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Littbrand, Håkan
Publications (10 of 47) Show all publications
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
Open this publication in new window or tab >>Having plans for the future in very old people
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2024 (English)In: The International Journal of Aging & Human Development, ISSN 0091-4150, E-ISSN 1541-3535Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
aged 80 and over, future perception, gerontology, optimism, plans for the future, survival
National Category
Gerontology, specialising in Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:umu:diva-221560 (URN)10.1177/00914150241231189 (DOI)001159569300001 ()38342991 (PubMedID)2-s2.0-85185275774 (Scopus ID)
Funder
Umeå UniversityThe Dementia Association - The National Association for the Rights of the DementedSwedish Research Council, K2014-99X-22610-01-6Visare NorrRegion VästerbottenKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2024-03-05 Created: 2024-03-05 Last updated: 2024-03-05
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.
Open this publication in new window or tab >>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 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 572Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Dementia, Experiences, Grounded theory, Informal caregiver, Interdisciplinary health team, Person-centered care, Rehabilitation
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:umu:diva-214772 (URN)10.1186/s12877-023-04269-3 (DOI)37723442 (PubMedID)2-s2.0-85171536442 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-0897Promobilia foundationThe Dementia Association - The National Association for the Rights of the DementedThe Janne Elgqvist Family FoundationRegion VästerbottenAlzheimerfondenFoundation for the Memory of Ragnhild and Einar LundströmStiftelsen Gamla Tjänarinnor
Available from: 2023-10-18 Created: 2023-10-18 Last updated: 2023-10-18Bibliographically approved
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
Open this publication in new window or tab >>Temporal dementia and cognitive impairment trends in the very old in the 21st century
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2023 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 93, no 1, p. 61-74Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
IOS Press, 2023
Keywords
Aged 80 and over, Alzheimer’s disease, cognition disorders, cohort studies, cross-sectional studies, dementia, epidemiologic studies, longitudinal studies, neurocognitive disorders, vascular dementia
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-209294 (URN)10.3233/JAD-220915 (DOI)000980906000005 ()36938733 (PubMedID)2-s2.0-85159555239 (Scopus ID)
Funder
Swedish Research Council, K2014–99X-22610–01–6Umeå UniversityRegion VästerbottenThe Dementia Association - The National Association for the Rights of the Demented
Available from: 2023-06-08 Created: 2023-06-08 Last updated: 2023-09-05Bibliographically approved
Öhlin, J., Toots, A., Dahlin Almevall, A., Littbrand, H., Conradsson, M., Hörnsten, C., . . . Söderberg, S. (2022). Concurrent validity of the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) - tested with accelerometer data from the SilverMONICA study. Gait & Posture, 92, 135-143
Open this publication in new window or tab >>Concurrent validity of the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) - tested with accelerometer data from the SilverMONICA study
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2022 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 92, p. 135-143Article in journal (Refereed) Published
Abstract [en]

Background: Physical activity and sedentary behavior vary across the life span, and in very old people activity behavior can vary considerably over 24 h. A physical activity questionnaire adapted for this age group is lacking. This study was conducted to validate such a newly developed questionnaire suitable for use in very old people.

Research question: Is the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) a valid measure of physical activity in very old people?

Methods: Seventy-six participants (55.3% women) with a mean age of 84.4 ± 3.8 years wore accelerometers for ≥ 5 consecutive days, and completed the IPAQ-E 80 +. Spearman's rho and Bland-Altman plots were used to analyze the validity of IPAQ-E 80 + against accelerometer measures. Analyses were conducted for the separate items sitting, laying down at daytime and nighttime, walking, moderate to vigorous (MV) walking, and moderate to vigorous physical activity (MVPA), and the summary measures: total inactive time, sedentary time (i.e. lying down at daytime + sitting), total active time, and total MVPA + MV walking.

