Changes in drug treatment in the elderly between 1971 and 2000.

Objective: To investigate changes in drug treatment among elderly men and women over a 29-year period between 1971 and 2000.

Methods: Drug consumption was investigated in five representative population samples of 70-year-olds born in 1901-1902 (n=973), 1906-1907 (n=1036), 1911-1912 (n=619), 1922 (n=449) and 1930 (n=506) and in three representative samples of 79- to 80-year-olds born in 1901-1902 (n=537), 1906-1907 (n=538) and 1915 (n=212).

Results: The proportion of 70-year-olds who used drugs increased from 60% to 79% in men and from 76% to 88% in women from 1972 to 2000.

Improved health among 70-year olds: comparison of health indicators in three different birth cohorts.

Background And Aims: Whether or not there has been a "compression of morbidity" in older ages has been vividly debated during the last decades. Previous studies have found indications of both improved and deteriorated health among elderly persons. Few studies have analyzed how changes in health indicators are influenced by social background factors.

Oral microbiota associated with hyposalivation of different origins.

We analysed and compared the oral microbial flora in four groups with hyposalivation caused by radiation therapy (RT), primary Sjögren's syndrome (pSS), medication or unknown factors (Unknown), or neuroleptic treatment (Neuro). A control group with normal salivary secretion was also included. The subjects included were 54 +/- 8 years old and had 25 +/- 4 teeth.

Change in blood pressure in the age interval 70-90. Late blood pressure peak related to longer survival.

Aims: To investigate longitudinal changes in systolic (SBP) and diastolic blood pressure (DBP) between age 70 and 90, and to analyse the relationship between blood pressure changes after 70 and survival in two representative population samples (n = 973 and n = 1036).

Major Findings: In the total population sample, SBP increased up to age 75 and declined thereafter. In survivors up to 90, SBP increased up to age 79 and decreased thereafter.

The two faces of presbyacusis: hearing impairment and psychosocial consequences.

A study of hearing disability and handicap was performed in a sample of elderly persons living in an urban area of Göteborg, Sweden. The aim was to describe the psychosocial consequences of presbyacusis. For this purpose, elderly persons with fairly uncontaminated presbyacusis were chosen.

The predictive value of microbiologic diagnostic tests if asymptomatic carriers are present.

If a proper gold standard is not available, then the predictive value of a test cannot be estimated. In this paper the concept of etiologic predictive value (EPV) is introduced. It is a quantity that will yield the predictive value of a test to predict presence of a specified disease in situations for which no proper gold standard is available.

Colour perception among the very elderly related to visual and cognitive function.

Colour perception was studied among a representative sample of 95-year olds and compared with previously examined 80-year olds and a group with Alzheimer's disease (AD), mean age of 80 years. The 95-year olds' results were on a significantly lower level than the other two groups but showed a similar pattern as to colour -discrimination, -naming, -preferences and colour/form recognition. Visual function among 95-year olds had only minor influence on their result in contrast to cognitive function which had a more profound impact.

Health and well-being among 70-year-old migrants living in Sweden--results from the H 70 gerontological and geriatric population studies in Göteborg.

Background: Comparative epidemiological studies in migrants in Sweden have shown increased prevalence of psychosocial morbidity in young adults, but there is paucity of information on health in people aged 65 years and over.

Aims: We aim to compare prevalence of mental, physical and social health problems, rates of hospital admission, and mortality in Swedish and non-Swedish born people aged 70 years living in Göteborg, Sweden, and examine associations between social factors, physical health, mood and life satisfaction in the ethnic groups. In addition, we aim to test for the hypothesis that differences in mental health between migrants and natives are explained by social disadvantages rather than ethnicity.

Event recording in psychiatric care: development of an instrument and 1-year results.

Methods for regular monitoring of care and services are needed for psychiatrists to act on, to refine practice. We developed a computer-based instrument to be used by staff working with schizophrenic patients. The instrument was tested in a group of patients randomly assigned to an integrated-care program.

Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.

Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected.

A population-based study on brain atrophy and motor performance in elderly women.

Background: Brain atrophy is a common neuroimaging finding in healthy elderly individuals as well as in patients with movement-related disorders. The relationship between brain atrophy and motor changes has not been frequently reported. This study investigates this relationship.

Cognitive function and functional ability. A cross-sectional and longitudinal study at ages 85 and 95 in a non-demented population.

We studied the relationship between cognitive function and ability in daily life activities (ADL) at ages 85 (N=332) and 95 (N=63) cross-sectionally and longitudinally in representative populations of non-demented persons, in order to focus on manifestations related to healthy aging. Among the 85-year olds, 31% were independent, 42% were dependent on personal assistance in instrumental ADL (IADL) and 27% in personal ADL (PADL); the corresponding figures for the 95-year olds were 8, 40 and 52%, respectively. Regarding the relationship between cognitive function and ADL, the analysis could only be performed in the cross-sectional data.

Utilization of private and public health-care providers for tuberculosis symptoms in Ho Chi Minh City, Vietnam.

