Mikael Rennemark

Relationships between physical activity and perceived qualities of life in old age. Results of the SNAC study

Objectives: The aim of the present study was to investigate the relationships of different types of quality of life to strenuous and light physical activity in old age. Methods: The Swedish SNAC-Blekinge baseline database, consisting of data on 585 men and 817 women 60–96 years of age, was utilized. The independent variables were light and strenuous physical activity. Four dependent variables concerned with various quality of life components were employed (well-being, engagement, emotional support and social anchorage). Age, gender, functional ability and co-morbidity were included as possible confounders. Non-parametric bivariate and multivariate statistical tests were performed. Results: Correlations suggested there to generally be a positive relationship between physical activity and quality of life. Multivariate logistic regression analyses controlling for possible confounders showed light physical activity to increase the odds of experiencing well-being, engagement and social anchorage, whereas strenuous physical activity increased the odds of experiencing engagement and emotional support. Thus, light physical activity and strenuous physical activity differed in their relation to quality of life generally. Conclusions: The results indicate that physical activity has a salutogenic effect by enhancing the quality of life, and it can be assumed to be connected to quality of life by generating pleasure and relaxation.

Factors related to frequent usage of the primary healthcare services in old age: findings from The Swedish National Study on Aging and Care

People aged 60 or more are the most frequent users of healthcare services. In this age range, however, both frequent and infrequent users can be found. Frequent users have high rates of illnesses. Previous research has found that the frequency may be influenced also by psychological and social factors. The aim of this study was to investigate to what degree such factors add to the explanation of differences in number of visits to a physician. A cross-sectional study was conducted with a random sample consisting of 1017 individuals, aged 60 to 78 years, from the Blekinge part of the Swedish National Study on Aging and Care database. The data were collected during 2001 to 2003. Hierarchical logistic regression analyses were used with frequent (three visits or more during a year) and infrequent use as a dichotomous dependent variable. The final statistical analyses included 643 individuals (63% of the sample). Independent variables were sense of coherence (SOC), internal locus of control, education level and social anchorage. Control variables were age, gender, functional ability and comorbidity. The results showed that comorbidity was most strongly related to frequent use [adjusted odds ratio (OR) = 8.17, 95% confidence interval (CI) 5.54–12.04]. In addition, SOC and internal locus of control had small, but significant effects on the odds of being a frequent user (adjusted OR = 1.03, 95% CI 1.00–1.06 and adjusted OR = 1.14, 95% CI 1.02–1.27, respectively). The lower the SOC and the internal locus of control were, the higher were the odds of frequent use. Education level and social anchorage were unrelated to frequency of use. The results indicate that frequent healthcare services users are more ill than infrequent users. Psychological factors influence the use only marginally, and social factors as well as age and gender are not by themselves reason for frequent healthcare services use.

Gender specific associations between social network and health behavior in old age

Social networks may affect old peoples health behaviors, such as their subjective health evaluations, health care utilization and symptom reporting. In this study, the relationships between social network characteristics and health behaviors were investigated for each gender separately. It was assumed that the relationships differ between the genders and that female health behavior would be more strongly related to the social network. Social network characteristics, reported symptoms, subjective health and health care utilization were assessed for 107 men and 77 women that were 71 years of age.The results showed that, for women, a general satisfaction with the social network was associated with good subjective health. In addition, satisfaction with social participation and social anchorage were associated with a high frequency of health care utilization. For men, none of these health-related behaviors were bivariately associated with the social network. Furthermore, for women, the frequency of reported s...

Distribution of personality, individual characteristics and internet usage in Swedish older adults

Objectives: This article investigated factors associated with internet usage in the Swedish older adults ranging in age from 60 to 96. Personality traits and individual characteristics have been previously noted to influence internet usage, where older adults have not been the focus population. In this study, the relationships between personality, individual characteristics and internet usage were investigated. Methods: A descriptive analysis of the personality tests of a total of 1402 subjects included in the Swedish National Study on Aging and Care was conducted. Three variables were controlled for: sex, age and education. Descriptive statistics, Mann–Whitney and Kruskal–Wallis tests, chi-square tests and a logistic regression were used in order to detect the relationships with internet usage. Results: Men differ significantly from women in the personality traits analysis. Those with higher education were more open and neuroticism was lower in the oldest older adults. Internet usage declined significantly with age and those with middle to higher education were using the internet the most. No other associations with internet use were found. Conclusion: Personality traits and individual characteristics do not seem to influence the Swedish older adult and their internet usage. What one needs to account for is the age and education of the person. The more educated and the youngest cohorts were using the internet more frequently.

Relationship between pain and Quality of Life: Findings from the Swedish National Study on Aging and Care - Blekinge study

