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Wressle, Ewa
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Publications (10 of 57) Show all publications
Edvardsson, M., Sund-Levander, M., Milberg, A., Ernerudh, J., Wressle, E., Marcusson, J. & Grodzinsky, E. (2022). Classification of ≥80-year-old individuals into healthy, moderately healthy, and frail based on different frailty scores affects the interpretation of laboratory results. Asian Journal of Medical Sciences, 13(9), 63-71
Open this publication in new window or tab >>Classification of ≥80-year-old individuals into healthy, moderately healthy, and frail based on different frailty scores affects the interpretation of laboratory results
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2022 (English)In: Asian Journal of Medical Sciences, ISSN 2091-0576, E-ISSN 2091-0576, Vol. 13, no 9, p. 63-71Article in journal (Refereed) Published
Abstract [en]

Background: Interpretation laboratory analyses are crucial when assessing the patient’s condition. Reference intervals from apparently healthy and disease-free individuals may cause problems when outcomes from elderly patients with chronic diseases and on medications are being interpreted. Elderly individuals are a heterogeneous group ranging from individuals managing their daily life independently to individuals with diseases and impairment, in need of nursing care around the clock, that is, frail; a term widely used although there is no consensus on the definition.

Aims and Objectives: The aim of the study was to study the effect of classification of elderly into healthy, moderately healthy, and frail, based on activities of daily living (ADL) and Mini-Mental State Examination (MMSE) or frailty index (FI), on the interpretation of outcomes regarding: Albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, and gamma-glutamyltransferase (γ-GT) levels.

Materials and Methods: Individuals ≥80 years (n=568) were classified either on ADL and MMSE or number of deficits, (FI).

Results: Individuals classified as frail based on FI had lower mean levels for ALT, creatinine and γ-GT than individuals classified based on ADL and MMSE (P<0.05).

Conclusion: The model to define health status to some extent affected laboratory analyte levels in ≥80 years old, classified as healthy, moderately healthy, and frail based on ADL and MMSE versus FI.

Place, publisher, year, edition, pages
Nepal Journals Online (NepJOL), 2022
Keywords
Aging; Frail elderly; Analyte; Reference interval; Clinical interpretation
National Category
Geriatrics Clinical Laboratory Medicine
Identifiers
urn:nbn:se:liu:diva-192092 (URN)10.3126/ajms.v13i9.45298 (DOI)
Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2023-03-02
Samuelsson, K. & Wressle, E. (2021). Decisions on driving after brain injury/disease: Feasibility and construct validity of a new simulator assessment tool. British Journal of Occupational Therapy, 84(7), 421-429
Open this publication in new window or tab >>Decisions on driving after brain injury/disease: Feasibility and construct validity of a new simulator assessment tool
2021 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 84, no 7, p. 421-429Article in journal (Refereed) Published
Abstract [en]

Introduction Driving is a complex activity involving a high level of cognitive abilities and thus might be affected after a brain injury/disease. The aim of this research was to evaluate the feasibility and construct validity of a driving simulator tool as a complement to existing driving assessments of patients with cognitive dysfunctions after a brain injury/disease. Method A descriptive and prospective research design was achieved. For construct validation, decisions were based on results from the Useful Field of View, Nordic Stroke Driver Screening Assessment, Trail Making Test and, when necessary for the decision, an on-road observation. Results from the simulator tool were not included in the clinical decision process. Results A total of 129 patients from four different rehabilitation services were included. The results showed a significant difference in test results between those who were considered medically fit versus unfit to drive. A factor analysis revealed four components, all including attention in combination with processing speed, visuospatial function, simultaneous capacity and executive function; these are all represented in the simulator tool. A correlation analysis showed that simulator subtest 3 (response/divergent response to stimuli) had the strongest correlation with most of the other tests included. Conclusions The simulator was found to be feasible and valid and found to include components other than those measured in the other tests.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
Cognition; driving assessment; evaluation; occupational therapy; rehabilitation
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-170191 (URN)10.1177/0308022620950986 (DOI)000568837900001 ()
Note

