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Biomedical subjects

D Mellström

Publications and source records attributed to D Mellström.

At least 73 records · Page 4Linked to original sources
PubMed1987

Incidence of hip fracture in western Sweden 1974-1982. Comparison of rural and urban populations.

Several epidemiological studies in northern Europe have shown that fractures in the elderly exceed the expected increase in the aging populations. We have compared the incidence of hip fracture in the rural county of Skaraborg and the city of Göteborg in Sweden. After adjustment for age changes in the population, the incidence of hip fracture in Skaraborg County was lower than in Göteborg during the period 1974-1984. The non-age-related increase in the incidence of fractures found in the city was not confirmed in the rural area.

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PubMed1987

Medical-social intervention in a 70-year-old Swedish population. A general presentation of methodological experience.

The possibilities of improving physical, mental and social functioning or retarding the development of handicap and reducing the need for medical and social services were investigated in an interdisciplinary intervention study in a representative population sample of 1206 70-year-olds. The assessments concerned cognitive function and mental health, earlier and current social interaction and living conditions, state of health including dental status, muscular strength and performance, pulmonary and cardiovascular function, bone mineral content, ADL and dietary habits. The intervention (response rate 76.8%) concerned social, psychological, environmental and medical aspects in 400 and medical aspects only in 406 probands. 400 register controls were sampled for comparison. The intervention period was 2 years, and a follow-up study will be performed at the age of 75. The interventions were guided by the life-style and the activity hypotheses within the resource perspective to promote everyday activities. The study allows comparisons with two previous 70-year-old cohorts investigated with similar methods in Gothenburg.

Activities of Daily Living↗
PubMed1987

Tobacco smoking--a major cause of sex differences in health.

Differences between men and women regarding morbidity have been investigated in relation to tobacco smoking, among 2,009 70-year-olds in the longitudinal gerontological study in Gothenburg, Sweden. Male smokers (44%) had started smoking earlier (age 18) than female (14%, age 30), consumed more tobacco and more often inhaled tobacco smoke. Peptic ulcer, chronic bronchitis and lung cancer were examples of diseases more common in males. ECG evidences of myocardial ischemia were more common in males, while anginal pain showed the same prevalence. Cholecystectomy and antihypertensive treatment were more common among females. When adjustments were made for duration of smoking, amount of tobacco consumed, significant sex differences were still observed for ECG evidence of myocardial ischemia (dominance in males), peptic ulcer (dominance in males), intermittent claudication (dominance in females) and treatment for hypertension (dominance in females). The majority of disorders predominant in males were found to be related to smoking, while those predominating among females showed the same sex difference when adjustments were made for smoking habits. Future increasing segments of females addicted to tobacco smoking will obviously markedly influence sex difference in morbidity.

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PubMed1986

Tobacco smoking: a major risk factor for loss of teeth in three 70-year-old cohorts.

Oral health was examined in a random sample of 1377 people in three 70-year-old cohorts studied within 5-yr intervals. During the studied period 1971-1983 the prevalence of toothlessness decreased from 52 to 34%. Toothlessness in men was more common in smokers, 48%, and ex-smokers, 32%, than in non-smokers, 20%. Eichner's index was used as a measurement of dental invalidity. This index showed a worse dental state among smokers and ex-smokers compared to non-smokers. Multivariate analyses indicated that tobacco smoking was a major independent risk factor for tooth loss in elderly men.

Age Factors↗
PubMed1985

Occurrence, nature and treatment of urinary incontinence in a 70-year-old female population.

An intervention trial using oral oestriol to treat urinary incontinence was performed in a number of patients taken from a representative sample of 562 women aged 75 yr. The clinical series consisted of 34 patients who took part in a double-blind crossover study of the possible effects of oestriol, given in a single daily dose of 3 mg, and of a placebo over a period of 3 mth. The clinical examinations included bacteriological cultures and an assessment of the degree of atrophy of the surface membranes in the vagina. In most patients, oestriol was effective in reversing the atrophy. The clinical effect was excellent in urgency and mixed incontinence, but not in stress incontinence.

