Biomedical subjects

A Svanborg

Publications and source records attributed to A Svanborg.

At least 55 records · Page 3Linked to original sources

PubMed1990

Presbycusis and noise-induced hearing loss.

In a longitudinal and an age cohort comparing study the influence of aging and occupational noise exposure on hearing sensitivity was studied. The participants of the longitudinal study were studied at 70, 75, and 79 years of age. Seventy year old men exposed to occupational noise had 10 to 15 dB poorer hearing in the high frequency range than nonexposed men. The difference in hearing acuity decreased with increasing age. The differences between exposed and nonexposed older persons was no longer significant at age 79. In women there were no differences in hearing sensitivity between those exposed to noise and those not exposed to noise. Men not exposed to noise had 10 to 15 dB poorer hearing at 4 kHz compared with women of the same age also not exposed to noise.

Age Factors↗

PubMed1990

Overtreatment of hypertension in the elderly?

In a representative population sample of 619 70-year-old people, 26% were taking antihypertensive treatment. Twenty per cent (n = 32) of them showed no signs of cardiovascular disease and had a blood pressure of less than 175/95 mmHg. Treatment was withdrawn in 25 of the 32 patients. Casual blood pressure, blood pressure during isometric exercise and left ventricular morphology and function were studied repeatedly over 2 years, using non-invasive methods. A significant increase in mean systolic and diastolic blood pressures was observed in the 14 patients who completed the study. No change was observed with respect to left ventricular morphology and left ventricular diastolic function. A statistically significant decrease in left ventricular fractional shortening, but no clinical signs of congestive heart failure were observed. Withdrawal of antihypertensive treatment in elderly patients free from signs of cardiovascular disease may thus be attempted without harmful effects on cardiovascular function.

Aged↗

PubMed1990

High anti-phosphorylcholine antibody levels and mortality associated with pneumonia.

Phosphorylcholine is an immunodominant determinant of pneumococcal teichoic acids. Antibodies to phosphorylcholine are naturally occurring in man and decline in amount with age. Since antibodies to phosphorylcholine are markers of the immune responsiveness to polysaccharides and since anti-polysaccharide antibodies are highly protective against most bacterial pneumonia we expected a higher rate of pneumonia in elderly individuals with low levels of antibodies to phosphorylcholine. The relationship between the levels of antibodies to phosphorylcholine and mortality was analyzed prospectively in a representative sample of elderly individuals. A significant anti-phosphorylcholine antibody response occurred in a subgroup of the probands. There was a strong association (p less than 0.0001) between high levels of antibodies to phosphorylcholine in the serum at 70 years of age and pneumonia related death up to 14 years later. A similarly strong association was not observed between mortality and the antibody titer to another naturally occurring polysaccharide antigen: the blood group B antigen. Furthermore, there was no association between mortality due to diseases other than pneumonia and the levels of antibodies to phosphorylcholine. The association between antibody levels and subsequent fatal pneumonia provides a means of detecting individuals at risk for pneumonia-related death.

Age Factors↗

PubMed1989

Age-related change in anti-carbohydrate antibody levels.

It has been proposed that immunity declines with age. Most evidence for this hypothesis has been obtained from cross-sectional samples of unrelated populations that differ in age, antigen exposure, and morbidity. In the present study, the authors used serum samples collected repeatedly from the same persons in longitudinal studies. Two representative samples of the population in Göteborg, Sweden were obtained; the first was studied at ages 38, 50, and 62 years, and the second at ages 70, 75, 79, and 81 years, respectively. The phosphorylcholine determinant of pneumococcal teichoic acid and the B blood group determinant were selected as model polysaccharide antigens. The results demonstrate a consistent decline in individual antibody levels in the decades before age 70 years but not later. Antibodies to phosphorylcholine and blood group B were highly parallel, suggesting that the decline was a general phenomenon for antibodies to polysaccharide antigens.

ABO Blood-Group System↗

PubMed1989

Bacteriuria in representative population samples of persons aged 72-79 years.

