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Marcusson, Jan
Publications (10 of 86) Show all publications
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
Törnvall, E., Marcusson, J. & Wressle, E. (2016). Health-related quality in life in relation to mobility and fall risk in 85-year-old people: a population study in Sweden. Ageing & Society, 36(9), 1982-1997
Open this publication in new window or tab >>Health-related quality in life in relation to mobility and fall risk in 85-year-old people: a population study in Sweden
2016 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 36, no 9, p. 1982-1997Article in journal (Refereed) Published
Abstract [en]

Optimal mobility is fundamental for healthy ageing and quality of life. This study is part of a cross-sectional population-based study of 85-year-old people residing in Linköping municipality, Sweden. The purpose was to describe 85-year-old peoples' health-related quality of life (HRQoL) in relation to mobility and fall risk while adjusting for gender and body mass index. Data collection included a postal questionnaire, a home visit and a reception visit. HRQoL was assessed with EQ-5D-3L, mobility with the Timed Up and Go test (TUG) and fall risk with the Downton Fall Risk Index (DFRI). All those who completed the DFRI, TUG and EQ-5D-3L were included in the present study (N = 327). Lower HRQoL was associated with longer time taken to complete TUG and higher fall risk in both genders but not with body mass index. Women had higher risk of falling, took a longer time to complete TUG and reported less physical activity compared with men. Health-care professionals should address mobility capacity and fall risk in order to maintain quality of life in elderly people. This is of utmost importance, especially for elderly women because impaired mobility, high risk of falling and occurrence of pain are common among women, and related to lower HRQoL.

Place, publisher, year, edition, pages
Cambridge University Press, 2016
Keywords
Downton Fall Risk Index;Timed Up and Go;EQ-5D;elderly;gender;body mass index
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-126586 (URN)10.1017/S0144686X15000896 (DOI)000384713200010 ()
Note

Funding agencies: Health Research Council of the South-East of Sweden [FORSS-8888, 11636, 31811]; County of Ostergotland [LIO-11877, 31321, 79951]; Janne Elgqvist Family Foundation

Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2017-11-30
Ludvigsson, M., Marcusson, J., Wressle, E. & Milberg, A. (2016). Markers of subsyndromal depression in very old persons.. International Journal of Geriatric Psychiatry, 31(6), 619-628
Open this publication in new window or tab >>Markers of subsyndromal depression in very old persons.
2016 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 31, no 6, p. 619-628Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate factors associated with subsyndromal depression (SSD) in very old persons, and to develop a model for prediction of SSD among very old persons.

METHODS: A cross-sectional, population-based study was undertaken on 85-year-old persons in Sweden. Data were collected from a postal questionnaire, assessments in the participants' homes and at reception visits. Depressiveness was screened with GDS-15 (Geriatric Depression Scale), and the results were classified into three outcome categories: non-depression (ND), SSD and syndromal depression. Data were analysed with binary logistic, ordinal logistic and linear regression.

RESULTS: With univariate logistic regression 20 factors associated with SSD were identified in very old persons, and the four hypothesized domains-sociodemographic factors, declining physical functioning, neuropsychiatric factors and existential factors-significantly related to SSD. The multivariate logistic model included seven independent factors that increase the likelihood of SSD instead of ND (lower self-perceived health, life not meaningful, problems with self-care, use of tranquilizing medication, no contact with neighbours, history of affective disorder and history of stroke). The ordinal logistic and the linear regression models resulted in seven partly different factors for predicting SSD and depressiveness, in the very old.

CONCLUSIONS: The identified markers may help clinicians with the detection, prevention and treatment of SSD in very old persons. The findings indicate the importance of a comprehensive functional approach to diagnosing and treating depressiveness in this population, and the findings might be interpreted as offering support for the coexistence of a dimensional and a categorical view on depressive disorders.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-127480 (URN)10.1002/gps.4369 (DOI)000374700000009 ()26489528 (PubMedID)
Note

Funding agencies: County Council of Ostergotland, Sweden

Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2018-07-26
Johansson, M., Marcusson, J. & Wressle, E. (2015). Cognitive impairment and its consequences in everyday life: experiences of people with mild cognitive impairment or mild dementia and their relatives. International psychogeriatrics, 27(6), 949-958
Open this publication in new window or tab >>Cognitive impairment and its consequences in everyday life: experiences of people with mild cognitive impairment or mild dementia and their relatives
2015 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 27, no 6, p. 949-958Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to explore experiences of cognitive impairment, its consequences in everyday life and need for support in people with mild cognitive impairment (MCI) or mild dementia and their relatives.

Methods: A qualitative approach with an explorative design with interviews was chosen. The participants included five people with MCI and eight people with mild dementia and their relatives. All participants were recruited at a geriatric memory clinic in Sweden. The Grounded Theory method was used.

