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Sölve Elmståhl

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University of Cologne

SUNY: Stony Brook University

Morten Tønnessen

University of Stavanger

STMIK AMIKOM Yogyakarta

Gisela van Rensburg

UNISA

Aftab Hameed Memon

QUEST Engineering University Nawabshah, Sindh, Pakistan

Jeanette Maritz

University of South Africa

Ben Gurion University of the Negev

University of Ibadan Nigeria

Sasa Ani Arnomo

Universitas Putera Batam

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Papers by Sölve Elmståhl

The association between physical frailty and cognitive performance in older adults aged 60-96 years. Data from the “Good Aging in Skåne” (GÅS) Swedish population study

Annals of geriatric medicine and research, May 17, 2024

Background: The association between physical frailty and performance in different cognitive domai... more Background: The association between physical frailty and performance in different cognitive domains in the absence of cognitive disorders is poorly understood. Hence, we aimed to explore the associations between frailty levels based on the Fried Physical Frailty Phenotype and performance of different cognitive domains. We also aimed to examine the associations between cognitive function and each criterion in the Fried Frailty Scale using the same cognitive domains in a non-dementia population aged 60-96 years. Methods: This cross-sectional study included 4,329 participants aged 60-93 years, drawn from the "Good Aging in Skåne" population study. Frailty indices included handgrip strength, physical endurance, body mass index (BMI), physical activity, and walking speed. Cognitive function was assessed across eight domains: episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, executive function, and visual perception. We constructed adjusted multiple linear regression models for each cognitive domain, with the frailty levels as the independent variable. Likewise, we constructed linear regression models with each cognitive domain as the dependent variable and frailty criteria as independent variables. Results: Physical frailty was associated with poor performance in episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, and executive functions (p < 0.001 for all associations). Weaker hand grip strength was independently associated with poorer performance in all cognitive domains (p < 0.001-0.015) Conclusions: Higher levels of frailty were associated with poorer performance in all cognitive domains except visual perception. Describing frailty by considering cognitive functioning may provide a better understanding of frailty.

Mortality risk relationship using standard categorized BMI or knee-height based BMI – does the overweight/lower mortality paradox hold true?

Aging Clinical and Experimental Research, Apr 8, 2024

Background The body mass index (BMI) is prone to misclassification of obesity due to age-related ... more Background The body mass index (BMI) is prone to misclassification of obesity due to age-related height loss and resulting measurement errors. Knee-height based BMI (KH-BMI) has not been previously studied in relation to mortality risk in older adults. Aim To evaluate the age-and sex-specific mortality risk relationship using classic BMI and knee height predicted BMI (KH-BMI) overweight and obesity in a 15-year follow-up study including older Swedish adults aged 60-93 years. Methods A 15-year follow-up study among 2,786 individuals aged ≥ 60 years. Height, weight and KH were measured. KH-predicted height was estimated using formulated gender-specific equations. Classic BMI and KH-BMI (kg/m 2 ) were calculated. Mortality data was obtained from the Swedish death registry. Questionnaires were used to collect data on obesityrelated lifestyle factors and comorbidities. Results Cox regression revealed that using the classic BMI, when comparing with the normal/underweight reference group, there was a mortality risk among overweight men (HR = 0.67, 0.52-0.87), overweight women (HR = 0.79, 0.65-0.97), and obese men (HR = 0.60, 0.41-0.89) aged ≥ 80 years old. Using the KH-BMI, only overweight men and overweight women aged ≥ 80 years had a lower mortality risk, men (HR = 0.71, 0.55-0.92); women (HR = 0.77, 0.62-0.95) after adjusting for obesity-related lifestyle factors and comorbidities. Discussion There is evidence that obesity is overestimated by the BMI, in comparison with the KH-BMI classification. In terms of mortality risk and after adjusting for height, there remains a paradoxical protective association between overweight and mortality. Conclusion Regardless of classic BMI or KH-BMI estimation, overweight men and women aged ≥ 80 years had a lower mortality risk compared to normal/underweight men and women ≥ 80 years.

Loneliness, social isolation, and health complaints among older people: A population-based study from the “Good Aging in Skåne (GÅS)” project

SSM - Population Health

Iconography : Associations between cognitive abilities and life satisfaction in the oldest-old

Physical Performance in Older Cohorts: A Comparison of 81-Year-Old Swedish Men and Women Born Twelve Years Apart—Results from the Swedish Study “Good Aging in Skåne”

Journal of Aging Research, 2021

Materials and Methods Birth cohorts of both sexes drawn from the Swedish study “Good Aging in Skå... more Materials and Methods Birth cohorts of both sexes drawn from the Swedish study “Good Aging in Skåne” for the years 1920–22 and 1932–34 were compared. Walking, the step test, the chair stand test, and the handgrip strength test were used as proxies for the physical performance. The results were adjusted for lifestyle habits and common chronic geriatric diseases. Results Both men and women in the later-born cohort walked more quickly and completed the chair stand test faster, and women were also quicker in the step test. No significant differences were found in the grip test, in either the male or female cohorts. Discussion. Normative reference values for physical tests of subjects of different ages can be misleading unless cohort effects are considered. Furthermore, age-related trajectories can also be misinterpreted if cohort effects are neglected which, in the longer perspective, could affect health care planning. Conclusion Birth cohort effects should be considered when comparing ...