In Vietnam, as in many other countries, tuberculosis (TB) control has long been organized exclusively within the public health-care system. However, recently the private health-care sector has become more important and private health-care providers currently have a role in TB care delivery in Vietnam. Through a retrospective survey of patients at District Tuberculosis Units (DTUs) of the National Tuberculosis Programme in Ho Chi Minh City, we investigated utilization of private and public health-care providers among people with symptoms of TB.

Can I afford free treatment?: Perceived consequences of health care provider choices among people with tuberculosis in Ho Chi Minh City, Vietnam.

Vietnam has a well-organised National TB Control Programme (NTP) with outstanding treatment results. Excellent prospect of cure is provided free of charge. Still, some people prefer to pay for their TB treatment themselves in private clinics.

Population studies of diet and obesity.

Population-based research on diet, obesity and the metabolic syndrome is faced with accumulating evidence of biases that may profoundly affect results. One potential source of bias, which is often neglected in nutritional epidemiology, arises from self-selected study populations. Subjects who agree to participate in surveys may be at less risk of metabolic syndrome than those who refuse.

Preventive nutrition in old age - a review.

Preventive nutrition in the elderly is reviewed also from points of view of the concepts of prevention, nutrition and old age, respectively. The demographic, medical, psychosocial and other differences between individuals of the same age but belonging to different birth cohorts are emphasized, as well as the need for a multifactorial preventive approach. The interaction between dietary aspects and physical activity is discussed, and it is also pointed out that risk indicators and risk factors may be different in old age compared to middle life.

Pre-existing risk factor profiles in users and non-users of hormone replacement therapy: prospective cohort study in Gothenburg, Sweden.

Objective: To assess whether risk factor profiles for cardiovascular disease differed, before starting treatment, between women who would subsequently use hormone replacement therapy and those who would remain untreated.

Design: Prospective population study, initiated in 1968-9, with follow ups in 1974, 1980, and 1992.

Setting: Gothenburg, Sweden.

Helicobacter pylori serology in elderly people: a 21-year cohort comparison in 70-year-olds and a 20-year longitudinal population study in 70-90-year-olds.

Aims: (i) to compare Helicobacter pylori serology in two 70-year-old cohorts in Gothenburg, Sweden, born 21 years apart, (ii) to study H. pylori serology in a 70-year-old cohort over 20 years.

Population And Method: H.

Bacteriuria in a population sample of women: 24-year follow-up study. Results from the prospective population-based study of women in Gothenburg, Sweden.

The aims of the study were to estimate the prevalence of bacteriuria in a female urban population, to follow up the same population over the years, and to relate bacteriuria to long-term prognosis with respect to mortality and kidney disease. The study was based on a randomly selected population sample comprising 1462 women aged 38-60 years at entrance to the study in 1968-69 with an initial participation rate of 90.1%.

A population-based study on blood pressure and brain atrophy in 85-year-olds.

In the general population, mean systolic and diastolic blood pressure increases up to age 75 years but decreases thereafter. The brain has a role in blood pressure regulation; it is not clear whether the cerebral changes that occur with aging contribute to the decline in blood pressure in the very elderly. We examined a population-based sample of 484 85-year-old persons (344 nondemented and 140 demented, 61 with Alzheimer's disease, 65 with vascular dementia, and 14 with other types of dementia) with a neuropsychiatric examination and blood pressure measurements.

Bone mineral density is a predictor of survival.

The purpose of this study was to examine the relationship between bone mineral density (BMD) and survival in both sexes and to compare BMD with other established risk factors such as blood pressure and cholesterol. A population-based prospective study of 1924 individuals (850 men, 1074 women) was performed in Göteborg from 1980 to 1983. Measurements of BMD were obtained in 1468 (76%) of the participants (653 men, 815 women).

Risks and benefits of private health care: exploring physicians' views on private health care in Ho Chi Minh City, Vietnam.

As in a number of other low- and middle-income countries, the health sector in Vietnam is transforming with a rapid shift from fully state run and financed health care towards more private financing and delivery of health care. This development has been particularly noticeable in the largest city in the country, Ho Chi Minh City, where a majority of physicians now are practising in private clinics and where the private health care sector is an increasingly popular option for people. While the private sector is an important part of the health care system in Vietnam, few data are available on the characteristics and quality of private health care services.

High rates of psychosocial complications after road traffic injuries.

A total of 134 people, aged between 25 and 60, were randomly selected from the Traffic Injury Register in Göteborg and interviewed 2 years after the accident. They were asked by telephone about their lives before and after the accident. There was a high rate of complications, even after some minor injuries.

The prevalence of potential pathogenic bacteria in nasopharyngeal samples from healthy children and adults.

Objective: To elucidate the prevalence of potential pathogenic bacteria in nasopharyngeal samples from healthy individuals, and the influence on the carrier rate of age, season of the year, and type of child day care.

Design: Nasopharyngeal swab samples obtained in routine medical care from individuals with no sign of infection were studied in 159 pre-school children aged below 7 years, 198 schoolchildren aged 7-15 years, and 261 adults (.16 years).