B. (2024). Having plans for the future in very old people. The International Journal of Aging & Human Development
Öppna denna publikation i ny flik eller fönster >>Having plans for the future in very old people
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2024 (Engelska)Ingår i: The International Journal of Aging & Human Development, ISSN 0091-4150, E-ISSN 1541-3535Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

This study aimed to investigate the prevalence of having plans for the future among very old people and the factors associated with having such plans. A longitudinal population-based study with home visits for 85-, 90-, and ≥95-year-old participants in Sweden and Finland was used. Multivariate logistic regression and Cox proportional-hazards regression models with a maximum 5-year follow-up period were used. The prevalence of having plans for the future was 18.6% (174/936). More men than women and more people living in Sweden than in Finland had plans for the future. In multivariate models, having plans for the future was associated with speaking Swedish, being dentate, and living in the community in the total sample; speaking Swedish and being dentate among women; and speaking Swedish, having a lower Geriatric Depression Scale score, and urban residence among men. Having plans for the future was associated univariately, but not multivariately, with increased survival.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2024
Nyckelord
aged 80 and over, future perception, gerontology, optimism, plans for the future, survival
Nationell ämneskategori
Gerontologi, medicinsk/hälsovetenskaplig inriktning Omvårdnad
Identifikatorer
urn:nbn:se:umu:diva-221560 (URN)10.1177/00914150241231189 (DOI)001159569300001 ()38342991 (PubMedID)2-s2.0-85185275774 (Scopus ID)
Forskningsfinansiär
Umeå universitetDemensförbundetVetenskapsrådet, K2014-99X-22610-01-6Visare NorrRegion VästerbottenKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Tillgänglig från: 2024-03-05 Skapad: 2024-03-05 Senast uppdaterad: 2024-03-05
Almevall, A., Dahlin Almevall, A., Öhlin, J., Gustafson, Y., Zingmark, K., Niklasson, J., . . . Olofsson, B. (2024). Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort. Archives of gerontology and geriatrics (Print), 122, Article ID 105392.
Öppna denna publikation i ny flik eller fönster >>Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort
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2024 (Engelska)Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 122, artikel-id 105392Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.

Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.

Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.

Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).

Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.

Ort, förlag, år, upplaga, sidor
Elsevier, 2024
Nyckelord
Aged 80 and over, Aging/psychology, Diagnostic self evaluation, Longitudinal studies, Population characteristics, Self-rated health, Survival analysis
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-222682 (URN)10.1016/j.archger.2024.105392 (DOI)38492492 (PubMedID)2-s2.0-85187986768 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2016-01074Vetenskapsrådet, K2014-99X-22610-01-6Visare NorrRegion NorrbottenRegion VästerbottenStiftelsen Svenskt demenscentrumStiftelsen Ragnhild och Einar Lundströms MinneSvenska läkaresällskapetKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Tillgänglig från: 2024-04-09 Skapad: 2024-04-09 Senast uppdaterad: 2024-04-09Bibliografiskt granskad
Snellman, S., Hörnsten, C., Olofsson, B., Gustafson, Y., Lövheim, H. & Niklasson, J. (2024). Validity and test–retest reliability of the Swedish version of the Geriatric Depression Scale among very old adults. BMC Geriatrics, 24(1), Article ID 261.
Öppna denna publikation i ny flik eller fönster >>Validity and test–retest reliability of the Swedish version of the Geriatric Depression Scale among very old adults
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2024 (Engelska)Ingår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 24, nr 1, artikel-id 261Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The Geriatric Depression Scale (GDS) has shown good validity and reliability, but few studies have examined the GDS among very old adults or the Swedish translation.

Objectives: Evaluate the validity and reliability of the Swedish version of GDS-15 among very old adults.

Methods: In the Umeå85 + /GErontological Regional DAtabase (GERDA) study, 387 participants were assessed with both the GDS-15 and the Montgomery-Åsberg Depression Rating Scale (MADRS). The mean age was 91 years. Concurrent validity between the scales was calculated using Spearman's correlation. We used the Diagnostic and Statistical Manual of Mental Disorders (DSM) V symptom criteria for depression based on MADRS item scores to define depression. We calculated the Area Under the Curve (AUC) and found an optimal cut-off. A convenience sample with 60 individuals was used to calculate test–retest reliability with Cohen’s kappa and Intraclass Correlation Coefficient (ICC).

