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  • 1.
    Andersson, Ewa K.
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Dellkvist, Helen
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Johansson, Ulrika Bernow
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health. Blekinge Inst Technol, Dept Hlth, Karlskrona, Sweden.;Karlskrona Municipal, Karlskrona, Sweden..
    Skär, Lisa
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care: An interview study2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 276-282Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this study was to describe relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care. Design An explorative descriptive qualitative design was used. Methods The data were collected using semi-structured interviews with a purposeful sample of eight relatives and analyzed using a qualitative content analysis. Results Results show that creating and sharing the life story of a close family member could help relatives handle grief and stress. It was perceived as an important, yet difficult, task to ensure that the close family member got good quality care. The creation of a meaningful life story takes time and requires cooperation with family members and other significant people.

  • 2.
    Axmon, Anna
    et al.
    Lunds Universitet, SWE.
    Kristensson, Jimmie
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Ahlström, Gerd
    Lunds Universitet, SWE.
    Midlöv, Patrik
    Lunds Universitet, SWE.
    Use of antipsychotics, benzodiazepine derivatives, and dementia medication among older people with intellectual disability and/or autism spectrum disorder and dementia2017In: Research in Developmental Disabilities, ISSN 0891-4222, Vol. 62, p. 50-57Article in journal (Refereed)
    Abstract [en]

    Background Although people with intellectual disability (ID) and people with dementia have high drug prescription rates, there is a lack of studies investigating drug use among those with concurrent diagnoses of ID and dementia. Aim To investigate the use of antipsychotics, benzodiazepine derivatives, and drugs recommended for dementia treatment (anticholinesterases [AChEIs] and memantine) among people with ID and dementia. Methods and procedures Having received support available for people with ID and/or autism spectrum disorder (ASD) was used as a proxy for ID. The ID cohort consisted of 7936 individuals, aged at least 55 years in 2012, and the referent cohort of age- and sex-matched people from the general population (gPop). People with a specialists’ diagnosis of dementia during 2002–2012 were identified (ID, n = 180; gPop, n = 67), and data on prescription of the investigated drugs during the period 2006–2012 were collected. Outcome and results People with ID/ASD and dementia were more likely than people with ID/ASD but without dementia to be prescribed antipsychotics (50% vs 39% over the study period; odds ratio (OR) 1.85, 95% confidence interval 1.13–30.3) and benzodiazepine derivatives (55% vs 36%; OR 2.42, 1.48–3.98). They were also more likely than people with dementia from the general population to be prescribed antipsychotics (50% vs 25%; OR 3.18, 1.59–6.34), but less likely to be prescribed AChEIs (28% vs 45%; OR 0.32, 0.16–0.64).

  • 3.
    Frögren, Joakim
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Quitana, M.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Designing a model app for older persons with cognitive impairment: insights from a usability perspective2018In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 17, p. 80-Article in journal (Refereed)
    Abstract [en]

    Purpose Research indicates that health-oriented applications on mobile units such as smartphones and PDAs, so called mHealth applications, can be useful to support older persons with cognitive impairment and their informal caregivers1. However, several studies suggest that a prerequisite for older persons to start using computer-based technology is that it offers individual customization according to personal preference 2,3,4. In the ongoing Horizon 2020 project SMART4MD (Support, Monitoring And Reminder Technology for older persons with Mild Dementia), an health-oriented model app has been developed through a user-centered process involving stakeholders in six European countries and with an emphasis on customization to allow for the various needs of older persons with cognitive impairment and their informal caregivers. The aim of this study is to gain insights about the specific needs of the target group and success factors related to the user-centered design process. Method Within the frames of the SMART4MD project, an initial Feasibility study was conducted in two countries (Spain and Sweden) simultaneously, in which in total nineteen persons with cognitive impairment aged 66-93, and their respective informal caregivers, performed a taskbased usability test of the SMART4MD model app individually in a clinical setting, followed by a four-week testing of the app in their home environment. Finally, a usability evaluation was done through individual structured interviews. Results & Discussion The result indicates that less exposure to similar technology affects both ability and self-esteem when confronted with the model app, and that evaluating usability with the target group using standard forms within usability testing requires pre-cautions. © 2018 International Society for Gerontechnology.

