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Biomedical subjects

M Schroll

Publications and source records attributed to M Schroll.

At least 19 recordsLinked to original sources
PubMed1992

[Research on aging: geriatric perspectives].

Geriatric efforts have prophylactic effects on further reduction of functional ability at every link in the therapeutic chain by means of interdisciplinary qualitative and quantitative assessment which establishes goal and plans which lead to coordinated action. This results in early diagnosis of multiple pathology, reduction of polypharmacy, confidence on account of good information, continuity on account of coordination between primary and secondary sectors, simultaneous efforts, early interruption of the cascade effect which results in production of helpless patients. By means of clinically controlled trials, effects have been obtained on a number of recently discovered diagnoses requiring treatment, unnecessary medication is withdrawn, conditions of rehabilitation, functional ability, quality of life, employment of bed-days, institutionalization and mortality. It is necessary to state that this is the only age group where the effect is obtained without further expense or where the effort has even resulted in economic savings. In Denmark, research is required as regards how prophylactic health visits to the elderly can best be carried out in all communities, the risk situations (death of a spouse, removal, illness) which require immediate increased efforts and research into how offensive geriatrics is to be established, how rehabilitation is ensured for healthy and sick elderly patients and research into the occurrence and treatment of the five geriatric giants (immobility, instability, incontinence, intellectual reduction and iatrogenesis). More Danish controlled trials are required of the individual components in and the total function of geriatric assessment and rehabilitation and the significance of personal choice when the functional ability is such that dependence on care by others is inevitable and, finally, the conduct and expenses of various arrangements.

Aged↗
PubMed1992

Interrelations between migraine and tension-type headache in the general population.

In a cross-sectional epidemiological survey of a general population, headache disorders were diagnosed according to a structured interview and a neurological examination using the criteria of the International Headache Society. The prevalences and sex distribution of the primary headache disorders were assessed, and characteristics of and interrelationships between different types of headache were analyzed. Severity and frequency of migraine attacks were not correlated, indicating that the migraine attack is an all-or-none phenomenon triggered with an individually variable threshold. Tension-type headache, in contrast, showed increasing severity with increasing frequency, indicating that it is a graded phenomenon. In the previous year, 6% had migraine without aura (previously called "common migraine") and 4% had migraine with aura (previously called "classic migraine"); 63% had episodic tension-type headache and 3% chronic tension-type headache. In women, migraine without aura was twice as prevalent as migraine with aura; in men, an opposite trend emerged. In migraine without aura, pain was more severe than in migraine with aura. Tension-type headache in migraineurs was not significantly more prevalent than in nonmigraineurs and, except for greater frequency and severity, it did not deviate nosographically from pure tension-type headache. Our results support the contention that migraine and tension-type headache are distinct entities, contradict the so-called continuum-severity model, and indicate that the terms combination headache, mixed headache, and interval headache should be avoided.

Adult↗
PubMed1992

Geriatric follow-up by home visits after discharge from hospital: a randomized controlled trial.

The aim of this prospective, randomized and controlled trial was to carry out and evaluate a model for follow-up by home visits after discharge from hospital of persons aged 75 years or more. The trial was a feasibility study in which hospital staff, district nurses, and general practitioners already working within the hospital and the primary health sector participated, with changes in the usual organization. On the day after their discharge from hospital, 163 patients were visited in their homes by the district nurse. Two weeks later, they were evaluated at home by their general practitioner. For 181 control patients, discharge took place according to the usual procedures. Endpoints were evaluated one year after discharge. Significantly more patients from the control group had been admitted to nursing homes as compared with the trial group (25/10, p < 0.05); the control patients stayed 2700 days at institutions, the trial group 1950 days. It is proposed that this simple and practicable follow-up routine be introduced in connection with discharge of elderly persons from hospital.

Aged↗
PubMed1992

Does increased life expectancy imply active life expectancy?