Funding Agencies|County Council of Ostergotland, Sweden [LIO-582071, SC-2017-00091-26]; Medical Research Council of Southeast Sweden [FORSS -605951, 654091, 755541, 850271]

Available from: 2020-10-01 Created: 2020-10-01 Last updated: 2022-04-26
Selander, H., Wressle, E. & Samuelsson, K. (2020). Cognitive prerequisites for fitness to drive: Norm values for the TMT, UFOV and NorSDSA tests. Scandinavian Journal of Occupational Therapy, 27(3), 231-239
Open this publication in new window or tab >>Cognitive prerequisites for fitness to drive: Norm values for the TMT, UFOV and NorSDSA tests
2020 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, no 3, p. 231-239Article in journal (Refereed) Published
Abstract [en]

Background: Fitness-to-drive assessment is a growing area for occupational therapists. There are few off-road tests specially developed to assess fitness to drive, and several cognitive tests have no age-specific norms. Aims/objectives: The aim was to identify and describe age-related norm values for the Trail Making Test, Nordic Stroke Driver Screening Assessment and Useful Field of View test, and to study inter-correlation between test results. Materials and methods: The sample included 410 volunteers; 149 men and 261 women, mean age 52 +/- 16.8 years. Commonly used off-road tests were used: TMT A and B, UFOV and NorSDSA. Results: Normative data for the specific subtests and total score for NorSDSA and UFOV are provided and presented in four age groups. Age correlated with the results for most of the subtests. Conclusions: Off-road cognitive test scores are necessary and valuable for occupational therapists in their contribution to the final decision on continued driving. In clinical practice, it can be difficult to interpret cognitive test results when working with driving assessments. Age-based norm values are suggested to be a way to provide clinicians with a benchmark against which scores can be compared. Significance: Age-based norms can guide occupational therapists working with fitness to drive.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2020
Keywords
Cognition; driving assessment; off-road test; screening
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-158569 (URN)10.1080/11038128.2019.1614214 (DOI)000470419300001 ()31088186 (PubMedID)
Note

Funding Agencies|Swedish Transport Agency; Vinnova; County Council Ostergotland; Medical Research Council of Southeast Sweden

Available from: 2019-07-03 Created: 2019-07-03 Last updated: 2021-05-05
Pohl, P., Wressle, E., Lundin, F., Enthoven, P. & Dizdar (Segrell), N. (2020). Group-based music intervention in Parkinsons disease: findings from a mixed-methods study. Clinical Rehabilitation, 34(4), 533-544
Open this publication in new window or tab >>Group-based music intervention in Parkinsons disease: findings from a mixed-methods study
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2020 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 34, no 4, p. 533-544Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate a group-based music intervention in patients with Parkinsons disease. Design: Parallel group randomized controlled trial with qualitative triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinsons disease were randomized into intervention group (n = 26), which received training with the music-based intervention, and control group (n = 20) without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinsons disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Parkinsons disease; randomized controlled trial; mixed-methods; music-based intervention; rehabilitation
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-164256 (URN)10.1177/0269215520907669 (DOI)000514528400001 ()32070122 (PubMedID)
Note

Funding Agencies|grants (ALF) from Region Ostergotland; Henry and Ella Margareta Stahls Foundation; Tornspiran Foundation; Neuro Sweden; Swedish Parkinsons foundation; Linkoping University Hospital Research Fund

Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2021-12-29Bibliographically approved
Fällman, K., Lundgren, L., Wressle, E., Marcusson, J. & Classon, E. (2020). Normative data for the oldest old: Trail Making Test A, Symbol Digit Modalities Test, Victoria Stroop Test and Parallel Serial Mental Operations. Aging, Neuropsychology and Cognition, 27(4), 567-550
Open this publication in new window or tab >>Normative data for the oldest old: Trail Making Test A, Symbol Digit Modalities Test, Victoria Stroop Test and Parallel Serial Mental Operations
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2020 (English)In: Aging, Neuropsychology and Cognition, ISSN 1382-5585, E-ISSN 1744-4128, Vol. 27, no 4, p. 567-550Article in journal (Refereed) Published
Abstract [en]