Results: The IPAQ-E 80 + correlated with the accelerometer measures of total inactive- (r = 0.55, p < 0.001), sedentary- (r = 0.28, p = 0.015), walking- (r = 0.54 p < 0.001) and total active- (r = 0.60, p < 0.001) times, but not with measures of intensity of walking or physical activity; MV walking (r = 0.06, p = 0.58), MVPA (r = 0.17, p = 0.13).

Significance: In this study the IPAQ-E 80 + showed fair to substantial correlations with accelerometers, and it therefore seems able to rank very old people according to levels of PA (total inactive-, sedentary-, and total active time, and walking time). The IPAQ-E 80 + seems promising for use in studies investigating associations between activity behavior and health in this population. Further investigation is needed to determine whether the IPAQ-E 80 + can accurately measure PA intensity.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Validity, Physical activity questionnaire, Sedentary behavior, Very old people, Accelerometry
National Category
Physiotherapy Geriatrics Public Health, Global Health, Social Medicine and Epidemiology
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-187217 (URN)10.1016/j.gaitpost.2021.11.019 (DOI)000788079500011 ()34847411 (PubMedID)2-s2.0-85120962874 (Scopus ID)
Funder
Swedish Research Council Formas, 2016-01074Swedish Research Council, K2014-99X-22610-01-6
Note

Originally included in thesis in manuscript form.

Available from: 2021-09-06 Created: 2021-09-06 Last updated: 2023-09-05Bibliographically approved
Lampinen, J., Conradsson, M., Nyqvist, F., Olofsson, B., Gustafson, Y., Nilsson, I. & Littbrand, H. (2022). Loneliness among very old people with and without dementia: prevalence and associated factors in a representative sample. European Journal of Ageing, 19, 1441-1453
Open this publication in new window or tab >>Loneliness among very old people with and without dementia: prevalence and associated factors in a representative sample
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2022 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 19, p. 1441-1453Article in journal (Refereed) Published
Abstract [en]

Loneliness and dementia are common among very old (aged ≥ 80 years) people, but whether the prevalence of loneliness differs between very old people with and without dementia is unknown and few studies have investigated associated factors. The aims of the present study were to compare the prevalence of loneliness between people with and without dementia in a representative sample of very old people, and to investigate factors associated with loneliness in the two groups separately. This population-based study was conducted with data on 1176 people aged 85, 90, and ≥ 95 years (mean age 89.0 ± 4.47 years) from the Umeå 85 + /Gerontological Regional Database study conducted in northern Sweden, during year 2000–2017. Structured interviews and assessments were conducted during home visits. Loneliness was assessed using the question “Do you ever feel lonely?.” Multivariable logistic regression analysis was conducted to identify factors associated with loneliness in participants with and without dementia. The prevalence of loneliness did not differ between people with and without dementia (50.9% and 46.0%, respectively; p = 0.13). Seven and 24 of 35 variables were univariately associated with the experience of loneliness in participants with and without dementia, respectively. In the final models, living alone and having depressive symptoms were associated with the experience of loneliness in both study groups. In participants without dementia, living in a nursing home was associated with the experience of less loneliness. These findings contribute with important knowledge when developing strategies to reduce loneliness in this growing age group.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Aged 80 and over, Cross-sectional study, Dementia, Social participation
National Category
Nursing Gerontology, specialising in Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-199917 (URN)10.1007/s10433-022-00729-8 (DOI)000854398500001 ()36157280 (PubMedID)2-s2.0-85138167224 (Scopus ID)
Funder
Swedish Research Council, K2014-99X-22610-01- 6Vårdal FoundationKonung Gustaf V:s och Drottning Victorias FrimurarestiftelseThe Kempe FoundationsRegion VästerbottenThe Dementia Association - The National Association for the Rights of the DementedEuropean CommissionInterreg
Available from: 2022-10-05 Created: 2022-10-05 Last updated: 2022-12-30Bibliographically approved
Öhlin, J., Toots, A., Littbrand, H., Wennberg, P., Olofsson, B., Gustafson, Y., . . . Söderberg, S. (2022). Physical activity in late middle- to older-aged people and dementia, cognitive, and physical function two decades later. Dementia and Geriatric Cognitive Disorders, 51, 135-141
Open this publication in new window or tab >>Physical activity in late middle- to older-aged people and dementia, cognitive, and physical function two decades later
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2022 (English)In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 51, p. 135-141Article in journal (Refereed) Published
Abstract [en]