  • 4. Hellström, A.
    et al.
    Nilsson, C.
    Nilsson, A.
    Fagerström, Cecilia
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Leg ulcers in older people: A national study addressing variation in diagnosis, pain and sleep disturbance2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 25Article in journal (Refereed)
    Abstract [en]

    Background: Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. Methods: The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9 % were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. Results: We found the prevalence of pain intensity ≥ 5 on the NRS to be 34.8 % in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p < 0.001) and were found in 34.8 % of the total sample. Although more women than men reported pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venous-arterial ulcers increased the risk of sleep disturbances, as did higher pain scores. Conclusions: The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to receive less attention in ulcer management, as do sleep disturbances, implying that individual needs might not be satisfactorily met. National guidelines in managing leg ulcers, which also consider consequences such as sleep disturbances, pain and discomfort, are needed. © 2016 Hellström et al.

  • 5.
    Holst, Adelheid
    et al.
    Faculty of Professional Studies Nord University Bodø, NOR.
    Skär, Lisa
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Formal caregivers' experiences of aggressive behaviour in older people living with dementia in nursing homes: A systematic review2017In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 12, no 4, article id e12158Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of this study was to investigate formal caregivers' experiences of aggressive behaviour in older people living with dementia in nursing homes. Background: Aggressive behaviour symptoms among older people living with dementia are reported to be prevalent. As aggressive behaviour includes both verbal and physical behaviours, such as kicking, hitting and screaming, it causes an increased burden on formal caregivers. Professionals experiencing this aggression perceived it as challenging, causing physical and psychological damage, leading to anger, stress and depression. Methods: A systematic review was conducted. A search of published research studies between 2000 and 2015 was conducted using appropriate search terms. Eleven studies were identified and included in this review. Results: The analysis resulted in four categories: formal caregivers' views on triggers of aggression, expressions of aggression, the effect of aggressive behaviours on formal caregivers and formal caregivers' strategies to address aggression. The results show that aggressive behaviour may lead to negative feelings in formal caregivers and nursing home residents. Conclusion: The results of this study suggest that having the ability to identify triggers possibly assists caregivers with addressing aggressive behaviour. Aggressive behaviour might also affect quality of care. Implications for practice: Results from this systematic review indicate that caregivers prefer person-centred strategies to handle aggressive behaviour among older people, while the use of pharmaceuticals and coercion strategies is a last resort. © 2017 John Wiley & Sons Ltd.

  • 6.
    Karlsson, Staffan
    et al.
    Lund Univ, SWE.
    Rahm Hallberg, Ingalill
    Lund Univ, SWE.
    Midlöv, Patrik
    Lund Univ, SWE.
    Fagerstrom, Cecilia
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Trends in treatment with antipsychotic medication in relation to national directives, in people with dementia: a review of the Swedish context2017In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 251Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in nursing homes as reported in the most recent empirical studies on the topic, and to relate these trends to directives from the national authorities. Methods: The study included two scoping review studies based on searches of electronic databases as well as the Swedish directives in the field. Results: During the past decade, directives have been developed for antipsychotic medication in Sweden. These directives were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and in those with moderate cognitive impairment and living in nursing homes for people with dementia. A decreasing trend in antipsychotic use has been seen over the last 15 years. Conclusions: Directives from the authorities in Sweden may have had an impact on treatment with antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while treatment with combinations of psychotropic medications is common. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.

