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Biomedical subjects

Bertil Steen

Publications and source records attributed to Bertil Steen.

34 records · Page 2Linked to original sources
PubMed2002

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. The aim of this study was to analyze the differences in morbidity--measured as self-assessed health, number of symptoms, number of diseases and physical function--in three different cohorts of 70-year olds, with special regard to the impact of social factors. METHODS: We used data from random samples of 70-year-old people born in 1901/02 (cohort 1), 1906/07 (cohort 2), and 1911/12 (cohort 3). In the three cohorts there were 973, 1036 and 619 participants, respectively. They had a medical examination and were interviewed regarding social background, social network, self-assessed health, need of care, and number of diseases. RESULTS: There were fewer 70-year olds not feeling healthy in the two younger cohorts (OR = 0.68; CI = 0.56-0.83, and OR = 0.67; CI = 0.53-0.84 respectively) and fewer with many symptoms. There were also indications of better physical functioning in the younger cohorts. Women seemed to have gained more than men, while the institutionalized persons had a deterioration. CONCLUSIONS: There are indications of good years being added, but not for the institutionalized persons.

Aged↗
PubMed2002

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. Most interestingly though, the subjects with Alzheimer's diagnosis, younger than the 95-year olds but with a conclusive diagnosis of dementia, performed on an overall higher level than the 95-year olds. This advantage for the Alzheimer group remained even when compared with a sub sample of the 95-year olds with possible dementia diagnosis excluded. On the other hand, only including 95-year olds with a Mini Mental Examination score of >26 in comparison with the Alzheimer group made the differences between the two groups disappear. It is suggested that colour perception as measured in this study is well preserved throughout life. The overall lower colour perception ability in 95-year olds compared with both 80-year olds and subjects with AD may be an expression of the complexity of very high age rather than any isolated concomitant factor.

Aged↗
PubMed2002

Waist circumference, body mass index, and risk for stroke in older people: a 15 year longitudinal population study of 70- year-olds.

OBJECTIVES: To investigate waist circumference (WC) and body mass index (BMI) at age 70 as risk factors for stroke. DESIGN: Cohort study of 70-year-olds with 15-year follow-up. SETTING: Geriatric Medicine Department, Göteborg University, Sweden. PARTICIPANTS: Two thousand two hundred eighty-seven (1,045 men; 1,242 women) 70-year-olds examined between 1971 and 1981 in Göteborg, Sweden. MEASUREMENTS: Cox regression model was used to calculate relative risk (RR) and 95% confidence interval (CI) for first-ever stroke (fatal and nonfatal) in reference to the lowest quartiles of WC and BMI. Tests for trend were performed fitting WC and BMI in their original continuous form. RESULTS: In men and women, RRs for stroke, in the highest WC quartile were 1.65 (95% CI = 1.08-2.51) and 1.31 (95% CI = 0.88-1.92), respectively, after adjustment for cohorts, smoking habit, coronary heart disease (CHD), diabetes mellitus, total cholesterol (TC), systolic blood pressure (SBP), and height at age 70. In men, RR for stroke in the highest BMI quartile (> or=28 kg/m2) was 1.68 (95% CI = 1.12-2.53) after adjustment for cohorts, smoking habits, CHD, diabetes mellitus, TC, and SBP at age 70. In women, adjusted RRs for stroke across the BMI quartiles were not significantly different. In men, population attributable fractions of stroke were 24.8% and 25.2% for the highest quartiles of WC and BMI, respectively. CONCLUSIONS: High WC (> or =99 cm) and BMI (> or =28 kg/m2) are risks for stroke in older men but not in older women.

Aged↗
PubMed2002

Motor performance in relation to age, anthropometric characteristics, and serum lipids in women.

BACKGROUND: The relationships between motor performance and age, anthropometric characteristics, and serum lipids were studied in a population-based sample of women (N = 865). METHODS: Motor performance was measured by a precise laboratory test, the Postural-Locomotion-Manual test, using an optoelectronic technique. Anthropometric measurements included body mass index (BMI) and waist-to-hip ratio. Blood samples were drawn for the measurement of total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride concentrations. RESULTS: Motor performance deteriorated with age in a curvilinear way. High BMI, high waist-to-hip ratio, high triglycerides and low HDL cholesterol were all correlated to poor motor performance after adjustment for age, vascular disease, hypertension, diabetes, smoking, physical exercise, and some chronic diseases. Stepwise regression analyses showed that age, waist-to-hip ratio, triglycerides, HDL cholesterol, physical exercise, and vascular diseases were independent predictors of motor performance. CONCLUSIONS: High age, high waist-to-hip ratio, high triglycerides, and low HDL cholesterol were associated with poor motor performance in women. Monitoring abdominal adiposity and serum lipids in clinical work might help us to identify people with early motor impairment and to prevent more severe mobility disability.