Results: The following categories emerged: noticing cognitive changes; changed activity patterns; coping strategies; uncertainty about own ability and environmental reactions; support in everyday life; support from the healthcare system; consequences in everyday life for relatives; and support for relatives. The main findings were that people with MCI and dementia experienced cognitive changes that could be burdensome and changed activity patterns. Most of them, however, considered themselves capable of coping on their own. The relatives noticed cognitive changes and activity disruptions to a greater extent and tried to be supportive in everyday life. Degree of awareness varied and lack of awareness could lead to many problems in everyday life.

Conclusions: Perceived cognitive impairment and its consequences in everyday life were individual and differed among people with MCI or dementia and their relatives. Thus, healthcare professionals must listen to both people with cognitive impairment and their relatives for optimal individual care planning. Support such as education groups and day care could be more tailored towards the early stages of dementia.

Place, publisher, year, edition, pages
Cambridge University Press, 2015
Keywords
Alzheimer’s disease; activities of daily living; qualitative research
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-115307 (URN)10.1017/S1041610215000058 (DOI)000354093800009 ()25644289 (PubMedID)
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2017-12-04Bibliographically approved
Nägga, K., Mayer, S., Marcusson, J. & Wressle, E. (2015). Evaluation of short cognitive screening tests in 85-year-old men and women. European Geriatric Medicine, 6(6), 545-550
Open this publication in new window or tab >>Evaluation of short cognitive screening tests in 85-year-old men and women
2015 (English)In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, no 6, p. 545-550Article in journal (Refereed) Published
Abstract [en]

Introduction: The study aimed to investigate different aspects of cognition using the Cognitive Assessment Battery (CAB) in community-dwelling older adults aged 85 years. We also investigated the eventual influence of sex on the results and aimed to identify predictors for further cognitive decline after 1 year. Methods: CAB consists of 10 subtests covering the cognitive domains of speed and attention, learning and episodic memory, visuospatial abilities, language, and executive functions. Cognitive tests were performed at baseline (n = 335) and follow-up after 1 year (n = 270). Results: Univariate statistics revealed that men performed better than women on episodic memory (P < 0.05) and on the naming test (P < 0.001). However, floor effects in the paragraph memory test were revealed. There was a high rate of abnormal results on Token Test (67%), PaSMO (50%), Clox (48%), and the cube copying (40%) tests in participants with normal cognition. Logistic regression showed that impaired results on the Stroop III test (odds ratio, 2.38; P < 0.05) was independently associated with an increased risk of cognitive decline. Conclusion: Men performed better than women on the memory and on the naming test. However, due to floor effects in the paragraph memory test in 85 year olds, these results can be disputed. The high rate of abnormal results on the Token Test, PaSMO, Clox, and the cube copying tests in cases with normal cognition indicate that these tests are less suitable for screening in the age group. Impaired result on the Stroop test increased the risk more than two-fold for cognitive decline after 1 year.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
populations study, oldest old, MMSE
National Category
Geriatrics Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-123648 (URN)10.1016/j.eurger.2015.10.002 (DOI)000368322100006 ()
Note

Funding agencies: Skane County Council; Lund University; Health Research Council in south east Sweden [FORSS-8888, FORSS-11636, FORSS-31811]; County of Ostergotland [LIO-11877, LIO-31321, LIO-79951]; Family Janne Elgqvist Foundation

Available from: 2016-01-04 Created: 2016-01-04 Last updated: 2017-12-01
Ludvigsson, M., Milberg, A., Marcusson, J. & Wressle, E. (2015). Normal Aging or Depression? A Qualitative Study on the Differences Between Subsyndromal Depression and Depression in Very Old People.. The Gerontologist, 55(5), 760-769
Open this publication in new window or tab >>Normal Aging or Depression? A Qualitative Study on the Differences Between Subsyndromal Depression and Depression in Very Old People.
2015 (English)In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, no 5, p. 760-769Article in journal (Refereed) Published
Abstract [en]

Purpose of the Study: The aim of this study was to make a qualitative comparison of experiences of being in very old people with subsyndromal depression (SSD), in relation to the experiences of very old people with syndromal depression or nondepression. Through investigation and deeper understanding of the interface between depressive disease and normal aging, clinicians might give more accurate prevention or treatment to those very old persons who need such help.

DESIGN AND METHODS: Semistructured qualitative interviews were conducted for 27 individuals of 87-88 years of age, who were categorized in the 3 strata of nondepressive, SSD, and syndromal depression. Transcripts were analyzed using qualitative content analysis within each stratum and later with a comparison between the strata.

RESULTS: The content analysis resulted in 4 themes in people with SSD, as defined by a self-report depression screening instrument, giving a comprehensive picture of SSD in very old people, and also showed qualitative differences between the SSD, syndromal depression, and nondepressive groups. A main finding was that SSD differs qualitatively from syndromal depression but not clearly from nondepression.

