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  • 1.
    Agüero-Torres, Hedda
    et al.
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    von Strauss, Eva
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Viitanen, Matti
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Winblad, Bengt
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Fratiglioni, Laura
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Institutionalization in the elderly: The role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study2001In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 54, no 8, p. 795-801Article in journal (Refereed)
    Abstract [en]

    A population-based study of 1810 persons, aged 75+, was investigated to evaluate the role of dementia and other chronic diseases as determinants of institutionalization in the elderly. The study population was examined at baseline and after a 3-year interval. After adjustment for sociodemographic characteristics, functional dependence, dementia, cerebrovascular disease and hip fracture were associated with living in an institution at baseline. Additionally, functional dependence, hip fracture and dementia were also associated with moving to an institution during the 3-year follow-up. In a similar analysis, including only nondemented subjects, the Mini-Mental State Examination emerged as one of the strongest determinants. The population attributable risk percentage of institutionalization during the 3-year follow-up due to dementia was 61%. This study confirms that dementia and cognitive impairment are the main contributors to institutionalization in the elderly, independently of their sociodemographic status, social network, or functional status.

  • 2.
    von Strauss, Eva
    et al.
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Agüero-Torres, Hedda
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Kåreholt, Ingemar
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Winblad, Bengt
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Fratiglioni, Laura
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Women are more disabled in basic activities of daily living than men only in very advanced ages: A study on disability, morbidity, and mortality from the Kungsholmen Project2003In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 56, no 7, p. 669-677Article in journal (Refereed)
    Abstract [en]

    Objective: We explored the effect of morbidity, mortality, and occurrence of new disability on gender differences in activities of daily living (ADL) functioning in different age groups in the elderly population.

    Methods: All 77+-year-old members of a community-based cohort were clinically examined by physicians, assessed by psychologists, and interviewed by nurses at baseline and after a 3-year interval. Diseases were diagnosed according to ICD-9 and the DSM-III-R criteria for dementia. The Katz index of ADL was used to measure basic functional status.

    Results: After adjustment for socio-demographic characteristics, the oldest women (90+ years) had higher disability prevalence and a tendency for higher long-term disability incidence. Women aged 85+ years also had higher morbidity prevalence. Mortality among disabled subjects was similar for both genders, whereas higher mortality was found in younger nondisabled men (77–84 years).

    Conclusion: We conclude that gender differences in disability, morbidity, and mortality vary with age in the elderly population. Gender differences in morbidity and basic functional dependence were evident only in the oldest old. Based on current and previous findings, we speculate that more women may be at higher risk of developing severe disability than men in the advanced ages due to longer survival with slight disability earlier in adult life.

  • 3.
    von Strauss, Eva
    et al.
    Stockholm Gerontology Research Center, Division of Geriatric Medicine, Karolinska Institute, Stockholm.
    Fratiglioni, Laura
    Stockholm Gerontology Research Center, Division of Geriatric Medicine, Karolinska Institute, Stockholm,.
    Jorm, Anthony F
    NH & MRC Social Psychiatry Research Unit, The Australian National University, Canberra, Australia.
    Viitanen, Matti
    Stockholm Gerontology Research Center, Division of Geriatric Medicine, Karolinska Institute, Stockholm.
    Winblad, Bengt
    Stockholm Gerontology Research Center, Division of Geriatric Medicine, Karolinska Institute, Stockholm.
    Attitudes and participation of the elderly in population surveys: data from a longitudinal study on aging and dementia in Stockholm1998In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 51, no 3, p. 181-187Article in journal (Refereed)
    Abstract [en]

    The aim of this article was to assess the attitudes of older adults (age >74 years) toward research participation. A questionnaire was mailed to the study population (n = 1197) which included people who had participated in a longitudinal study once, twice, three times, or more. The participants showed a positive attitude in general as 79% saw an advantage of participation and 72% did not report any negative reaction. Older elderly with impaired cognitive functioning and lower education showed the least positive attitude, reporting the first contact and the cognitive testing as the most stressful situations. The group who had participated more than once was the most positive, but more often refused some parts of the clinical examination. We conclude that: (1) more attention is necessary to the initial contact; (2) reduction of stressful or tiring examinations is recommended; and (3) complete information about the research, including the right to refuse individual parts of the study, must be given. Such procedures will improve both the quality and the ethics of the research.

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