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PubMed1984

The effect of tobacco smoking on the bone mineral content of the ageing skeleton.

The relationship between the bone mineral content (BMC) of the heel bone and cigarette smoking has been determined in representative samples of 409 men and 559 women at the age of 70, 75 and 79 in a longitudinal and cohort comparison study. The BMC was measured by dual photon absorptiometry with stationary geometry over the dorsal aspect of the heel bone. The mean values of the BMC for smokers compared to non-smokers were for men about 10-20% lower and for women 15-30% lower in all age groups studied. The difference in body weight between smokers and non-smokers could not explain the lower values of BMC for the smokers. No difference was found in physical activity between the groups.

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PubMed1984

Thyroregulatory changes associated with smoking in 70-year-old men.

In a previous study we have analysed serum free T4 concentrations in a representative population of 70-year-old men. In the present study the effect of previous or present tobacco smoking on free T4, T4, T3, rT3, TSH and thyroid hormone binding proteins was analysed in 181 of the 460 men, excluding those with past or present goitre, those who were obviously ill or had died between 70 and 75 years of age and those who had any disease or medication influencing free T4 concentrations. Smokers had higher T4 and rT3 levels, and lower TSH levels but T3 levels no different from non-smokers. The difference in T4 levels, but not rT3 or TSH levels, between smokers and non-smokers could be attributed to differences in body mass and also to differences in TBG levels. The results indicate that tobacco smoking is associated with long-term alterations in thyroregulatory function.

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PubMed1984

Interrelationships among body mass, thyrotropin, thyroid hormones, and thyroid-hormone binding proteins in healthy 70-year-old men.

In a previous study of a representative population of 460 men of age 70, we found that the free thyroxin (free T4) concentration was negatively correlated to body mass. In the present study we analyzed other indicators of thyroid function in relation to body mass and body mass index in 181 individuals without any disease or medication influencing thyroidal homeostasis or body mass. There was a significant negative relationship between body mass and body mass index and free T4, total T4, and 3,3',5'-triiodothyronine (rT3). Thus, individuals with high body mass normally had lower circulating concentrations of these hormones than lean individuals, whereas there was no such relationship for thyrotropin or 3,5,3'-triiodothyronine (T3). The thyroid-hormone binding proteins (thyroxin-binding globulin, prealbumin, and albumin) did not correlate with body mass or body mass index. As expected, thyroxin-binding globulin correlated with T4, T3, and rT3, but not with free T4 or thyrotropin. Concentrations of serum albumin correlated with T3 and rT3 concentrations but not with free T4, T4, or thyrotropin concentrations. Thyrotropin concentrations correlated negatively with free T4, T4, and rT3, but not with T3, indicating that circulating T4 plays the dominant role in feedback regulation of thyrotropin in healthy individuals.

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PubMed1983

Factors influencing serum free T4 in 70-year-old men. Implications for reference intervals in the elderly.

We tested a procedure to obtain reference values based on careful clinical analysis of a population sample with the background (a) that there are conflicting reports of age effects on thyroid function parameters, possibly reflecting differences in numbers of sick and drug-treated subjects in the studied populations, and (b) that recommended procedures for the selection of reference subjects in elderly populations may give unacceptably high exclusion rates. Serum free T4 was determined by a ligand-analogue technique in a representative population of 460 males at age 70. The determinations were performed 5 years after the clinical study, and the results were analysed in relation to information obtained at the study as well as during a 5-year follow-up. The free T4 concentration was significantly low in subjects with neoplastic disease and subjects with chronic bronchitis and significantly high in subjects taking non-selective beta-adrenergic blockers. Selective beta 1-blockers had no apparent effect. Information on death during the 5 years after the study proved to have no significance. The free T4 concentration was found to be negatively correlated to body mass and body mass index, a correlation which has previously not been shown. Smoking was associated with a significantly low body mass but had no apparent effect on mean free T4 concentration. A procedure with successive exclusions of clinically defined diagnostic groups with significantly low or high analyte concentration and/or body mass may be used to obtain reference values for thyroid function and may reveal previously unknown relationships.

