Mobility-related fatigue, walking speed, and muscle strength in older people.

Background: Fatigue is an important early marker of functional decline among older people, but the mechanisms underlying this association are not fully understood. The purpose of the present study was to examine the association between mobility-related fatigue and walking speed and to test the degree to which muscle strength accounts for this association.

Methods: The study is based on baseline (n = 523) and 5-year follow-up data (n = 292) from a cohort of 75-year-old persons.

Method for Assigning Priority Levels in Acute Care (MAPLe-AC) predicts outcomes of acute hospital care of older persons--a cross-national validation.

Background: Although numerous risk factors for adverse outcomes for older persons after an acute hospital stay have been : identified, a decision making tool combining all available information in a clinically meaningful way would be helpful for daily hospital practice. The purpose of this study was to evaluate the ability of the Method for Assigning Priority Levels for Acute Care (MAPLe-AC) to predict adverse outcomes in acute care for older people and to assess its usability as a decision making tool for discharge planning.

Methods: Data from a prospective multicenter study in five Nordic acute care hospitals with information from admission to a one year follow-up of older acute care patients were compared with a prospective study of acute care patients from admission to discharge in eight hospitals in Canada.

Assessing caries increments in elderly patients with and without dementia: a one-year follow-up study.

Background: The authors conducted a study to determine one-year coronal and root caries increments in patients newly diagnosed as having Alzheimer disease (AD), other dementia (OD) or no dementia.

Methods: The authors recruited patients from two hospital memory clinics in Copenhagen. The oral examination included an assessment of dental status and dental caries.

Admission profile is predictive of outcome in acute hospital care.

Background And Aims: The purpose of this study is to describe predictors for discharge and one-year outcomes of acute-care hospital patients, 75 years of age or over, based on admission status information. We carried out a prospective study of a randomly selected patient population, from one urban acute-care hospital in each of the Nordic countries. 763 persons aged 75+ were randomly selected from acute admissions to the participating hospitals.

Vision and hearing impairments and their associations with falling and loss of instrumental activities in daily living in acute hospitalized older persons in five Nordic hospitals.

Background: Many older people believe sensory problems are inevitably, a part of growing old, and avoid assessment and help. Such problems are often also overlooked by health professionals. The aim of this study was to find the prevalence of hearing and vision impairment and their associations with loss of instrumental activities in daily living (IADL) and risk of falling in patients aged 75 years or older, admitted to a medical ward in an acute hospital in each of the five Nordic countries.

Comparison of nurses' and physicians' documentation of functional abilities of older patients in acute care--patient records compared with standardized assessment.

Aim: To compare nurses' and physicians' documentation of geriatric issues and explore double documentation and undocumented areas of importance in an acute care setting in two Nordic countries.

Method: 158 participants, aged 75+, of whom the Minimum Data Set for Acute Care (MDS-AC) instrument was conducted at admission and from which 56 variables were taken in comparison with notes from patient records documented by nurses and/or physicians in two acute care hospitals, in Finland and Iceland.

Findings: Documentation of the impairment of personal Activities of Daily Living (ADL) was missing in 40-60% of the nurses' reports and 80-97% of the physician's reports.

A 30-year survey of drug use in the 1914 birth cohort in Glostrup County, Denmark: 1964-1994.

Background And Aims: Use of drugs increases with age. Several drugs as well as multiple drug intake are recognized risk factors for symptoms, disability, hospitalizations, and even mortality, due to side effects and problems with compliance. Yet, little is known about the long-term effects.

[The care requirements of residents in Danish nursing homes].

Introduction: An increasing number of elderly remain in their own homes longer. The purpose of this study was to assess the care requirements of elderly in nursing homes.

Materials And Methods: A total of 441 nursing home residents from 11 Danish nursing homes were assessed by means of Minimum Data Set (MDS).

Hemoglobin concentrations in 358 apparently healthy 80-year-old Danish men and women. Should the reference interval be adjusted for age?

Background And Aims: In elderly Danes, reference intervals for hemoglobin (Hb) concentrations are derived from younger population groups. The aim was to examine reference intervals for Hb and cut-off limits for anemia by application of criteria for normality to a representative population of 80-year-olds.

Methods: Participants in this epidemiological health survey cohort were 358 subjects (171 men) 80 years of age.

Caries prevalence in older persons with and without dementia.

Objectives: To examine the prevalence of coronal and root caries in a memory clinic-based population of elderly patients with and without a diagnosis of dementia and to examine the influence of age, sex, social relations, social position, and functional ability.

Design: Cross-sectional.

Setting: Patients referred with possible cognitive dysfunction were recruited from two university hospital dementia clinics.

Variations in quality of Home Care between sites across Europe, as measured by Home Care Quality Indicators.

Background And Aims: The increase in the proportion of elderly people and a consequent increase in the demand for care have caused healthcare systems to become overloaded. This paper describes the use of Home Care Quality Indicators (HCQIs), derived from the Minimum Data Set for Home Care, for monitoring quality of care. Research questions were, "Do HCQI scores vary between home care organizations in different countries?" and "Are one or more country-specific sites consistently scoring better on most or all HCQIs"?

Methods: a cross-sectional observational study of 65+ randomly selected clients of home care organizations in urban areas in 11 European countries who had been receiving home care for at least two weeks.

Factors underlying tiredness in older adults.