Adult↗
PubMed2002

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 study group consisted of 154 persons (59 men and 95 women) between the ages of 70 and 91 with a median age of 78 years. The methods used included a self-assessed hearing instrument, pure-tone audiometry, and registration of desired services regarding rehabilitative audiology. The questionnaire included 26 items, 20 of them within four areas: assessment of normality, communication, quality of life and environment/orientation. The results showed that the assessment, whether the hearing was normal or not, was correlated with audiometrically measured hearing. Many of the participants expressed concern that their hearing had deteriorated. Communication situations with background noise were troublesome for many of the participants, but they had only minor problems when performing daily activities like shopping. The quality of life in general was only mildly affected by hearing loss. Items regarding environment and orientation showed varying results. Some everyday aspects of listening were related to hearing ability, but directional hearing was not correlated with measured hearing. In spite of the participants' worry about hearing deterioration, only 8% requested hearing aids as a result of the examination.

Aged↗
PubMed2002

Physical activity and mortality of 75-year-old people in three Nordic localities: a five-year follow-up.

The purpose of this 5-year follow-up study was to investigate the relationship between physical activity and mortality in persons aged 75 in three Nordic localities. The study is part of the common NOrdic Research project on Ageing (NORA). The samples consisted of 221 men and 259 women in Glostrup, Denmark, 159 men and 209 women in Göteborg, Sweden, and 119 men and 236 women in Jyväskylä, Finland. Physical activity was measured with a self-report questionnaire, from which a dichotomous explanatory variable was created for the subsequent analysis. Covariates examined in this study were smoking, use of alcohol and the presence of cardiovascular diseases. Baseline measurements were conducted in Glostrup and Jyväskylä in 1989, and a year later in Göteborg. Mortality data was collected from the mortality registry in each country. The follow-up period was 5 years. Fisher's exact test, Cox regression and Kaplan-Meier survival analysis were used in the statistical analysis of the data. The results showed that when physical activity alone was considered, inactivity was associated with an increased mortality risk in all groups except for the men in Jyväskylä. Of the covariates, only smoking and cardiovascular diseases were found to be associated with increased mortality risk and only among the women in Göteborg and Jyväskylä, respectively. When the effect of physical activity on mortality was analyzed together with the covariates, the relationship between physical inactivity and increased mortality risk remained significant in all groups except for the men in Jyväskylä. In addition to this, smoking remained a significant predictor of mortality for women in Göteborg, and the effect of cardiovascular diseases for women in Jyväskylä was nearly significant. The results showed that being physically active predicted survival for persons aged 75 during the follow-up period in all three localities.

Aged↗
PubMedDate not supplied

Do systolic murmurs predict mortality in the elderly? A 15-year longitudinal population study of 70-year-olds.

Systolic murmurs are common in the elderly but there is a striking paucity regarding published reports on their clinical significance and relation with mortality. This study describes prevalence of systolic murmurs in the elderly and cardiovascular diseases in 70-year-olds with or without systolic murmurs, and investigates the relation between systolic murmurs at age 70 and 15-year mortality. This cohort study is based on 973 (449 males and 524 females) 70-year-olds from Göteborg, Sweden who were examined in 1971/1972 at the Department of Geriatric Medicine, Göteborg University, and was followed-up to the year 2001. The prevalence of systolic murmur was 31% (females 36.4%, males 23.9%). Among subjects with systolic murmurs the prevalence of coronary heart disease (CHD) and hypertension was significantly higher in both sexes and congestive heart failure (CHF) in females only. Systolic murmur was a predictor for mortality in females (RR 1.49, 95% CI 1.17-1.91) but not in males (RR 1.14, 95% CI 0.89-1.49). Diagnosis of a cardiovascular disease was a significant predictor in both sexes for mortality irrespective of having systolic murmurs. In conclusion, there is a significant positive association of cardiovascular diseases with systolic murmurs in the elderly. The increased risk for mortality due to the presence of systolic murmur at age 70 is mediated through cardiovascular diseases.

