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Biomedical subjects

B Steen

Publications and source records attributed to B Steen.

At least 19 recordsLinked to original sources

Dental state and functional capacity in 75-year-olds in three Nordic localities.

The aims of the study were to compare dental state in three Nordic 75-year-old populations and to evaluate dental state as a marker of functional ageing. The study is part of a Nordic comparative study of 75-year-olds in Glostrup, Göteborg and Jyväskylä. In the dental studies, 411 subjects in Denmark, 308 in Sweden and 310 in Finland participated. Odontological history was obtained from interviews. Other methods, which are described elsewhere, were used to measure various functional parameters. In Göteborg, 23% of the 75-year-olds reported they were edentulous and 27% that they had more than 20 of their own teeth. The corresponding figures in Glostrup were 45% and 15% and in Jyväskylä 58% and 9%, respectively. In all three localities, economic factors and lifestyle factors, such as tobacco smoking, low physical activity and low social activity, were significant predictors for impaired dental health. The number of teeth was significantly associated with, for example, spirometry parameters, reaction time, body extention and body flexion in males. In females, significant associations were obtained with spirometry parameters, reaction time, handgrip, body extension and body flexion. Internordic differences regarding dental state were obvious. Dental state was associated with functional capacities. We suggest that dental state is a marker of functional capacity in elderly populations.

Aged

The Johanneberg study--a sociomedical survey in an urban elderly population. I. General presentation of the study including an analysis of non-response and identification of risk groups.

This study is the Swedish part of a world-wide transcultural and interdisciplinary study in elderly populations which addresses food habits, health and life-style. The aim of this paper is to present the general design including an analysis of non-response, and to identify risk-groups for intervention programmes. The study comprised 217 noninstitutionalized males (n = 73) and females (n = 144), aged 70 and over (mean age 78 years) in a small urban area. Home visits and clinical examinations with standard methods were used. The participation rate was 76%. Significant differences between non-respondents and respondents could be seen, which may be important when planning health promotion. On the basis of experiences during the examinations, a risk-group was identified for prospective and intervention study purposes, based on a multiple variable model and a clinical model.

Activities of Daily Living

Risk factors for carotid artery stenosis: an epidemiological study of men aged 69 years.

Four hundred and seventy-eight men born in 1914 and residing in the city of Malmö, Sweden, underwent ultrasonic Doppler examination of the carotid arteries in 1982/83. The known risk factors for vascular disease--blood pressure, lipids, glucose, hematocrit, alcohol consumption and Body Mass Index were also measured. A moderate stenosis (diameter reduction 30-59%) of the internal carotid artery was found in 95 men (20%); 15 men (3%) had a greater than or equal to 60% stenosis of the internal carotid artery, while 7 (1.5%) had complete unilateral occlusion. Smoking was found to be significantly related to severe carotid artery disease. There was also a significant correlation between maximum flow velocity in the internal carotid artery and triglycerides. Those quitting smoking before the age of 50 had the same incidence of internal carotid artery disease as non-smokers, while those quitting later in life had a slightly higher incidence than life-long smokers.

Aged

Effects of tobacco and diuretics on human palatal salivary glands.

The prevalence of macrophotographically documented sialadenitis in the palatal mucosa of 184 probands, aged 23 yr or older, was studied in the Koster Health project. A total of 75 (mean age 58.9) revealed inflammatory changes around the duct orifices of the palatal glands. In 10, biopsies were performed for histomorphologic analyses to confirm the diagnosis of sialadenitis. Statistics with matched pairs showed a significantly higher ratio of tobacco use among individuals with sialadenitis than among those with clinically unchanged palatal gland orifices. A relationship between the use of diuretics and sialadenitis was also statistically significant. It can be concluded that tobacco use and diuretics may induce inflammatory changes in the palatal glands and that macrophotography of the palatal mucosa may serve as a valuable, non-invasive method for scoring sialadenitis.

Adult

The importance of diagnostic procedures to ensure quality of health care in geriatric medicine. Examples from recent studies.

Within the health care of the elderly with prevention, diagnosis, therapy, rehabilitation, nursing care and social service, diagnostic procedures are of great importance to avoid under- and over-diagnosis. Many diagnostic difficulties exist in elderly patients such as changed reference values, changed normal values and changed signs and symptoms. Well-known examples of conditions which are likely to be under-diagnosed include depression and urinary incontinence. Examples are given from the cardiopulmonary field where e.g. dyspnoea showed to be very common, but in only 36% of males and 52% in females related to cardiac failure or pulmonary disease. The most common symptom of acute myocardial infarction in elderly patients was shown to be dyspnoea, whereas chest pain occurred in only one fifth of the cases. In another study of patients with ulcer disease loss of appetite and weight, nausea and anemia were more common than abdominal pain and heartburn. In peritonitis patients, abdominal pain was observed in only just more than half of the cases and guarding and/or abdominal rigidity in about one third. In patients with suspect age dementia a detailed investigation showed the prevalence of organic dementia to be 89% whereas 3% had treatable dementia and 8% non-dementia conditions. In geriatric long-term patients the mean hearing loss in the speech area was about 50 dB, in spite of the fact that only about 10% of the patients had hearing aids. The need for nursing diagnosis is also obvious. It is concluded that a detailed multidisciplinary diagnostic investigation procedure is very important in geriatric medicine.