Background And Aims: The purpose of the present study was to examine for factors related to tiredness, cross-sectionally at the age of 75 years, and factors related to subsequent onset of tiredness, from age 75 to 80 in a non-disabled community-living population.

Methods: The study is part of the prospective Nordic Research on Aging Study (NORA) on the 1914 cohort in Jyväskylä, Finland and Glostrup, Denmark. In total, 546 non-disabled older men and women participated in the cross-sectional study at age 75, and 299 persons without tiredness and disability at baseline took part in the follow-up study, from age 75 to 80.

Tiredness and subsequent disability in older adults: The role of walking limitations.

Background: The purposes of the present study are to analyze whether tiredness in daily activities is associated with subsequent disability among nondisabled older adults and whether this association is mediated by walking limitations.

Methods: The investigation is based on baseline and follow-up data on 419 nondisabled 75-year-old persons in Jyväskylä, Finland, and Glostrup, Denmark. Onset of disability was measured by a validated scale based on seven items: combing hair, washing upper body, washing lower body, using the toilet, dressing upper body, dressing lower body, and cutting fingernails.

Proposal of a service delivery integration index of home care for older persons: application in several European cities.

Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities.

Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach.

Method: Items considered as part of both dimensions according to an expert consensus (face validity) were extracted from a standardised questionnaire used in "Aged in Home care" (AdHoc) study to capture basic characteristics of home care services.

[Geriatric rehabilitation as an integral part of geriatric medicine in the nordic countries.].

Objective: Firstly to outline the theoretical and practical framework for geriatric rehabilitation in Iceland and other Nordic countries and secondly to survey the scientific medical publications for evidence based geriatric rehabilitation.

Methods: Brain storming on geriatric rehabilitation in a working group of Nordic teachers in geriatric medicine. Papers on scientific programs for geriatric rehabilitation from Internet sources were collected and analyzed.

[The significance of cataract surgery and balance function of the elderly].

Injuries and other consequences of falls are serious for the individual patient and costly for society. Reduced acuity of vision is common among elderly people, and falls are frequent. The relationship between instability and falls as well as the association between reduced vision and falls has been recognized, but it has not as yet been examined whether cataract surgery improves balance in elderly people and thereby promotes fall prevention.

The AdHOC Study of older adults' adherence to medication in 11 countries.

Objective: Authors investigated, cross-nationally, the factors, including demographic, psychiatric (including cognitive), physical, and behavioral, determining whether older people take their prescribed medication. Older adults are prescribed more medication than any other group, and poor adherence is a common reason for non-response to medication.

Methods: Researchers interviewed 3,881 people over age 65 who receive home care services in 11 countries, administering a structured interview in participants' homes.

Depressive symptomatology at age 75 and subsequent use of health and social services.

It is well documented that elderly persons are the largest consumers of many health and social services. Consequently it is of interest to identify characteristics of users of those services. The purpose of this study is to examine whether depressive symptoms among men and women at age 75 are an independent determinant of incident hospitalization and use of home help 5 years later.

Implementation of functional assessment scales in geriatric practice: a feasibility study.

Aim: A study was undertaken to evaluate the feasibility of functional assessment scales regarding completion rate and ability to document functional changes in geriatric rehabilitation patients.

Methods: Five functional assessment scales were implemented, and used on admission and discharge as part of standard care.

Results: Of 2,812 patients, 90 patients (3.

Aging, food patterns and disability.

To lay the groundwork for devising, improving and implementing strategies to prevent or delay the onset of disability in the elderly, a systematic literature review was conducted of longitudinal studies published between 1985 and 2001 that reported statistical significant associations between individual baseline nutritional risk factors and subsequent functional status in community-living older persons. The review revealed that nutrition has been neglected in past research. Not more than three studies fulfilled the methodological criteria (e.

Potentially inappropriate medication use among elderly home care patients in Europe.

Context: Criteria for potentially inappropriate medication use among elderly patients have been used in the past decade in large US epidemiological surveys to identify populations at risk and specifically target risk-management strategies. In contrast, in Europe little information is available about potentially inappropriate medication use and is based on small studies with uncertain generalizability.

Objective: To estimate the prevalence and associated factors of potentially inappropriate medication use among elderly home care patients in European countries.

Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study.

This article provides an overview of the longitudinal Survey in Europe on Nutrition and the Elderly: a Concerted Action (SENECA) study, which was designed to assess differences in dietary and lifestyle factors among elderly Europeans, and to identify the factors that contribute to healthy aging. Elderly people from Belgium, Denmark, France, Italy, Portugal, Spain, Switzerland, and The Netherlands participated in the SENECA study. Standardized measurements were conducted at baseline in 1988-1989 and were repeated in 1993 and 1999.

Community care in Europe. The Aged in Home Care project (AdHOC).

Background And Aims: Community care for older people is increasing dramatically in most European countries as the preferred option to hospital and long-term care. While there has been a rapid expansion in Evidence-Based Medicine, apart from studies of specific interventions such as home visiting and hospital at home (specialist visits or hospital services provided to people in their own homes in the community), there is little evidence of characteristics of the recipients of community care services or the organisation of services that produce the best outcomes for them and their informal carers. The AdHOC Study was designed to compare outcomes of different models of community care using a structured comparison of services and a comprehensive standardised assessment instrument across 11 European countries.