From Danish results, it is argued that longer life need not imply worse health. If we as individuals and society will prevent the "pawnbroker-diseases," increase access to geriatric rehabilitation, and supply necessary services in an individualised way, most added years can be active years. The following conclusions are drawn: In the first decades after the year 2000, morbidity, disability and mortality will be postponed, but treatment will be more important for prolongation of life than prevention. Therefore, the net result will be extension of morbidity. The next question is how severe disability will be among the increased number of people who have a disease, but are not dying from it. The elderly will be more healthy in the future, but the prevalence of chronic disabling diseases may not change, or may even increase. That is because healthy men and women can postpone disability and death until higher ages (successful aging), but some elderly persons live with premature disabling diseases, which might have killed them some decades ago. When elderly people make the transition from autonomy to dependence in the course of a disease, it is possible by early geriatric intervention and rehabilitation to restore them to functional levels and provide them with more active years. It is possible to disseminate geriatric rehabilitation to a much wider population of elderly with multipathology and social problems. In this way, disability can be overcome in a higher fraction of diseased elderly.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1992

Reproducibility and validity of 7-day food records.

The reproducibility of the 7-day food record method, as used in The Glostrup Population Studies, has been tested by 40 adult volunteers, mainly hospital staff, recording their dietary intakes in two 7-day periods. To validate the calculated protein intake a 24-h urine specimen was collected from all participants in period II, but for various reasons urine specimens were only obtained from 31 in period I. There were significant differences in the intakes of energy, protein and some vitamins and minerals between the two periods, but the nutrient densities, except for vitamin A, were equal. The mean energy distributions in the diet showed no significant differences between the two periods. The weekly variance ratio (S2within/S2between) was between 0.25 and 0.80 for most nutrients. The only ratios above 1.0 were found for vitamin A, vitamin C, vitamin D, vitamin B12 and chromium, selenium and sodium. The weekly coefficients of variance (CV) were for most nutrients less than 30%. In period II the mean protein intake estimated from the urine samples was 74.7 (+/- 15.9 SD) g/day, whereas the protein intake calculated from the diet records was 70.6 (+/- 18.4) g/day. The average estimated protein intake for the 31 people who collected urine in period I was 72.1 (+/- 18.3) g/day, whereas the calculated intake was 78.0 (+/- 22.7) g/day. In neither period were the mean differences significant.

Adolescent↗
PubMed1992

Differences between participants and non-participants in a population study on nutrition and health in the elderly.

In November 1988 a random sample of 435 men and women aged 70-75 years from the general population in Roskilde, a provincial town in Denmark, were invited to participate in a study of nutrition and health. Forty-six per cent of the total sample agreed to participate. The total sample could be characterized by socio-economic variables and data on previous hospitalizations obtained from public registers. A subgroup of the non-participants could be further characterized by some of the topics under study using information obtained by telephone interviews. It was found that the non-participants differed from participants by selected health variables. More non-participants than participants had been hospitalized one year before contact. Telephone interviews with non-participants revealed generally poorer self-judged health and less-frequent eating of cooked meals compared with participants. The degree of bias introduced by this selectivity is estimated by weighting and by a minimum/maximum calculation. Review of participation in previous studies of nutrition and health in the elderly shows that problems with non-participation have been treated in various ways. It is concluded that consideration of factors discriminating between participants and non-participants is important for proper estimation of population parameters.

Aged↗
PubMed1992

The Glostrup Population Studies, 1964-1992.

The Glostrup Population Studies, 1964-92, comprise descriptive and analytical, clinical epidemiological studies. Since 1964, different birth cohorts have been examined. More than 20,000 persons, randomly selected from the background population of 300,000 inhabitants (Copenhagen County), have been invited to participate. The project started in 1964 with a survey of the 1914 population on risk factors for coronary heart disease. As the 1914 population has been followed and new cohorts added, a time-sequential design, suited for studies of aging, has been constructed. The staff has been kept in the unit for up to 28 years. Doctoral candidates in medical science and Ph.D candidates have defended their analyses of Glostrup data in several fields and continue to belong to the group of representatives, supporting the board of leaders. The head of Medical Department C serves as chairman, thus maintaining a close connection with clinical medicine.