Results: Spearman's correlation coefficients between total scores for GDS-15 and MADRS were 0.60. Cronbach's alpha for the whole scale was 0.73. The AUC was 0.90 for distinguishing major depression, and the recommended cut-off of ≥ 5 showed a sensitivity of 95.2% and specificity of 65.8%. The test–retest showed that Cohen’s kappa was substantial (0.71) and the ICC was excellent (0.95).

Conclusions: The Swedish version of the GDS-15 showed good validity and reliability among very old adults. The generally recommended cut-off of ≥ 5 seems reasonable to use with the Swedish version and among very old adults.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2024
Nyckelord
Aged 80 and over, Depression, Psychiatric status rating scales, Psychometrics, ROC curve
Nationell ämneskategori
Geriatrik Omvårdnad
Identifikatorer
urn:nbn:se:umu:diva-222888 (URN)10.1186/s12877-024-04869-7 (DOI)001187389700003 ()38500031 (PubMedID)2-s2.0-85188072998 (Scopus ID)
Forskningsfinansiär
Vetenskapsrådet, K2014– 99X-22610–01–6Region VästerbottenRegion NorrbottenDemensförbundet
Tillgänglig från: 2024-04-08 Skapad: 2024-04-08 Senast uppdaterad: 2024-04-08Bibliografiskt granskad
Lindelöf, N., Nilsson, I., Littbrand, H., Gustafson, Y., Olofsson, B. & Fjellman-Wiklund, A. (2023). A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers: a co-creative journey. BMC Geriatrics, 23(1), Article ID 572.
Öppna denna publikation i ny flik eller fönster >>A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers: a co-creative journey
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2023 (Engelska)Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, nr 1, artikel-id 572Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.

Methods: The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.

Results: The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.

Conclusions: The staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2023
Nyckelord
Dementia, Experiences, Grounded theory, Informal caregiver, Interdisciplinary health team, Person-centered care, Rehabilitation
Nationell ämneskategori
Omvårdnad Geriatrik
Identifikatorer
urn:nbn:se:umu:diva-214772 (URN)10.1186/s12877-023-04269-3 (DOI)37723442 (PubMedID)2-s2.0-85171536442 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014-0897Stiftelsen PromobiliaDemensförbundetFamiljen Janne Elgqvists StiftelseRegion VästerbottenAlzheimerfondenStiftelsen Ragnhild och Einar Lundströms MinneStiftelsen Gamla Tjänarinnor
Tillgänglig från: 2023-10-18 Skapad: 2023-10-18 Senast uppdaterad: 2023-10-18Bibliografiskt granskad
Olofsson, E., Gustafson, Y., Mukka, S., Tengman, E., Lindgren, L. & Olofsson, B. (2023). Association of depressive disorders and dementia with mortality among older people with hip fracture. BMC Geriatrics, 23(1), Article ID 135.
Öppna denna publikation i ny flik eller fönster >>Association of depressive disorders and dementia with mortality among older people with hip fracture
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2023 (Engelska)Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, nr 1, artikel-id 135Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Hip fracture (HF) is a significant cause of mortality among older people. Almost half of the patients with HF have dementia, which increases the mortality risk further. Cognitive impairment is associated with depressive disorders (DDs) and both dementia and DDs are independent risk factors for poor outcome after HF. However, most studies that evaluate mortality risk after HF separate these conditions.

AIMS: To investigate whether dementia with depressive disorders (DDwD) affects the mortality risk at 12, 24, and 36 months after HF among older people.

METHODS: Patients with acute HF (n = 404) were included in this retrospective analysis of two randomized controlled trials performed in orthopedic and geriatric departments. Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive function was assessed using the Mini-Mental State Examination. A consultant geriatrician made final depressive disorder and dementia diagnoses using the Diagnostic and Statistical Manual of Mental Disorders criteria, with support from assessments and medical records. The 12-, 24- and 36-month mortality after HF was analyzed using logistic regression models adjusted for covariates.

RESULTS: In analyses adjusted for age, sex, comorbidity, pre-fracture walking ability, and fracture type, patients with DDwD had increased mortality risks at 12 [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.75-12.51], 24 (OR 3.61, 95% CI 1.71-7.60), and 36 (OR 4.53, 95% CI 2.24-9.14) months. Similar results were obtained for patients with dementia, but not depressive disorders, alone.

CONCLUSION: DDwD is an important risk factor for increased mortality at 12, 24, and 36 months after HF among older people. Routinely assessments after HF for cognitive- and depressive disorders could identify patients at risk for increased mortality, and enable early interventions.