Adrenergic beta-Antagonists↗
PubMed1983

Cholecystectomy and colon cancer in the elderly.

The incidence of colon cancer is increasing in Sweden. This is partly due to the increase of the older segments of the population. Various risk factors, such as diet, low serum cholesterol and, more recently, cholecystectomy have been found. Earlier studies, particularly regarding cholecystectomy, were carried out on in-patients of varying ages. In this longitudinal study, a representative sample of people investigated at the ages of 70 and 75 was analysed with regard to earlier cholecystectomy. Twenty-two per cent of women and 11% of men at the ages of 70 and 75 years were found to have had this operation. A relationship between cholecystectomy and colon cancer was found for women but not for men. The cholecystectomized women had low serum cholesterol values. The female colon cancer cases were related to a high body weight. Cholecystectomized individuals can be regarded as a special group with risk factors for colon cancer.

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PubMed1983

Zopiclone to geriatric patients. A parallel double-blind dose-response clinical trial of zopiclone as a hypnotic to geriatric patients - a study in a geriatric hospital.

Zopiclone was given for 14 nights to 68 geriatric patients (mean age 81 years) with sleep problems. The patients were randomly allocated to four treatment groups: 3.75 mg, 5.0, 7.5, or 10.0 mg of zopiclone. Sleep quantity and quality, side effects, and influence on psychomotor performance (digit symbol substitution and letter cancellation test) were studied before treatment, during active treatment, and after withdrawal of the drug. All patients slept better on zopiclone compared to placebo. There were only slight differences between the different dose levels as regards quantity and quality. No influence on psychomotor performance could be shown. The side effects were mild. Zopiclone showed a good hypnotic efficacy, and 7.5 mg is probably the best dose for elderly patients.

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PubMed1983

Institutional care at the age of 79 in an urban population--an analysis from a longitudinal population study.

The need of institutional care is strongly correlated to age. In the population, that is between 70 and 79 years of age the proportion of patients in long-term medical care units increases twenty-fold. The present investigation is a part of the longitudinal population study of 70-year-olds who have been followed to 79 years of age in Göteborg. A representative sample of 79-year-old men and women has been investigated. At this age 8.7 per cent of the men and 8.3 per cent of the women were living in medical and social institutions. Institutionalization was defined as constant care outside the patient's home for at least three successive months at the time of the investigation. The percentage of men living in somatic long-term medical care facilities was 4.3, while for women it was 2.4. The corresponding figures for psychiatric long-term care were 1.9 per cent for men and 1.8 per cent for women. 1.9 per cent of the men and 3.7 per cent of the women had moved to old people's homes where the subjects are expected to manage their own daily activities. Among the institutionalized probands only 7 per cent of the women were married, while this was the case for 43 per cent of the men. The subjects in psychiatric long-term care had the longest nursing time, i.e. about 20 years, while in the other types of institutions this time was about 3 years. The longitudinal strategy makes it possible to describe age-related changes in the background factors behind institutionalization.

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PubMed1982

Tobacco smoking, ageing and health among the elderly: a longitudinal population study of 70-year-old men and an age cohort comparison.

In the population study Seventy-year-old People in Göteborg, 449 70-year-old men were examined in 1971/72. Out of these, 331 were re-examined in 1976/77 at age 75, together with a cohort-comparison group of 474 70-year-old men. Cohort differences and a lower smoking prevalence at higher ages were observed. The loss of body weight after the age of 70 was higher in smokers and was not due to differences in energy intake. The levels of certain blood components showed differences among smokers compared to non-smokers, indicating an influence on liver metabolism and on the hormone function. Tobacco smoking was not only related to ill health but also to an impaired functional capability in bone mineral density, pulmonary function and muscle strength.

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