IMPLICATIONS: The results might indicate that SSD in very old people is not related to pathology but to normal aging, even though the condition correlates with negative health parameters. Overlooking certain psychosocial aspects of living in the very old may pose a risk of both underdiagnosis and overdiagnosis in the spectrum of depressive disorders.

Keywords
Coping, Frailty, Healthy aging, Subthreshold depression, Successful aging
National Category
Psychiatry Geriatrics
Identifiers
urn:nbn:se:liu:diva-120848 (URN)10.1093/geront/gnt162 (DOI)000362984500006 ()24398652 (PubMedID)
Funder
Östergötland County Council
Available from: 2015-08-27 Created: 2015-08-27 Last updated: 2018-07-26Bibliographically approved
Dong, H.-J., Marcusson, J., Wressle, E. & Unosson, M. (2015). Obese very old women have low relative handgrip strength, poor physical function, and difficulty in daily living. The Journal of Nutrition, Health & Aging, 19(1), 20-25
Open this publication in new window or tab >>Obese very old women have low relative handgrip strength, poor physical function, and difficulty in daily living
2015 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 19, no 1, p. 20-25Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate how anthropometric and body composition variables, and handgrip strength (HS) affect physical function and independent daily living in 88-year-old Swedish women.

Participants: A cross-sectional analysis of 83 community-dwelling women, who were 88 years old with normal weight (n=30), overweight (n=29), and obesity (n=24) in Linköping, Sweden, was performed.

Measures: Assessments of body weight (Wt), height, waist circumference (WC), and arm circumference were performed by using an electronic scale and measuring tape. Tricep skinfold thickness was measured by a skinfold calliper. Fat mass (FM) and fat-free mass (FFM) were measured by bioelectrical impedance analysis, and HS was recorded with an electronic grip force instrument. Linear regression was used to determine the contributions of parameters as a single predictor or as a ratio with HS to physical function (Short Form-36, SF-36PF) and instrumental activities of daily living (IADL).

Results: Obese women had greater absolute FM and FFM, and lower HS corrected for FFM and HS-based ratios (i.e., HS/Wt, HS/body mass index [BMI]) than their normal weight and overweight counterparts. After adjusting for physical activity levels and the number of chronic diseases, HS-based ratios explained more variance in SF-36PF scoring (R2: 0.52–0.54) than single anthropometric and body composition variables (R2: 0.45–0.51). WC, HS, and HS-based ratios (HS/Wt and HS/FFM) were also associated with the number of IADL with no difficulty.

Conclusion: Obese very old women have a high WC, but their HS is relatively low in relation to their Wt and FFM. These parameters are better than BMI for predicting physical function and independent daily living.

Place, publisher, year, edition, pages
Springer, 2015
Keywords
Very old; Handgrip strength; Body composition; Physical function; Instrumental activities of daily living
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-105215 (URN)10.1007/s12603-014-0512-6 (DOI)000348024800003 ()
Available from: 2014-03-13 Created: 2014-03-13 Last updated: 2017-12-05Bibliographically approved
Dong, H.-J., Wressle, E. & Marcusson, J. (2015). Unaltered image of health maintenance: An observation of non-participants in a swedish cohort study of 85 to 86 years olds. The Journal of Frailty & Aging, 4(2), 93-99
Open this publication in new window or tab >>Unaltered image of health maintenance: An observation of non-participants in a swedish cohort study of 85 to 86 years olds
2015 (English)In: The Journal of Frailty & Aging, ISSN 2260-1341, Vol. 4, no 2, p. 93-99Article in journal (Refereed) Published
Abstract [en]

Background: Selection bias is often inevitable in epidemiologic studies. It is not surprising that study conclusions based on participants’ health status are frequently questioned. Objective: This study aimed to assess whether the non-participants affected the characteristics of a general population of the very old people. Design, Setting and Participants: Prospective, cross-sectional (N=650, aged 85 years old) analysis and 1-year follow-up (n=273), in Linköping, Sweden. Measurements: We analysed data on health-related factors from a postal questionnaire, a home visit and a clinic visit at baseline and at the 1-year follow-up. We calculated the effect size to evaluate the degree of differences between the groups. Results: A greater proportion of non-participants resided in sheltered accommodation or nursing homes (participants vs non-response vs refusal, 11% vs 22% vs 40, P<0.001, φ=0.24). During the home visit or clinic visit, a higher proportion of dropouts reported mid-severe problems in EQ-5D domains (mobility and self-care) and limitations in personal activities of daily living, but the differences between participants and dropouts were very small (φ<0.2). No significant difference was found between the groups with regard to emergency room visits or hospital admissions, despite the fact that more participants than dropouts (φ=0.23) had multimorbidities (≥2 chronic diseases). Living in sheltered accommodation or a nursing home (odds ratio (OR), 2.8; 95% confidence interval (CI), 1.5-5), female gender (OR, 1.8; 95% CI, 1.1-3.1) and receiving more home visits in primary care (OR, 1.03; 95% CI, 1-1.06) contributed positively to drop out in the data collection stages over the study period. Conclusion: Non-participants were not considered to be a group with worse health. Mobility problems may influence very old people when considering further participation, which threatens attrition.

