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  • 1.
    Naseer, Mahwish
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Aging Research Center, Karolinska Institutet & Stockholm Universit.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work. Aging Research Center, Karolinska Institutet & Stockholm University.
    Fagerström, Cecilia
    Health related quality of life and emergency department visits in adults of age ≥ 66 years: a prospective cohort study.2018In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 16, no 1, article id 144Article in journal (Refereed)
    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.

  • 2.
    Svedbo Engström, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. University of Gothenburg, Sahlgrenska Academy.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Unn-Britt
    Borg, Sixten
    Palaszewski, Bo
    Franzén, Stefan
    Gudbjörnsdottir, Soffia
    Eeg-Olofsson, Katarina
    Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes: a nationwide cross-sectional study2019In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, no 1, article id 141Article in journal (Refereed)
    Abstract [en]

    Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting.

    Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18–80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36- item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes.

    Results: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures.

    Conclusions: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

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