Introduction: Low physical activity (PA) is a potential risk factor for dementia and cognitive impairment. However, few studies have focused on very old people (aged ≥80 years), the age group with highest prevalence of dementia. The aim was to investigate if PA associated with subsequent dementia, cognitive function, and gait speed (GS), in very old people.

Methods: A population-based survey was conducted in 1999 and followed-up between 2016 and 2019 in participants ≥80 years. Altogether 541 individuals (56.2% women), 64.9 ± 4.2 years of age at baseline participated. Self-rated baseline PA was categorized into low, medium, or high. Cognitive function was assessed with the Mini-Mental State Examination (MMSE), executive function with the Frontal Assessment Battery (FAB), and GS (in meters/second) was measured over 2.4 m at follow-up.

Results: During a mean of 19.0 ± 1.1 years, 175 (32.3%) developed dementia. Low or medium PA compared to high PA did not associate with subsequent dementia, and PA did not associate with future cognitive function (MMSE). PA associated with executive function (FAB) (unstandardized beta [95% confidence interval]) (0.67 [0.07–1.27]), but not after adjustments. PA associated with subsequent GS in the unadjusted model and after adjustment for age, sex, smoking, and education (0.06 [0.02–0.09], and 0.04 [0.01–0.08], respectively), but not after adding adjustment for hypertension, obesity, and glucose intolerance.

Conclusion: No support was found for the hypothesis that low PA is a potential risk factor for dementia in very high age. However, PA and executive function were associated in unadjusted analyses which indicate that PA may be important for at least one aspect of cognitive function. The association between PA and GS around 2 decades later seems attenuated by cardiometabolic risk factors. Future investigations regarding PA, dementia, and cognitive decline may consider cardiometabolic risk factors such as hypertension, obesity, and glucose intolerance, and include repeated measures of PA over the life course.

Place, publisher, year, edition, pages
S. Karger, 2022
Keywords
cognitive function, dementia, executive function, gait speed, physical activity, very old people
National Category
Physiotherapy Geriatrics
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-187213 (URN)10.1159/000523726 (DOI)000779096600001 ()2-s2.0-85128538079 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01074Swedish Research Council, K2014-99X22610-01-6The Dementia Association - The National Association for the Rights of the DementedKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Note

Originally included in thesis in manuscript form.

Available from: 2021-09-06 Created: 2021-09-06 Last updated: 2023-05-26Bibliographically approved
Sondell, A., Lampinen, J., Conradsson, M., Littbrand, H., Englund, U., Nilsson, I. & Lindelöf, N. (2021). Experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program. BMC Geriatrics, 21(1), Article ID 341.
Open this publication in new window or tab >>Experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program
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2021 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 21, no 1, article id 341Article in journal (Refereed) Published
Abstract [en]

Background: There is great need for development of feasible rehabilitation for older people with dementia. Increased understanding of this population’s experiences of rehabilitation participation is therefore important. The aim of this study was to explore the experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program.

Methods: Sixteen older people with dementia were interviewed about their experiences of participation in a person-centred multidimensional interdisciplinary rehabilitation program. The program comprised assessments by a comprehensive team of rehabilitation professionals followed by a rehabilitation period of 16 weeks, including interventions based on individualized rehabilitation goals conducted with the support of the rehabilitation team. The rehabilitation was performed in the participants’ homes, in the community and at an outpatient clinic, including exercise with social interaction in small groups offered twice a week to all participants. The interviews were conducted at the end of the rehabilitation period and analysed with qualitative content analysis.

