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Naseer, M., Agerholm, J., Fastbom, J., Schön, P., Ehrenberg, A. & Dahlberg, L. (2020). Factors associated with emergency department revisits among older adults in two Swedish regions: A prospective cohort study. Archives of gerontology and geriatrics (Print), 86, Article ID 103960.
Open this publication in new window or tab >>Factors associated with emergency department revisits among older adults in two Swedish regions: A prospective cohort study
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2020 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 86, article id 103960Article in journal (Refereed) Published
Abstract [en]

Objectives

To assess the association between baseline characteristics at an index ED visit and ED revisit within 30 days among adults aged ≥ 65 years in two Swedish regions.

Methods

This was a register-based prospective cohort study. The sample included (N=16 688; N=101 017) older adults who have had an index ED visit in 2014 at hospital based EDs in the regions of Dalarna and Stockholm, Sweden. Several registers were linked to obtain information on sociodemographic factors, living conditions, social care, polypharmacy and health care use. Multivariate logistic regression was used to analyse the data.

Results

Seventeen percent of the study sample in Dalarna and 20.1% in Stockholm revisited ED within 30 days after an index ED visit. In both regions, male gender, being in the last year of life, excessive polypharmacy (≥ 10 drugs), ≥11 primary care visits and ED care utilization were positively associated with ED revisits. In Stockholm, but not in Dalarna, low level of education, polypharmacy, and institutional care was also associated with ED revisits. In contrast, home help was associated with ED revisits in Dalarna but not in Stockholm.

Conclusion

These findings call for further in-depth examinations of variations within single countries. ED revisits among older adults are driven by need of care but also by the social and care situation.

Keywords
Emergency department, Care utilisation, Older adults, Health and social care, Primary care
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-31108 (URN)10.1016/j.archger.2019.103960 (DOI)000496954500020 ()31704624 (PubMedID)2-s2.0-85074431752 (Scopus ID)
Available from: 2019-11-18 Created: 2019-11-18 Last updated: 2019-12-09
Naseer, M., Agerholm, J., Fastbom, J., Schön, P., Ehrenberg, A. & Dahlberg, L. (2020). Factors associated with emergency department revisits among older adults in two Swedish regions: A prospective cohort study. Archives of gerontology and geriatrics (Print), 86, Article ID 103960.
Open this publication in new window or tab >>Factors associated with emergency department revisits among older adults in two Swedish regions: A prospective cohort study
Show others...
2020 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 86, article id 103960Article in journal (Refereed) Epub ahead of print
National Category
Health Sciences
Research subject
Health and Welfare, Varför söker äldre personer akutsjukvård? Orsaker, omständigheter och förklaringar
Identifiers
urn:nbn:se:du-31431 (URN)10.1016/j.archger.2019.103960 (DOI)
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-01-23Bibliographically approved
Burholt, V., Winter, B., Aartsen, M., Constantinou, C., Dahlberg, L., Feliciano, V., . . . Waldegrave, C. (2019). A critical review and development of a conceptual model of exclusion from social relations for older people. European Journal of Ageing
Open this publication in new window or tab >>A critical review and development of a conceptual model of exclusion from social relations for older people
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2019 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed) Epub ahead of print
Abstract [en]

Social exclusion is complex and dynamic, and it leads to the non-realization of social, economic, political or cultural rights or participation within a society. This critical review takes stock of the literature on exclusion of social relations. Social relations are defined as comprising social resources, social connections and social networks. An evidence review group undertook a critical review which integrates, interprets and synthesizes information across studies to develop a conceptual model of exclusion from social relations. The resulting model is a subjective interpretation of the literature and is intended to be the starting point for further evaluations. The conceptual model identifies individual risks for exclusion from social relations (personal attributes, biological and neurological risk, retirement, socio-economic status, exclusion from material resources and migration). It incorporates the evaluation of social relations, and the influence of psychosocial resources and socio-emotional processes, sociocultural, social-structural, environmental and policy contextual influences on exclusion from social relations. It includes distal outcomes of exclusion from social relations, that is, individual well-being, health and functioning, social opportunities and social cohesion. The dynamic relationships between elements of the model are also reported. We conclude that the model provides a subjective interpretation of the data and an excellent starting point for further phases of conceptual development and systematic evaluation(s). Future research needs to consider the use of sophisticated analytical tools and an interdisciplinary approach in order to understand the underlying biological and ecopsychosocial associations that contribute to individual and dynamic differences in the experience of exclusion from social relations.