TRIAL REGISTRATION: RCT2: International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN15738119.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2023
Nyckelord
Dementia, Depressive disorders, Hip fracture, Mortality, Older people
Nationell ämneskategori
Ortopedi Geriatrik
Identifikatorer
urn:nbn:se:umu:diva-205678 (URN)10.1186/s12877-023-03862-w (DOI)000945613200001 ()36890449 (PubMedID)2-s2.0-85149626612 (Scopus ID)
Forskningsfinansiär
VårdalstiftelsenVisare NorrKempestiftelsernaUmeå universitetRegion VästerbottenVetenskapsrådet, K2005‐27VX‐15357‐01A
Tillgänglig från: 2023-03-14 Skapad: 2023-03-14 Senast uppdaterad: 2023-04-03Bibliografiskt granskad
Claesson Lingehall, H., Gustafson, Y., Svenmarker, S., Appelblad, M., Davidsson, F., Holmner, F., . . . Olofsson, B. (2023). Is a hyperosmolar pump prime for cardiopulmonary bypass a risk factor for postoperative delirium?: A double blinded randomised controlled trial. Scandinavian Cardiovascular Journal, 57(1), Article ID 2186326.
Öppna denna publikation i ny flik eller fönster >>Is a hyperosmolar pump prime for cardiopulmonary bypass a risk factor for postoperative delirium?: A double blinded randomised controlled trial
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2023 (Engelska)Ingår i: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 57, nr 1, artikel-id 2186326Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: Postoperative delirium (POD) is common after cardiac surgery. We have previously identified plasma sodium concentration and the volume of infused fluids during surgery as possible risk factors. Both are linked to the selection and composition of the pump prime used for cardiopulmonary bypass (CPB). Present study aims to examine whether hyperosmolality increases the risk for POD.

Design: Patients ≥65 years (n = 195) scheduled for cardiac surgery were prospectively enrolled into this double blinded randomised clinical trial. Study group received a pump prime containing mannitol and ringer-acetate (966 mOsmol) (n = 98) vs. ringer-acetate (388 mOsmol) (n = 97) in the control group. Postoperative delirium was defined according to DSM-5 criteria based on a test-battery pre- and postoperatively (days 1–3). Plasma osmolality was measured on five occasions and coordinated with the POD assessments. The primary outcome was the POD incidence related to hyperosmolality as the secondary outcome.

Results: The incidence of POD was 36% in the study group and 34% in the control group, without intergroup difference (p=.59). The plasma osmolality was significantly higher in the study group, both on days 1 and 3 and after CPB (p<.001). Post hoc analysis indicated that high osmolality levels increased the risk for delirium on day 1 by 9% (odds ratio (OR) 1.09, 95% CI 1.03–1.15) and by 10% on day 3 (OR 1.10, 95% CI 1.04–1.16).

Conclusions: Use of a prime solution with high osmolality did not increase the incidence of POD. However, the influence of hyperosmolality as a risk factor for POD warrants further investigation.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2023
Nyckelord
Cardiac surgery, cardiopulmonary bypass, delirium, mannitol, osmolality
Nationell ämneskategori
Kardiologi Omvårdnad Kirurgi
Identifikatorer
urn:nbn:se:umu:diva-206772 (URN)10.1080/14017431.2023.2186326 (DOI)000962391200001 ()37009834 (PubMedID)2-s2.0-85151638529 (Scopus ID)
Forskningsfinansiär
Region VästerbottenUmeå universitet
Tillgänglig från: 2023-04-26 Skapad: 2023-04-26 Senast uppdaterad: 2023-04-26Bibliografiskt granskad
Weidung, B., Lövheim, H., Littbrand, H., Wahlin, J., Olofsson, B. & Gustafson, Y. (2023). Temporal dementia and cognitive impairment trends in the very old in the 21st century. Journal of Alzheimer's Disease, 93(1), 61-74
Öppna denna publikation i ny flik eller fönster >>Temporal dementia and cognitive impairment trends in the very old in the 21st century
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2023 (Engelska)Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 93, nr 1, s. 61-74Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Long-increasing dementia incidence and prevalence trends may be shifting. Whether such shifts have reached the very old is unknown.

OBJECTIVE: To investigate temporal trends in the incidence of dementia and cognitive impairment and prevalence of dementia, cognitive impairment, Alzheimer's disease, vascular dementia, and unclassified dementia among 85-, 90-, and ≥ 95-year-olds in Sweden during 2000-2017.

METHODS: This study was conducted with Umeå 85 + /Gerontological Regional Database data from 2182 85-, 90-, and ≥ 95-year-olds in Sweden collected in 2000-2017. Using logistic regression, trends in the cumulative 5-year incidences of dementia and cognitive impairment; prevalences of dementia, cognitive impairment, Alzheimer's disease, and vascular dementia; and Mini-Mental State Examination thresholds for dementia diagnosis were estimated.

