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  • 1.
    Fagerström, Cecilia
    et al.
    Blekinge Institute of Technology.
    Borglin, Gunilla
    Blekinge Institute of Technology.
    Mobility, functional ability and health-related quality of life among people 60 years or older2010In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 22, no 5-6, p. 387-394Article in journal (Refereed)
    Abstract [en]

    Background and aims: Knowledge about Health-Related Quality of Life (HRQoL) in advanced age is sparse. This study investigated to what extent mobility factors explained older people’s HRQoL when age, gender and functional ability (ADL) were controlled for. 

    Methods: Subjects were 1128 people aged 60–96 participating in a Swedish longitudinal multi-center cohort study. Besides descriptive and correlation statistics, a three-tier multiple logistic regression analysis was performed, which included the ADL scale, mobility tests and items, with physical and mental HRQoL as outcome variables. 

    Results: In the models containing the control variables, functional ability was found to be associated with both physical and mental HRQoL. In the models including both functional ability and mobility factors, the importance of functional ability remained for mental but not for physical HRQoL. The mobility factors were found to have a stronger negative influence on HRQoL, i.e., physical and mental, than functional ability in itself. 

    Conclusions: For optimal identification of various types of disabilities and their impact on older people’s HRQoL, the ADL scale should be used together with more targetspecific tests of disabilities. However, in certain situations, it appears that one mobility factor alone — the ability to walk — has the capacity to pick up changes in both physical and mental HRQoL. Thus, it is important that healthcare professionals should focus activities toward maintaining older people’s mobility as a means of enhancing their HRQoL.

  • 2.
    Lagergren, Mårten
    et al.
    Stockholm Gerontology Research Center.
    Fagerström, Cecilia
    Blekinge Institute of Technology.
    Sjölund, Britt-Marie
    Karolinska Institutet;Stockholm University.
    Berglund, Johan
    Blekinge Institute of Technology.
    Fratiglioni, Laura
    Stockholm Gerontology Research Center;Karolinska Institutet;Stockholm University.
    Nordell, Eva
    Lund University;Skåne University Hospital.
    von Strauss, Eva
    Karolinska Institutet;Stockholm University;Red Cross University College.
    Wimo, Anders
    Karolinska Institutet;Stockholm University.
    Elmståhl, Sölve
    Lund University;Skåne University Hospital.
    Horizontal and vertical targeting: a population-based comparison of public eldercare services in urban and rural areas of Sweden2016In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 28, no 1, p. 147-158Article in journal (Refereed)
    Abstract [en]

    The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontal target efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001-2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70-90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40-50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern-it was almost 100 % in all areas for IADL dependency, but only 50-60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.

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