Aged

[Basic education in geriatrics is still unequally distributed in Scandinavia].

A survey is in progress of the training in geriatrics given in Europe, and the status of such training in the Nordic countries is reported here. The Nordic countries--particularly Sweden--have a fairly long tradition of basic training in geriatrics and the research possibilities are also comparatively good. But the distribution of professorships, university departments, and basic training in geriatric medicine are still uneven in the Nordic countries.

Aged

Increased mortality in men with ST segment depression during 24 h ambulatory long-term ECG recording. Results from prospective population study 'Men born in 1914', from Malmö, Sweden.

'Men born in 1914', from Malmö, Sweden, is a cohort study of the morbidity and mortality of cardiovascular diseases among 68-year-old men in an urban population. Ambulatory long-term ECG recording was part of the health examination that these men were invited to undergo in 1982. Five hundred attended (80.5%) of the 621 invited. Ninety-eight of the 394 men in whom the ECG recording was technically satisfactory had at least one episode with horizontal or downsloping ST segment depression greater than or equal to 0.1 mV. The median total duration of ST segment depression was 135 min. 90% of these episodes were not preceeded by any increase in heart rate. In only eight of the 47 men who reported an occurrence of chest symptoms during the recording period did ST segment depression and chest symptoms occur simultaneously. 43 months after the health examination, 33 (8.4%) men had died. The mortality in men without ST segment depression and without any history of coronary heart disease was 6.5%. The incidence of fatal and non-fatal myocardial infarction in men without ST depression greater than or equal to 0.1 mV and without a history of IHD was 2.3%. Men with ST depression greater than or equal to 0.1 mV in comparison with this group had a 4.4 times greater relative risk. The risk in men with both ST segment depression greater than or equal to 0.1 mV and history of coronary heart disease was 16.0 times greater. This study shows that asymptomatic ST segment depression is a frequent finding in elderly men. The occurrence of asymptomatic ST segment depression is associated with an increased cardiovascular mortality. This increased mortality is independent of a history compatible with angina pectoris or previous myocardial infarction.

Aged

Carotid artery blood flow velocity related to transient ischemic attack and stroke in a population study of 69-year-old men.

A population-based sample of 478 men aged 69 years living in Malmö, Sweden, underwent Doppler ultrasonic examination of their carotid arteries; cerebrovascular symptoms and signs were recorded independently. Among 471 men with complete examinations, 117 (25%) showed significant abnormalities in carotid blood flow velocity (moderate stenoses [30-60% diameter reduction] in 20%, severe stenosis [greater than or equal to 60% reduction] or occlusion in 5%). The latter seemingly formed a group separate from the main distribution curve. Stroke was reported in 28 men (6%), during the year before examination in nine (2%). Carotid transient ischemic attack (TIA) was clinically confirmed in one man during this year, while unconfirmed symptoms were reported in 63 (13%). There was a relation between ipsilateral hemispheric stroke/TIA and severe carotid disease (p less than 0.001). Four of seven men with total occlusion had a stroke or a clinically confirmed TIA. Nevertheless, the majority of carotid stenoses (including severe stenoses) were asymptomatic. Cerebrovascular symptoms were not significantly more frequent among the men having moderate stenosis than among those having healthy arteries.

Aged

Dietary habits in the eighth decade of life.

Of a representative sample of 231 subjects (mean age 74.6 years) 89 women and 94 men were interviewed. The dietary history method was used and the calculated intake compared with Swedish recommendations (RDA-S). Mean intakes of energy and nutrients, except for vitamin D among women, were above the RDA-S. Intake of fat was above the RDA-S, and the proportion of energy intake from fat increased with age. Those who had three cooked meals per day had a higher nutrient density than those who ate one or two such meals. Although the RDA-S were the same for men and women, women had lower mean intakes and a higher proportion of subjects below the RDA-S for calcium, iron and vitamins C and D. More women had intakes of calcium and vitamin D simultaneously below the RDA-S. In most aspects the mean dietary intake was satisfactory according to current standards, but the RDA-S for calcium seems low. Fat intake was too extensive for both sexes and many women stood in risk of undernutrition.

Aged

Age retirement in women. I. General presentation.

Within the framework of a longitudinal population study of age retirement in women, the short-term consequences of retirement were studied in 116 municipally employed women in the city of Malmö (230,000 inhabitants) in southern Sweden half a year before and half a year after retirement. The women represented about 40 different occupations, mostly within the sectors of health care, social services and administration. The study comprised four main parts, namely health and discomfort, social psychology, dietary habits and body composition, and oral health. The present paper concerns a general presentation of the study including sampling procedures and analyses of non-response. The response rate was a little more than 70%. Only a few significant differences were observed between non-responders and responders, such as more working hours per week, and more frequently a negative attitude towards retirement in the non-responders after retirement. This longitudinal prospective study of the same cohort of women has so far shown that the general design, sampling procedure and general methods of data collection appear adequate and feasible. In general, the study population was representative of women about to retire from municipal employment in Sweden. Results from the different studies will be presented elsewhere. To illustrate not only the short-term effects of retirement we intend to reexamine the same women about 2 years after the retirement.

Dental Health Surveys