RESULTS: Dementia and cognitive impairment incidences decreased in younger groups, which generally showed more-positive temporal trends. The prevalences of overall dementia, cognitive impairment, and Alzheimer's disease were stable or increasing; longer disease durations and increasing dementia subtype classification success may mask positive changes in incidences. Vascular dementia increased while unclassified dementia generally decreased. CONCLUSION: The cognitive health of the very old may be changing in the 21st century, possibly indicating a trend break.

Ort, förlag, år, upplaga, sidor
IOS Press, 2023
Nyckelord
Aged 80 and over, Alzheimer’s disease, cognition disorders, cohort studies, cross-sectional studies, dementia, epidemiologic studies, longitudinal studies, neurocognitive disorders, vascular dementia
Nationell ämneskategori
Geriatrik
Identifikatorer
urn:nbn:se:umu:diva-209294 (URN)10.3233/JAD-220915 (DOI)000980906000005 ()36938733 (PubMedID)2-s2.0-85159555239 (Scopus ID)
Forskningsfinansiär
Vetenskapsrådet, K2014–99X-22610–01–6Umeå universitetRegion VästerbottenDemensförbundet
Tillgänglig från: 2023-06-08 Skapad: 2023-06-08 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Johansson, S., Lövheim, H., Olofsson, B., Gustafson, Y. & Niklasson, J. (2022). A clinically feasible short version of the 15-item geriatric depression scale extracted using item response theory in a sample of adults aged 85 years and older. Aging & Mental Health, 26(2), 431-437
Öppna denna publikation i ny flik eller fönster >>A clinically feasible short version of the 15-item geriatric depression scale extracted using item response theory in a sample of adults aged 85 years and older
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2022 (Engelska)Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 26, nr 2, s. 431-437Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: To extract the items most suitable for a short version of the 15-item Geriatric Depression Scale (GDS-15) in a sample of adults aged ≥ 85 years using item response theory (IRT).

Method: This population-based cross-sectional study included 651 individuals aged ≥ 85 years from the Umeå 85+/GErontological Regional DAtabase (GERDA) study. Participants were either community dwelling (approximately 70%) or resided in institutional care (approximately 30%) in northern Sweden and western Finland in 2000–2002 and 2005–2007. The psychometric properties of GDS-15 items were investigated using an IRT-based approach to find items most closely corresponding to the GDS-15 cut off value of ≥5 points. Receiver operating characteristic curves were used to compare the performance of the proposed short version with that of previously proposed short GDS versions.

Results: GDS-15 items 3, 8, 12, and 13 best differentiated respondents’ levels of depressive symptoms corresponding to the GDS-15 cut off value of ≥5, regardless of age or sex, and thus comprise the proposed short version of the scale (GDS-4 GERDA). For the identification of individuals with depression (total GDS-15 score ≥ 5), the GDS-4 GERDA with a cut-off score of ≥2 had 92.9% sensitivity and 85.0% specificity.

Conclusion: The GDS-4 GERDA could be used as an optimized short version of the GDS-15 to screen for depression among adults aged ≥ 85 years.

Ort, förlag, år, upplaga, sidor
Routledge, 2022
Nyckelord
80 and over, Aged, depression, item response theory, psychiatric status rating scales, psychometrics, ROC curve
Nationell ämneskategori
Annan hälsovetenskap
Identifikatorer
urn:nbn:se:umu:diva-180763 (URN)10.1080/13607863.2021.1881759 (DOI)000616203400001 ()2-s2.0-85100803309 (Scopus ID)
Forskningsfinansiär
Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseRegion VästerbottenRegion NorrbottenVisare NorrVetenskapsrådet, K2014-99X-22610-01-6
Tillgänglig från: 2021-02-25 Skapad: 2021-02-25 Senast uppdaterad: 2023-03-24Bibliografiskt granskad
Toots, A., Eriksson Domellöf, M., Lundin-Olsson, L., Gustafson, Y. & Rosendahl, E. (2022). Backward relative to forward walking speed and falls in older adults with dementia. Gait & Posture, 96, 60-66
Öppna denna publikation i ny flik eller fönster >>Backward relative to forward walking speed and falls in older adults with dementia
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2022 (Engelska)Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 96, s. 60-66Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Adults with dementia have a high risk of falls and fall-related injuries. A greater slowing of backward walking speed (BWS) relative to forward (FWS) has been indicated with older age, and slower BWS has been related to an increased risk of falls. Similarly, slow BWS relative to FWS has been observed in people with dementia.