Normative data for evaluating cognitive function in the oldest old, aged 85 years and above, are currently sparse. The normative values used in clinical practice are often derived from younger old persons, from small sample sizes or from broad age spans (e.g. amp;gt;75 years) resulting in a risk of misjudgment in assessments of cognitive decline. This longitudinal study presents normative values for the Trail Making Test A (TMT-A), the Symbol Digit Modalities Test (SDMT), the Victoria Stroop Test (VST) and the Parallel Serial Mental Operations (PaSMO) from cognitively intact Swedes aged 85 years and above. 207 participants, born in 1922, were tested at 85, 90 (n = 68) and 93 (n = 35) years of age with a cognitive screening test battery. The participants were originally recruited for participation in the Elderly in Linkoping Screening Assessment. Normative values are presented as mean values and standard deviations, with and without adjustment for education. There were no clinically important differences between genders, but education had a significant effect on test results for the 85-year-olds. Age effects emerged in analyses of those participants who completed the entire study and were evident for TMT-A, SDMT, VST1 and PaSMO. When comparisons can be made, our results are in accordance with previous data for TMT-A, SDMT and VST, and we present new normative values for PaSMO.

Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2020
Keywords
Neuropsychological tests; aged; 80 and over; executive function; attention; normative
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-159866 (URN)10.1080/13825585.2019.1648747 (DOI)000480134100001 ()31382824 (PubMedID)
Note

Funding Agencies|Linkoping University [LIO-696631, LIO 602761, LIO 537591]; Linkopings Universitet [LIO- 696631, LIO- 602761, LIO- 537591]

Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2021-05-08
Segernäs Kvitting, A., Fällman, K., Wressle, E. & Marcusson, J. (2019). Age-Normative MMSE Data for Older Persons Aged 85 to 93 in a Longitudinal Swedish Cohort. Journal of The American Geriatrics Society, 67(3), 534-538
Open this publication in new window or tab >>Age-Normative MMSE Data for Older Persons Aged 85 to 93 in a Longitudinal Swedish Cohort
2019 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 67, no 3, p. 534-538Article in journal (Refereed) Published
Abstract [en]

BACKGROUND/OBJECTIVES: Normative Mini-mental state examination (MMSE) reference values in elderly are scarce. Therefore, the aim is to present normative MMSE values for 85-93 year olds.

DESIGN: A longitudinal age cohort study.

SETTING: A population study of the residents in the municipality of Linköping, Sweden.

PARTICIPANTS: Residents (n = 650) born in 1922 during the course of 2007. In total, 374 individuals participated and were tested with MMSE at age 85, 280 of these were willing and able to also participate at age 86, 107 at age 90 and 51 at age 93.

MEASUREMENTS: MMSE, from 0-30, with lower scores denoting more impaired cognition.

RESULTS: Median MMSE values for the total population over the ages 85, 86, 90 and 93 years was 28 for all ages investigated. The 25th percentile values were 26, 26, 26 and 27, respectively. For a "brain healthy" sub-group median values were 28, 29, 28, and 28. The 25th percentile values were 27, 28, 26 and 27, respectively. Comparisons for age-effects showed no differences when all individuals for each age group were compared. When only the individuals reaching 93 years of age (n = 50) were analyzed, there was a significant lowering of MMSE in that age group.