Adult↗
PubMed1991

[Follow-up of elderly patients in their homes by general practitioners after discharge from hospital].

The present project which is part of a more extensive coordination project has had the goal of carrying out and assessing the proposals about follow up home visits by the general practitioner after discharge from hospital made by "The coordinating committee for the health services". General practitioners in the municipality of Roskilde made a total of 210 visits to elderly patients aged 75 years or over who had been discharged to their homes after hospitalization for at least three days. During these visits, the practitioners discovered newly developed problems in 49% of the visits while adjustment of medication proved necessary at 52% of the visits. This investigation is concerned with the risk situation, viz discharge of elderly patients from hospital but it also attempts to identify the risk groups which obtain most benefit from follow up. The majority of problems were found among the oldest patients aged 85 years and over who had been hospitalized for more than seven days. In addition, the general practitioners found that significantly more elderly patients aged 85 years and over (less than or equal to 0.05) and elderly patients who had been hospitalized for over seven days should be followed up by home visits. It is emphasized that the model outlined here would not stress the individual general practitioner's daily routine to any great extent.

Aftercare↗
PubMed1991

Epidemiology of headache in a general population--a prevalence study.

We present the first prevalence study of specific headache entities using the operational diagnostic criteria of the International Headache Society. One thousand 25-64 year old men and women, who lived in the western part of Copenhagen County were randomly drawn from the Danish National Central Person Registry. All subjects were invited to a general health examination focusing on headache and including: a self-administered questionnaire concerning sociodemographic variables, a structured headache interview and a general physical and neurological examination. The participation rate was 76%. Information about 79% of the non-participants showed a slightly differing headache prevalence which was not quantitatively important. The following results in participants are therefore representative of the total sample. The lifetime prevalences of headache (including anybody with any form of headache), migraine, and tension-type headache were 93, 8 and 69% in men; and 99, 25 and 88% in women. The point prevalence of headache was 11% in men and 22% in women. Prevalence of migraine in the previous year was 6% in men and 15% in women and the corresponding prevalences of tension-type headache were 63 and 86%. Differences according to sex were significant with a male: female ratio of 1:3 in migraine, and 4:5 in tension-type headache. The prevalence of tension-type headache decreased with increasing age, whereas migraine showed no correlation to age within the studied age interval. Headache disorders are extremely prevalent and represent a major health problem, which merits increased attention.

Adult↗
PubMed1991

Secular trends in serum cholesterol, high density lipoproteins and triglycerides 1964-1987.

Total mortality from cardiovascular disease in Denmark has decreased over the last 20 years for women and the last ten years for men. The possible role of simultaneous changes in serum total cholesterol has been investigated. Secular trends in serum cholesterol, high density lipoprotein cholesterol, and triglycerides, 1964-1987, are presented on the basis of four studies of 30-, 40-, 50- and 60-year-old men and women, some 8737 subjects in all. A significant decrease of 1% per year in total serum cholesterol (p less than 0.05) in both sexes and in all age groups up to 1982 was detected followed by a subsequent stabilization, 1982-1987. The decrease is not a result of methodological bias. The impact of storage at -20 degrees C for 13-24 months compared to immediate analysis of sera was studied as well as differences in analysis methods over time. The fall in population cholesterol levels might be associated with changes in polyunsaturated/saturated fat (P/S) ratio rather than total fat content of the diet, but other lifestyle changes have taken place as well.

Adult↗
PubMed1991

A dietary study of the elderly in the City of Roskilde 1988/1989 (II). A nutritional risk assessment.