The Life Satisfaction Index-A (LSI-A): Normative Data for a General Swedish Population Aged 60 to 93 Years

Clinical Interventions in Aging, 2020

To gain Swedish norm value for the Life Satisfaction Index-A (LSI-A) in a population 60-93+ years... more To gain Swedish norm value for the Life Satisfaction Index-A (LSI-A) in a population 60-93+ years old stratified for sex and age and to relate these norm values with respect to number of chronic diseases and functional impairment. The study population included a random sample of 2656 men (45.7%) and 3159 (54.3%) women from the longitudinal national studies' "Good Aging in Skåne" (GÅS) and SNAC-B, both part of the Swedish National Study on Aging and Care (SNAC). Data on Neugartens Life Satisfaction Index-A (LSI-A), medical history, activities of daily life (ADL) and socio-demographics were collected through structured interviews and questionnaires. Results: Men scored significantly higher than women; 28.5, sd=6.9, and 27.3, sd=6.6, respectively, out of maximum 40 points. For both genders the scores decreased with age, mean score 6.0 points, lower for men and 7.1 points lower for women between 60 and 93+ years. The highest score was noted for healthy individuals where both men and women scored 29.5 points, sd=6.2. Increased number of chronic diseases and dependency in ADLs were associated with lower LS. Norm values here presented may facilitate assessments and evaluation of life satisfaction in the general elder population and as reference values to clinical trials. Female sex, rising age, morbidity and impaired functional ability were all associated with impaired LS.

Analyzing the situation of older family caregivers with a focus on health-related quality of life and pain: a cross-sectional cohort study

Health and Quality of Life Outcomes, 2020

Background For a significant proportion of the older population, increasing age is associated wit... more Background For a significant proportion of the older population, increasing age is associated with health problems and worsening health. Older family caregivers are largely responsible for care of next-of-kin living at home, which impacts their own physical and mental health both positively and negatively. However, evidence is insufficient regarding the health situation of older caregivers. The aim of this study was to investigate health-related quality of life (HRQoL) and pain, and their associations, among caregivers aged ≥60 years. Methods The participants (n = 3444) were recruited from the Swedish National Study on Aging and Care-Blekinge and Good Aging in Skåne during 2001–2004. Participants aged ≥60 years were selected randomly and underwent cognitive tests, with demographic information obtained through questionnaires. The response rate was 60%. A predefined research protocol was used. HRQoL was measured with the Short-Form Health Survey, dimension mental health. Logistic regr...

The association between medical diagnosis and caregiver burden: a cross-sectional study of recipients of informal support and caregivers from the general population study ‘Good Aging in Skåne’, Sweden

Aging Clinical and Experimental Research, 2017

Background Different kinds of chronic diseases might imply different dimensions of caregiver burd... more Background Different kinds of chronic diseases might imply different dimensions of caregiver burden, not previously described among the caregivers to recipients from the general elder population. Aim The main objective was to examine differences in burden between the 343 caregivers to persons with different diagnoses. Methods A group of elderly recipients of informal care (n = 343) from the general population study 'Good Aging in Skåne' (GÅS) Sweden, were divided into five diagnostic groups: dementia (n = 90), heart and lung diseases (n = 48), stroke (n = 62), fractures (n = 66), depression (n = 40) and the group "other", consisting of different diagnoses (n = 37) according to ICD-10. Differences in burden were analyzed using the Caregiver Burden Scale (CBS), a 22-item scale consisting of five dimensions: general strain, isolation, disappointment, emotional involvement and environmental burden. A total burden index comprises the mean of all the 22 items and a higher score indicates a higher burden. The most common diagnosis associated to caregiving was dementia and fracture and the median hours weekly for informal support with instrumental ADL for the five diagnostic groups ranged from 7 to 45 h for spouses and from 4 to 7 h for parents. The highest proportion of caregivers scoring high total burden was seen among recipients with dementia (50%) and depression (38%); the OR for high total burden for the dementia group was 4.26 (2.29-7.92) and depression group 2.38 (1.08-5.24) adjusted for covariates like age, gender and ADL and these two groups had higher self-perception of burden in all the dimensions, especially the dimension's emotional burden and strain. Conclusion Informal support constitutes a substantial time for instrumental ADL for the diseased elders. Caregivers to persons with dementia and depression experience high burden.

Physical performance in relation to birth cohort: A comparison of 60 year old Swedish men and women born twelve years apart

Archives of Gerontology and Geriatrics, 2019

Pain and alcohol: a comparison of two cohorts of 60 year old women and men: findings from the Good Aging in Skåne study

Scandinavian Journal of Pain, 2018

Background and aims Pain, use of painkillers and alcohol are highly prevalent in the general popu... more Background and aims Pain, use of painkillers and alcohol are highly prevalent in the general population. Aims of the study were to describe differences in pain, alcohol consumption and use of painkillers among two 60 year old birth cohorts stratified by gender. Methods Participants were recruited from the Skåne centre of The Swedish National study on Aging and Care, a multicentre, prospective, longitudinal study. The sample comprised 60 year old men and women born between 1941 and 1943 and recruited to the study between 2001 and 2004 (n=663) and 60 year old men and women born in the period 1952–1954 and recruited to the study between 2013 and 2015 (n=924). Specially trained research staff conducted the interviews. For descriptive statistics the variables were presented in total numbers, percentages, mean and standard deviation, and 1st and 3rd quartile are also shown. The sample was divided into four groups: men and women born in the period 1941–1943, men and women born in the perio...

