Dementia is a neurodegenerative disorder that affects the older adult population. To date, no cure or treatment to change its course is available. Since changes in the brains of affected individuals could be evidenced as early as 10 years before the onset of symptoms, prognosis research should consider this time frame. This study investigates a broad decision tree multifactorial approach for the prediction of dementia, considering 75 variables regarding demographic, social, lifestyle, medical history, biochemical tests, physical examination, psychological assessment and health instruments. Previous work on dementia prognoses with machine learning did not consider a broad range of factors in a large time frame. The proposed approach investigated predictive factors for dementia and possible prognostic subgroups. This study used data from the ongoing multipurpose Swedish National Study on Aging and Care, consisting of 726 subjects (91 presented dementia diagnosis in 10 years). The proposed approach achieved an AUC of 0.745 and Recall of 0.722 for the 10-year prognosis of dementia. Most of the variables selected by the tree are related to modifiable risk factors; physical strength was important across all ages. Also, there was a lack of variables related to health instruments routinely used for the dementia diagnosis.

Förändras personligheten när vi åldras? Är äldre en särskilt utsatt och ensam grupp i samhället? Vad betyder ålderism och hur yttrar den sig? I Psykologiska perspektiv på åldrande och hälsa avhandlas dessa frågor. Teoribildning och forskning om åldrandets psykologi, såväl historisk som samtida, beskrivs utifrån aktuella forskningsstudier.

Med hjälp av konkreta exempel får läsaren ta del av forskningsresultat om vad som gör att vi åldras olika. Här visas hur livsstil, utsatthet, förmåga att möta stress, personlighet och attityder i samhället kan förklara dessa olikheter. Kunskaper om området kan undanröja missförstånd och fördomar om åldrandets villkor och möjligheter, samt öka förståelsen för äldre såväl inom vård och omsorg som i samhället i stort.

Background: Personality has been shown to be related to numerous health-related factors. In the SNAC-B study, relationships between health variables and the personality traits of neuroticism (N), conscientiousness (C), agreeableness (A), openness (O), and extraversion (E) have been investigated. Aim: In this chapter, stability and change of personality during the ages of 60 to 90 years are explored. In addition, relationships between personality traits and health-related variables are presented. Methods: The results are based on data from the SNAC-B studies of 1402 men and women aged 60 to 90. The participants have been followed up during 12 years, while data on health, well-being, and autonomy have been continuously collected. In addition, variables assumed to influence health have been collected, such as lifestyles, demographic factors, social environment, and personality. Results: The results show personality to be stable over time according to rank order, but all personality traits except neuroticism were shown to have small but significant mean level changes. In addition, connections between a number of health-related variables and personality traits, such as mortality, self-care, work ability, and perception of pain, were indicated. Conclusions: The results indicate that the role of personality should be taken into account in research on health and aging. Personality traits have a lifelong influence on health behaviors and have been shown to affect both subjective and objective aspects of health and the way we cope with health-related experiences.

Losing a child or a spouse is described as the worst of experiences. However, it is not known whether older adults bereaved of a child, spouse, or both child and spouse experience these losses as among the most important negative events in their life- time. The aim of this study was to investigate whether the 1,437 older adults bereaved of a child, spouse, or both included in the southern part of the Swedish National Study of Aging and Care mentioned these losses when asked about their three most important negative life events. Gender differences in their choices of important negative life events were also explored. About 70% of those bereaved of a child or a spouse mentioned these losses as among their three most important negative life experiences. In the child-and-spouse-bereaved group, 48% mentioned both the loss of their child and spouse, while 40% mentioned either the loss of a child or a spouse. Gender differences were only found in the child-and-spouse-bereaved group, with a few more women mentioning the loss of the child but not the spouse, and the men showing the opposite pattern. 

Objectives: Moderate physical activity gains survival. There are, however, several variables that may affect this relationship. In this study, the relationship between moderate physical activity and longevity was investigated, taking into account age, gender, smoking habits, cohabitation status, body mass index, leg strength and balance, education level and cognitive function. Method: A sample of 8,456 individuals aged 60 to 96 years, representative of the Swedish population, was included. Participants were followed from 2004 to 2015. Cox regression analyses were used to investigate the predictive value of physical activity on longevity. Results: Participants still alive in the follow-up measure were more physically active on a moderate level. Being active 2 to 3 times a week or more was related to a 28% lower risk of not being alive at the follow-up measure. Discussion: The low frequency of physical activity, necessary for survival benefits should be considered in public health programs.