Keywords
Disadvantage, Later life, Knowledge synthesis, Old-age exclusion, Social relations
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30239 (URN)10.1007/s10433-019-00506-0 (DOI)
Available from: 2019-06-14 Created: 2019-06-14 Last updated: 2019-06-14Bibliographically approved
Dahlberg, L. (2019). Ageing in a changing place: a qualitative study of neighbourhood exclusion. Ageing & Society
Open this publication in new window or tab >>Ageing in a changing place: a qualitative study of neighbourhood exclusion
2019 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779Article in journal (Refereed) Epub ahead of print
Abstract [en]

An inclusive neighbourhood is a key facilitator enabling older adults to age in place. Neighbourhoods have been identified as a dimension of social exclusion important to older adults, and it has been argued that older adults are particularly vulnerable to neighbourhood change. The aim of this study was to explore older adults’ experiences of neighbourhood exclusion within the context of neighbourhood change. Focus groups were undertaken in the urban and rural areas of a metropolitan borough in England involving a total of 41 older adults, with data analysed via thematic analysis. Urban areas in the borough studied have transformed following the closure of the mining industry, with a high level of deprivation in many areas, while some rural areas have undergone gentrification. Within the context of structural neighbourhood change, four themes were identified: community cohesion, political agency, feelings of safety and the physical environment. The themes were interlinked, which calls for collaboration across traditional lines of professional responsibility, and for research that encompasses different aspects of neighbourhood exclusion. This study contributes with knowledge on older adults’ experiences of exclusion, including novel findings on the importance of political agency and collective memory, and identifies actions to combat exclusion. An active involvement of older adults in the development of initiatives to tackle social exclusion is recommended.

Keywords
older adults, social exclusion, social integration, neighbourhood, community, political agency, crime, environment
National Category
Social Work Gerontology, specialising in Medical and Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30081 (URN)10.1017/S0144686X1900045X (DOI)2-s2.0-85065313812 (Scopus ID)
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-05-21Bibliographically approved
Naseer, M., Agerholm, J., Fastbom, J., Schön, P., Ehrenberg, A. & Dahlberg, L. (2019). Emergency department revisits among older adults: A prospective cohort study. In: : . Paper presented at International Association of Gerontology and Geriatrics European Region Congress 2019, 23rd – 25th May 2019, Gothenburg, Sweden.
Open this publication in new window or tab >>Emergency department revisits among older adults: A prospective cohort study
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2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Social Work
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-31161 (URN)
Conference
International Association of Gerontology and Geriatrics European Region Congress 2019, 23rd – 25th May 2019, Gothenburg, Sweden
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-12-05 Created: 2019-12-05 Last updated: 2019-12-06Bibliographically approved
Agahi, N., Dahlberg, L. & Carin, L. (2019). Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample. Drug And Alcohol Dependence, 196, 40-45
Open this publication in new window or tab >>Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample
2019 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 196, p. 40-45Article in journal (Refereed) Published
Abstract [en]

Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.

Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.

Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.