In winter 1988/1989, a total of 435 randomly selected men and women aged 70-75 years and living in the city of Roskilde were invited to participate in a diet and health study. Nutritional status was assessed through a dietary interview, antropometric and biochemical measurements on 188 of the invited elderly. Assessed in relation to dietary recommendations, the average fat intake was found to be high (41% energy), whereas intakes of vitamin B6 and D were found to be below recommended levels in 22-26% of the subjects. The prevalences of obesity (12% had BMI over 30 kg/m2) and elevated levels of serum cholesterol (16% had serum levels over 7.5 mmol/l) were relatively high, the percentages being higher for females than for males. Many of the elderly had low levels of 25-hydroxy-vitamin D in plasma (30% under 30 nmol/l) indicating a marginal status. The prevalences of low blood levels of vitamin B6 (40% under 30 mmol/l) and betacarotene (26% under 0.3 mumol/l) were also high among the elderly. The prevalence of anaemia was 3%. It is concluded that osteoporosis-related parameters and risk factors for cardiovascular diseases are prevalent among the elderly in Denmark. The origin of these risk factors have to be studied in more detail, and consequences of any changes occurring must be monitored.

Aged↗
PubMed1991

Assessment of health: self-perceived health, chronic diseases, use of medicine. Euronut SENECA investigators.

In 17 towns in 11 countries across Europe, 10 questions on health were asked as part of a general standardized interview regarding self-perceived global and relative health, quality of life, chronic diseases, use of medicine and specific ailments. 2544 men and women born between 1913 and 1918 participated in the survey. No age-related health differences were found within this 5-year age group. Self-perceived global health was better in men than in women, and more men than women judged their health to be better than that of other persons of their age. The gender difference in prevalence of chronic diseases and use of medicine was less pronounced. Most people judged their health to be good (20-82%) despite a high prevalence of chronic disease (59-92%) and symptoms from different organ systems (leg problems: 16-60%). There were large variations in all measures of health between towns, even between towns within the same country. The trend was in the direction of better health in northern industrial towns than in southern rural towns. The differences were still significant after correction for differences in non-participation rate. The findings are consistent with findings in other health surveys. The findings about self-rated health, chronic diseases and specific ailments will be used in further cross-sectional analyses of the role of differences in diet habits and nutrition for health in Europeans, controlled for living conditions and life-style.

Activities of Daily Living↗
PubMed1991

Design, methods and participation. Euronut SENECA investigators.

At the initiative of EC/Euronut a European Community project (SENECA) began in 1988, with 19 research groups working on the major nutritional issues affecting the growing number of elderly people in Europe. Some 2600 people born between 1913 and 1918 were studied, using strictly standardized methodology. Data have been collected on the dietary intake of these people, their nutritional status, physical activity, life-style, health and performance. It is envisaged that the SENECA project will be continued according to a mixed longitudinal design. The mean response rate in a group of 18 communities in which a non-participation study was conducted was 51%, while 60% of the non-responders were prepared to complete a non-responders' questionnaire. On the basis of the data collected from both responders and non-responders, it was found that males, non-smokers, healthy and better educated persons participated better in the SENECA study than females, smokers, persons who judged their health to be poor, and persons with comparatively poor education, respectively. Housing (having a garden), age, and marital state (single) were only of minor importance for the participation. Persons who did not eat a cooked meal daily, generally participated less, but this differed between towns. It is demonstrated how stratum-specific weighting factors can be calculated to partially remove bias due to selectivity in participation.

Aged↗
PubMed1990

[The cardiovascular risk profile in the Glostrup region, Monica screening II, 1986/87].

Information about risk factors and cardiovascular disease was collected from 30, 40, 50, and 60 year old representatives of the suburban Danish population (n = 1,504). Reference values for systolic and diastolic blood pressure and total serum-cholesterol are given. A comprehensive risk profile is discussed on the basis of selected risk factors: arterial hypertension, total serum-cholesterol greater than 7.5 mmol/l, smoking of ten cigarettes or more per day, intake of five alcoholic drinks or more per day, lack of physical exercise, and body mass index greater than 25 kg/m2.

Adult↗