CONCLUSION: The literature is variable and in clinical practice a low (24) MMSE cut off is often used for possible cognitive impairment in old age. The present data indicate that MMSE 26 is a reasonable cut off for possible cognitive decline in older persons up to the age of 93. J Am Geriatr Soc 67:534-538, 2019.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019
Keywords
aged 80 and over, dementia test, mental status
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-160367 (URN)10.1111/jgs.15694 (DOI)000461567700019 ()30536796 (PubMedID)2-s2.0-85058337422 (Scopus ID)
Available from: 2019-09-20 Created: 2019-09-20 Last updated: 2020-04-29Bibliographically approved
Samuelsson, K., Tropp, M., Lundqvist, A. & Wressle, E. (2019). Development, concurrent validity and internal consistency of a simulator tool for assessing continued car driving after a brain injury/disease. British Journal of Occupational Therapy, 82(9), 544-552
Open this publication in new window or tab >>Development, concurrent validity and internal consistency of a simulator tool for assessing continued car driving after a brain injury/disease
2019 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 9, p. 544-552Article in journal (Refereed) Published
Abstract [en]

Introduction

Beyond relevant cognitive tests, a simulated driving activity could be useful to observe performance and behaviour in a standardized ‘driving-like’ situation and provide information on attention, reaction time and information processing speed when evaluating the ability to continue driving after a brain injury or disease. The aim was to develop and evaluate concurrent validity and internal consistency of a computerized simulated driving task tool.

Methods

Results from a new tool (CyberSiM, including three subtests and four result variables) were compared with results from the Trail Making Test, Useful Field of View test and Nordic Stroke Driver Screening Assessment. There were 126 healthy adults included in the study.

Results

The correlation analysis showed significant correlations (p<0.001) for CyberSiM reaction time and all cognitive tests except for Useful Field of View 1. The CyberSiM showed good internal consistency, with Cronbach’s alpha=0.85.

Conclusion

The analysis of concurrent validity showed conformity to most cognitive tests. CyberSiM might be a useful complement to cognitive testing with the opportunity to observe some behaviours ‘in a driving-like activity’. Further studies on clinical groups are needed to confirm its usefulness.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Age; attention; cognition; evaluation; traffic safety; occupational therapy
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-160404 (URN)10.1177/0308022619836935 (DOI)000483494800003 ()2-s2.0-85063984917 (Scopus ID)
Available from: 2019-09-23 Created: 2019-09-23 Last updated: 2020-04-30Bibliographically approved
Johansson, M. M., Marcusson, J. & Wressle, E. (2019). Maintaining health-related quality of life from 85 to 93 years of age despite decreased functional ability. British Journal of Occupational Therapy, 82(6), 348-356
Open this publication in new window or tab >>Maintaining health-related quality of life from 85 to 93 years of age despite decreased functional ability
2019 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 6, p. 348-356Article in journal (Refereed) Published
Abstract [en]

Introduction

The ‘oldest-old’ is the most rapidly growing age group in Sweden and in the western world. This group is known to be at great risk of increased functional dependency and the need for help in their daily lives. The aim of this research was to examine how the oldest-old change over time regarding health-related quality of life, cognition, depression and ability to perform activities of daily living and investigate what factors explain health-related quality of life at age 85 and 93 years.

Methods

In this study, 60 individuals from the Swedish Elderly in Linköping Screening Assessment study were followed from age 85 to 93 years. Measurements used were EQ-5D, Geriatric Depression Scale, Mini Mental State Examination and ability to perform activities of daily living. Nonparametric statistics and regression analyses were used.

Results

Although the individuals had increased mobility problems, decreased ability to manage activities of daily living, and thus had increased need of assistance, they scored their health-related quality of life at age 93 years at almost the same level as at age 85 years. No depression and low dependence in activities of daily living speaks in favour of higher health-related quality of life.