Screening for bacteriuria was performed between 1984 and 1988 in persons aged 72-79 years representative of the general population in Göteborg, Sweden. The frequency of bacteriuria (greater than or equal to 10(5)/ml) at a single screening was 6% and 16% at age 72 years and 6% and 14% at age 79 years for the screened men (n = 235 and 259) and women (n = 259 and 297), respectively. By repeated screening after one month and 30 months of those previously negative at age 72 years, an additional 4% and 3% of men and 3% and 7% of women with bacteriuria were detected. Bacteriuric persons were excluded from further screening and controlled by frequent cultures during several years, with careful monitoring of clinical interventions. The persistence of untreated bacteriuria was analyzed in relation to bacterial species and number in the untreated subgroup of bacteriuric individuals. Nine of 10 Escherichia coli (E. coli) with less than 10(6)/ml and 22/22 non-E. coli strains disappeared spontaneously. In contrast, 20/26 (77%, p less than 0.01) with greater than or equal to 10(6) E. coli/ml persisted. Of 17 persons with bacteriuria persisting at least 12 months, 16 were women and 16 had E. coli. Of 201 E. coli cultures obtained from this group, 94% had greater than or equal to 10(6)/ml, and 99% had greater than or equal to 5 x 10(5)/ml. The results indicate that screening for high counts (greater than 10(6)/ml) of E. coli most effectively detects persisting bacteriuria in the general elderly population.

Aged↗

PubMed1989

Decline of blood haemoglobin in the aged: a longitudinal study of an urban Swedish population from age 70 to 81.

Blood haemoglobin (Hb) and related components were determined in a representative sample (n = 973, 449 men and 524 women) of a 70-year-old population, reinvestigated at age 75, 79 and 81. At age 81, 145 men and 259 women remained in the study. Longitudinal analysis demonstrated a significant decline in Hb concentration with advancing age, in the total study groups as well as in subsamples remaining after exclusions due to disease. The mean annual decline from age 70 to 81 in a subsample without definable disorders was in men 0.063 g/dl, in women 0.035 g/dl. There was a similar decline among subjects with high, intermediate or low Hb concentrations during the study. Only part of the observed intraindividual variations could be explained by factors other than age.

Aged↗

PubMed1989

Intermittent nursing home care. Development of an alternative to institutional care.

Intermittent care was offered as an alternative to 178 patients who were at risk of permanent nursing home care, and this proved to be feasible for 55% of these patients. Non-participation was most common due to a pronounced deterioration of health status, hesitance or sick relatives. A more detailed evaluation of this form of long-term care was made for the 27 patients who were in the programme at a specific time and were able to participate in an interview. Although the patients had advanced medical problems and disabilities (80% had balance problems, 74% urinary incontinence, etc.) the majority had a positive outlook on life and appreciated intermittent care. Also from a clinical aspect this form of long-term care proved acceptable, although a decline in performance of activities of daily living and health status was frequently observed during the periods at home.

Activities of Daily Living↗

PubMed1988

The health of the elderly population: results from longitudinal studies with age-cohort comparisons.

In the longitudinal study of 70-year-olds in Göteborg the first age cohort (born 1901-1902) has now been followed for 15 years and the second cohort (born 1906-1907) for nine years; an intervention study has been added to the third age cohort (born 1911-1912). These longitudinal perspectives (derived from studies of samples shown to be representative of the total population) have successively improved the possibilities of distinguishing between ageing manifestations and symptoms caused by definable diseases. In addition to previously reported figures on the proportions of apparently healthy people at age 70 and 75, preliminary conclusions from the follow-up periods from age 79 indicate that at that age at least 20% do not suffer from symptoms of definable diseases. These findings have allowed detailed analyses to be made of the morphological and functional consequences of ageing as well as the calculation of clinical reference values for the age interval 70-79. The improving possibilities for distinguishing between ageing and morbidity have allowed certain conclusions to be drawn on obvious differences between age cohorts relating to the prevalence of disease and manifestations of ageing. These age-cohort differences could not be related to migration and ongoing genetic changes but there is indirect evidence for relationships to lifestyle and certain environmental factors. The reasons for these age-cohort differences in the manifestations of ageing are being analysed retrospectively through information on differences in living conditions between the cohorts and prospectively through the intervention programme (InterVention Elderly in Göteborg, IVEG).

Activities of Daily Living↗

PubMed1988

Predictors of stroke in the elderly.

Hypertension, diabetes mellitus, coronary heart disease and cigarette smoking have repeatedly been identified as risk factors for stroke in young and middle-aged individuals. In order to find predicting factors for stroke in the elderly we assessed health characteristics in 55 stroke victims in the age range 65-75 years (mean 70.7 +/- 2.7) allocated to our stroke unit at Ostra University Hospital in Gothenburg. For comparison we used data from 2,009 individuals participating in the ongoing longitudinal population study "70-year-old people in Gothenburg, Sweden". Among the stroke victims we found a higher prevalence of hypertension (63.5% vs. 27.8%, p less than 0.001), diabetes mellitus (21.8% vs. 6.2%, p less than 0.001) and a history of previous myocardial infarction (12.7% vs. 4.8%, p less than 0.01), thus confirming previous findings. There was no difference with regard to smoking habits (32.7% vs. 27.5%, NS), which is at variance with findings in the young and middle-aged.