Home and Health in the Third Age — Methodological Background and Descriptive Findings

International Journal of Environmental Research and Public Health, 2014

Background: The understanding of the complex relationship between the home environment, well-bein... more Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67-70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens.

Extension of ENABLE-AGE research questions and methodology to a younger cohort in Sweden

Reference EPFL-CONF-185743View record in Web of Science Record created on 2013-03-28, modified on... more

Kommunal och regional vård till äldre: Vård och omsorg i Eslöv, Hässleholm, Malmö, Osby och Ystad till personer 65 och däröver, En delstudie i SNAC. Rapport 1

Kommunal och regional vard till aldre : Vard och omsorg i Eslov, Hassleholm, Malmo, Osby och Ysta... more

Analys och utveckling av system för registrering av vårdbehov och vårdinsatser till äldre i kommunal vård och omsorg.-En delstudie i SNAC Rapport 2

Den offentliga statistiken inom aldreomsorgsomradet ar for narvarande begransad till mangdstatist... more Den offentliga statistiken inom aldreomsorgsomradet ar for narvarande begransad till mangdstatistik (Statistik - socialtjanst 2000:5, Socialstyrelsen 2000 och Halso- och sjukvardsstatistisk arsbok 1999, Socialstyrelsen 2000). Fran denna statistik erhalles uppgifter om antalet aldre som far vard och hjalp fordelade pa alder, kon och vardinsats samt vardkostnader. For att fa insikt i aldreomsorgssystemets maluppfyllelse, funktionssatt, effektivitet och kvalitet kravs en mer systematisk och individbaserad ansats an den som mangdstatistik kan erbjuda. I Region Skane finns sedan tio ar tillbaka ett valutvecklat patientadministrativt system, PASiS. I Skanes 33 kommuner anvands olika system for registrering av individdata inom omsorg och halso- och sjukvard. Kunskapen ar for narvarande begransad om vilken typ av information som dokumenteras och finns att tillga om aldre i vard och omsorg pa kommunal niva, delvis ocksa pa landstingsniva. Projektets syfte var att inventera och analysera befintliga registreringssystem samt att utveckla en gemensam och komplementar dataterminologi, att anvandas vid planering av vard och omsorg. Vidare att utveckla ett system som mojliggor sammanlankning av relevanta data mellan olika vardaktorer och foresla sakerhetslosningar som skyddar vardtagarens integritet och anonymitet. Faltstudier bedrevs i fem kommuner, Eslov, Hassleholm, Malmo och Osby, samt i Region Skane dar befintliga registreringssystem inventerades och analyserade. Resultatet visade stora olikheter i dokumentation mellan kommunerna. Dokumentationen forekom mestadels i fri text och varierade i omfattning och innehall. Standardiserade instrument for behovs- och funktionsbedomning saknades. Manuella och datoriserade system anvandes. Informationsoverforing mellan respektive kommun och Region Skane gjordes manuellt nar vardtagaren flyttades mellan huvudmannen. Tva kommuner, Hassleholm, Osby, hade vidareutvecklat blanketter for informationsoverforing. Inom projektets ram utvecklades ett formular, baserat pa inventering av vardsystem, litteraturstudier och diskussioner i en expertgrupp, som beskriver den aldres behov av vard och omsorg, beslut och planering samt insatta och forandrade atgarder. Formularet testades i en pilotstudie. I utvarderingen av pilotstudien framkom bl.a. att bistandshandlaggare och distriktsskoterskor var den adekvata malgruppen att ansvara for registrering av vard och omsorg. Det standardiserade formularet omfattar sex delomraden; administrativa uppgifter, persondata, omgivningsfaktorer, vardberoende, nuvarande och pagaende insatser, sarskilda sjukvardsinsatser, samt informell vard. I registreringen av vard och omsorg har det ingatt aldre over 65 ar som erhaller varaktiga insatser fran kommun och/eller landsting. Efter den inledande undersokningen har formularet utvarderats av personal inom vard och omsorg i de fem kommunerna. Skriftligt informerat samtycke har inhamtats fran de aldre som ingar i studien. Vid sammankoppling av individbaserad statistik mellan aktuella kommuner och Region Skane och for anvandning i forskning galler sarskilda sekretessbestammelser och informerat samtycke fran de aldre som ingar i studien kravs. Datainsamlingen har genomforts i tva steg; baseline som genomfordes under cirka 6 manader med registrering av aldre med pagaende vard och omsorg, och darefter paborjades kontinuerlig registrering. De forsta registreringarna av vard och omsorg i baslinjeundersokningen gjordes manuellt. Dataprogram ar under vidareutveckling for att mota kravet pa samordnad dokumentation om aldres vard och omsorg i kommunerna. En integrering av de variabler som ingar i formularet for registrering av vard och omsorg har genomforts. For att underlatta hanteringen finns det elektroniskt internetbaserade formularet tillgangligt via losenordsforfarande pa en lokal server vid Institutionen for Omvardnad, Lunds Universitet. I en av kommunerna, Malmo, tillampas ett nytt dataprogram som innehaller dokumentation av samtliga variabler som ingar i det utarbetade formularet och medger dokumentation fran samtliga verksamheter inom kommunal vard och omsorg. Insamlat material utgor databasen med uppgifter om aldres vard och omsorg i kommunerna och i forhallande till vard i Region Skane. I databasen kommer det att vara mojligt att folja vardtagare pa individniva inom den kommunala varden och vardtagare som forflyttas mellan kommunal vard och vard i Region Skane. Informationen i databasen kan anvandas av beslutsfattare och handlaggare i kommuner och i Region Skane, samt vidare analyseras och utvecklas genom nya forskningsansatser. (Less)

Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne

Clinical interventions in aging, 2014

To determine the relationship between long-term change in activities of daily living (ADL) and fa... more To determine the relationship between long-term change in activities of daily living (ADL) and falls in the elderly and to identify characteristics of groups at risk for falls. This was a 6-year, prospective cohort study using data from the Good Aging in Skåne study in southern Sweden, involving 1,540 elderly subjects, including the oldest-old (age, 60-93 years). The subjects were recruited from the general population. ADL was measured at a baseline and follow-up assessment, using Sonn and Åsberg's revised scale and the ADL staircase. Falls were recorded in a period of 6 months before the follow-up assessment. The association between falls and change in ADL was calculated using adjusted, multiple logistic regression analysis and presented in odds ratios (ORs). Thirteen percent of the study population reported one or several falls in the measured period. Over the course of 6 years, one in four participants changed their ADL status, and parts of this category had an increased risk...

Oral and Poster Papers Submitted for Presentation at the 5th Congress of the EUGMS “Geriatric Medicine in a Time of Generational Shift September 3–6, 2008 Copenhagen, Denmark

The Journal of Nutrition Health and Aging, 2008

Recent demographic evolution has changed the trends of the two fundamental variables - natality a... more

Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months

Scandinavian Journal of Caring Sciences, 2008

A number of different intervention programmes have been described in the literature for caregiver... more A number of different intervention programmes have been described in the literature for caregivers of people with dementia, but the nature of intervention has varied widely. The aim of the present study was to evaluate the efficacy of psychosocial intervention on family caregiver's level of burden and satisfaction, and possible influence of the caregiver's relationship and health and the patient's severity of the disease on the effects of intervention. All persons, 70 years and older, from two districts of a municipality (2721 individuals) who were in receipt of any form of social services were invited to participate in a screening of cognitive decline, and 1656 home visits were made. Those with symptoms of cognitive decline, and having a family caregiver, were invited for a further medical examination. Data were analysed from 308 family caregivers: 153 caregivers who underwent intervention and 155 control caregivers who did not. Repeated measures were carried out 6 and ...

Sleep quality, use of hypnotics and sleeping habits in different age‐groups among older people

Scandinavian Journal of Caring Sciences, 2014

BackgroundSleep disturbances are common among older people (>65 years). Further, long‐term use... more BackgroundSleep disturbances are common among older people (>65 years). Further, long‐term use of sedative‐hypnotics in older people is associated with morbidity and mortality. However, older people represent a large span of life years, and few studies have included the oldest‐old above 85 years.AimTo investigate and compare sleep quality, use of hypnotics and sleeping habits in different age groups of the older population in the Scania region, Sweden and in relation to sociodemographic‐ and functional status.Design and participantsA cross‐sectional population‐based study including 2931 people aged 60–93 years from five different municipalities in Scania was performed during 2001–2004.MethodThe sample was divided into age groups, young‐old (60–72 years), old‐old (78–84 years) and oldest‐old (87–93) years. Data constitutes of sleep related questions, sociodemographic‐ and functional status from the study ‘Good Ageing in Skåne’. Descriptive statistics were used to describe sleep qu...

Associations between cognitive abilities and life satisfaction in the oldest-old. Results from the longitudinal population study Good Aging in Skåne

Clinical Interventions in Aging, 2013

Studies on the associations between cognitive abilities and life satisfaction (LS) in the oldest-... more Studies on the associations between cognitive abilities and life satisfaction (LS) in the oldest-old are few. The aim of this study was to explore whether abilities in six different cognitive domains could predict LS in the oldest-old 3 years later. Methods: The study population consisted of 681 individuals aged 78-98 years, drawn from the longitudinal population study "Good Aging in Skåne," which is part of a national survey (The Swedish National Study on Aging and Care). Scores on 13 cognitive tests were related to scores on Neugartens' LS index A (LSI-A) 3 years later. The cognitive tests were added into six different cognitive domains. A multiple regression analysis was constructed for each cognitive domain separately, with scores on the LSI-A as the dependent variable. The model was adjusted stepwise for sex, age, education, functional capacity, and depressive mood. Results: Significant correlations were found between digit cancellation, word recall, verbal fluency (VF) A, VF animals, VF occupations, and mental rotations at baseline, as well as LSI-A at follow-up. The domains of spatial abilities (B = 0.453, P = 0.014) and processing speed (B = 0.118, P = 0.020) remained significantly associated with LSI-A 3 years later after adjustment. The cognitive domains of spatial abilities and processing speed predicted LS 3 years later in the oldest-old. Clinical implications are discussed.