Conclusions

Health-related quality of life can be maintained during ageing despite decreased functional ability and increased need of assistance in daily life.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Health-related quality of life; daily living; elderly; occupational therapy
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-158562 (URN)10.1177/0308022619830261 (DOI)000469876400004 ()2-s2.0-85062771149 (Scopus ID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden [FORSS-8888, FORSS-11636, FORSS-31811]; County Council of Ostergotland [LIO-11877, LIO-31321, LIO-79951]; Janne Elgqvist Family Foundation

Available from: 2019-07-03 Created: 2019-07-03 Last updated: 2019-11-27Bibliographically approved
Dannapfel, P., Törnvall, E. & Wressle, E. (2017). Education to Increase Skills in Research Methods among Clinicians in Health Care. Journal of Health & Medical Informatics, 8(4)
Open this publication in new window or tab >>Education to Increase Skills in Research Methods among Clinicians in Health Care
2017 (English)In: Journal of Health & Medical Informatics, ISSN 2157-7420, Vol. 8, no 4Article in journal (Refereed) Published
Abstract [en]

Introduction

The aim of this study was to evaluate participants’ and managers’ experience of the design and content of an education programme. The Knowledge to Action (KTA) framework was applied to identify the steps of knowledge creation and action in the education programme.

Methods

Data were collected from 18 participants representing two groups: participants in the intervention and supervisors and managers. Two focus groups took place: two with participants in the intervention (4 and 3 in each) and one with eleven managers.

Results

All steps in the KTA framework were identified and discussed from several aspects. The importance of selecting projects that were relevant and added value in their clinics was mentioned by all participants. The participants also mentioned that after the education, they had further understanding and increased skills in how to be active and perform continuous improvement projects. The step in the KTA process regarding how to adapt knowledge to local context was not discussed explicitly by the participants or managers.

Discussion

Education in research methods and performing improvement projects to develop the clinic creates a more positive attitude to working with continuous improvement. The participant’s self-esteem and knowledge increased regarding how to work with improvements. It is important to have the manager’s support to perform a project. Emphasis was on knowledge inquiry and synthesis and presenting the results with or without possible solutions. The participants and managers talked about barriers and knowledge use more generally and at an organizational level. This means that the participants did not gain the last bit of nowledge needed to put the action into practice. This implies that the problem regarding lack of implementation skills in health care might remain.

Place, publisher, year, edition, pages
Los Angeles, United States: Omics Publishing Group, 2017
Keywords
Continuous education; Clinicians; Knowledge to Action
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-142293 (URN)10.4172/2157-7420.1000282 (DOI)
Available from: 2017-10-25 Created: 2017-10-25 Last updated: 2018-05-03Bibliographically approved
Johansson, M., Marcusson, J. & Wressle, E. (2016). Development of an instrument for measuring activities of daily living in persons with suspected cognitive impairment. Scandinavian Journal of Occupational Therapy, 23(3), 230-239
Open this publication in new window or tab >>Development of an instrument for measuring activities of daily living in persons with suspected cognitive impairment
2016 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 3, p. 230-239Article in journal (Refereed) Published
Abstract [en]

Background: According to the Swedish National Board of Health and Welfare, structured assessment of function and activity has high priority when investigating for dementia.

Aim/objectives: The aim was to develop and psychometrically test an instrument to measure self-reported and/or informant-reported ability to perform activities of daily living in persons with suspected cognitive impairment.

Material and methods: The Cognitive Impairment in Daily Life (CID) instrument has been developed in several phases. Content validity was achieved through five expert panels using a Content Validity Index (CVI). The content was tested further in a pilot study of 51 patients and 49 relatives from primary care or a specialist memory clinic.

Results: Content validity was good with a CVI index of 0.83. All patients considered that relevant activities were included. Most relatives considered that the activities included in the instrument were adequate and captured the patients’ difficulties in daily life. Some adjustments to the items and scale were suggested and these were done after each phase. In general, relatives indicated more difficulties than patients.

Conclusion: The CID instrument seems promising in terms of content validity. Further testing of reliability and construct validity is ongoing.

Keywords
Cognition, dementia investigation, instrument development
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-115306 (URN)10.3109/11038128.2016.1139621 (DOI)000374634100006 ()
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2017-12-04Bibliographically approved
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