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Biomedical subjects

S Landahl

Publications and source records attributed to S Landahl.

At least 37 records · Page 2Linked to original sources
PubMed1992

Accidents in the institutionalized elderly: injuries and consequences.

A total of 308 major and 519 minor accidents involving 588 patients occurred during one year at a somatic long-term care hospital and its associated nursing homes. In relation to the number of patients, the incidence of accidents was nearly three times higher in the nursing homes than in the hospital. The most prevalent injuries in female patients were fractures and hematomas, while open wounds were more frequent among male patients. Hip fractures were about as common in women as in men, while fractures of the extremities were three times more frequent in women. The majority of the accidents occurred during daytime, in the patient's room and in many cases soon after admission. Most of the injuries were caused by falls and in more than 90% no staff was present. Accidents were reported most frequently in October-December, and least often in July-September. Two thirds of the severely injured had to be transferred to an emergency hospital for surgery or other treatment. Patients who had had major accidents also had a higher mortality rate six months after the accidents as compared to a control group. The medical and functional consequences for the patients were considerable. Measures to reduce the number of accidents among geriatric patients are therefore urgently needed.

Accidents↗
PubMed1992

Falls in 84- to 85-year-old people living at home.

The present study is a part of the Swedish longitudinal population study "70-year-old people in Gothenburg". The aim of the present study was to analyse retrospectively incidence, circumstances, and consequences of falls during one year among 741 home-living people aged 84-85. A comparison of social and medical characteristics of fallers and non-fallers aged 85 was performed. Information was collected by interviews and clinical examinations. In 1986/1987, 732 home-living people (244 men and 488 women), aged 85 gave information about falls during the last year. Three hundred and one (41%), 97 men and 204 women, had fallen at least once during the last year, mainly indoors. No sex difference was found in incidence. The most dominant triggering causes of falls were stumbling, dizziness, and feebleness. In 80% of the falls an injury occurred, of which every fourth was a fracture. A multivariate regression procedure showed that dizziness, vertigo and unsteadiness, transient ischemic attacks, antidepressant drugs, and poor subjectively experienced health characterized the fallers. Mortality rate of those between 85 and 88 years of age showed no association with falls.

Accidental Falls↗
PubMed1992

Individual evaluation of accident risks at nursing homes.

The purpose of the study was to find a practical applicable method for estimating risk of accidents among nursing home patients by localizing specified risk factors and recording accidents during a period of one year. During 1987-January-15 to 1988-January-14, a total of 153 accidents happened to 23 men and 76 women among 335 admitted patients. The strongest accident predictors suggested by a logistic regression procedure were: impaired balance, walking with device or human assistance, drugs influencing the central nervous system, dizziness and poor night-time sleep. The conclusion is reached that it will probably be possible to reduce accidents in the institutionalized elderly by education of staff, identification of risk patients, individual nursing planning and measurements.

Accidents↗
PubMed1992

Pharmacokinetic study of omeprazole in elderly healthy volunteers.

The pharmacokinetics of omeprazole and its metabolites were studied in 8 healthy elderly volunteers using [14C]omeprazole. In another 6 healthy elderly volunteers, the pharmacokinetics of omeprazole were studied using unlabelled drug. Each volunteer received single doses of omeprazole intravenously (20mg) and orally (40mg) as solutions in a randomized crossover design. The plasma concentrations and urinary excretion of omeprazole and metabolites were followed for 24 and 96h, respectively. The results indicate that the average metabolic capacity of omeprazole is decreased in the elderly compared with that found in earlier studies of healthy young individuals. This was reflected in an increase in bioavailability from 56 to 76%, a reduction in mean systemic clearance by approximately 50% (0.25 L/min) and a prolongation of the mean elimination half-life from 0.7 to 1.0h compared with the young. Despite these findings, the considerable overlap in these parameters between young and old volunteers, together with data from previous pharmacodynamic studies and the wide therapeutic range of omeprazole, indicate that dosage reductions are not needed in the elderly.

Administration, Oral↗
PubMed1991

Intermittent care and caregivers at home.

The role of the caregivers of 22 patients treated in an intermittent nursing home programme was studied. Intermittent care was effective and often led to improvements in the patients. Because of their pronounced feeling of responsibility for these often very demanding patients, the main objection of the caregivers was that they wanted longer or more frequent nursing home periods than were currently offered. Half of the patients were regarded by the formal caregivers as more demanding than other clients in the home help service. In some cases the home helpers considered the patients more dependent in various activities of daily living than did the patients themselves. Meeting other people at the nursing home stimulated the patients and positively influenced the relationship between them and the home helpers. The most important aspect of intermittent care was its potential for variety, medical treatment and nursing care. The caregivers felt secure with it, which was necessary in order for them to relax when being relieved.