Aged↗
PubMedDate not supplied

Urinary incontinence and related symptoms in older men and women studied longitudinally between 70 and 97 years of age. A population study.

The aim of this study was to assess the prevalence of urinary incontinence and other lower urinary tract symptoms among an aged population and follow this prevalence longitudinally. A random sample of 70-years-olds participated and the survivors have been reinvestigated longitudinally, between 70 and 97 years of age. The prevalence of urinary incontinence was 17% among men and 48% among women 70 years of age. No change in the total prevalence of urinary incontinence or stress incontinence was seen among those that were investigated at the age of 70, 75, 79, 81, 85, 88, 90, 92, 95 and 97. There was some increase in the prevalence of urge incontinence among men and women and some increase in the prevalence of weak stream among men. Urinary catheters were uncommon in this investigation, even among the oldest, and those with long-term catheter use had a high risk of dying. In this study, urinary incontinence was common among men and women 70 years of age. Those who participated in all examinations up to very high age had no increase in prevalence of total urinary incontinence or stress incontinence, but there was some increase with increasing age in the prevalence of urge incontinence and weak stream. These increases were, however, smaller than those found in cross-sectional studies, perhaps due to the fact that those who attended these investigations were healthy and active and, therefore, not afflicted as much, and when they were, they tended to seek help more often. Indwelling catheter use was uncommon in this group of elderly individuals and those who had a catheter had a high mortality, probably due to the fact that only the very ill get an indwelling catheter in Sweden today.

Journal Article↗
PubMedDate not supplied

Urinary incontinence, its influence on daily life, and use of continence aids in two cohorts of 85/86-year-old free-living men and women, born 10 years apart.

The aim of this study was to assess the prevalence of urinary incontinence and other urinary tract symptoms, the use of incontinence aids and how urinary incontinence influences daily life in two 85/86-year-old cohorts born 10 years apart. There were no statistically significant differences between the two cohorts except for the use of incontinence aids, where 23% of women born in 1901/1902 and 42% of women born in 1911/1912 used aids (P=0.002). In this study, urinary incontinence was common among 85/86-year-old men and women but there were no significant differences except for the more frequent use of incontinence aids among women born in 1911/1912 than among women born in 1901/1902. The reason for this difference regarding use of incontinence aids among women could be that taboos are gradually lifting in many cultures, for example in Sweden, but so far mostly for women.

Journal Article↗
PubMedDate not supplied

Ninety-seven-year-old people: general presentation, and some general and medical characteristics from a Swedish population study.

This study--the first in a series of reports--is a description of some general and medical characteristics of 97-year-olds from the representative longitudinal Gerontological and geriatric population studies in Göteborg, Sweden. The sample comprised 117 females and 15 males, a total of 132 97-year-olds. The probands were examined in their homes, with an interview based on a questionnaire. Blood hemoglobin, blood glucose and serum cobolamines were analyzed with standard methods, as well as a detailed hematological analysis which will be reported separately. An examination by a nurse and a physician was completed, comprising also dental status, visual ability and a simple hearing test. Anthropometric measurements and ECG were performed, and blood pressure was measured. Judged from cross-sectional data from our population studies, many symptoms and conditions seem to have a higher prevalence at age 97 than at age 70 and 85, respectively, especially regarding visual impairment, oral dryness, and hearing and ECG abnormalities. On the other hand the prevalence of edentulousness was surprisingly low. We find this investigation important for several reasons, namely its comprising a total community sample at this very high age in an urban area. Furthermore, the subjects are survivors of a cohort of elderly investigated several times by us since 1971/72 at age 70. In some aspects these survivors seem to be an elite of elderly people.

Aged↗
PubMedDate not supplied

Social and medical risk indicators for 8-year mortality in a Swedish urban elderly population.

The aim of this study was to identify and evaluate social and medical risk indicators for mortality in an urban elderly population. Altogether 217 subjects (144 women and 73 men, mean age 78 years, range 69-96 years of age) participated in an examination 1990/91. Eighty-eight persons (55 women and 33 men) had died, and 129 subjects (89 women and 40 men) were alive January 1, 1999. Several risk indicators were found and those with the highest statistical explanatory power to predict mortality were: tremor, inability for heavy housework, a pathological second heart sound, low triceps skinfold, low diastolic blood pressure and decreased appetite. A multivariate model (MVM) utililizing both social and medical risk indicators, and a clinical model (CM) based on the judgement of a registered nurse identified 49 and 34%, respectively, of those who died during the 8-year period (n = 88). A third risk group, the intervention group, comprising individuals selected by either the MVM or CM models, identified 56% of those who died. The latter procedure could be used to define risk groups for mortality in future intervention studies. The combination of social and medical risk indicators in MVM, and a CM might be used in studies with larger sample sizes in order to increase the knowledge in this field.