Accidental falls, health-related quality of life and life satisfaction: A prospective study of the general elderly population

Archives of Gerontology and Geriatrics, 2014

Accidental falls, health-related quality of life and life satisfaction: A prospective study of th... more

The association between physical frailty and cognitive performance in older adults aged 60-96 years. Data from the “Good Aging in Skåne” (GÅS) Swedish population study

Annals of geriatric medicine and research, May 17, 2024

Background: The association between physical frailty and performance in different cognitive domai... more Background: The association between physical frailty and performance in different cognitive domains in the absence of cognitive disorders is poorly understood. Hence, we aimed to explore the associations between frailty levels based on the Fried Physical Frailty Phenotype and performance of different cognitive domains. We also aimed to examine the associations between cognitive function and each criterion in the Fried Frailty Scale using the same cognitive domains in a non-dementia population aged 60-96 years. Methods: This cross-sectional study included 4,329 participants aged 60-93 years, drawn from the "Good Aging in Skåne" population study. Frailty indices included handgrip strength, physical endurance, body mass index (BMI), physical activity, and walking speed. Cognitive function was assessed across eight domains: episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, executive function, and visual perception. We constructed adjusted multiple linear regression models for each cognitive domain, with the frailty levels as the independent variable. Likewise, we constructed linear regression models with each cognitive domain as the dependent variable and frailty criteria as independent variables. Results: Physical frailty was associated with poor performance in episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, and executive functions (p < 0.001 for all associations). Weaker hand grip strength was independently associated with poorer performance in all cognitive domains (p < 0.001-0.015) Conclusions: Higher levels of frailty were associated with poorer performance in all cognitive domains except visual perception. Describing frailty by considering cognitive functioning may provide a better understanding of frailty.

Mortality risk relationship using standard categorized BMI or knee-height based BMI – does the overweight/lower mortality paradox hold true?

Aging Clinical and Experimental Research, Apr 8, 2024

Background The body mass index (BMI) is prone to misclassification of obesity due to age-related ... more Background The body mass index (BMI) is prone to misclassification of obesity due to age-related height loss and resulting measurement errors. Knee-height based BMI (KH-BMI) has not been previously studied in relation to mortality risk in older adults. Aim To evaluate the age-and sex-specific mortality risk relationship using classic BMI and knee height predicted BMI (KH-BMI) overweight and obesity in a 15-year follow-up study including older Swedish adults aged 60-93 years. Methods A 15-year follow-up study among 2,786 individuals aged ≥ 60 years. Height, weight and KH were measured. KH-predicted height was estimated using formulated gender-specific equations. Classic BMI and KH-BMI (kg/m 2 ) were calculated. Mortality data was obtained from the Swedish death registry. Questionnaires were used to collect data on obesityrelated lifestyle factors and comorbidities. Results Cox regression revealed that using the classic BMI, when comparing with the normal/underweight reference group, there was a mortality risk among overweight men (HR = 0.67, 0.52-0.87), overweight women (HR = 0.79, 0.65-0.97), and obese men (HR = 0.60, 0.41-0.89) aged ≥ 80 years old. Using the KH-BMI, only overweight men and overweight women aged ≥ 80 years had a lower mortality risk, men (HR = 0.71, 0.55-0.92); women (HR = 0.77, 0.62-0.95) after adjusting for obesity-related lifestyle factors and comorbidities. Discussion There is evidence that obesity is overestimated by the BMI, in comparison with the KH-BMI classification. In terms of mortality risk and after adjusting for height, there remains a paradoxical protective association between overweight and mortality. Conclusion Regardless of classic BMI or KH-BMI estimation, overweight men and women aged ≥ 80 years had a lower mortality risk compared to normal/underweight men and women ≥ 80 years.

Loneliness, social isolation, and health complaints among older people: A population-based study from the “Good Aging in Skåne (GÅS)” project

SSM - Population Health

Iconography : Associations between cognitive abilities and life satisfaction in the oldest-old

Physical Performance in Older Cohorts: A Comparison of 81-Year-Old Swedish Men and Women Born Twelve Years Apart—Results from the Swedish Study “Good Aging in Skåne”

Journal of Aging Research, 2021

Materials and Methods Birth cohorts of both sexes drawn from the Swedish study “Good Aging in Skå... more Materials and Methods Birth cohorts of both sexes drawn from the Swedish study “Good Aging in Skåne” for the years 1920–22 and 1932–34 were compared. Walking, the step test, the chair stand test, and the handgrip strength test were used as proxies for the physical performance. The results were adjusted for lifestyle habits and common chronic geriatric diseases. Results Both men and women in the later-born cohort walked more quickly and completed the chair stand test faster, and women were also quicker in the step test. No significant differences were found in the grip test, in either the male or female cohorts. Discussion. Normative reference values for physical tests of subjects of different ages can be misleading unless cohort effects are considered. Furthermore, age-related trajectories can also be misinterpreted if cohort effects are neglected which, in the longer perspective, could affect health care planning. Conclusion Birth cohort effects should be considered when comparing ...