Aged↗
PubMed1991

Accidents in the institutionalized elderly: a risk analysis.

Among a total of 4,862 admittances to a Swedish geriatric hospital and its associated nursing homes, 827 accidents occurred in 588 patients during one year. The purpose of the present study was to establish the direct causes of these accidents and to identify possible risk factors. Information was collected from medical records, interviews with patients and staff, examination of the mental and physical state of the patients, and through reconstruction of the accidents. The investigation embraced 270 patients with 308 major accidents (fractures, sprains, open wounds, concussions and injuries to ligaments), and 318 patients with 519 minor accidents (bruises, contusions, abrasions and minor burns). Injury-free patients with nearest lower bed number in relation to patients with major accidents formed a control group. Patients with previous injuries, balance disturbances, and polypharmacy were at high risk, and intrinsic factors such as dizziness and impaired balance proved to be more significant as direct causes for the occurrence of accidents than environmental factors. The estimated risk for a patient with all these risk factors to have an accident during one year was 94%.

Accidents↗
PubMed1991

Serum cobalamins in the elderly: a longitudinal study of a representative population sample from age 70 to 81.

In a representative population sample (n = 973) born 1901-1902 and examined at the ages of 70, 75, 79, and 81, the change in serum cobalamins with increasing age was studied by trend analysis using values obtained in single individuals at all four examinations. In subsamples without definable disorders, the mean annual decline was: among men 3.4 pmol/l (p less than 0.05), among women 3.2 pmol/l (n.s.). The decline was possibly more pronounced among individuals with low and intermediate concentrations. The health-related lower reference limits (the 2.5 percentile values of subsamples without definable disorders) did not differ significantly between sexes and age groups, but low concentrations or ongoing cobalamin medication became more common with advancing age. The results indicate a slight fall in serum cobalamins between age 70 and 81 but do not call for age-related lower reference limits.

Aged↗
PubMed1991

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↗
PubMed1990

Coronary heart disease at 70, 75 and 79 years of age: a longitudinal study with special reference to sex differences and mortality.

In a population study of 70-year-old people in Göteborg, Sweden, a representative sample of 449 men and 524 women was followed for nine years. The prevalence of coronary heart disease (CHD) at age 70 was about 30% in both sexes and did not change up to age 79. Myocardial infarction appeared twice as often in men as in women at age 70 but angina pectoris and ST-T changes on ECG showed no sex difference. Myocardial infarction and probable ischaemia on ECG increased significantly between ages 70 and 79 in both sexes. Half of the men with angina pectoris had a history of myocardial infarction and/or probable ischaemia on ECG criteria compared with 23% of the women. The mortality rate was twice as high in men as in women irrespective of CHD. When CHD was present at age 70 the nine-year mortality was doubled. CHD was shown to be a strong independent risk factor for death also in this age group.

Aged↗
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

Comparison of oral and general health development among institutionalized elderly people.

This investigation comprises a longitudinal (2 yr) study of development in oral and general health among 100 institutionalized elderly people in Gothenburg. The aim of the study was to photographically document variations in oral health in relation to variation in the general health of these individuals during the period of the project. Changes noted from one examination to the next were limited to a judgment of an "unchanged", "deteriorated", or "improved" status. Medical analyses were based upon information collected from medical charts and the subjective impressions of the care staff, and odontological analyses were based upon photographic screening according to a set of given criteria. Results demonstrated a relation between developments in oral and general health among older people. The strongest relationships were registered between changes on the tongue and general health. The project has shown that a standardized photographic follow-up of health developments in oral tissues can be a valuable aid in cooperative efforts between medical physicians and dentists regarding health supervision of the elderly.

Aged↗
PubMed1989

Low serum cobalamin levels in a population study of 70- and 75-year-old subjects. Gastrointestinal causes and hematological effects.

We examined causes and hematological consequences of low serum cobalamin (vitamin B12) concentration in two representative population samples of 70-year-old (N = 293) and 75-year-old subjects (N = 486). Subjects with values below 130 pmol/liter (4.8% and 5.6%, respectively) were investigated with Schilling test, upper gastrointestinal endoscopy, determination of serum gastrin and group I pepsinogens, and bone marrow examination. Gastrointestinal abnormalities of etiologic significance were found in 26 of the 32 examined subjects: atrophy of the gastric body mucosa (N = 16, with pernicious anemia in six), partial gastrectomy (N = 6), and intestinal malabsorption (N = 4). Megaloblastic hematopoiesis was found in 10 individuals, four of whom had macrocytic anemia. Our results indicate that low serum cobalamin concentration in the elderly is usually a consequence of disease rather than of high age per se and that gastric mucosal atrophy is a major etiologic factor.

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

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↗