Abstract Background and aims The influence of pain as well as Quality of Life (QoL) varies in accordance with biological, social, psychological and existential factors. This study investigates the influence of such factors on the relationship between pain and QoL among older adults from a gender perspective. Methods The Swedish National Study on Aging and Care (SNAC-Blekinge) baseline sample comprised 1402 individuals aged 60–96 years, of whom 769 (55%) reported pain. The participants were invited by a letter to take part in the study, which was carried out by research staff in two sessions of three hour each. Participants gave informed consent and completed a questionnaire between the two sessions. The reason for non-participation was registered among subjects who declined the invitation. Pain and insomnia were self-reported. Data on age, gender and if living alone or not were collected from the questionnaire. Co-morbidity was obtained from electronic patients records for a period of up to two years prior to participating in the SNAC study. SoC was measured by a translated short form from the original twenty-nine question instrument. QoL, was estimated using the HRQL Medical Outcome Study-Short Form (SF 12). In a model, pain, age, sex, insomnia, co-morbidity, living alone, sense of coherence (SOC), household economy, education and QoL were calculated through multivariate logistic regression. Results Among women, pain was found to have the highest OR (odds ratio) for low QoL [OR 2.27 (CI 1.36–3.78)], followed by low economic status [OR 1.75 (CI 1.08–2.84)], co-morbidity [OR 1.24 (CI 1.05–1.46)], low SOC [OR 1.08 (CI 1.06–1.10)] and lower age [OR 1.05 (CI 1.02–1.08)]. In men, insomnia was found to be the main contributor to low QoL [OR 1.86 (CI 1.04–3.33)], followed by low SOC [OR 1.08 (CI 1.05–1.11)] and lower age [OR 1.04 (CI 1.01–1.07)]. Conclusions Pain has a strong relationship with low QoL among elderly women. Insomnia is associated with low QoL among men who suffer less from pain. Thus the main result is a striking gender difference: Elderly women suffer from pain, elderly men suffer from insomnia. Implications It is importanttotake accountof sex, age, sleep problems, co-morbidity, SOC and economic status in order to understand the relationship between pain and QoL among older adults.

Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden

Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults’ Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.

Pain among older adults from a gender perspective: findings from the Swedish National Study on Aging and Care (SNAC-Blekinge):

Background and aims: Pain is common in the elderly population and its prevalence varies according to the studied disease, clinical setting, sex and age. This study examines pain in an aging population from a gender perspective. Methods: The Swedish National study on Aging and Care (SNAC) is conducted at four research centres. Participants were recruited from the baseline sample (n=1402) at one of the research centres, SNAC-Blekinge. Individuals aged 60 years and older were included and non-participation was documented. Research personnel conducted the medical examination on two occasions. Results: The prevalence of pain was 769/1402 (54.8%), distributed as 496/817 (64.5%) women and 273/585 (35.5%) men, p<0.01. Women reported more pain located in the vertebral column, p<0.01. The most common pain location was the legs and feet. About 84% reported pain intensity as 4 or higher on the visual analogue scale (VAS). Pain intensity declines with age among men, p<0.01. The most frequent treatment was painkillers. A total of 128/263 (48.7%) of the men received no pain treatment compared with 177/478 (37.0%) of the women, p<0.01. In a multivariate logistic regression model, women yielded the highest OR [OR 1.94 (C.I. 1.51–2.49)] for pain. Conclusions: Pain is common among older adults and there are significant differences between the sexes. Almost 55% of participants reported pain, predominantly women. In the majority of cases the intensity was rated as moderate or severe (VAS >4) and women rated higher than men p<0.02. Almost half of the men (48.7%) did not receive any treatment compared to 37% of the women, p<0.01.

Factorial validity and invariance of the Life Satisfaction Index in older people across groups and time: Addressing the heterogeneity of age, functional ability, and depression

In the last decades, extensive research efforts have been directed at exploring life satisfaction in old age, and the Life Satisfaction Index A (LSIA) scale, developed by Neugarten et al. in the 1960s, is one of the most commonly used instruments. However, studies have focused on predicting and comparing changes in peoples life satisfaction without testing if the LSIA instrument is equally valid for different subgroups of people. The present study investigated the underlying dimensions of the LSIA in a Swedish population (n=1402) of people 60-96 years of age. The study also examined factorial invariance across age, gender, functional ability and depression during a six-year period. The results showed that while a five-factor solution of the LSIA did not exhibit an acceptable fit to the data, a three-factor solution did show a close fit. The two three-factor models that demonstrated the best fit showed invariance across gender and across time, but noninvariance across groups with different levels of reduced functional ability, depressive symptoms and age. These findings suggest that the psychometric properties of life satisfaction instruments like the LSIA need to be taken into consideration before drawing conclusions about life satisfaction when comparing older people of different ages and with different depression and function levels.

Factors associated with change in Internet usage of Swedish older adults (2004–2010)

The increased reliance on Internet use in social functions has presumably left out a part of the population: the oldest-older adults. These are people who have not kept themselves up to date with the technological developments for various reasons. There are, however, exceptions from whom we have something to learn. This study investigates the older people in Sweden who started to use the Internet over a period of 6 years. Cognition, extraversion, openness, functional disability, household economy, sex, age and education were investigated in relation to starting to use the Internet. A chi-square test, Spearman correlation and a logistic regression analysis were conducted. It was found that higher cognition, being male and being between the ages of 60 and 80 years were determining factors in starting to use the Internet for the Swedish older adult. Our results indicate that the oldest-older adults are slow to adapt to using the Internet and more attention should be paid on how to support this group.

Decreased cognitive functions at the age of 66, as measured by the MMSE, associated with having left working life before the age of 60: Results from the SNAC study

Aims: The age of retirement has financial implications as we tend to live longer, with the result that an increasing number of older inhabitants have to share limited financial resources. However, this is not only a financial issue. It is also of interest to investigate factors related to health and quality of life associated with the age of retirement. The aim of this study was to investigate changes in mood, activity level, and cognition at the age of 66 associated with leaving working life before 60. Methods: Baseline and follow-up data on 840 participants of the Swedish National Study on Aging and Care – Blekinge was used. Mood was measured by the Montgomery–Åsberg Depression Scale and activity level by 27 survey items. Cognition was measured by the Mini Mental State Examination. Results: Retirement before 60 years of age was not associated with lower cognitive functions and a higher score on depression at baseline, but retirees were less active. Six years later, at the age of 66, a decline in their cognition was found. Retirees were still not more depressed but less active. In a logistic regression analysis, being retired increased the odds ratio for cognitive decline by 1.36-times (OR 2.36) when gender, activity level, education level, and depression were adjusted for. Conclusions: Participants who retired before the age of 60 declined in cognitive ability over the 6-year study period.