Age Factors↗

PubMed1988

Haematological abnormalities in a 75-year-old population. Consequences for health-related reference intervals.

A representative sample (n = 486) of a 75-year-old population was studied, and probands with defined laboratory aberrations were re-investigated. Anaemia was present in 6% of the men and 3% of the women; in 17/22 anaemic subjects a cause was found. The prevalence of plasma cobalamin concentrations less than 130 pmol/l was 6%, of iron deficiency approximately 6%. Divergences in white blood cell and platelet counts were rare. The observed haematological aberrations were almost always caused by disease. Reference intervals for haematological components were calculated in the total study group and two reference sample groups after exclusions based on anamnestic and/or laboratory screening criteria or anamnestic criteria and/or verified disease. The lower reference limits for B-Hb and P-B12 in a group obtained after exclusions based on anamnestic and screening data were considered to be minimum values for healthy subjects. The WHO criteria for anaemia were applicable.

Aged↗

PubMed1988

Practical and functional consequences of aging.

In the gerontologic and geriatric study of 70-year-old people in Göteborg, Sweden, the first cohort (born 1901/1902) has been followed for 15 years, the second (born 1906/1907) for 9 years, and an intervention study has been added to the third cohort (born 1911/1912). The results have allowed a comparison between age-related changes in joint function and manifestations of aging in other organs and organ systems, e.g. striated muscles, density of the skeleton, certain cardiovascular parameters, as well as changes in body mass and body composition. At age 79, a considerable proportion of the elderly had some restriction of their range of motion in one or several joints (one fifth in knee joints, two thirds in hip joints) compared with younger individuals. In the vast majority of probands, this restriction was rather limited and could be described as a stiffness of the locomotor system that could be due either to the aging process with a decrease in elastic tissue components or to age-related changes in behavior and physical activities. Joint complaints of the lower extremities were more frequent than complaints of the upper extremities. Previous sedentary workers were more disabled in activities of daily living than those whose work had previously been physically strenuous.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1988

Home care and intermittent care--a realistic alternative to nursing-home care?

An inventory was made among 210 elderly nursing-home patients to investigate the feasibility of exchanging their permanent stay in the nursing home for another form of care and whether they wanted to. The main alternative was intermittent nursing-home care. The patients were assessed as to physical and mental health and social conditions. The majority (62.7%) were considered too ill for other than nursing-home care. In some patients (24.8%) there were social factors, the main one being that they no longer had a home of their own. However, 26 patients (12.4%) were recommended for intermittent care, but only three were interested. From these results it was concluded that if intermittent home care is to represent a realistic alternative it should be offered to the patients before they move into a nursing home.

Aged↗

PubMed1988

Screening for thyroid disease in the elderly. Serum concentrations of thyrotropin and 3,5,3'-triiodothyronine in a representative population of 79-year-old women and men.

Thyroid function in individuals from a representative population of 79-year-olds was evaluated clinically and from measurements of serum thyrotropin (TSH) and 3,5,3'-triiodothyronine (T3). High TSH concentrations (greater than or equal to 10 mU/l) were found in 16 of 320 women (5%) and 2 of 204 men (1%). Signs and symptoms which traditionally are regarded as related to hypothyroidism were as common in subjects with high TSH concentration as in the remaining population and occurred in 10-50% of the subjects. In the 16 women with high TSH, free thyroxine (free T4) concentrations were low in 10, whereas only one subject had low thyroxine (T4) and T3 concentrations, indicating that free T4 is a more sensitive parameter for thyroid hypofunction in the elderly. Based on the T3 assay, there was no evidence for hyperthyroidism in this population. The results indicate that high TSH concentrations are common in elderly women, less common in men. The results show that classical symptoms of thyroid dysfunction are quite common in 79-year-olds, but do not correlate with biochemical indicators of thyroid dysfunction, indicating that defining "clinically euthyroid" in an elderly may be almost impossible.

Aged↗

PubMed1988

Intermittent care for old patients--when should it be offered?