Results: The analysis resulted in one overarching theme: Empowered through participation and togetherness and four sub-themes: Being strengthened through challenges; Gaining insights, motives, and raising concerns about the future; Being seen makes participation worthwhile; and Feelings of togetherness in prosperity and adversity. The participants increased their self-esteem by daring and coping in the rehabilitation. The insights about themselves and their condition motivated them to continue with their prioritized activities, but also raised concerns about how the future would play out. Collaboration in the group and being seen and acknowledged by staff strengthened their own motivation and self-efficacy.

Conclusion: According to community-dwelling older people with dementia, a person-centred multidimensional interdisciplinary rehabilitation program was experienced as viable and beneficial. The participants seemed empowered through the rehabilitation and expressed mostly positive experiences and perceived improvements. Providers of interdisciplinary rehabilitation programs for this group should consider aspects raised by the participants e.g. the positive experience of being challenged in both exercise and daily activities; the importance of being seen and feeling secure; the benefits and challenges of collaboration with others in the same situation; and the generation of new perspectives of current and future situation.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
Aged, Dementia, Experiences, Interdisciplinary, Qualitative research, Rehabilitation
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-184444 (URN)10.1186/s12877-021-02282-y (DOI)000660608300004 ()2-s2.0-85107216049 (Scopus ID)
Available from: 2021-06-14 Created: 2021-06-14 Last updated: 2023-09-05Bibliographically approved
Öhlin, J., Gustafson, Y., Littbrand, H., Olofsson, B. & Toots, A. (2021). Low or declining gait speed is associated with risk of developing dementia over 5 years among people aged 85 years and over. Journal of Aging and Physical Activity, 29(4), 678-685
Open this publication in new window or tab >>Low or declining gait speed is associated with risk of developing dementia over 5 years among people aged 85 years and over
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2021 (English)In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 29, no 4, p. 678-685Article in journal (Refereed) Published
Abstract [en]

Improving dementia screening procedures beyond simple assessment of current cognitive performance is timely given the ongoing phenomenon of population aging. A slow or declining gait speed (GS) is a potential early indicator of cognitive decline scarcely investigated in very old people. Here, we investigated the 5-year associations of baseline GS, change in GS, and cognitive function with subsequent dementia development in people aged 85 years and older (n = 296) without dementia at baseline. Declining and a slow baseline GS were associated with higher odds of dementia development after adjusting for confounders (e.g., age, sex, and dependency in activities of daily living) and missing GS values at follow-up. The GS decline was associated with cognitive decline in participants who developed dementia. The results support the potential of GS tests to predict future cognitive decline among community- and nursing home-dwelling very old people.

Place, publisher, year, edition, pages
Human Kinetics, 2021
Keywords
Cognitive decline, Dementia disorders, Very old people, Walking speed
National Category
Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-186641 (URN)10.1123/JAPA.2020-0266 (DOI)000674164600015 ()33421958 (PubMedID)2-s2.0-85111964969 (Scopus ID)
Available from: 2021-08-25 Created: 2021-08-25 Last updated: 2021-09-07Bibliographically approved
Hörnsten, C., Littbrand, H., Boström, G., Rosendahl, E., Lundin-Olsson, L., Nordström, P., . . . Lövheim, H. (2021). Measurement error of the Mini-Mental State Examination among individuals with dementia that reside in nursing homes. European Journal of Ageing, 18(1), 109-115
Open this publication in new window or tab >>Measurement error of the Mini-Mental State Examination among individuals with dementia that reside in nursing homes
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2021 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 18, no 1, p. 109-115Article in journal (Refereed) Published
Abstract [en]