Activities of Daily Living↗
PubMedDate not supplied

A longitudinal study on changes of movement performance and their relation to medical conditions in a female population followed from age 70 to 78.

We described longitudinal changes of movement performance in a population-based sample of women followed from age 70 to 78. We also studied the cross-sectional relationships between medical conditions and movement performance at baseline, and longitudinal relationships between baseline medical conditions and changes of movement performance. Two hundred and thirty-four women aged 70 years participated in the baseline study, and 88 women participated in a follow-up study 8 years later. Movement performance was measured by an optoelectronic test, the postural-locomotor-manual (PLM) test, which objectively and precisely measures the subject's mobility of lower and upper extremities. Information on medical conditions including selected diseases and symptoms were obtained by self-report and/or by physical examination. Movement time (MT), an indicator of the overall movement performance of the PLM test, increased over 8 years. This change was mainly related to prolonged duration of the locomotor phase (walking forward), but not to the duration of the manual phase (goal-directed arm reaching). At baseline, poor PLM performance was related to hypertension, orthostatic hypotension, cerebrovascular diseases, chronic bronchitis, depression, arthritis, dizziness, chest pain, dyspnea, joint problems, leg pain, tiredness, number of diseases and number of symptoms at baseline. Increased MT during follow-up was associated with arthritis and dyspnea at baseline, and newly developed diseases during follow-up. Our study results indicated that 70-year-old women had a general slowing of their movement performance over 8 years. Age-related decrements of movement performance were more striking in the lower extremities than in the upper extremities. Arthritis and dyspnea at baseline, and incident diseases during follow-up were related to this age-related decline of movement performance.

Activities of Daily Living↗
PubMedDate not supplied

The compression of morbidity debate in aging: an empirical test using the gerontological and geriatric population studies in Göteborg, Sweden (H70).

The H70 longitudinal study of aging, Göteborg, Sweden is used to empirically test the compression of morbidity theory advanced by. We reconceptualize compression as postponement of morbidity in the sense of decreasing amounts of illness for increasingly long life spans. Operationally, morbidity is defined as the average number of hospital days in the last year of life. The date of death and the date of 1-year prior to death define the risk period. The linear regression model with age at death, age at death squared, year of birth, and sex are statistically significant with the oldest having the fewest hospital days. The findings offer partial support for the compression of morbidity theory.

Aged↗
PubMedDate not supplied

Cognitive impairment and dementia 20 months after stroke.

BACKGROUND AND PURPOSE: Dementia is common after stroke, but the dementia syndrome does not cover the whole spectrum of cognitive impairment. Our aim was to quantify and compare dementia and cognitive impairments in elderly patients 1.5 years after stroke and a matched normal population. SUBJECTS AND METHODS: We examined dementia and cognitive impairments in 149 out of an initial total of 243 acute stroke patients after a mean 20 months. Inclusion criteria were age > or =70 years, not living in an institution and no previous cerebral lesion. The patients' mean age was 81 years. Five controls matched by age and gender and fulfilling the same exclusion criteria were selected for each patient (n = 745) from a population-based survey in the same area. Dementia was diagnosed according to the DSM-III-R criteria, and impairments in different dimensions of cognitive function were assessed. RESULTS: The prevalence of dementia was 28% in the stroke patients and 7.4% in the controls (OR 4.7; 95% CI 3.0-7.5). Seventy-two percent of the patients had cognitive impairments compared to 36% in the controls. Cognitive impairments were more common in nondemented stroke patients than in nondemented controls: 61 vs. 31% (OR 3.5; 95% CI 2.3-5.3). The risk increase attributable to stroke was highest for patients below 80 years of age. CONCLUSIONS: Stroke confers an increased risk of dementia and cognitive impairments in the elderly, especially in the younger ones. Apraxia is the most frequent neuropsychiatric impairment after stroke. The concept of dementia does not describe cognitive impairments well, since it underestimates their extent not only after stroke but also in normal ageing.

Acute Disease↗