Place, publisher, year, edition, pages
Paris, France: Editions S E R D I, 2015
Keywords
85 year olds, non-participants, health, mobility
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-121821 (URN)10.14283/jfa.2015.47 (DOI)
Projects
ELSA 85
Funder
Medical Research Council of Southeast Sweden (FORSS), 8888Östergötland County Council, 11877
Available from: 2015-10-07 Created: 2015-10-07 Last updated: 2015-10-19Bibliographically approved
Johansson, M., Segernäs Kvitting, A., Wressle, E. & Marcusson, J. (2014). Clinical Utility of Cognistat in Multiprofessional Team Evalutations of Patients with Cognitive Impairment in Swedish Primary Care. International Journal of Family Medicine, 2014, 649253
Open this publication in new window or tab >>Clinical Utility of Cognistat in Multiprofessional Team Evalutations of Patients with Cognitive Impairment in Swedish Primary Care
2014 (English)In: International Journal of Family Medicine, ISSN 2090-2042, E-ISSN 2090-2050, Vol. 2014, p. 649253-Article in journal (Refereed) Published
Abstract [en]

Background. Diagnostic evaluations of dementia are often performed in primary health care (PHC). Cognitive evaluation requires validated instruments.

Objective. To investigate the diagnostic accuracy and clinical utility of Cognistat in a primary care population.

Methods. Participants were recruited from 4 PHC centres; 52 had cognitive symptoms and 29 were presumed cognitively healthy. Participants were tested using the Mini-Mental State Examination (MMSE), the Clock Drawing Test (CDT), and Cognistat. Clinical diagnoses, based on independent neuropsychological examination and a medical consensus discussion in secondary care, were used as criteria for diagnostic accuracy analyses.

Results. The sensitivity, specificity, positive predictive value, and negative predictive value were 0.85, 0.79, 0.85, and 0.79, respectively, for Cognistat; 0.59, 0.91, 0.90, and 0.61 for MMSE; 0.26, 0.88, 0.75, and 0.46 for CDT; 0.70, 0.79, 0.82, and 0.65 for MMSE and CDT combined. The area under the receiver operating characteristic curve was 0.82 for Cognistat, 0.75 for MMSE, 0.57 for CDT, and 0.74 for MMSE and CDT combined.

Conclusions. The diagnostic accuracy and clinical utility of Cognistat was better than the other tests alone or combined. Cognistat is well adapted for cognitive evaluations in PHC and can help the general practitioner to decide which patients should be referred to secondary care.

 

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2014
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-107048 (URN)10.1155/2014/649253 (DOI)
Available from: 2014-06-04 Created: 2014-06-04 Last updated: 2017-12-05Bibliographically approved
Andersson, L. B., Marcusson, J. & Wressle, E. (2014). Health-related quality of life and activities of daily living in 85-year-olds in sweden. Health and Social Care in the Community, 22(4), 368-374
Open this publication in new window or tab >>Health-related quality of life and activities of daily living in 85-year-olds in sweden
2014 (English)In: Health and Social Care in the Community, ISSN 0966-0410, Vol. 22, no 4, p. 368-374Article in journal (Refereed) Published
Abstract [en]

Few studies have examined health-related quality of life (HRQoL) with respect to daily living and health factors for relatively healthy elderly individuals. To this end, this study examines 85-year-olds’ reported HRQoL in relation to social support, perceived health, chronic diseases, health care use and instrumental activities of daily living. Data were collected from 360 participants (55% response rate) between March 2007 and March 2008 using a postal questionnaire and a home visit interview.  HRQoL was assessed using the EQ-5D-3L. For the items in the EQ-5D-3L, more problems were related to lower HRQoL. Restricted mobility and occurrence of pain/discomfort was common.  Lower HRQoL was associated with increased risk for depression, increased use of medication, increased number of chronic diseases, and more problems with instrumental activities of daily living (IADL). Health care use and health care costs was correlated to lower HRQoL.  HRQoL is of importance to health care providers and must be considered together with IADL in the elderly population when planning interventions. These should take into account the specific needs and resources of the older individuals.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
ADL, elderly, EQ-5D, healthcare, healthcare costs
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-107513 (URN)10.1111/hsc.12088 (DOI)000337695100004 ()
Available from: 2014-06-13 Created: 2014-06-13 Last updated: 2017-02-09Bibliographically approved
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