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.

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

Family caregivers' assessment of symptoms in persons with dementia using the GBS-scale: differences in rating after psychosocial intervention - an 18-month follow-up study.

The purpose of this study was to examine if psychosocial intervention for family caregivers made any differences in describing symptoms of dementia in the persons they cared for. The study population comprised family caregivers of persons aged 70 years and older receiving social services and diagnosed with dementia disorders. A group of 129 family caregivers underwent psychosocial intervention including education, information, and provision of a support group, while 133 family caregivers did not and these formed the control group. Family caregivers were followed-up every 6 months for a total of 18 months. They rated intellectual, emotional, and activity of daily living (ADL) functions in persons with dementia using the Gottfries-Bråne-Steen scale (GBS-scale). Family caregivers who underwent psychosocial intervention rated the intellectual and emotional symptoms of dementia significantly higher 6 months later compared to controls and the effect was sustained during the 18-month follow-up irrespective of relationship and education. Most notably, decrease in function of recent memory, ability to increase tempo, long-windedness, distractibility, and blunting were better identified. Our findings suggest that the family caregivers who underwent psychosocial intervention achieved better understanding of different symptoms and the behaviors of dementia. These findings may explain earlier findings of positive effects after psychosocial intervention on family caregivers' sense of burden, satisfaction, and ability to delay nursing home placement

Health Economic Analysis on a Psychosocial Intervention for Family Caregivers of Persons with Dementia.

Background/Aims: Psychosocial intervention has shown positive effects on the caregivers' burden and satisfaction. The aims of this study were to describe the cost and cost-effectiveness of such an intervention. Methods: We analyzed resource use and costs of formal care for 308 persons with dementia and their caregivers' health-related quality of life (HRQoL). Results: The costs of home help services were lower in the subgroup of spouse caregivers in the intervention group and the cost of nursing home placement was lower in the intervention group. While the person with dementia lived at home, caregivers in the intervention group reported a higher HRQoL (p < 0.01). After the person with dementia had moved to a nursing home, spouses in the control group had a lower HRQoL (p < 0.001). Conclusion: The result can be interpreted as a positive effect of the intervention focusing on the identified specific needs of the family caregivers. © 2013 S. Karger AG, Basel

Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study 'Good ageing in Skane'.

Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design

Falls, fractures and function. Focus on women with a distal forearm fracture

Falls and fractures in older people are a common and increasing health problem which causes physical, social and psychological problems for the individual and is costly to society. The aims of this thesis were to investigate accidental falls of patients aged 65 - 74 who attended an orthopedic emergency ward, to investigate reliability of the modified figure of eight (MFE) and compare it with other balance performance tests, to investigate whether patients with a distal forearm fracture exhibited risk factors for new falls and fractures, and to follow physical performance and evaluate health-related quality of life in women after a distal forearm fracture. In the accidental falls, 72% led to fractures. More women than men sustained fractures and the most common fracture was a distal forearm fracture. One third were admitted to hospital. Patients who were less healthy sustained fractures more often. Information regarding risk factors for falls and fractures were often not documented in the patients’ medical files. Satisfactory documentation is a prerequisite for prevention measures for further falls and fractures. Two examiners measured balance capacity in elderly women on two occasions with one week in between. The tests were MFE, one-legged stance, tandem stance, standing on foam and walking tests. There was a high to very high inter-rater reliability for all the tests. MFE-time significantly correlated to walking speed. The MFE was highly reliable, showed satisfactory concurrent validity and can be recommended for use by different examiners and over time. Sixty-six patients with a fall-related distal forearm fracture were examined shortly after the fracture. The majority of the patients were physically active. One third reported previous falls and fall-related fractures. Half of the patients were regularly examined for chronic ailments and were on regular medication. Their physical performance was comparable to a healthy population of the same age. One year after the fracture, 43 women came for a follow-up. A significant decrease in handgrip strength and walking speed was found. Women who reported comorbidity and low physical activity scored lower in the two health-related quality of life (HRQoL) questionnaires; EQ-5D and SF-12. Besides the fracture treatment, patients with a fall-related distal forearm fracture should be screened for fall and fracture risk, and be targeted for secondary preventive measures for falls and fractures. Additional treatment aimed at maintaining physical capacity should be further explored for this patient group. Low results in HRQoL questionnaires might indicate underlying comorbidity, not captured by physical performance tests alone. Those patients should be referred to continued health care. There is a strong relationship between falls and fractures in elderly persons. Although most falls do not result in a fracture, a majority of fractures in the elderly are sustained in a fall. There is a great need for increased awareness among the caregivers concerning falls, fractures and function. Local action plans and fracture treatment protocols should include preventive measures with the focus on falls and function

Snöupplag för säsongslagring av kyla

Internrapport, avdelningen för Vattenteknik</p

Snöupplag för säsongslagring av kyla

Internrapport, avdelningen för Vattenteknik</p