Keywords
alcohol, social integration, social context, older adults, change
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29319 (URN)10.1016/j.drugalcdep.2018.12.011 (DOI)000459519900006 ()30660938 (PubMedID)2-s2.0-85060098267 (Scopus ID)
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-03-07Bibliographically approved
Dahlberg, L., Frank, A., Naseer, M. & McKee, K. (2019). Systematic review of longitudinal risk factors for loneliness among older adults. In: : . Paper presented at International Association of Gerontology and Geriatrics European Region Congress (IAGG-ER), 23-25 May 2019, Gothenburg.
Open this publication in new window or tab >>Systematic review of longitudinal risk factors for loneliness among older adults
2019 (English)Conference paper, Oral presentation only (Refereed)
National Category
Social Work
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30228 (URN)
Conference
International Association of Gerontology and Geriatrics European Region Congress (IAGG-ER), 23-25 May 2019, Gothenburg
Funder
Nordic Council of Ministers, 18291
Available from: 2019-06-13 Created: 2019-06-13 Last updated: 2019-06-14Bibliographically approved
Nordin, S., Dahlberg, L., McKee, K. & Elf, M. (2019). Technology to support decision-making for older people with dementia. In: : . Paper presented at IAGG 2019 The International Association of Gerontology and Geriatrics European Region Congress 2019, 23-25 May, Gothenburg.
Open this publication in new window or tab >>Technology to support decision-making for older people with dementia
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29866 (URN)
Conference
IAGG 2019 The International Association of Gerontology and Geriatrics European Region Congress 2019, 23-25 May, Gothenburg
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-04-11Bibliographically approved
Aartsen, M., Valtorta, N., Dahlberg, L., van Regenmortel, S., Waldegrave, C. & Corrigan, T. (2018). Exclusion from social relations in later life: Briefing paper.
Open this publication in new window or tab >>Exclusion from social relations in later life: Briefing paper
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2018 (English)Report (Other academic)
Series
ROSEnet Policy Briefing Paper Series ; 1
National Category
Social Work
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-28361 (URN)
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-21Bibliographically approved
Naseer, M., Dahlberg, L. & Fagerström, C. (2018). Health related quality of life and emergency department visits in adults of age ≥ 66 years: a prospective cohort study.. Health and Quality of Life Outcomes, 16(1), Article ID 144.
Open this publication in new window or tab >>Health related quality of life and emergency department visits in adults of age ≥ 66 years: a prospective cohort study.
2018 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 16, no 1, article id 144Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Age increases the risk of emergency department [ED] visits. Health related quality of life (HRQoL) is often estimated as an outcome of ED visits, but it can be a risk factor of ED visits. This study aims to assess the association of HRQoL with time to first ED visit and/or frequent ED use in older adults during four-year period and if this association differs in 66-80 and 80+ age groups.

METHODS: Data from the Swedish National Study on Aging and Care-Blekinge of wave 2007-2009 was used in combination with electronic health records on ED visits. The analytical sample included 673 participants of age 66 years and older with information on HRQoL. Cox proportional hazard model was used to assess the association between HRQoL and time to first ED visit. Logistic regression analysis was performed to estimate the association of HRQoL with frequent ED use.

RESULTS: During the study period, 55.3% of older adults visited the ED and 28.8% had a frequent ED use. Poor physical HRQoL was independently associated with first ED visit both in total sample (p < 0.001) and in 66-80 (p < 0.001) and 80+ (p = 0.038) age groups. Poor mental HRQoL had no significant association with first ED visit and frequent ED use.

CONCLUSION: Findings suggest that poor physical HRQoL is associated with time to first ED visit in older adults. Therefore, physical HRQoL should be considered while planning interventions on the reduction of ED utilisation in older adults. Explanatory factors of frequent ED use may differ in age groups. Further studies are needed to identify associated factors of frequent ED visits in 80+ group.

Keywords
Care utilisation, Emergency visit, Older adults, Quality of life, Subjective health
National Category
Social Work
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-28261 (URN)10.1186/s12955-018-0967-y (DOI)000439735900001 ()30041629 (PubMedID)
Available from: 2018-08-07 Created: 2018-08-07 Last updated: 2018-08-09
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7685-3216

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