An inventory was made among 229 elderly individuals in out- and in-patient care, community care and social welfare. The aim was to investigate the patients' possibilities and interest for intermittent nursing home care in order to avoid or postpone permanent institutional care. The patients were assessed as to physical and mental health and social conditions. Intermittent care was thought to be appropriate for 81 of these patients (35%). After an interview of the patients and cohabiting relatives, 21 patients (9%), mainly out-patients, took a positive interest in this form of care. The in-patients were mostly too ill, and patients in community care found intermittent care interesting but were not prepared for this form of rehabilitation and preferred to wait despite risk of acute deterioration. The most suitable and interested patients and relatives were found among those in day hospital and those on the waiting list for geriatric care.

Aged↗

PubMed1988

Comparison between methylphenidate and placebo as adjuvant in care and rehabilitation of geriatric patients.

The aim of the present study was to establish to what extent a short-term treatment with methylphenidate would have such practical clinical effects that possibilities for medical rehabilitation would be improved. Other purposes of the investigation were to certify therapeutically acceptable plasma concentrations in the elderly, and to study possible mental and physical effects of the suddenly improved and greatly extended daily attention given to the patient during the course of the study. 24 fatigued, elderly patients (70-93 years) were treated with methylphenidate/placebo for 9 days. The study was carried out as a double-blind test. Although a significant effect on heart rate and blood pressure was recorded when the full dose (20 mg) had been reached, no difference in mental or physical performance was observed between the two groups.

Affect↗

PubMed1988

Subjective health in relation to aging and disease in a representative sample at ages 70, 75 and 79.

This study explores the relationship between perception of health in 70-79-year-olds and documented functional ability/disability as well as prevalence of definable disorders. Two thirds of both men and women declared themselves healthy at age 70, 2/3-3/4 at age 75 and 3/4 at age 79. Subjective health correlated significantly with the results of an extensive clinical examination for men at age 75 and for women at ages 75 and 79. In both sexes the correlation coefficients between the number of definable diseases and subjective health scoring was statistically significant as well as between mortality and subjective health. Some correlations were also found between subjective health and certain parameters of organ system functions. Contrary to objective findings, the proportion of those who declared themselves healthy was not decreasing by increasing age, and sex difference in consumption of care was not reflected in any sex difference in subjective health. The correlation between subjective health and number of disorders illustrates that the subjective health answers were influenced by knowledge obtained at previous clinical examinations and from drug prescriptions. Many elderly with functional disorders and drug treatment reported, however, that they were well. Subjective evaluation of health seemed to be markedly influenced by their willingness to accept impairment, disability and handicaps as being normal for their age.

Aged↗

PubMed1988

Haematological abnormalities and reference intervals in the elderly. A cross-sectional comparative study of three urban Swedish population samples aged 70, 75 and 81 years.

We compared three representative population samples aged 70 (n = 312), 75 (n = 486) and 81 (n = 404) years. Anaemia defined either as blood haemoglobin concentration below the corresponding health-related lower reference limits or according to WHO was, in the total study groups, more common at age 81. Anaemia of unknown cause was rare, but somewhat more common at age 81. Mean blood haemoglobin concentrations in subsamples without definable disorders were significantly lower at age 81 than at ages 70 and 75, whereas the lower health-related reference limits did not differ significantly. White blood cell counts tended to be lower and iron deficiency was somewhat more common at age 81. No significant differences were found in platelet counts or in the prevalence of low plasma cobalamin concentrations. These results indicate a fall in blood haemoglobin with advancing age. The arbitrary WHO criteria for anaemia are clinically applicable at age 70-81.

Age Factors↗

PubMed1987

The influence of gonadal steroids and the pituitary on the levels and composition of plasma phospholipids in the rat.

Gonadal steroids have been shown to influence plasma phospholipids. In the present study, the possible interaction between gonadal steroids and the pituitary in the regulation of plasma phospholipids was studied in rats. The total phospholipid concentration (higher in females) and the fatty acid composition of plasma lecithin was different in male compared to female rats. Gonadectomy resulted in a "feminization" of plasma phospholipids (total concentration and fatty acids in lecithin) in male rats but had no effect in females. Testosterone treatment of gonadectomized males or intact females resulted in a "masculinization" of plasma phospholipids, whereas estrogen treatment of intact males resulted in a "feminization." Hypophysectomy resulted in a marked decrease in plasma phospholipid concentration and the fatty acid composition of lecithin showed a "masculine" pattern in both males and females. Neither testosterone nor estrogen treatment had any effects on plasma phospholipids in hypophysectomized male and female rats, respectively. It is concluded that gonadal steroids and the hypothalamic-pituitary axis interact in the regulation of the synthetic and perhaps also degradative pathways controlling plasma phospholipids.

Animals↗