  • 7.
    Lindberg, Terese
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Bohman, Doris M.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Elmstahl, Solve
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Jogreus, Claes
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mathematics and Natural Sciences.
    Berglund, Johan Sanmartin
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG2016In: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 11, p. 1083-1090Article in journal (Refereed)
    Abstract [en]

    Purpose: With longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged. 66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom (R). Methods: Two hundred elderly persons aged 66-93 years were recruited from the Swedish National Study on Aging and Care in 2010-2013, and data were collected via wireless LTR ECG-BodyKom. Results: Screening with the LTR ECG revealed that persistent atrial fibrillation (AF) occurred in 10% of the outpatient population aged. 66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60-80 years) and older (>80 years) elderly participants. Furthermore, all patients with paroxysmal AF had a CHA(2)DS(2)VASc score of >= 2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it. Conclusion: The increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment.

  • 8.
    Moraes, Ana Louiza Dallora
    et al.
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science and Engineering.
    Eivazzadeh, Shahryar
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Mendes, Emilia
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science and Engineering.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Prognosis of Dementia Employing Machine Learning and Microsimulation Techniques: A Systematic Literature Review2016In: Procedia Computer Science / [ed] Martinho R.,Rijo R.,Cruz-Cunha M.M.,Bjorn-Andersen N.,Quintela Varajao J.E., Elsevier, 2016, Vol. 100, p. 480-488Conference paper (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this paper is to investigate the goals and variables employed in the machine learning and microsimulation studies for the prognosis of dementia. METHOD: According to preset protocols, the Pubmed, Socups and Web of Science databases were searched to find studies that matched the defined inclusion/exclusion criteria, and then its references were checked for new studies. A quality checklist assessed the selected studies, and removed the low quality ones. The remaining ones (included set) had their data extracted and summarized. RESULTS: The summary of the data of the 37 included studies showed that the most common goal of the selected studies was the prediction of the conversion from mild cognitive impairment to Alzheimer's Disease, for studies that used machine learning, and cost estimation for the microsimulation ones. About the variables, neuroimaging was the most frequent used. CONCLUSIONS: The systematic literature review showed clear trends in prognosis of dementia research in what concerns machine learning techniques and microsimulation.

  • 9.
    Moraes, Ana Luiza Dallora
    et al.
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science and Engineering.
    Eivazzadeh, Shahryar
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Mendes, Emilia
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science and Engineering. Blekinge Institute of Technology, Faculty of Computing, Department of Software Engineering.
    Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Machine learning and microsimulation techniques on the prognosis of dementia: A systematic literature review2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 6, article id e0179804Article in journal (Refereed)
    Abstract [en]