Research question: Is slower BWS, and slower BWS relative to FWS associated with increased risk of prospective falls in older adults with dementia?

Methods: In total, 52 women and 12 men with dementia living in nursing homes, mean age 86 years, and mean Mini-Mental State Examination score of 14.2 points were included. BWS and FWS was measured over 2.4 m, and the directional difference (DD) calculated (100*((FWS-BWS)/FWS)). Falls were followed for 6 months by review of fall incident reports in electronic medical records at nursing homes and the regional healthcare provider.

Results: Altogether, 95 falls occurred with mean incidence rate 3.1 falls per person-years. Of included participants, 15 (23%) fell once, and 17 (27%) fell twice or more. In negative binomial regression analyses, greater DD was associated with lower prospective incidence fall rate ratio, IRR (IRR= 0.96, p < .001), while BWS was not (IRR= 0.04, p = .126).

Significance: In this study of adults with dementia, slower BWS was not associated with prospective falls. However, slower BWS relative to forward (greater DD) was associated with fewer falls, and possibly a protective response. This is novel research, yet results are promising and indicate that assessing walking speed in multiple directions may inform fall risk in adults with dementia.

Ort, förlag, år, upplaga, sidor
Elsevier, 2022
Nyckelord
Accidental falls, Alzheimer's, Gait
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-195060 (URN)10.1016/j.gaitpost.2022.05.013 (DOI)000804643500009 ()2-s2.0-85129987110 (Scopus ID)
Forskningsfinansiär
Region VästerbottenVårdalstiftelsenStiftelsen PromobiliaDemensförbundetVetenskapsrådet, K2009-69P-21298-01-4Vetenskapsrådet, K2009-69P-21298-04-4Vetenskapsrådet, K2009-69X-21299-01-1Vetenskapsrådet, K2014-99X- 22610-01-6Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseForte, Forskningsrådet för hälsa, arbetsliv och välfärdSvenska läkaresällskapetAlzheimerfonden
Tillgänglig från: 2022-05-23 Skapad: 2022-05-23 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Unneby, A., Gustafson, Y., Olofsson, B. & Lindgren, B.-M. (2022). Between Heaven and Hell: Experiences of Preoperative Pain and Pain Management among Older Patients with Hip Fracture. Sage Open Nursing, 8, 1-10
Öppna denna publikation i ny flik eller fönster >>Between Heaven and Hell: Experiences of Preoperative Pain and Pain Management among Older Patients with Hip Fracture
2022 (Engelska)Ingår i: Sage Open Nursing, E-ISSN 2377-9608, Vol. 8, s. 1-10Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: Among older adults, hip fracture is a common and serious consequence of a fall. Preoperative pain is common and often severe among patients with hip fracture. Opioids are usually used but have many side effects. One alternative is a femoral nerve block, which has been shown to reduce pain and lower the need for opioids. However, to our knowledge no study has explored qualitatively how patients with hip fracture experience treatment with femoral nerve block.

Objective: The aim of this study was to explore experiences of preoperative pain and pain management among older patients with hip fracture who had received a femoral nerve block.MethodA qualitative design with semi-structured interviews (n =23) conducted 2-6 days after surgery. Inclusion criteria were Swedish-speaking patients aged 70 years or older with hip fracture admitted to the orthopedic ward, treated with femoral nerve block before nursing actions. Data were analyzed with qualitative content analysis.

Results: Our result revealed one theme, hovering between heaven and hell, with five subthemes: how the pain was described - no pain, to worst pain and everything in between; they were dealing with pain in their own way; felt dependent on staff?s willingness to relieve pain; pain management could be lifesaving and a near-death experience; and how they experienced memory loss with respect to the pain and pain management.

Conclusion: The experience of pain and pain management was described as hovering between heaven and hell. We conclude that independent of which pain management given, staff should have an individualized pain mangement approach towards the patient in order to achieve well managed pain.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2022
Nyckelord
femoral nerve block, hip fracture, opioids, pain, pain managment, peripheral nerve block
Nationell ämneskategori
Ortopedi Geriatrik
Forskningsämne
ortopedi
Identifikatorer
urn:nbn:se:umu:diva-194654 (URN)10.1177/23779608221097450 (DOI)000797451700001 ()35558139 (PubMedID)2-s2.0-85129816171 (Scopus ID)
Tillgänglig från: 2022-05-12 Skapad: 2022-05-12 Senast uppdaterad: 2023-05-09Bibliografiskt granskad
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