The Life Satisfaction Index-A (LSI-A): Normative Data for a General Swedish Population Aged 60 to 93 Years

Clinical Interventions in Aging, 2020

To gain Swedish norm value for the Life Satisfaction Index-A (LSI-A) in a population 60-93+ years... more To gain Swedish norm value for the Life Satisfaction Index-A (LSI-A) in a population 60-93+ years old stratified for sex and age and to relate these norm values with respect to number of chronic diseases and functional impairment. The study population included a random sample of 2656 men (45.7%) and 3159 (54.3%) women from the longitudinal national studies' "Good Aging in Skåne" (GÅS) and SNAC-B, both part of the Swedish National Study on Aging and Care (SNAC). Data on Neugartens Life Satisfaction Index-A (LSI-A), medical history, activities of daily life (ADL) and socio-demographics were collected through structured interviews and questionnaires. Results: Men scored significantly higher than women; 28.5, sd=6.9, and 27.3, sd=6.6, respectively, out of maximum 40 points. For both genders the scores decreased with age, mean score 6.0 points, lower for men and 7.1 points lower for women between 60 and 93+ years. The highest score was noted for healthy individuals where both men and women scored 29.5 points, sd=6.2. Increased number of chronic diseases and dependency in ADLs were associated with lower LS. Norm values here presented may facilitate assessments and evaluation of life satisfaction in the general elder population and as reference values to clinical trials. Female sex, rising age, morbidity and impaired functional ability were all associated with impaired LS.

Analyzing the situation of older family caregivers with a focus on health-related quality of life and pain: a cross-sectional cohort study

Health and Quality of Life Outcomes, 2020

Background For a significant proportion of the older population, increasing age is associated wit... more Background For a significant proportion of the older population, increasing age is associated with health problems and worsening health. Older family caregivers are largely responsible for care of next-of-kin living at home, which impacts their own physical and mental health both positively and negatively. However, evidence is insufficient regarding the health situation of older caregivers. The aim of this study was to investigate health-related quality of life (HRQoL) and pain, and their associations, among caregivers aged ≥60 years. Methods The participants (n = 3444) were recruited from the Swedish National Study on Aging and Care-Blekinge and Good Aging in Skåne during 2001–2004. Participants aged ≥60 years were selected randomly and underwent cognitive tests, with demographic information obtained through questionnaires. The response rate was 60%. A predefined research protocol was used. HRQoL was measured with the Short-Form Health Survey, dimension mental health. Logistic regr...

The association between medical diagnosis and caregiver burden: a cross-sectional study of recipients of informal support and caregivers from the general population study ‘Good Aging in Skåne’, Sweden

Aging Clinical and Experimental Research, 2017

Background Different kinds of chronic diseases might imply different dimensions of caregiver burd... more Background Different kinds of chronic diseases might imply different dimensions of caregiver burden, not previously described among the caregivers to recipients from the general elder population. Aim The main objective was to examine differences in burden between the 343 caregivers to persons with different diagnoses. Methods A group of elderly recipients of informal care (n = 343) from the general population study 'Good Aging in Skåne' (GÅS) Sweden, were divided into five diagnostic groups: dementia (n = 90), heart and lung diseases (n = 48), stroke (n = 62), fractures (n = 66), depression (n = 40) and the group "other", consisting of different diagnoses (n = 37) according to ICD-10. Differences in burden were analyzed using the Caregiver Burden Scale (CBS), a 22-item scale consisting of five dimensions: general strain, isolation, disappointment, emotional involvement and environmental burden. A total burden index comprises the mean of all the 22 items and a higher score indicates a higher burden. The most common diagnosis associated to caregiving was dementia and fracture and the median hours weekly for informal support with instrumental ADL for the five diagnostic groups ranged from 7 to 45 h for spouses and from 4 to 7 h for parents. The highest proportion of caregivers scoring high total burden was seen among recipients with dementia (50%) and depression (38%); the OR for high total burden for the dementia group was 4.26 (2.29-7.92) and depression group 2.38 (1.08-5.24) adjusted for covariates like age, gender and ADL and these two groups had higher self-perception of burden in all the dimensions, especially the dimension's emotional burden and strain. Conclusion Informal support constitutes a substantial time for instrumental ADL for the diseased elders. Caregivers to persons with dementia and depression experience high burden.

Physical performance in relation to birth cohort: A comparison of 60 year old Swedish men and women born twelve years apart

Archives of Gerontology and Geriatrics, 2019

Pain and alcohol: a comparison of two cohorts of 60 year old women and men: findings from the Good Aging in Skåne study

Scandinavian Journal of Pain, 2018

Background and aims Pain, use of painkillers and alcohol are highly prevalent in the general popu... more Background and aims Pain, use of painkillers and alcohol are highly prevalent in the general population. Aims of the study were to describe differences in pain, alcohol consumption and use of painkillers among two 60 year old birth cohorts stratified by gender. Methods Participants were recruited from the Skåne centre of The Swedish National study on Aging and Care, a multicentre, prospective, longitudinal study. The sample comprised 60 year old men and women born between 1941 and 1943 and recruited to the study between 2001 and 2004 (n=663) and 60 year old men and women born in the period 1952–1954 and recruited to the study between 2013 and 2015 (n=924). Specially trained research staff conducted the interviews. For descriptive statistics the variables were presented in total numbers, percentages, mean and standard deviation, and 1st and 3rd quartile are also shown. The sample was divided into four groups: men and women born in the period 1941–1943, men and women born in the perio...