Few studies have investigated the measurement error of the Mini-Mental State Examination (MMSE) in the same unit of measurement, also known as absolute reliability. This measurement can help determine whether an observed score change for an individual is likely to represent true change. The aim of this study was to investigate the absolute reliability of the MMSE among individuals with dementia that reside in nursing homes. Among 88 participants, 19 (21.6%) were men, 35 (39.8%) had Alzheimer's disease, 35 (39.8%) had vascular dementia, and the mean age was 84.0 years (range 65-98). The participants were tested and retested with the MMSE within 1-6 days. Both tests were administered by the same assessor at the same time of day. The mean MMSE score was 13.7 (range 0-28). The absolute difference between MMSE scores varied from 0 to 6 points, and the differences did not correlate with the corresponding score means (p = 0.874). The smallest detectable change (SDC) between two measurements was 4.00. The SDC was independent of depression, impaired vision and hearing, delirium within the last week, dementia type and age. However, the SDC was 5.56 among men and 3.50 among women (p = 0.003). In conclusion, for individuals with dementia that reside in nursing homes, it seems like their MMSE score needs to change by four or more points between two measurements in order for their score change to be reliably higher than the measurement error.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Absolute reliability, Mini-Mental State Examination, Test-retest reliability, Intra-rater reliability, Dementia, Nursing homes
National Category
Geriatrics Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-172500 (URN)10.1007/s10433-020-00572-9 (DOI)000537668800001 ()2-s2.0-85085951902 (Scopus ID)
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 DementedSwedish Society of MedicineVästerbotten County Council
Available from: 2020-07-02 Created: 2020-07-02 Last updated: 2022-01-03Bibliographically approved
Öhlin, J., Ahlgren, A., Folkesson, R., Gustafson, Y., Littbrand, H., Olofsson, B. & Toots, A. (2020). The association between cognition and gait in a representative sample of very old people - the influence of dementia and walking aid use. BMC Geriatrics, 20, Article ID 34.
Open this publication in new window or tab >>The association between cognition and gait in a representative sample of very old people - the influence of dementia and walking aid use
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2020 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, article id 34Article in journal (Refereed) Published
Abstract [en]

Background: Cognition has been related with gait speed in older adults; however, studies involving the oldest age group, where many have mobility disability and cognitive impairment, are few. The aim was to investigate the association between global cognitive function and gait speed in a representative sample of very old people, and whether the association was affected by dementia, and walking aid use.

Method: This cross-sectional study included 1317 participants, mean age 89.4 years, and 68% women, from the Umeå85+/Gerontological Regional Database. Self-paced gait speed was measured over 2.4 m, with or without walking aids, and global cognitive function with the Mini-Mental State Examination (MMSE). The association between cognition and gait speed was analyzed using multiple linear regression and stratified according to dementia. The influence of missing gait speed values was explored using multiple imputation. An interaction analysis was performed to investigate the influence of walking aid use.

Results: In comprehensively adjusted analyses, MMSE associated with gait speed (unstandardized β (β) 0.011 m/s, 95% Confidence Interval [CI] = 0.009, 0.013, p < 0.001) in the total sample. No association was found in people with dementia (β 0.003 m/s, 95%CI = 0.000, 0.006, p = 0.058), until missing gait speed values were compensated for by multiple imputation (β 0.007 m/s, 95% [CI] = 0.002, 0.011, p = 0.002). In interaction analysis the use of walking aids attenuated the association between cognition and gait speed (β − 0.019 m/s, 95%CI = − 0.024, − 0.013, p < 0.001).

Conclusion: Global cognitive function appears to associate with gait speed in very old people. However, in people with dementia selection bias was indicated since unless missing gait speed values were accounted for no association was observed. Walking aid use attenuated cognitive load, which may not apply to walking in daily activities, and requires further investigation.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Gait speed, Cognition, Walking aids, Dementia, Aged 80 and over
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-168829 (URN)10.1186/s12877-020-1433-3 (DOI)000513522000003 ()32005103 (PubMedID)2-s2.0-85078838554 (Scopus ID)
Funder
Swedish Research Council, K2014-99X-22610-01-6
Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2021-09-09Bibliographically approved
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