Background: Few studies have compared the impact of different familial losses on life satisfaction (LS). Furthermore, there is a lack of research on the effect of having lost both a child and a spouse among older adults. Sample: A random sample of 1402 individuals, 817 women and 585 men, aged 60–96 years from the Blekinge part of the Swedish National Study of Aging and Care (SNAC-B) participated in this cross-sectional study. Aims: The first aim was to compare the effects of child or spouse or both child and spouse bereavement on LS and, the second aim, to investigate if there were gender differences within the bereaved groups. Results: The results showed that having lost a child, spouse or both child and spouse had a negative association with LS, although this effect was small. Having experienced multiple losses did not predict more variance than a single child or spouse loss. Gender differences were found within all the bereaved groups with bereaved men having lower LS than bereaved women. Longer time since the loss was associated with higher LS. Conclusions: Bereaved older adults have somewhat lower LS than non-bereaved and bereaved men seem more affected than bereaved women. Future research needs to address older men´s experiences after the loss of a loved one.

Background: Frail older adults are high consumers of medical care due to their age and multiple chronic conditions. Regular contact with a case manager has been proven to increase well-being of frail older adults and reduce their number of health-care visits. Skype calls through tablet PCs can offer easier communication. Objective: This paper examines frail older adults’ use of tablet computers and Skype, with their case managers.Method: Interviews were conducted on 15 frail older adults. A content analysis was used to structure and analyze the data. Results: The results indicate that tablet computers were experienced in a positive way for most frail older adults. Conflicting feelings did emerge, however, as to whether the frail elderly would adopt this in the long run. Skype needs to be tested further as to whether this is a good solution for communication with their case managers. Strong technical support and well-functioning technology are important elements to facilitate use. Conclusion: Using Skype and tablet PCs do have potential for frail older adults, but need to be tested further.

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.

Background

Longevity is multi-determined. In this study, biological, social and psychological factors were included in a multivariate model in order to investigate their predictive ability of survival in a nine year follow up period.

Methods

The sample was drawn from the Swedish National study on Aging and Care (SNAC), including a representative database of Swedish inhabitants aged 60 to 96 years. The participants (N = 6986) were followed during the years 2002 to 2011. Data was collected including age, physical activity, body mass index (BMI), muscle strength, living alone or not, household economy, functional status, smoking habits and education. These variables were used as predictors in multiple logistic regression analyses in order to estimate the odds ratios of survival during the follow up period.

Results

During the nine year period, 4447 participants (64%) survived. Education was the strongest predictor of survival with 57% higher odds to survive for higher educated participants (P<.001. 95%CI = 1.38 – 1.78), followed by not living alone, which increased the odds of survival with 37% (P<.001. 95%CI = .65 - .83). Light physical activity increased the odds of survival with 18% (P<.001. 95%CI = 1.12 – 1.24) and not smoking was significant related to survival but the odds ratio was as low as 10% (P<.01. 95%CI = 1.03 – 1.71).

Conclusions

Social aspects such as education and not living alone are strong predictors of survival in older populations and must be considered in the understanding of differences in longevity. In addition, life habits such as physical activity and smoking behaviors should be taken into account.

Key message:

• Both social and behavioral factors contribute to the understanding of differences in longevity in the Swedish population of 60 to 96 years old people in Sweden.

Objective: Bereavement effects on mortality risk were investigated in 1150 randomly selected participants, aged 60-104, in the Swedish National Study of Aging and Care.

Method: Cox proportional hazards models, controlling for age, gender, functional ability, the personality traits neuroticism and conscientiousness as well as time since the latest loss were used to predict mortality risk.

Results: Having lost a child, spouse or both child and spouse did not predict mortality risk. An indirect link between bereavement and mortality was found showing for each year since loss the mortality risk decreased by about 1%. Neuroticism, but not conscientiousness, was associated with mortality risk, with a small-effect size.

Conclusions: The different bereavements did not predict mortality risk while an indirect link was found showing that mortality risk decreased with time.