Home and Health in the Third Age — Methodological Background and Descriptive Findings

International Journal of Environmental Research and Public Health, 2014

Background: The understanding of the complex relationship between the home environment, well-bein... more Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67-70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens.

Extension of ENABLE-AGE research questions and methodology to a younger cohort in Sweden

Reference EPFL-CONF-185743View record in Web of Science Record created on 2013-03-28, modified on... more

Kommunal och regional vård till äldre: Vård och omsorg i Eslöv, Hässleholm, Malmö, Osby och Ystad till personer 65 och däröver, En delstudie i SNAC. Rapport 1

Kommunal och regional vard till aldre : Vard och omsorg i Eslov, Hassleholm, Malmo, Osby och Ysta... more

Analys och utveckling av system för registrering av vårdbehov och vårdinsatser till äldre i kommunal vård och omsorg.-En delstudie i SNAC Rapport 2

Den offentliga statistiken inom aldreomsorgsomradet ar for narvarande begransad till mangdstatist... more Den offentliga statistiken inom aldreomsorgsomradet ar for narvarande begransad till mangdstatistik (Statistik - socialtjanst 2000:5, Socialstyrelsen 2000 och Halso- och sjukvardsstatistisk arsbok 1999, Socialstyrelsen 2000). Fran denna statistik erhalles uppgifter om antalet aldre som far vard och hjalp fordelade pa alder, kon och vardinsats samt vardkostnader. For att fa insikt i aldreomsorgssystemets maluppfyllelse, funktionssatt, effektivitet och kvalitet kravs en mer systematisk och individbaserad ansats an den som mangdstatistik kan erbjuda. I Region Skane finns sedan tio ar tillbaka ett valutvecklat patientadministrativt system, PASiS. I Skanes 33 kommuner anvands olika system for registrering av individdata inom omsorg och halso- och sjukvard. Kunskapen ar for narvarande begransad om vilken typ av information som dokumenteras och finns att tillga om aldre i vard och omsorg pa kommunal niva, delvis ocksa pa landstingsniva. Projektets syfte var att inventera och analysera befintliga registreringssystem samt att utveckla en gemensam och komplementar dataterminologi, att anvandas vid planering av vard och omsorg. Vidare att utveckla ett system som mojliggor sammanlankning av relevanta data mellan olika vardaktorer och foresla sakerhetslosningar som skyddar vardtagarens integritet och anonymitet. Faltstudier bedrevs i fem kommuner, Eslov, Hassleholm, Malmo och Osby, samt i Region Skane dar befintliga registreringssystem inventerades och analyserade. Resultatet visade stora olikheter i dokumentation mellan kommunerna. Dokumentationen forekom mestadels i fri text och varierade i omfattning och innehall. Standardiserade instrument for behovs- och funktionsbedomning saknades. Manuella och datoriserade system anvandes. Informationsoverforing mellan respektive kommun och Region Skane gjordes manuellt nar vardtagaren flyttades mellan huvudmannen. Tva kommuner, Hassleholm, Osby, hade vidareutvecklat blanketter for informationsoverforing. Inom projektets ram utvecklades ett formular, baserat pa inventering av vardsystem, litteraturstudier och diskussioner i en expertgrupp, som beskriver den aldres behov av vard och omsorg, beslut och planering samt insatta och forandrade atgarder. Formularet testades i en pilotstudie. I utvarderingen av pilotstudien framkom bl.a. att bistandshandlaggare och distriktsskoterskor var den adekvata malgruppen att ansvara for registrering av vard och omsorg. Det standardiserade formularet omfattar sex delomraden; administrativa uppgifter, persondata, omgivningsfaktorer, vardberoende, nuvarande och pagaende insatser, sarskilda sjukvardsinsatser, samt informell vard. I registreringen av vard och omsorg har det ingatt aldre over 65 ar som erhaller varaktiga insatser fran kommun och/eller landsting. Efter den inledande undersokningen har formularet utvarderats av personal inom vard och omsorg i de fem kommunerna. Skriftligt informerat samtycke har inhamtats fran de aldre som ingar i studien. Vid sammankoppling av individbaserad statistik mellan aktuella kommuner och Region Skane och for anvandning i forskning galler sarskilda sekretessbestammelser och informerat samtycke fran de aldre som ingar i studien kravs. Datainsamlingen har genomforts i tva steg; baseline som genomfordes under cirka 6 manader med registrering av aldre med pagaende vard och omsorg, och darefter paborjades kontinuerlig registrering. De forsta registreringarna av vard och omsorg i baslinjeundersokningen gjordes manuellt. Dataprogram ar under vidareutveckling for att mota kravet pa samordnad dokumentation om aldres vard och omsorg i kommunerna. En integrering av de variabler som ingar i formularet for registrering av vard och omsorg har genomforts. For att underlatta hanteringen finns det elektroniskt internetbaserade formularet tillgangligt via losenordsforfarande pa en lokal server vid Institutionen for Omvardnad, Lunds Universitet. I en av kommunerna, Malmo, tillampas ett nytt dataprogram som innehaller dokumentation av samtliga variabler som ingar i det utarbetade formularet och medger dokumentation fran samtliga verksamheter inom kommunal vard och omsorg. Insamlat material utgor databasen med uppgifter om aldres vard och omsorg i kommunerna och i forhallande till vard i Region Skane. I databasen kommer det att vara mojligt att folja vardtagare pa individniva inom den kommunala varden och vardtagare som forflyttas mellan kommunal vard och vard i Region Skane. Informationen i databasen kan anvandas av beslutsfattare och handlaggare i kommuner och i Region Skane, samt vidare analyseras och utvecklas genom nya forskningsansatser. (Less)

Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne

Clinical interventions in aging, 2014

To determine the relationship between long-term change in activities of daily living (ADL) and fa... more To determine the relationship between long-term change in activities of daily living (ADL) and falls in the elderly and to identify characteristics of groups at risk for falls. This was a 6-year, prospective cohort study using data from the Good Aging in Skåne study in southern Sweden, involving 1,540 elderly subjects, including the oldest-old (age, 60-93 years). The subjects were recruited from the general population. ADL was measured at a baseline and follow-up assessment, using Sonn and Åsberg's revised scale and the ADL staircase. Falls were recorded in a period of 6 months before the follow-up assessment. The association between falls and change in ADL was calculated using adjusted, multiple logistic regression analysis and presented in odds ratios (ORs). Thirteen percent of the study population reported one or several falls in the measured period. Over the course of 6 years, one in four participants changed their ADL status, and parts of this category had an increased risk...

Oral and Poster Papers Submitted for Presentation at the 5th Congress of the EUGMS “Geriatric Medicine in a Time of Generational Shift September 3–6, 2008 Copenhagen, Denmark

The Journal of Nutrition Health and Aging, 2008

Recent demographic evolution has changed the trends of the two fundamental variables - natality a... more

Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months

Scandinavian Journal of Caring Sciences, 2008

A number of different intervention programmes have been described in the literature for caregiver... more A number of different intervention programmes have been described in the literature for caregivers of people with dementia, but the nature of intervention has varied widely. The aim of the present study was to evaluate the efficacy of psychosocial intervention on family caregiver's level of burden and satisfaction, and possible influence of the caregiver's relationship and health and the patient's severity of the disease on the effects of intervention. All persons, 70 years and older, from two districts of a municipality (2721 individuals) who were in receipt of any form of social services were invited to participate in a screening of cognitive decline, and 1656 home visits were made. Those with symptoms of cognitive decline, and having a family caregiver, were invited for a further medical examination. Data were analysed from 308 family caregivers: 153 caregivers who underwent intervention and 155 control caregivers who did not. Repeated measures were carried out 6 and ...

Sleep quality, use of hypnotics and sleeping habits in different age‐groups among older people

Scandinavian Journal of Caring Sciences, 2014

BackgroundSleep disturbances are common among older people (>65 years). Further, long‐term use... more BackgroundSleep disturbances are common among older people (>65 years). Further, long‐term use of sedative‐hypnotics in older people is associated with morbidity and mortality. However, older people represent a large span of life years, and few studies have included the oldest‐old above 85 years.AimTo investigate and compare sleep quality, use of hypnotics and sleeping habits in different age groups of the older population in the Scania region, Sweden and in relation to sociodemographic‐ and functional status.Design and participantsA cross‐sectional population‐based study including 2931 people aged 60–93 years from five different municipalities in Scania was performed during 2001–2004.MethodThe sample was divided into age groups, young‐old (60–72 years), old‐old (78–84 years) and oldest‐old (87–93) years. Data constitutes of sleep related questions, sociodemographic‐ and functional status from the study ‘Good Ageing in Skåne’. Descriptive statistics were used to describe sleep qu...

Associations between cognitive abilities and life satisfaction in the oldest-old. Results from the longitudinal population study Good Aging in Skåne

Clinical Interventions in Aging, 2013

Studies on the associations between cognitive abilities and life satisfaction (LS) in the oldest-... more Studies on the associations between cognitive abilities and life satisfaction (LS) in the oldest-old are few. The aim of this study was to explore whether abilities in six different cognitive domains could predict LS in the oldest-old 3 years later. Methods: The study population consisted of 681 individuals aged 78-98 years, drawn from the longitudinal population study "Good Aging in Skåne," which is part of a national survey (The Swedish National Study on Aging and Care). Scores on 13 cognitive tests were related to scores on Neugartens' LS index A (LSI-A) 3 years later. The cognitive tests were added into six different cognitive domains. A multiple regression analysis was constructed for each cognitive domain separately, with scores on the LSI-A as the dependent variable. The model was adjusted stepwise for sex, age, education, functional capacity, and depressive mood. Results: Significant correlations were found between digit cancellation, word recall, verbal fluency (VF) A, VF animals, VF occupations, and mental rotations at baseline, as well as LSI-A at follow-up. The domains of spatial abilities (B = 0.453, P = 0.014) and processing speed (B = 0.118, P = 0.020) remained significantly associated with LSI-A 3 years later after adjustment. The cognitive domains of spatial abilities and processing speed predicted LS 3 years later in the oldest-old. Clinical implications are discussed.

Accidental falls, health-related quality of life and life satisfaction: A prospective study of the general elderly population

Archives of Gerontology and Geriatrics, 2014

Accidental falls, health-related quality of life and life satisfaction: A prospective study of th... more