    Background Dementia is a complex disorder characterized by poor outcomes for the patients and high costs of care. After decades of research little is known about its mechanisms. Having prognostic estimates about dementia can help researchers, patients and public entities in dealing with this disorder. Thus, health data, machine learning and microsimulation techniques could be employed in developing prognostic estimates for dementia. Objective The goal of this paper is to present evidence on the state of the art of studies investigating and the prognosis of dementia using machine learning and microsimulation techniques. Method To achieve our goal we carried out a systematic literature review, in which three large databases -Pubmed, Socups and Web of Science were searched to select studies that employed machine learning or microsimulation techniques for the prognosis of dementia. A single backward snowballing was done to identify further studies. A quality checklist was also employed to assess the quality of the evidence presented by the selected studies, and low quality studies were removed. Finally, data from the final set of studies were extracted in summary tables. Results In total 37 papers were included. The data summary results showed that the current research is focused on the investigation of the patients with mild cognitive impairment that will evolve to Alzheimer's disease, using machine learning techniques. Microsimulation studies were concerned with cost estimation and had a populational focus. Neuroimaging was the most commonly used variable. Conclusions Prediction of conversion from MCI to AD is the dominant theme in the selected studies. Most studies used ML techniques on Neuroimaging data. Only a few data sources have been recruited by most studies and the ADNI database is the one most commonly used. Only two studies have investigated the prediction of epidemiological aspects of Dementia using either ML or MS techniques. Finally, care should be taken when interpreting the reported accuracy of ML techniques, given studies' different contexts. © 2017 Dallora et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • 10. Sandberg, Magnus
    et al.
    Ahlström, Gerd
    Axmon, Anna
    Kristensson, Jimmie
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Somatic healthcare utilisation patterns among older people with intellectual disability: an 11-year register study2016In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, no 1, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Background: People with intellectual disabilities (ID) are known to have more diseases and are believed to start aging earlier than the general population. The population of older people with ID is growing, but knowledge about their use of healthcare is limited. This study aimed to explore somatic healthcare utilisation patterns among people with ID living in Sweden, in comparison with the general population from 2002 to 2012. Methods: Participants were a group of people with ID (n = 7936) aged 55 years and older in 2012, and an equal-sized, birth year and sex matched, general population sample (n = 7936). Participants were divided into age groups of 5-year intervals. Data regarding in- and outpatient care were collected from the Swedish National Patient Register. Results: In the younger age groups, the ID group had higher healthcare utilisation compared with the general population sample, with higher risks for planned and unplanned somatic in- and outpatient care, particularly for unplanned inpatient registrations. Decreasing patterns were seen with age; with lower risks in the ID group for the oldest age groups. This was most evident in planned somatic in- and outpatient care. In those with at least one registration, the ID group had a longer unplanned length of stay in the younger age groups, but fewer planned visits to physicians in somatic outpatient care compared with the control group. Conclusions: Compared with the general population, people with ID show higher healthcare utilisation in younger age groups. Healthcare utilisation decreases with age, and in old age, fewer people with ID use healthcare compared with the general population. The barriers to accessing planned healthcare for older people with ID need more investigation. © 2016 The Author(s).

  • 11. Selan, S.
    et al.
    Siennicki-Lantz, A.
    Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Fagerström, Cecilia
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Self-awareness of heart failure in the oldest old-an observational study of participants, ≥ 80 years old, with an objectively verified heart failure2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 23Article in journal (Refereed)
    Abstract [en]

    Background: One of the primary reasons for hospitalisation among elderly individuals with heart failure (HF) is poor self-care. Self-awareness of having HF may be a key-element in successful self-care. The prevalence of self-awareness of HF, and how it is affected by age-and HF-related factors, remains poorly understood. The aims of the present study were to determine the prevalence of self-awareness of HF in participants, ≥ 80 years of age, and to investigate the association between this self-awareness and age-related and HF-related factors. Methods: A single-centre observational study was conducted in which non-hospitalised participants (80+) with objectively verified HF were identified (n = 90). The statement of having HF or not having HF was used to divide the participants into two groups for comparisons: aware or unaware of one’s own HF. Logistic regression models were completed to determine the impact of age-and HF-related factors on self-awareness. Results: Twenty-six percent (23/90) were aware of their own HF diagnosis. No significant differences were found between the participants who were aware of their own HF diagnosis and the participants who were not. Neither age-nor HF-related factors had influence on the prevalence of self-awareness. Conclusions: Prevalence of self-awareness of own HF in the oldest old is insufficient, and this self-awareness may be influenced by external factors. One such factor is likely the manner in which the HF diagnosis is relayed to the patient by health care professionals. © 2016 Selan et al.

  • 12.
    Wimo, A.
    et al.
    Karolinska Inst, SWE.
    Elmstål, S.
    Lunds universitet, SWE.
    Fratiglioni, L.
    Karolinska Inst, SWE.
    Sjölund, B.-M.
    Karolinska Inst, SWE.
    Sköldunger, A.
    Karolinska Inst, SWE.
    Fagerström, Cecilia
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Lagergren, M.
    Stockholm Gerontol Res Ctr., SWE.
    Formal and informal care of community-living older people: A population-based study from the Swedish National study on Aging and Care2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no §, p. 17-24Article in journal (Refereed)
    Abstract [en]

    Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC). Design: Cross-sectional, population based cohort. Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County. Participants: 3,338 persons ≥72 years. Measurements: Patterns and amounts of informal and formal care by cognition and area of residence. Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole. Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.

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